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Source
Health Rep. 2006 Aug;17(3):9-25
Publication Type
Article
Date
Aug-2006
Author
Michael Tjepkema
Author Affiliation
Health Statistics Division at Statistics Canada, Toronto Regional Office, 25 St. Clair Avenue E., Toronto, Ontario M4T 1M4. Michael.Tjepkema@statcan.ca
Source
Health Rep. 2006 Aug;17(3):9-25
Date
Aug-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Body mass index
Canada - epidemiology
Chi-Square Distribution
Female
Humans
Life Style
Logistic Models
Male
Middle Aged
Nutrition Surveys
Obesity - epidemiology
Prevalence
Social Class
United States - epidemiology
Abstract
Based on direct measures of height and weight, this article compares the prevalence of obesity among adults aged 18 or older in 1978/79 and 2004. Prevalence by demographic, socio-economic and lifestyle characteristics is presented, along with associations between obesity and selected chronic conditions. Canadian and US data are also compared.
Data are from the 2004 Canadian Community Health Survey: Nutrition, the 1978/79 Canada Health Survey and the 1986 to 1992 Canadian Heart Health Surveys. US data are from the 1999-2002 National Health and Nutrition Examination Survey.
Descriptive statistics were used to estimate the proportion of adults who were obese in 2004 in relation to selected characteristics. Logistic regression models were used to examine relationships between obesity and high blood pressure, diabetes and heart disease, controlling for socio-economic status and other risk factors such as smoking and physical activity.
In 2004, 23% of adults, 5.5 million people aged 18 or older, were obese--up substantially from 14% in 1978/79. An additional 36% (8.6 million) were overweight. Obese individuals tended to have sedentary leisure-time pursuits and to consume fruit and vegetables infrequently. As body mass index (BMI) increased, so did an individual's likelihood of reporting high blood pressure, diabetes and heart disease.
PubMed ID
16981483 View in PubMed
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Source
Health Rep. 2004;15 Suppl:9-19
Publication Type
Article
Date
2004
Author
Michael Tjepkema
Author Affiliation
Health Statistics Division, Statistics Canada, Toronto, Ontario. Michael.Tjepkema@statcan.ca
Source
Health Rep. 2004;15 Suppl:9-19
Date
2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - complications - epidemiology
Canada - epidemiology
Cluster analysis
Depression - complications - epidemiology
Female
Health Surveys
Humans
Incidence
Logistic Models
Male
Middle Aged
Prevalence
Risk factors
Substance-Related Disorders - complications - epidemiology
Abstract
This article estimates the prevalence of alcohol and illicit drug dependence among Canadians aged 15 or older Comorbidity with depression is examined.
The data are from the 2002 Canadian Community Health Survey: Mental Health and Well-being and the National Population Health Survey.
Cross-tabulations were used to estimate the prevalence of alcohol and illicit drug dependence by selected characteristics. Multiple logistic regression models were used to determine if associations persisted after controlling for potentially confounding factors, and to test temporal relationships between frequent heavy drinking and depression.
In 2002, an estimated 641,000 people (2.6% of the household population aged 15 or older) were dependent on alcohol, and 194,000 (0.8%), on illicit drugs. These people had elevated levels of depression compared with the general population. Heavy drinking more than once a week was a risk factor for a new episode of depression, and depression was a risk factor for new cases of frequent heavy drinking.
PubMed ID
15748041 View in PubMed
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Avoidable mortality among First Nations adults in Canada: A cohort analysis.

