Diabetes prevalence is associated with low socioeconomic status (SES), but less is known about the relationship between SES and diabetes incidence.
Data from eight cycles of the National Population Health Survey (1994/1995 through 2008/2009) are used. A sample of 5,547 women and 6,786 men aged 18 or older who did not have diabetes in 1994/1995 was followed to determine if household income and educational attainment were associated with increased risk of diagnosis of or death from diabetes by 2008/2009. Three proportional hazards models were applied for income and for education--for men, for women and for both sexes combined. Independent variables were measured at baseline (1994/1995). Diabetes diagnosis was assessed by self-report of diagnosis by a health professional. Diabetes death was based on ICD-10 codes E10-E14.
Among people aged 18 or older in 1994/1995 who were free of diabetes, 7.2% of men and 6.3% of women had developed or died from the disease by 2008/2009. Lower-income women were more likely to develop type 2 diabetes than were those in high-income households. This association was attenuated, but not eliminated, by ethno-cultural background and obesity/overweight. Associations with lower educational attainment in unadjusted models were almost completely mediated by demographic and behavioural variables.
Social gradients in diabetes incidence cannot be explained entirely by demographic and behavioural variables.
According to results from the 2007/2008 Canadian Community Health Survey, about 1 in 10 Canadians aged 12 to 44-9% of males and 12% of females, an estimated 1.5 million people--experienced chronic pain. The prevalence of chronic pain increased with age and was significantly higher among people in households where the level of educational attainment was low and among the Aboriginal population. The most common pain-related chronic conditions at ages 12 to 44 were back problems and migraine headaches. Chronic pain prevented at least a few activities in the majority of sufferers. It was associated with activity limitations and needing help with everyday tasks, and had work-related implications. Individuals with chronic pain were frequent users of health care services, and were less likely than people without chronic pain to respond positively on measures of well-being, including mood and anxiety disorders.
With data from the 2009 Canadian Community Health Survey--Healthy Aging Cognition Module, five cognitive functioning categories based on normative values that adjust for age, sex and education were created. The two lowest categories were combined to identify seniors (65 or older) without Alzheimer's disease or dementia living in private households, who had low scores on four cognitive tasks: first recall, second recall, semantic fluency, and processing speed. Low income, not living with a spouse or partner, and diabetes were associated with low scores on each task. Heart disease, impairment in instrumental and daily activities, receiving home care, social participation, loneliness, and self-perceived general and mental health were also associated with low cognitive performance, although the associations differed by cognitive task.
This article presents the prevalence of dependency and selected chronic conditions among Canadians aged 65 or older living in households. Associations between chronic conditions and dependency in activities of daily living (ADL) and instrumental activities of daily living (IADL) are examined.
Estimates are based on data from the 2003 Canadian Community Health Survey.
Cross-tabulations were used to estimate the prevalence of ADL/IADL dependency and chronic conditions. Associations between chronic conditions and dependency were studied using multiple logistic regression models.
The prevalence of ADL/IADL dependency and chronic conditions increased with age. IADL dependency was more common than ADL dependency. When chronic pain was taken into account, associations between ADL dependency and arthritis/rheumatism, diabetes and urinary incontinence were no longer significant, and the association between IADL dependency and diabetes lost significance. Regardless of chronic pain, Alzheimer's disease or other dementia and the effects of stroke were significantly related to dependency.
A population-based sample of 4948 men and women aged 40 or older who did not have heart disease in 1994/1995 were followed to 2006/ 2007 to determine if depression was associated with increased risk of heart disease diagnosis or death.
Data from seven cycles of the National Population Health Survey (NPHS), 1994/1995 through 2006/2007, were used for longitudinal analysis. Prevalence estimates of heart disease and depression in the population aged 40 years or older were based on the 2002 Canadian Community Health Survey 1.2: Mental Health and Well-being.
The association between depression and heart disease was analyzed with separate proportional hazards models for men and women, adjusting for socio-demographic characteristics and heart disease risk factors.
