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HEALTH AND SAFETY (599 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 12)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 24)
African Health Sciences     Open Access   (Followers: 3)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 40)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 12)
American Journal of Health Education     Hybrid Journal   (Followers: 32)
American Journal of Health Promotion     Hybrid Journal   (Followers: 28)
American Journal of Health Sciences     Open Access   (Followers: 7)
American Journal of Health Studies     Full-text available via subscription   (Followers: 11)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 29)
American Journal of Public Health     Full-text available via subscription   (Followers: 216)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5)
Annals of Global Health     Open Access   (Followers: 10)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 13)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 3)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 10)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 9)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 3)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 8)
Behavioral Healthcare     Full-text available via subscription   (Followers: 7)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 6)
BMC Pregnancy and Childbirth     Open Access   (Followers: 22)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 10)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 9)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 20)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 15)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 3)
Conflict and Health     Open Access   (Followers: 7)
Contraception and Reproductive Medicine     Open Access   (Followers: 1)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 4)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 4)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 13)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription   (Followers: 1)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 20)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 20)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 6)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 3)
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 19)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
Eurasian Journal of Health Technology Assessment     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 7)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 7)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 15)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Public Health     Open Access   (Followers: 7)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 8)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 10)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 8)
Health and Social Work     Hybrid Journal   (Followers: 56)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 15)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 21)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 43)
Health Policy and Technology     Hybrid Journal   (Followers: 4)
Health Professional Student Journal     Open Access   (Followers: 3)
Health Promotion International     Hybrid Journal   (Followers: 22)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 52)
Health Psychology Bulletin     Open Access  
Health Psychology Research     Open Access   (Followers: 19)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 14)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 4)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 12)
Health, Risk & Society     Hybrid Journal   (Followers: 13)
Healthcare     Open Access   (Followers: 3)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthcare Technology Letters     Open Access  
Healthy Aging Research     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
Histoire, médecine et santé     Open Access  
HIV & AIDS Review     Full-text available via subscription   (Followers: 12)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IJS Global Health     Open Access  
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 2)

        1 2 3 | Last

Journal Cover
Canadian Journal of Public Health
Journal Prestige (SJR): 0.609
Citation Impact (citeScore): 1
Number of Followers: 20  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0008-4263 - ISSN (Online) 1920-7476
Published by Springer-Verlag Homepage  [2352 journals]
  • Carbon pricing: a win-win environmental and public health policy
    • Authors: Anshula Ambasta; Jonathan J. Buonocore
      Abstract: Carbon pricing is an important tool for mitigating climate change. Carbon pricing can have significant health co-benefits. Air pollution from fossil fuels leads to detrimental health effects, including premature mortality, heart attacks, hospitalization from cardiorespiratory conditions, stroke, asthma exacerbations, and absenteeism from school and work, and may also be linked to autism spectrum disorder and Alzheimer’s disease. Reduction in fossil fuel combustion through a carbon price can lead to improvements in all these areas of health. It can also improve health by encouraging active transportation choices and improving ecosystems. Furthermore, it can promote health equity in society and improve overall societal health where the revenue from carbon pricing is used as a progressive redistribution mechanism for low-income households. Hence, carbon pricing is a win-win environmental and public health policy and an important step toward achieving Canada’s emission target by 2030. However, carbon pricing has several potential pitfalls which need to be considered in the design and implementation of any such policy. As Canada moves ahead with mandatory carbon pricing this fall, it is important to monitor its impact, evaluate it objectively, and modify and complement as necessary with policies and regulations.