https://arctichealth.org/en/permalink/ahliterature265515
Source
Health Rep. 2015 Aug 19;26(8):10-6
Publication Type
Article
Date
Aug-19-2015
Author
Jungwee Park
Michael Tjepkema
Neil Goedhuis
Jennifer Pennock
Source
Health Rep. 2015 Aug 19;26(8):10-6
Date
Aug-19-2015
Language
English
Publication Type
Article
Abstract
Avoidable mortality is a measure of deaths that potentially could have been averted through effective prevention practices, public health policies, and/or provision of timely and adequate health care. This longitudinal analysis compares avoidable mortality among First Nations and non-Aboriginal adults.
Data are from the 1991-to-2006 Canadian Census Mortality and Cancer Follow-up Study. A 15% sample of 1991 Census respondents aged 25 or older was linked to 16 years of mortality data. This study examines avoidable mortality among 61,220 First Nations and 2,510,285 non-Aboriginal people aged 25 to 74.
During the 1991-to-2006 period, First Nations adults had more than twice the risk of dying from avoidable causes compared with non-Aboriginal adults. The age-standardized avoidable mortality rate (ASMR) per 100,000 person-years at risk for First Nations men was 679.2 versus 337.6 for non-Aboriginal men (rate ratio = 2.01). For women, ASMRs were lower, but the gap was wider. The ASMR for First Nations women was 453.2, compared with 183.5 for non-Aboriginal women (rate ratio = 2.47). Disparities were greater at younger ages. Diabetes, alcohol and drug use disorders, and unintentional injuries were the main contributors to excess avoidable deaths among First Nations adults. Education and income accounted for a substantial share of the disparities.
The results highlight the gap in avoidable mortality between First Nations and non-Aboriginal adults due to specific causes of death and the association with socioeconomic factors.
PubMed ID
26288317 View in PubMed
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Avoidable mortality for causes amenable to medical care, by occupation in Canada, 1991-2001.

https://arctichealth.org/en/permalink/ahliterature136536
Source
Can J Public Health. 2010 Nov-Dec;101(6):500-6
Publication Type
Article
Author
Cameron A Mustard
Amber Bielecky
Jacob Etches
Russell Wilkins
Michael Tjepkema
Benjamin C Amick
Peter M Smith
Kristan J Aronson
Author Affiliation
Institute for Work & Health, Toronto, ON. cmustard@iwh.on.ca
Source
Can J Public Health. 2010 Nov-Dec;101(6):500-6
Language
English
Publication Type
Article
Keywords
Adult
Aged
Canada - epidemiology
Cause of Death - trends
Female
Humans
Male
Middle Aged
Occupations - statistics & numerical data
Abstract
To describe the incidence of avoidable mortality for causes amenable to medical care among occupation groups in Canada.
A cohort study over an 11-year period among a representative 15% sample of the non-institutionalized population of Canada aged 30-69 at cohort inception. Age-standardized mortality rates for causes amenable to medical care and all other causes of death were calculated for occupationally-active men and women in five categories of skill level and 80 specific occupational groups as well as for persons not occupationally active.
Age-standardized mortality rates per 100,000 person-years at risk for causes amenable to medical care and for all other causes were 132.3 and 218.6, respectively, for occupationally-active women, and 216.6 and 449.3 for occupationally-active men. For causes amenable to medical care and for all other causes, for both sexes, there was a gradient in mortality relative to the five-level ranking by occupational skill level, but the gradient was less strong for women than for men. Across the 80 occupation minor groups, for both men and women, there was a linear relationship between the rates for causes amenable to medical care and the rates for all other causes.
For occupationally-active adults, this study found similar gradients in mortality for causes amenable to medical care and for all other causes of mortality over the period 1991-2001. Avoidable mortality is a valuable indicator of population health, providing information on outcomes pertinent to the organization and delivery of health care services.
PubMed ID
21370790 View in PubMed
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The Canadian census mortality follow-up study, 1991 through 2001.

https://arctichealth.org/en/permalink/ahliterature154774
Source
Health Rep. 2008 Sep;19(3):25-43
Publication Type
Article
Date
Sep-2008
Author
Russell Wilkins
Michael Tjepkema
Cameron Mustard
Robert Choinière
Author Affiliation
Health Information and Research Division at Statistics Canada, Ottawa, Ontario. Russell.Wilkins@statcan.gc.ca
Source
Health Rep. 2008 Sep;19(3):25-43
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Canada - epidemiology
Censuses
Disability Evaluation
Educational Status
Ethnic Groups - statistics & numerical data
Female
Follow-Up Studies
Health Status Indicators
Humans
Income
Language
Male
Middle Aged
Mortality - trends
Occupations
Proportional Hazards Models
Socioeconomic Factors
Survival Analysis
Abstract
An important step in monitoring progress toward reducing or eliminating inequalities in health is to determine the distribution of mortality rates across various groups defined by education, occupation, income, language, ethnicity, and Aboriginal, visible minority and disability status. This article describes the methods used to link census data from the long-form questionnaire to mortality data, and reports simple findings for the major groups.
Mortality from June 4, 1991 to December 31, 2001 was tracked among a 15% sample of the adult population of Canada, who completed the 1991 census long-form questionnaire (about 2.7 million, including 260,000 deaths). Age-specific and age-standardized mortality rates were calculated across the various groups, as were hazard ratios and period life tables.
Compared with people of higher socio-economic status, mortality rates were elevated among those of lower socio-economic status, regardless of whether status was determined by education, occupation or income. The findings reveal a stair-stepped gradient, with bigger steps near the bottom of the socio-economic hierarchy.
PubMed ID
18847143 View in PubMed
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Cancer incidence and survival among Métis adults in Canada: results from the Canadian census follow-up cohort (1992-2009).

