Public Health Commons^™

Indigenous Approaches To Health Assessment: A Scoping Review Protocol., Nabina Sharma, Jennifer D Walker, Elizabeth Wenghofer, Taima Moeke-Pickering, Jeannette Lindenbach

Journal Articles

BACKGROUND: Health assessment tools developed using mainstream or Western concepts have been widely used in clinical practice worldwide. However, even culturally adapted or culturally based tools may not be relevant in other social contexts if they are grounded in Western beliefs and perspectives. The application of mainstream assessment tools, when used in Indigenous populations, can lead to the inappropriate application of normative data and inaccurate or biased diagnosis of conditions as Indigenous concepts of health differ from Western biomedical concepts of health. Thus, considering the need for culturally meaningful, sensitive, safe, and unbiased health assessment approaches and instruments over recent …

Sars-Cov-2 Transmission In Alberta, British Columbia, And Ontario, Canada, December 25, 2019, To December 1, 2020, Isaac Chun-Hai Fung, Yuen Wai Hung, Sylvia Ofori, Kamalich Muniz-Rodriguez, Po-Ying Lai, Gerardo Chowell

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Objective:

This study aimed to investigate coronavirus disease (COVID-19) epidemiology in Alberta, British Columbia, and Ontario, Canada.

Methods:

Using data through December 1, 2020, we estimated time-varying reproduction number, R t , using EpiEstim package in R, and calculated incidence rate ratios (IRR) across the 3 provinces.

Results:

In Ontario, 76% (92 745/121 745) of cases were in Toronto, Peel, York, Ottawa, and Durham; in Alberta, 82% (49 878/61 169) in Calgary and Edmonton; in British Columbia, 90% (31 142/34 699) in Fraser and Vancouver Coastal. Across 3 provinces, R t dropped to ≤ 1 after April. …

Health Is Wealth: The Correlation Of Wellness Programs & Productivity In Canada And The U.S., Madeline Wert

Business and Economics Summer Fellows

Does health impact the productivity of workers? Are there differences between the U.S. and Canada? Firms both in Canada and the U.S. deal with issues of presenteeism and absenteeism. Presenteeism is when an employee shows up to work but they are distracted by their own or a family member’s health issue. One response to reduce presenteeism and absenteeism are workplace wellness programs. Workplace wellness programs are facilitated programs by a firm to promote the health and wellbeing of their employees, which benefits the employer and the employees. There are additional incentives for U.S. employers to implement workplace wellness programs as …

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …

Trends In Obesity And Multimorbidity In Canada., Michael Lebenbaum, Gregory S Zaric, Amardeep Thind, Sisira Sarma

Epidemiology and Biostatistics Publications

Very few studies have examined trends in multimorbidity over time and even fewer have examined trends over time across different body mass index (BMI) groups. Given a general decline in death rates but increased cardiovascular risk factors among individuals with obesity, the trend in the association between obesity and multimorbidity is hypothesized to be increasing over time. The data for our study came from the 1996-97 National Population Health Survey and the 2005 and 2012-13 Canadian Community Health Surveys (N = 277,366 across all 3 surveys). We examined trends in the association between BMI groups and multimorbidity using a logistic …

Substance Use Patterns Among Women Living With Hiv Compared With The General Female Population Of Canada, Mostafa Shokoohi, Greta R Bauer, Angela Kaida, Ashley Lacombe-Duncan, Mina Kazemi, Brenda Gagnier, Alexandra De Pokomandy, Mona Loutfy

Epidemiology and Biostatistics Publications

BACKGROUND: HIV infection and substance use synergistically impact health outcomes of people with HIV. In this study, we assessed the prevalence of substance use among women living with HIV (WLWH) and compared them with expected values from general data.

METHODS: Cigarette smoking, frequency of alcohol consumption, last-month non-prescribed cannabis use (vs. last-year use), and last 3 months regular (≥once/week) and occasional (

RESULTS: Compared to expected estimates from general population women, a higher proportion of WLWH reported daily cigarette smoking (SPD: 26.8% [95% CI: 23.9, 29.7]), smoking ≥20 cigarettes/day (SPD: 11.6% [9.8, 13.6]), regular non-prescribed cannabis use (SPD: 8.0% [4.1, …

Which Type Of Tobacco Product Warning Imagery Is More Effective And Sustainable Over Time?, Dien Anshari, Hua-Hei Yong, Ron Borland, Kamala Swayampakala, Jim Thrasher

Faculty Publications

Objective This study examined smokers’ responses to pictorial health warnings (PHWs) with different types of imagery under natural exposure conditions.