      PubDate: 2018-06-28
      DOI: 10.17269/s41997-018-0099-5
  • The effect of socio-demographic factors on mental health and addiction
           high-cost use: a retrospective, population-based study in Saskatchewan
    • Authors: Maureen Anderson; Crawford W. Revie; Jacqueline M. Quail; Walter Wodchis; Claire de Oliveira; Meriç Osman; Marilyn Baetz; J. McClure; Henrik Stryhn; David Buckeridge; Cordell Neudorf
      Abstract: Objective A small proportion of the population accounts for the majority of healthcare costs. Mental health and addiction (MHA) patients are consistently high-cost. We aimed to delineate factors amenable to public health action that may reduce high-cost use among a cohort of MHA clients in Saskatoon, Saskatchewan. Methods We conducted a population-based retrospective cohort study. Administrative health data from fiscal years (FY) 2009–2015, linked at the individual level, were analyzed (n = 129,932). The outcome of interest was ≥ 90th percentile of costs for each year under study (‘persistent high-cost use’). Descriptive analyses were followed by logistic regression modelling; the latter excluded long-term care residents. Results The average healthcare cost among study cohort members in FY 2009 was ~ $2300; for high-cost users it was ~ $19,000. Individuals with unstable housing and hospitalization(s) had increased risk of persistent high-cost use; both of these effects were more pronounced as comorbidities increased. Patients with schizophrenia, particularly those under 50 years old, had increased probability of persistent high-cost use. The probability of persistent high-cost use decreased with good connection to a primary care provider; this effect was more pronounced as the number of mental health conditions increased. Conclusion Despite constituting only 5% of the study cohort, persistent high-cost MHA clients (n = 6455) accounted for ~ 35% of total costs. Efforts to reduce high-cost use should focus on reduction of multimorbidity, connection to a primary care provider (particularly for those with more than one MHA), young patients with schizophrenia, and adequately addressing housing stability.
      PubDate: 2018-06-28
      DOI: 10.17269/s41997-018-0101-2
  • Cancer incidence among First Nations adults in Canada: follow-up of the
           1991 Census Mortality Cohort (1992–2009)
    • Authors: Maegan V. Mazereeuw; Diana R. Withrow; E. Diane Nishri; Michael Tjepkema; Loraine D. Marrett
      Abstract: Objectives Estimate site-specific cancer incidence rates for a wide range of cancers in First Nations adults in Canada, and compare these with rates in non-Aboriginal adults. Methods Responses from persons aged 25 and older to the 1991 Long Form Census were linked to national mortality and cancer databases. First Nations- and non-Aboriginal-specific incidence rates were age-standardized to the world standard population. The sex- and site-specific relative risks (RR) of cancer in First Nations compared to those in non-Aboriginal adults were estimated with Poisson regression. Results were stratified by residence on-reserve (all cancers combined) and region of Canada (four most common cancer sites). Results Compared to non-Aboriginal adults, First Nations had higher incidence of colon and rectum, kidney, cervix, and liver cancers and lower incidence of prostate, breast, bladder, uterus, ovary, and brain cancers, as well as non-Hodgkin lymphoma, leukemia, and melanoma. First Nations women additionally had higher incidence of stomach, gallbladder, and laryngeal cancers and lower incidence of thyroid cancers compared to non-Aboriginal women. The higher relative incidence of stomach and gallbladder cancers was observed only among First Nations adults who reported living on-reserve. Incidence of lung cancer was similar for First Nations and non-Aboriginal adults nationally, though variation by region of Canada was observed. Conclusion First Nations people in Canada have disproportionately high rates of certain cancers, providing evidence to support public health policy and programming. More research is needed to identify factors contributing to the significantly lower incidence observed for various cancer types. Novel methods for studying disparities in cancer incidence among First Nations people are required to support ongoing cancer control planning and advocacy.
      PubDate: 2018-06-28
      DOI: 10.17269/s41997-018-0091-0
  • Towards equity-focused intersectoral practice (EquIP) in children’s
           environmental health and housing: the transformational story of RentSafe
    • Authors: Erica Phipps; Jeffrey R. Masuda
      Abstract: Setting This paper chronicles the transformational process through which a national intersectoral collaboration, the Canadian Partnership for Children’s Health and Environment (CPCHE), came to embrace a more upstream, equity-based focus in its mandate to advance children’s environmental health. Intervention After 15 years of working within a conventional, evidence-informed approach to health promotion and policy advocacy, in 2010–2013, CPCHE had the opportunity to collaborate on the development of equity-focused knowledge translation (EqKT). EqKT is a relational approach to knowledge practices that challenges intersectoral actors to work to uncover biases and limitations within their own institutional paradigms and professional practices that constrain their capacity to address population health inequities. Outcome The ensuing transformation towards equity-focused intersectoral practice led CPCHE to create an intersectoral initiative called RentSafe. Conceptually and operationally, RentSafe provides an intersectoral space within which the grounded expertise of people with experience of unhealthy and undignified housing provides a roadmap for public health and other practitioners to critically explore professional and institutional blind spots and barriers. With RentSafe as its watershed moment, CPCHE is shifting from a top-down “for whom” orientation to an authentically engaged “with whom” approach that seeks to work integrally with community partners to expose and challenge systemic roots of health inequity. Implications The transformational story of CPCHE underscores the competencies needed for public health professionals to acknowledge the sources of our own biases and limitations as a necessary first step in equity-focused intersectoral practice (EquIP). It also affirms the value of working in partnership with those who experience the environmental health inequities that such efforts seek to address.