https://arctichealth.org/en/permalink/ahliterature290642
Source
CMAJ. 2018 Mar 19; 190(11):E320-E326
Publication Type
Journal Article
Date
Mar-19-2018
Author
Maegan V Mazereeuw
Diana R Withrow
E Diane Nishri
Michael Tjepkema
Eduardo Vides
Loraine D Marrett
Author Affiliation
Prevention and Cancer Control (Mazereeuw, Withrow, Nishri, Marrett), Cancer Care Ontario; Dalla Lana School of Public Health (Withrow, Marrett), University of Toronto, Toronto, Ont.; Health Analysis Division (Tjepkema), Statistics Canada; Métis National Council (Vides), Ottawa, Ont. mmazereeuw@cihi.ca.
Source
CMAJ. 2018 Mar 19; 190(11):E320-E326
Date
Mar-19-2018
Language
English
Publication Type
Journal Article
Abstract
Métis people are 1 of 3 Aboriginal groups recognized by the Canadian constitution. We estimated site-specific incidence rates and survival for the most common cancers among Métis adults in Canada and compared these with rates among non-Aboriginal adults in Canada.
We examined responses to the 1991 long-form census, including self-reported Métis ancestry linked to national mortality and cancer databases for followup from 1992 to 2009. We estimated age-standardized incidence rates and 5-year relative survival. We determined relative risk (RR) of cancer among Métis and non-Aboriginal adults using Poisson regression, and estimated excess mortality rate ratios using ethnicity-specific life tables.
For all cancers and both sexes combined, cancer incidence was similar for Métis and non-Aboriginal adults. However, incidence was significantly higher among Métis adults than among non-Aboriginal adults for the following cancers: female breast (RR 1.18, 95% confidence interval [CI] 1.02-1.37), lung (RR 1.34, 95% CI 1.18-1.52), liver (RR 2.09, 95% CI 1.30-3.38), larynx (RR 1.60, 95% CI 1.03-2.48), gallbladder (RR 2.35, 95% CI 1.12-4.96) and cervix (RR 1.84, 95% CI 1.23-2.76). Métis people had poorer survival for prostate cancer (excess mortality rate ratio 2.60, 95% CI 1.52-4.46).
We found higher incidence for several cancers and poorer survival after prostate cancer among Métis adults. Several of these disparities may be related to lifestyle factors (including tobacco use, obesity and lack of cancer screening), providing evidence to support development of public health policy and health care to address cancer burden in the Métis people of Canada.
Notes
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PubMed ID
29555862 View in PubMed
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Cancer incidence and survival among Métis adults in Canada: results from the Canadian census follow-up cohort (1992-2009).