Among people aged 40 or older and free of heart disease in 1994/1995, 19% of men and 15% of women had developed or died from heart disease by 2006/2007. The risk of heart disease was significantly higher for women who had depression, but not for men. When heart disease events occurring within two years of baseline were removed, depression was not significantly associated with heart disease risk among women or men.
This article estimates the prevalence of depression among employed Canadians aged 25 to 64, and examines its association with work impairment, as measured by reduced work activity, mental health/general disability days, and work absence.
Data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being and the longitudinal household component of the National Population Health Survey (1994/1995 to 2002/2003).
Cross-tabulations were used to estimate and determine factors associated with the prevalence of depression among the employed population. Multiple logistic regression was used to examine associations between depression and work impairment while controlling for other variables. Longitudinal data for 1994/1995 to 2002/2003 were used to examine the temporal sequence of depression and work impairment.
In 2002, almost 4% of employed people aged 25 to 64 had had an episode of depression in the previous year. Crosssectional analysis indicates that these workers had high odds of reducing work activity because of a long-term health condition, having at least one mental health disability day in the past two weeks, and being absent from work in the past week. Longitudinally, depression was associated with reduced work activity and disability days two years later.
To develop and validate sex specific prediction algorithms for 4-year risk of major depressive episode (MDE) using data from a population-based longitudinal cohort.
Household residents from 10 provinces were randomly recruited and interviewed by Statistics Canada. 10,601 participants who were aged 18 years and older and who did not meet the criteria for MDE in the 12 months prior to a baseline interview in 2000/01 were included in algorithm development; data from 7902 participants who were aged 18 and older and who were free of MDE in 2004/05 were used for validation. Validation was also conducted in sub-populations that are of practice and policy importance. MDE was assessed using the World Health Organization's Composite International Diagnostic Interview(CIDI)-Short Form for Major Depression (CIDI-SFMD).
In the training data, the C statistics for algorithms in men was 0.7953 and was 0.7667 for algorithm in women. The algorithms had good predictive power and calibrated well in the development and validation data.
The data relied on self-report. MDE was assessed with CIDI-SFMD. It was not feasible to validate the algorithms in different populations from different countries.
More studies are needed to further validate and refine these algorithms. However, the ability of a small number of easily assessed variables to predict MDE risk indicates that algorithms are a promising strategy for identifying individuals in need of enhanced monitoring and preventive interventions. Ultimately, application of algorithms may lead to increased personalization of treatment, and better clinical outcomes.
Early results (January to April) from the 2010 Canadian Community Health Survey show that an estimated 41% of Canadians (excluding those in the territories) aged 12 or older had been vaccinated for H1N1 by April 2010. The percentages were higher in the Atlantic provinces, Quebec and Saskatchewan than in Canada overall. Relatively high percentages of females and people aged 45 or older were vaccinated; the percentage of immigrants who had done so was relatively low. Being in a priority group (health-care worker, having children younger than 5 in the household, or having a chronic condition that could increase the risk for complications from H1N1) increased the likelihood of vaccination. A history of seasonal flu vaccination and having a regular doctor were also associated with H1N1 vaccination. Nearly three-quarters of those who had not been vaccinated reported that they did not think it was necessary.
Social participation has been associated with health and well-being in older adults.
Data from the 2008/2009 Canadian Community Health Survey (CCHS)-Healthy Aging were used to examine the relationship between frequent social participation and self-perceived health, loneliness and life dissatisfaction in a sample of 16,369 people aged 65 or older. Multivariate logistic regression was used to identify significant relationships, while adjusting for potential confounders. The mediating role of social support and the prevalence of reported barriers to greater social participation were also examined.
An estimated 80% of seniors were frequent participants in at least one social activity. As the number of different types of frequent social activities increased, so did the strength of associations between social participation and positive self-perceived health, loneliness, and life dissatisfaction. The associations generally remained significant, but were attenuated by individual social support dimensions. The desire to be more involved in social activities was reported by 21% of senior men and 27% of senior women.
Social participation is an important correlate of health and well-being in older adults. It may be that social support gained through social contacts is as important in these associations as the number of activities in which one participates frequently.