      PubDate: 2018-06-15
      DOI: 10.17269/s41997-018-0094-x
  • The effect of body weight on employment among Canadian women: evidence
           from Canadian data
    • Authors: Nazmi Sari; Beliz Acan Osman
      Abstract: Objectives This paper examines the impact of obesity on labour market participation among Canadian women by using various Canadian population health surveys. Methods We estimate the impact of obesity on labour market participation using probit and bivariate probit regression models. To correct for a potential endogenous relationship between obesity and labour market participation, we also use instrumental variables in the bivariate probit regression context. Results The results suggest that the probability of employment has negative association with the body weight of women. This effect is statistically significant and has substantial impact on employment. The results show that obesity decreases employment probability by about 25 percentage points for women. Conclusion In addition to well-known negative health consequences, obesity also has additional negative effect on employment. This negative impact on employment is comparable to the impacts of mental health or illicit drug use on employment. Public health policies aimed at reducing obesity would generate additional benefits to society. Our results also provide additional evidence for lawmakers to amend the labour laws in Canada in order to acknowledge and prohibit hiring practices that discriminate against individuals with high body weight.
      PubDate: 2018-06-13
      DOI: 10.17269/s41997-018-0097-7
  • Contested roles of Canada’s Chief Medical Officers of Health
    • Authors: Patrick Fafard; Brittany McNena; Agatha Suszek; Steven J. Hoffman
      Abstract: The roles and responsibilities of Canada’s Chief Medical Officers of Health (CMOHs) are contested. On the one hand, they are senior public servants who confidentially advise government on public health matters and manage the implementation of government priorities. On the other hand, CMOHs are perceived as independent communicators and advocates for public health. This article analyzes public health legislation across Canada that governs the CMOH role. Our legal analysis reveals that the presence and degree of advisory, communication, and management roles for the CMOH vary considerably across the country. In many jurisdictions, the power and authority of the CMOH is not clearly defined in legislation. This creates great potential for confusion and conflict, particularly with respect to CMOHs’ authority to act as public health advocates. We call on governments to clarify their preferences when it comes to the CMOH role and either amend the relevant statute or otherwise find ways to clarify the mandate of their CMOHs.
      PubDate: 2018-06-12
      DOI: 10.17269/s41997-018-0080-3
  • Awareness of, interest in, and willingness to pay for HIV pre-exposure
           prophylaxis among Canadian gay, bisexual, and other men who have sex with
    • Authors: Jeffrey Morgan; Olivier Ferlatte; Travis Salway; James Wilton; Mark Hull
      Abstract: Objectives Pre-exposure prophylaxis (PrEP) is a highly effective, HIV prevention strategy increasingly being accessed by gay, bisexual, and other men who have sex with men (GBMSM). GBMSM face structural and individual-level barriers accessing PrEP, including awareness and cost. This paper assesses socio-demographic factors associated with awareness, interest, and willingness to pay for PrEP in a sample of Canadian GBMSM. Methods Data were derived from the 2015 Sex Now survey, a cross-sectional, online survey of GBMSM. Respondents were recruited through social media, sex-seeking “apps,” and by word of mouth. We used univariable and multivariable logistic regression models to estimate associations between socio-demographic factors and three primary outcomes. Results Our sample consisted of 7176 HIV-negative Canadian GBMSM. Of respondents, 54.7% were aware of PrEP, 47.4% were interested in PrEP, and 27.9% of PrEP-interested respondents reported they would pay for PrEP out-of-pocket. Awareness and interest varied between provinces, while GBMSM outside urban areas were less likely to be PrEP aware. Bisexual-identified men, and men over 50, were less likely to be aware and interested in PrEP in multivariable models. Only annual income and educational attainment were associated with willingness to pay for PrEP. Conclusion This study identifies important disparities in awareness, interest, and willingness to pay for PrEP. Future interventions and educational efforts should target non-gay-identified and older GBMSM, as well as GBMSM outside urban areas. PrEP implementation may risk further perpetuating existing health inequities based on socio-economic status if PrEP continues to be accessed primarily through private insurance or paid for out-of-pocket.