https://arctichealth.org/en/permalink/ahliterature301627
Source
CMAJ. 2018 03 19; 190(11):E320-E326
Publication Type
Journal Article
Date
03-19-2018
Author
Maegan V Mazereeuw
Diana R Withrow
E Diane Nishri
Michael Tjepkema
Eduardo Vides
Loraine D Marrett
Author Affiliation
Prevention and Cancer Control (Mazereeuw, Withrow, Nishri, Marrett), Cancer Care Ontario; Dalla Lana School of Public Health (Withrow, Marrett), University of Toronto, Toronto, Ont.; Health Analysis Division (Tjepkema), Statistics Canada; Métis National Council (Vides), Ottawa, Ont. mmazereeuw@cihi.ca.
Source
CMAJ. 2018 03 19; 190(11):E320-E326
Date
03-19-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Aged, 80 and over
American Native Continental Ancestry Group - statistics & numerical data
Canada - epidemiology
Censuses
Databases, Factual
Female
Follow-Up Studies
Healthcare Disparities
Humans
Incidence
Life Style
Male
Middle Aged
Neoplasms - ethnology - mortality
Population Surveillance
Risk factors
Sex Factors
Survival Analysis
Abstract
Métis people are 1 of 3 Aboriginal groups recognized by the Canadian constitution. We estimated site-specific incidence rates and survival for the most common cancers among Métis adults in Canada and compared these with rates among non-Aboriginal adults in Canada.
We examined responses to the 1991 long-form census, including self-reported Métis ancestry linked to national mortality and cancer databases for followup from 1992 to 2009. We estimated age-standardized incidence rates and 5-year relative survival. We determined relative risk (RR) of cancer among Métis and non-Aboriginal adults using Poisson regression, and estimated excess mortality rate ratios using ethnicity-specific life tables.
For all cancers and both sexes combined, cancer incidence was similar for Métis and non-Aboriginal adults. However, incidence was significantly higher among Métis adults than among non-Aboriginal adults for the following cancers: female breast (RR 1.18, 95% confidence interval [CI] 1.02-1.37), lung (RR 1.34, 95% CI 1.18-1.52), liver (RR 2.09, 95% CI 1.30-3.38), larynx (RR 1.60, 95% CI 1.03-2.48), gallbladder (RR 2.35, 95% CI 1.12-4.96) and cervix (RR 1.84, 95% CI 1.23-2.76). Métis people had poorer survival for prostate cancer (excess mortality rate ratio 2.60, 95% CI 1.52-4.46).
We found higher incidence for several cancers and poorer survival after prostate cancer among Métis adults. Several of these disparities may be related to lifestyle factors (including tobacco use, obesity and lack of cancer screening), providing evidence to support development of public health policy and health care to address cancer burden in the Métis people of Canada.
PubMed ID
29555862 View in PubMed
Less detail

Cancer patterns in Inuit Nunangat: 1998-2007.

https://arctichealth.org/en/permalink/ahliterature123806
Source
Int J Circumpolar Health. 2012;71:18581
Publication Type
Article
Date
2012
Author
Gisèle M Carrière
Michael Tjepkema
Jennifer Pennock
Neil Goedhuis
Author Affiliation
Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada.
Source
Int J Circumpolar Health. 2012;71:18581
Date
2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Arctic Regions - epidemiology
Canada - epidemiology
Child
Child, Preschool
Female
Humans
Infant
Inuits
Male
Middle Aged
Neoplasms - classification - epidemiology
Registries
Young Adult
Abstract
To compare cancer incidence patterns between residents of Inuit Nunangat and the rest of Canada.
Cancer cases were geographically linked to either Inuit Nunangat or the rest of Canada using postal codes or other geographic information. Population estimates were derived from the 2001 and 2006 censuses.
Cancer cases were combined from 1998 to 2007 for Inuit Nunangat and the rest of Canada. Age-standardised incidence rates were calculated for all site cancers and sub-sites by sex. Standardised rate ratios between these 2 areas were calculated for all site cancers and sub-sites.
The age-standardised incidence rate for all cancer sites (1998-2007) was 14% lower for the Inuit Nunangat male population and 29% higher for the female population by comparison to the rest of Canada. Cancers of the nasopharynx, lung and bronchus, colorectal, stomach (males), and kidney and renal pelvis (females), were elevated in the Inuit Nunangat population compared to the rest of Canada, whereas prostate and female breast cancers were lower in the Inuit Nunangat population.
Cancers with potentially modifiable risk factors, such as buccal cavity and pharynx, nasopharynx, lung and bronchus, and colorectal cancer were elevated in the Inuit Nunangat population compared to the rest of Canada. Besides greater smoking prevalence within Inuit Nunangat by comparison to the rest of Canada, distinct socioeconomic characteristics between respective area populations including housing, and income may have contributed to incidence differentials. This study demonstrated that a geographic approach can be used in cancer surveillance when populations of interest are spatially distinguishable, and reside across distinct jurisdictions whose combined cancer registries will not completely provide information to identify the population of interest.
Notes
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Cites: Sex Transm Dis. 2001 Dec;28(12):694-70011725224
PubMed ID
22663938 View in PubMed
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Cause-specific mortality by education in Canada: a 16-year follow-up study.