Methods Adult smokers from online panels in Canada (n=2357), Australia (n=1671) and Mexico (n=2537) were surveyed every 4 months from 2012 to 2013. Participants were shown PHWs on packs in their respective countries and asked about: (1) noticing PHWs; (2) negative affects towards PHWs; (3) believability of PHWs; (4) PHW-stimulated discussions; and (5) quit motivation due to PHWs. Country-specific generalised estimating equation models regressed these outcomes on time (ie, survey wave), PHW imagery type (ie, symbolic representations of risk, suffering …

Canada: Obesity, Marissa Olson

Global Public Health

Canada is a country with a relatively healthy population of approximately 37 million people. Canada has few major public health problems; however, Canada has experienced a rise of obesity in its population with a higher rise in the adult population than childhood. The male population is at a greater risk of becoming obese than the female population, and people 35 years old and over than below 35 years old. This brief discusses the effects of obesity, Canada’s interventions to obesity such as surgery, drugs, and healthier school lunches, and a possible new method of health counseling or more convenient healthier …

Self-Reported Sleep Apnea And Dementia Risk: Findings From The Prevention Of Alzheimer's Disease With Vitamin E And Selenium Trial, Xiuhua Ding, Richard J. Kryscio, Joshua Turner, Gregory A. Jicha, Gregory E. Cooper, Allison M. Caban-Holt, Frederick A. Schmitt, Erin L. Abner

Sanders-Brown Center on Aging Faculty Publications

OBJECTIVES: To investigate the association between baseline sleep apnea and risk of incident dementia in the Prevention of Alzheimer's Disease with Vitamin E and Selenium (PREADViSE) study and to explore whether the association depends on apolipoprotein E (APOE) ɛ4 allele status.

DESIGN: Secondary analysis based on data collected during PREADViSE.

SETTING: Participants were assessed at 128 local clinical study sites during the clinical trial phase and later were followed by telephone from a centralized location.

PARTICIPANTS: Men enrolled in PREADViSE (without dementia or other active neurological conditions that affect cognition such as major psychiatric disorders, including depression; N = …

Smoking On The Margins: A Comprehensive Analysis Of A Municipal Outdoor Smoke-Free Policy, Ann Pederson, Chizimuzo T. C. Okoli, Natalie Hemsing, Renée O'Leary, Amanda T. Wiggins, Wendy Rice, Joan L. Bottorff, Lorraine Greaves

Nursing Faculty Publications

Background: This study examined the formulation, adoption, and implementation of a ban on smoking in the parks and beaches in Vancouver, Canada.

Methods: Informed by Critical Multiplism, we explored the policy adoption process, support for and compliance with a local bylaw prohibiting smoking in parks and on beaches, experiences with enforcement, and potential health equity issues through a series of qualitative and quantitative studies.

Results: Findings suggest that there was unanimous support for the introduction of the bylaw among policy makers, as well as a high degree of positive public support. We observed that smoking initially declined following the ban’s …

Does Reactance Against Cigarette Warning Labels Matter? Warning Label Responses And Downstream Smoking Cessation Amongst Adult Smokers In Australia, Canada, Mexico And The United States, Yoo Jin Cho, Jim Thrasher, Kamala Swayampakala, Hua-Hie Yong, Robert Mckeever, David Hammond, Dien Anshari, K. Michael Cummings, Ron Borland

Faculty Publications

Objective

Some researchers have raised concerns that pictorial health warning labels (HWLs) on cigarette packages may lead to message rejection and reduced effectiveness of HWL messages. This study aimed to determine how state reactance (i.e., negative affect due to perceived manipulation) in response to both pictorial and text-only HWLs is associated with other types of HWL responses and with subsequent cessation attempts.