      PubDate: 2018-06-05
      DOI: 10.17269/s41997-018-0090-1
  • Population-level trends in the distribution of body mass index in Canada,
    • Authors: Alexandre Lebel; S. V. Subramanian; Denis Hamel; Pierre Gagnon; Fahad Razak
      Abstract: Objective Research studying population-level body mass index (BMI) trends document increases in mean or prevalence of overweight/obese but less consideration has been given to describing the changing distribution of BMI. The objective of this research was to perform a detailed analysis of changes in the BMI distribution in Canada. Methods Using data from the CCHS (2000–2014), we analyzed distributional parameters of BMI for 492,886 adults aged 25–64 years. We further stratified these analyses for women and men, education level, and region of residence. Results Mean BMI has increased for most subgroups of the Canadian population. Mean BMI values were higher for men, while standard deviation (SD) of the BMI distribution was systematically higher in women. Increases in mean BMI were accompanied with increases in SD of BMI across cycles. Across survey cycles, the 95th percentile increased more than 10 times more rapidly compared to the 5th percentile, showing a very unequal change between extreme values in the BMI distribution over time. There was a relationship between SD with BMI, but these relations were generally not different between educational categories and regions. This suggests that the growing inter-individual inequalities (i.e., dispersion) in BMI were not solely attributable to socioeconomic and demographic factors. Conclusions This study supports the hypothesis that the simultaneous increases in mean BMI and SD of the BMI distribution are occurring, and suggests the need to move beyond the mean-centric paradigm when studying a complex public health phenomenon such as population change in BMI.
      PubDate: 2018-06-04
      DOI: 10.17269/s41997-018-0060-7
  • Severe obesity in children 17 to 24 months of age: a cross-sectional study
    • Authors: Meloja Satkunam; on behalf of the TARGet Kids! Collaboration and Team ABC; Laura N. Anderson; Sarah Carsley; Jonathon L. Maguire; Patricia C. Parkin; Ann E. Sprague; Geoff D. C. Ball; Catherine S. Birken
      Abstract: Objectives International data suggest the prevalence of severe obesity in young children may be increasing, yet no Canadian data are available. The objectives of this study were to examine definitions of severe obesity and to evaluate associated risk factors among young children in Ontario. Methods A cross-sectional study was conducted in children 17 to 24 months of age using two Ontario data sources: TARGet Kids! (n = 3713) and BORN Ontario (n = 768). Body mass index z score (zBMI) definitions were adapted from the World Health Organization (WHO) (z score > 3) and the US Centers for Disease Control (CDC) (> 120% of the 95th percentile) and applied to define severe obesity in young children. Multinomial logistic regression was used to evaluate associations between demographic and pregnancy risk factors and zBMI categories. Results A total of 1.1% (95% CI, 0.8–1.4) of children met the adapted WHO definition of severe obesity compared to 0.3% (95% CI, 0.2–0.6) using the CDC definition. Median neighbourhood household income (OR = 0.80, 95% CI, 0.69–0.93) and maternal pre-pregnancy BMI (OR = 1.08, 95% CI, 1.01–1.15) were associated with severe obesity in unadjusted analyses. After adjustment for potential confounders, the OR for the association between maternal pre-pregnancy BMI and severe obesity was 1.04 (95% CI, 0.94–1.15). Conclusion More than 1% of Ontario children met the adapted WHO definition of severe obesity in very early childhood. Modifiable risk factors were identified. Future studies are needed to understand the terminology, prevalence, and risk factors for severe obesity in young children across Canada.
      PubDate: 2018-05-30
      DOI: 10.17269/s41997-018-0065-2
  • Food sources among young people in five major Canadian cities
    • Authors: Danielle Wiggers; Lana Vanderlee; Christine M. White; Jessica L. Reid; Leia Minaker; David Hammond
      Abstract: Objective To examine food sources among young people in five major Canadian cities. Methods As part of the 2016 Canada Food Study, respondents aged 16–30 were recruited from five Canadian cities (Toronto, Montreal, Halifax, Edmonton, and Vancouver) using in-person intercept sampling and completed an online survey (n = 2840 retained for analysis). Descriptive statistics were used to summarize food preparation and purchase locations. A linear regression model was fitted to examine correlates of the proportion of meals that were ready-to-eat or prepared outside the home. Results In total, 80% of meals were prepared at home and 20% were prepared outside the home. More than 25% of meals prepared at home were ready-to-eat/box food. Of all meals consumed, 42% were either ready-to-eat/box food prepared at home or prepared outside the home. Food for meals prepared at home was purchased predominantly at grocery stores/supercentres while meals prepared outside the home were purchased predominantly at fast food/quick service/coffee shop outlets. Respondents who were younger, identified as Aboriginal, had obesity, had no children, lived in residence at school, university, or college, and reported poorer cooking skills reported more meals that were ready-to-eat or prepared outside the home. Conclusions The current findings indicate that a substantial proportion of meals consumed by young people consist of meals either prepared outside the home or ready-to-eat/box food prepared at home. Dietary recommendations should highlight basic patterns of food preparation and eating, such as limiting ultra-processed food and food prepared outside the home.