https://arctichealth.org/en/permalink/ahliterature119919
Source
Health Rep. 2012 Sep;23(3):23-31
Publication Type
Article
Date
Sep-2012
Author
Michael Tjepkema
Russell Wilkins
Andrea Long
Author Affiliation
Health Analysis Division at Statistics Canada, Ottawa, Ontario K1A 0T6. michael.tjepkema@statcan.gc.ca
Source
Health Rep. 2012 Sep;23(3):23-31
Date
Sep-2012
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Canada - epidemiology
Cause of Death - trends
Censuses
Educational Status
Female
Follow-Up Studies
Humans
Male
Middle Aged
Sex Distribution
Socioeconomic Factors
Abstract
People with lower levels of education tend to have higher rates of disease and death, compared with people who have higher levels of education. However, because death registrations in Canada do not contain information on the education of the deceased, unlinked vital statistics cannot be used to examine mortality differentials by education.
This study examines cause-specific mortality rates by education in a broadly representative sample of Canadians aged 25 or older. The data are from the 1991 to 2006 Canadian census mortality follow-up study, which included about 2.7 million people and 426,979 deaths. Age-standardized mortality rates (ASMRs) were calculated by education for different causes of death. Rate ratios, rate differences and excess mortality were also calculated.
All-cause ASMRs were highest among people with less than secondary graduation and lowest for university degree-holders. If all cohort members had the mortality rates of those with a university degree, the overall ASMRs would have been 27% lower for men and 22% lower for women. The causes contributing most to that "excess" mortality were ischemic heart disease, lung cancer, chronic obstructive pulmonary disease, stroke, diabetes, injuries (men), and respiratory infections (women). Causes associated with smoking and alcohol abuse had the steepest gradients.
A mortality gradient by education was evident for many causes of death.
Notes
Erratum In: Health Rep. 2012 Dec;23(4):67
PubMed ID
23061261 View in PubMed
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Health care use among gay, lesbian and bisexual Canadians.

https://arctichealth.org/en/permalink/ahliterature157395
Source
Health Rep. 2008 Mar;19(1):53-64
Publication Type
Article
Date
Mar-2008
Author
Michael Tjepkema
Author Affiliation
Health Information and Research Division at Statistics Canada in the Toronto Regional Office, 25 St. Clair Avenue E., Toronto, Ontario M4T 1M4. Michael.Tjepkema@statcan.ca
Source
Health Rep. 2008 Mar;19(1):53-64
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Anxiety Disorders - epidemiology
Bisexuality - psychology - statistics & numerical data
Canada - epidemiology
Chronic Disease - epidemiology
Diagnostic Tests, Routine - utilization
Female
Health Knowledge, Attitudes, Practice
Health Services - utilization
Health status
Homosexuality - psychology - statistics & numerical data
Humans
Logistic Models
Male
Mammography - utilization
Mass Screening - utilization
Mental Health Services - utilization
Middle Aged
Mood Disorders - epidemiology
Vaginal Smears - utilization
Abstract
This article examines whether consultations with health care providers, not having a regular doctor, unmet health care needs, and receipt of preventive screening tests vary by sexual identity for Canadians aged 18 to 59.
Results are based on the Canadian Community Health Survey, combined 2003 and 2005 data.
Cross-tabulations were used to compare utilization rates of selected health care providers by sexual identity. Multiple logistic regression models that controlled for predisposing, enabling and health need variables were employed to ascertain if sexual identity was independently associated with health care use, not having a regular doctor, unmet health care needs, and receipt of preventive screening tests.
Gay men, lesbians and bisexual people were more likely than heterosexuals to consult mental health service providers. Lesbians had lower rates of consulting family doctors and were less likely to have had a Pap test, compared with heterosexual women. Bisexuals reported more unmet health care needs than did their heterosexual counterparts.
PubMed ID
18457211 View in PubMed
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25 records – page 1 of 3.