Methods

Survey data were collected every 4 months between September 2013 and 2014 from online panels of adult smokers in Australia, Canada, Mexico, and the US were analyzed. Participants with at least one wave of follow-up were included …

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …

Hivpositive People's Perspectives On Canadian Criminal Law And Non-Disclosure, Barry D. Adam, Jason Globerman, Richard Elliott, Patrice Corriveau, Ken English, Sean Rourke

Sociology, Anthropology, and Criminology Publications

The largest survey to date of people living with HIV regarding attitudes toward criminalization of HIV non-disclosure, this study investigates: sources of legal information available to HIV-positive people; perceptions of how criminal prosecutions and media coverage affect understanding of rights and responsibilities of self and others; and where HIV-positive people themselves stand on the role the criminal justice system should play. While mainstream media constructions of criminal iconography do affect PHA views, those who have higher levels of formal education, are active in the dating scene, and have been living longer with HIV hold less punitive views than those who …

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

Immigrant Women's Experiences Of Maternity-Care Services In Canada: A Systematic Review Using A Narrative Synthesis, Gina M A. Higginbottom, Myfanwy Morgan, Mirande Alexandre, Yvonne Chiu, Joan Forgeron, Deb Kocay, Rubina Barolia

School of Nursing & Midwifery

Background: Canada's diverse society and its statutory commitment to multiculturalism means that a synthesis of knowledge related to the healthcare experiences of immigrants is essential to realise the health potential for future Canadians. Although concerns about the maternity experiences of immigrants in Canada are relatively new, recent national guidelines explicitly call for the tailoring of services to user needs. We therefore assessed the experiences of immigrant women accessing maternity-care services in Canada. In particular, we investigated the experiences of immigrant women in Canada in accessing and navigating maternity and related healthcare services from conception to 6 months postpartum in Canada. …

Slides: Best Management Practices For Oil And Gas Development And Comparative Water Quality Database Of Regulations Relating To Shale Oil And Gas, Matt Samelson, University Of Colorado Boulder. Getches-Wilkinson Center For Natural Resources, Energy, And The Environment. Intermountain Oil And Gas Bmp Project

Fracking, Water Quality and Public Health: Examining Current Laws and Regulations (March 20)

Presenter: Matt Samelson, J.D., Attorney, Consultant for Intermountain Oil and Gas Best Management Practices (BMP) Project, Getches-Wilkinson Center for Natural Resources, Energy and the Environment, University of Colorado Law School

34 slides

Health Capabilities And Diabetes Self-Management: The Impact Of Economic, Social, And Cultural Resources, Robert Weaver, Manon Lemonde, Naghmeh Payman, William M. Goodman

Faculty Scholarship for the College of Science & Mathematics

While the “social determinants of health” view compels us to explore how social structures shape health outcomes, it often ignores the role individual agency plays. In contrast, approaches that focus on individual choice and personal responsibility for health often overlook the influence of social structures. Amartya Sen's “capabilities” framework and its derivative the “health capabilities” (HC) approach attempts to accommodate both points of view, acknowledging that individuals function under social conditions over which they have little control, while also acting as agents in their own health and well-being. This paper explores how economic, social, and cultural resources shape the health …

Impacts Of The Criminalization On The Everyday Lives Of People Living In With Hiv In Canada, Barry D. Adam, Richard Elliott, Patrice Corriveau, Ken English

Sociology, Anthropology, and Criminology Publications

As part of a study on the social consequences of the criminal justice system on people living with HIV or AIDS (PHAs) in Canada, this article focuses on how heightened public identification of HIV with criminal matters is having wide ranging effects on perceived personal security and in particular on negotiating potential romantic and sexual interactions. As articulated by the Supreme Court of Canada, the courts have been enforcing a requirement that HIV-positive people disclose their sero-status to prospective partners, relying on the notion that “through deterrence it [the Criminal Code] will protect and serve to encourage honesty, frankness and …

Paper Versus Practice: Occupational Health And Safety Protections And Realities For Temporary Foreign Agricultural Workers In Ontario, Janet Mclaughlin, Jenna Hennebry, Ted Haines

Health Studies

Over 20,000 temporary foreign agricultural workers come to Ontario each year, primarily from Mexico and the Caribbean. Agricultural workers are exposed to a number of occupational health and safety (OHS) risks. This article discusses the various OHS protections available to workers and their limitations, and analyzes the specific challenges that temporary foreign workers face in accessing rights, such as language and cultural barriers, information gaps, and precarious employment and immigration status. It also analyzes the limitations with respect to OHS training and the provision and use of personal protective equipment, arguing that these protections are under-regulated and inconsistent. The article …