      PubDate: 2018-05-29
      DOI: 10.17269/s41997-018-0083-0
  • Industry and geographic patterns of use and emission of carcinogens in
           Ontario, Canada, 2011–2015
    • Authors: Catherine E. Slavik; Sheila Kalenge; Paul A. Demers
      Abstract: Objectives The goal of this study was to leverage data from two environmental regulatory initiatives, Ontario’s Toxics Reduction Act (TRA) and Canada’s National Pollutant Release Inventory (NPRI), to assess their ability to monitor trends in the use and emission of carcinogens by industry sector in Ontario. Methods Data reported to the TRA and NPRI by industrial facilities in Ontario were retrieved from 2011 to 2015. Twenty-six known and suspected carcinogens were identified (IARC) and the trends in the use and emission were evaluated by industry sector. The locations of industrial facilities that used and released carcinogens were mapped by Public Health Unit (PHU). Results Chemical manufacturing and primary metal manufacturing sectors accounted for 84% of all reported industrial use of carcinogens during the period 2011–2015. The largest source of carcinogen emissions came from facilities in the primary metal manufacturing and paper manufacturing sectors. The largest number of industrial facilities that reported the use and release of carcinogens were located in the City of Toronto and Peel Region PHUs. Overall, the use of carcinogens across all sectors appeared to decrease by 8%, while emissions increased by about 2%. Conclusion The results of this study show the need to reduce the use and emission of select carcinogens in priority industry sectors. Environmental reporting programs, such as the TRA and NPRI, can serve as important tools in cancer prevention by tracking potential carcinogen exposures in the environment and in the workplace.
      PubDate: 2018-05-29
      DOI: 10.17269/s41997-018-0075-0
  • Lived experience of a record wildfire season in the Northwest Territories,
    • Authors: Warren Dodd; Patrick Scott; Courtney Howard; Craig Scott; Caren Rose; Ashlee Cunsolo; James Orbinski
      Abstract: Objectives During the period of June–September 2014, the Northwest Territories (NWT) experienced its worst wildfire season on record, with prolonged smoke events and poor air quality. In the context of climate change, this study sought to qualitatively explore the lived experience of the 2014 wildfire season among four communities in the NWT. Methods Our team conducted 30 semi-structured interviews in four communities (Yellowknife, N’Dilo, Detah, and Kakisa). Interviewees were purposively sampled to include a broad cross-section of backgrounds and experiences. Interviews were video recorded, and the audio portion of each interview was transcribed to facilitate analysis and theme generation. Results Interviewees reported how their experiences of evacuation and isolation as well as feelings of fear, stress, and uncertainty contributed to acute and long-term negative impacts for their mental and emotional well-being. Prolonged smoke events were linked to extended time indoors and respiratory problems. Livelihood and land-based activities were disrupted for some interviewees, which had negative consequences for mental, emotional, and physical well-being. Individual and community stories of adaptation and resilience prior to and during the summer, including the opening of indoor recreational spaces, were shared; however, there was consensus about the need for improved risk communication and coordination at the community and territorial levels to address similar events in the future. Conclusion Coordinated community-based education, communication, and adaptation initiatives that are inclusive of local knowledge, values, and context are needed to address the expressed needs of community members associated with prolonged smoke events and wildfire seasons.
      PubDate: 2018-05-25
      DOI: 10.17269/s41997-018-0070-5
  • Ethnic differences in vascular function and factors contributing to blood
    • Authors: Heather J. A. Foulds; Shannon S. D. Bredin; Darren E. R. Warburton
      Abstract: Objective Indigenous populations experience greater proportions of cardiovascular disease, diabetes, and obesity, though lower rates of hypertension. This investigation evaluated blood pressure relationships with vascular measures, anthropometry, cultural identity, and smoking status among Canadian Indigenous and European adults. Methods In 2013, in Vancouver, Canada, blood pressure, anthropometry, cultural identity, smoking status, pulse wave velocity (PWV), arterial compliance, baroreceptor sensitivity, and intima-media thickness (IMT) were directly measured among 58 Indigenous (39 ± 18 years, 31 female) and 58 age- and sex-matched European Canadian (42 ± 18 years) adults. Systolic (SBP) and diastolic (DBP) blood pressures were related to vascular measures, and hypertension was related to anthropometry, cultural identity, and smoking status. Results Similar vascular measures were recorded between Indigenous and European adults, respectively (PWV 5.3 ± 2.4 vs. 6.2 ± 3.4 m s−1, p = 0.12; IMT 0.59 ± 0.11 vs. 0.61 ± 0.11 mm, p = 0.40; and large arterial compliance 16.1 ± 6.4 vs. 17.5 ± 6.6 mL mmHg−1 × 10, p = 0.26). Similar relationships between vascular measures with SBP and DBP were identified between Indigenous and European adults (spectral baroreceptor sensitivity and SBP, r = 0.48, p = 0.001 vs. r = − 0.11, p = 0.44; ethnic difference p = 0.38; PWV; and DBP, r = 0.23, p = 0.09 vs. r = 0.06, p = 0.65, ethnic difference p = 0.23). Anthropometry only related to blood pressures among Europeans. Cultural identity only related to blood pressures among Indigenous populations. Smoking was not related to hypertension. Conclusion Similar vascular measures between Indigenous and European Canadians were identified among populations experiencing similar social determinants of health.
      PubDate: 2018-05-11
      DOI: 10.17269/s41997-018-0076-z
  • Assessing health literacy among older adults living in subsidized housing:
           a cross-sectional study
    • Authors: Gina Agarwal; Kendra Habing; Melissa Pirrie; Ric Angeles; Francine Marzanek; Jenna Parascandalo
      Abstract: Objectives This study aimed to assess functional health literacy levels among older adults living in subsidized housing in Hamilton, Ontario, and to assess the relationships between health literacy and other important health indicators, such as education level, age, ethnicity, body mass index (BMI), and self-reported health status. Methods Older adults (n = 237) living in subsidized housing buildings in Hamilton, ON, were assessed using the NVS-UK as a measure of functional health literacy in addition to a health indicator questionnaire through structured interview. Health literacy levels were analyzed using descriptive statistics and logistic regression to determine relationships between health literacy levels and other health indicators. Results Participants’ mean age was 73 years, 67% were female, 70% were not educated beyond high school, and 91% were white. Over 82% of participants had below adequate health literacy levels using the NVS-UK. Multivariable logistic regression revealed significant relationships between functional health literacy and BMI, education level, and pain and discomfort levels. No significant relationships were found between health literacy level and age group, anxiety and depression levels, CANRISK (Diabetes risk) score, gender, marital status, mobility issues, self-care issues, self-reported health status, or performance of usual activities. Conclusions As the population of older adults continues to grow, the appropriate resources must be available to both improve and support the health literacy level of the population. Future health research should gather information on the health literacy levels of target populations to ensure more equitable health service. This research provides a significant opportunity to better understand populations with health literacy barriers.
      PubDate: 2018-05-09
      DOI: 10.17269/s41997-018-0048-3
  • Child maltreatment and adult multimorbidity: results from the Canadian
           Community Health Survey
    • Authors: Gillian England-Mason; Rebecca Casey; Mark Ferro; Harriet L. MacMillan; Lil Tonmyr; Andrea Gonzalez
      Abstract: Objectives This study investigated associations between three types of child maltreatment (exposure to intimate partner violence, sexual, and physical abuse) and multimorbidity (chronic physical conditions, pain conditions, and mental disorders) in adults. Methods Multinomial logistic regression was used to analyze weighted data from the 2012 Canadian Community Health Survey (CCHS - MH 2012), a representative population sample (N = 23,846) of respondents ages 18+. Results All three subtypes of child maltreatment independently predicted increased odds of experiencing multimorbidity as an adult, while adjusting for covariates (adjusted odds ratios ranged from 1.34 (95% CI = 1.00, 1.80) to 4.87 (95% CI = 2.75, 8.63)). A dose-response relationship between the number of child maltreatment subtypes and risk for multimorbidity was also observed (adjusted odds ratios ranged from 1.38 (95% CI = 1.11, 1.73) to 10.96 (95% CI = 6.12, 19.64)). Conclusion The current results highlight the importance of considering a range of childhood adversities and suggest that public health approaches that aim to decrease the prevalence and severity of child maltreatment have the potential to ameliorate adult multimorbidities. Future research is encouraged to investigate these issues using longitudinal population-level data.
      PubDate: 2018-05-09
      DOI: 10.17269/s41997-018-0069-y
  • Cost-effectiveness of alternative strategies for use of 13-valent
           pneumococcal conjugate vaccine (PCV13) in Canadian adults
    • Authors: Mark Atwood; Linda Beausoleil; Marie-Claude Breton; Craig Laferriere; Reiko Sato; Derek Weycker
      Abstract: Objectives The Canadian National Advisory Committee on Immunization (NACI) recommends use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine in a sequential schedule (PCV13 → PPV23) among adults aged ≥ 65 years and those aged ≥ 18 years who are immunocompromised. In light of recent PCV13 efficacy data from the Community-Acquired Pneumonia Immunization Trial in Adults (CAPiTA), and new sero-epidemiology data on community-acquired pneumonia (CAP), we examined the economic implications of funding an expanded adult pneumococcal immunization program in Canada. Methods A microsimulation model depicting expected lifetime risks, consequences, and costs of invasive pneumococcal disease (IPD) and CAP was developed. PPV23 effectiveness was based on published literature, and PCV13 effectiveness was based on CAPiTA; all other model parameters were based on published data or secondary sources. Herd effects from the PCV13 pediatric program were considered. Outcomes and costs were evaluated assuming use of PPV23 alone, and alternatively, use of PCV13 → PPV23 among (1) all adults aged ≥ 65 years (n = 5.4 M) and (2) immunocompromised and high-risk adults aged ≥ 65 years (n = 3.0 M). Results For population no. 1, PCV13 → PPV23 reduced IPD cases by 1100, CAP cases by 7000, and disease costs by $135.8M; vaccination costs increased by $254.3M, and cost per QALY gained was $35,484. For population no. 2, PCV13 → PPV23 reduced IPD cases by 900, CAP cases by 6000, and disease costs by $120.3M; vaccination costs increased by $149.8M, and cost per QALY gained was $10,728. Conclusion Expanding use of PCV13 → PPV23 by funding PCV13 among Canadian adults aged ≥ 65 would be a cost-effective use of healthcare resources.
      PubDate: 2018-05-09
      DOI: 10.17269/s41997-018-0050-9
  • Red blood cell folate levels in Canadian Inuit women of childbearing
           years: influence of food security, body mass index, smoking, education,
           and vitamin use
    • Authors: Kait Duncan; Anders C. Erickson; Grace M. Egeland; Hope Weiler; Laura T. Arbour
      Abstract: Background The benefits of folic acid for prevention of congenital anomalies are well known. For the Inuit of Canada, where vitamin use is low and access to folate-rich foods limited, fortification is likely a major source of intake. We sought to determine whether red blood cell folate (RBCF) levels of Inuit women reached accepted target levels. Methods The Inuit Health Survey, 2007–2008, included evaluation of RBCF levels among 249 randomly selected non-pregnant women of reproductive age. Using descriptive statistics and linear regression analyses, RBCF levels were assessed and compared across several socio-demographic variables to evaluate the characteristics associated with RBCF status. Results Mean (SD) RBCF levels of 935.5 nmol/L (± 192) reached proposed target levels (> 906 nmol/L); however, 47% of women had lower than target levels. In bivariate analysis, non-smoking, higher education, higher income, food security, increased body mass index, and vitamin use were each significantly associated with higher RBCF. Increased levels of smoking had a negative association with RBCF levels (− 5.8 nmol/L per cigarette smoked per day (p = 0.001)). A total of 6.8% of women reported taking vitamin supplements, resulting in a 226 nmol/L higher RBCF level on average compared to non-users (p < 0.001). Conclusion While mean levels of folate reached target levels, this was largely driven by the small number of women taking vitamin supplements. Our results suggest that folate status is often too low in Inuit women of childbearing years. Initiatives to improve food security, culturally relevant education on folate-rich traditional foods, vitamin supplements, and smoking cessation/reduction programs may benefit Inuit women and improve birth outcomes.
      PubDate: 2018-05-09
      DOI: 10.17269/s41997-018-0085-y
  • What is the effect of ADHD stimulant medication on heart rate and blood
           pressure in a community sample of children'
    • Authors: Meagan D. St. Amour; Deborah D. O’Leary; John Cairney; Terrance J. Wade
      Abstract: Objective This study examines the effect of ADHD (attention deficit hyperactivity disorder) diagnosis and stimulant medication for ADHD treatment on child heart rate (HR) and blood pressure (BP) in a community sample compared to children without ADHD. Methods Data came from the HBEAT Study. From 49 schools, 2013 participants from southern Ontario in grades 5–8 were included. Linear regression analyses examined the effects of ADHD medications on systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate adjusting for age, sex and body mass index (BMI). Results Compared to non-ADHD children and adjusting for age, sex and BMI, children with ADHD on stimulant medication had a 12.3-bpm higher HR, and 3.0-mmHg higher SBP and DBP (all statistically significant). Children with ADHD on no stimulant medication had no differences in HR and BP compared to those children without a diagnosis of ADHD. Conclusion Stimulant medications used to treat ADHD are associated with elevated HR and higher BP. While it is unknown whether children on ADHD medications may be at risk for longer-term cardiovascular issues, this study supports the need to examine the long-term consequences of ADHD medication.
      PubDate: 2018-05-07
      DOI: 10.17269/s41997-018-0067-0
  • Comparing individual and area-based income measures: impact on analysis of
           inequality in smoking, obesity, and diabetes rates in Canadians
    • Authors: Erin Pichora; Jane Y. Polsky; Christina Catley; Nita Perumal; Jing Jin; Sara Allin
      Abstract: Objectives The aims of this study were to examine (1) the concordance between income measured at the individual and area-based level and (2) the impact of using each measure of income on inequality estimates for three health indicators—the prevalence, respectively, of diabetes, smoking, and obesity. Methods Data for the health indicators and individual income among adults came from six cycles of the Canadian Community Health Survey (cycles 2003 through 2013). Area-based income was obtained by linking respondents’ residential postal codes to neighbourhood income quintiles derived from the 2006 Canadian census. Relative and absolute inequality between the lowest and highest income quintiles for each measure was assessed using rate ratios and rate differences, respectively. Results Concordance between the two income measures was poor in the overall sample (weighted Kappa estimates ranged from 0.19 to 0.21 for all years), and for the subset of participants reporting diabetes, smoking, or obesity. Despite the poor concordance, both individual and area-based income measures identified generally comparable levels of relative and absolute inequality in the rates of diabetes, smoking, and obesity over the 10-year study period. Conclusion The results of this study show that individual and area-based income measures categorize Canadians differently according to income quintile, yet both measures reveal striking income-related inequalities in rates of diabetes and smoking, and obesity among women. This suggests that either individual or area-level measures can be used to monitor income-related health inequalities in Canada; however, whenever possible, it is informative to consider both measures since they likely represent distinct social constructs.
      PubDate: 2018-05-07
      DOI: 10.17269/s41997-018-0062-5
  • Are young Canadians supportive of proposed nutrition policies and
           regulations' An overview of policy support and the impact of
           socio-demographic factors on public opinion
    • Authors: Jasmin Bhawra; Jessica L. Reid; Christine M. White; Lana Vanderlee; Kim Raine; David Hammond
      Abstract: Objectives Many countries, including Canada, are considering nutrition policies that seek to improve dietary behaviour and related health outcomes. The current study examined support for policy measures among youth and young adults in Canada. Methods Participants aged 16–30 years were recruited for online surveys using in-person intercept sampling in five Canadian cities as part of the Canada Food Study conducted in October–December, 2016 (n = 2729). Items included support for 21 specific policies in seven key areas: menu labelling, food package symbols and warnings, school policies, taxation and subsidies, zoning restrictions, marketing bans, and food formulation. Linear regression models examined support by age, sex, city, race/ethnicity, parental status, body mass index (BMI), and health literacy. Results Very high levels of support were observed for menu labelling in restaurants and schools, as well as food package symbols and warnings. Taxation, zoning restrictions (e.g., fast food and convenience stores near schools), and bans on marketing to children received relatively lower levels of support. In general, policy support increased with age for all 21 policies (p < 0.01) and greater health literacy for 4 policies (p < 0.05). Males were less supportive than females for 5 policies (p < 0.01). There were significant differences in support for specific race/ethnicity groups for 4 policies (p < 0.05). Support for menu labelling policies increased with BMI (p < 0.05). Conclusion Overall, youth and young adults in Canada reported high levels of support for menu labelling, food package symbols/warnings, and school policies. Levels of support were generally consistent across socio-demographic subgroups, with some exceptions.
      PubDate: 2018-05-07
      DOI: 10.17269/s41997-018-0066-1
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