Outcomes Of A Smoking Cessation Clinic In Cardiology Services, Vancouver, Canada, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

BACKGROUND: Adults who have experienced cardiac events have a high burden of smoking and are likely to continue post cardiac event. Research in this population suggests that smoking cessation services offered to this population can reduce the re-occurrence of cardiac events by assisting patients in cessation. However, few cardiology clinics offer smoking cessation services and few cardiologists refer patients to such services. The Smoking Cessation Clinic (SCC) provides evidence-based smoking cessation treatment within Cardiology services in Vancouver General Hospital in Vancouver, Canada. The aim of this study was to evaluate the SCC program in terms of its program engagement …

[Sabbatical Report], Emmanuel Iyiegbuniwe

Sabbatical Reports

The main purpose of this sabbatical leave was to provide me the opportunity to conduct relevant research and subsequently write two book chapters on environmental health and policy issues in two countries: Belize (a developing country) and Canada (a developed country). Specifically, the two book chapters were titled "Analysis of Environmental Health Policy in Belize" and "Analysis of Environmental Health and Policy Issues in Canada." As called for in my proposal, I was able to travel to Belize with a group of CHHS faculty and students during the 2013 winter term. During the leave period, I success fully conducted research …

Determinants Of Negative Pathways To Care And Their Impact On Service Disengagement In First-Episode Psychosis., Kelly K. Anderson, Rebecca Fuhrer, Norbert Schmitz, Ashok K Malla

Epidemiology and Biostatistics Publications

PURPOSE: Although there have been numerous studies on pathways to care in first-episode psychosis (FEP), few have examined the determinants of the pathway to care and its impact on subsequent engagement with mental health services.

METHODS: Using a sample of 324 FEP patients from a catchment area-based early intervention (EI) program in Montréal, we estimated the association of several socio-demographic, clinical, and service-level factors with negative pathways to care and treatment delay. We also assessed the impact of the pathway to care on time to disengagement from EI services.

RESULTS: Few socio-demographic or clinical factors were predictive of negative pathways …

Better Colon Cancer Care For Extremely Poor Canadian Women Compared With American Women, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Sundus Haji-Jama, Eric J. Holowaty, Caroline Hamm, Sindu M. Kanjeekal, Fraces C. Wright, Madhan K. Balagurusamy, Nancy L. Richter

Social Work Publications

Extremely poor Canadian women were recently observed to be largely advantaged on most aspects of breast cancer care as compared with similarly poor, but much less adequately insured, women in the United States. This historical study systematically replicated the protective effects of single- versus multipayer health care by comparing colon cancer care among cohorts of extremely poor women in California and Ontario between 1996 and 2011. The Canadian women were again observed to have been largely advantaged. They were more likely to have received indicated surgery and chemotherapy, and their wait times for care were significantly shorter. Consequently, the Canadian …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

Equitable Consequences? Issues Of Evidence, Equity And Ethics Arising From Outdoor Smoke-Free Policies, Ann Pederson, Wendy Rice, Phoebe M. Long, Natasha Jategaonkar, Lorraine Greaves, Steven Chasey, Natalie Hemsing, Chizimuzo T.C. Okoli, Joan L. Bottorff

Nursing Faculty Publications

From Introduction:

Kass argues that an ethical approach in public health is one that places the fewest burdens on individuals’ health without significantly reducing the potential benefits of intervening. Yet many population health regulations are highly intrusive, compromising individual liberty and imposing penalties for non-compliance. Moreover, the benefits of these regulations and the burdens they impose may not be shared equally. When developing interventions, the state has, therefore, an obligation to consider the benefits and burdens, particularly on those vulnerable to health inequities and other disparities.

Advancing The Future Of Physical Activity Guidelines In Canada: An Independent Expert Panel Interpretation Of The Evidence, Antero Kesäniemi, Chris J. Riddoch, Bruce Reeder, Steven N. Blair, Thorkild I. A. Sørensen

Faculty Publications

The Canadian Society for Exercise Physiology, in partnership with the Public Health Agency of Canada, has initiated a review of their physical activity guidelines to promote healthy active living for Canadian children, youth, adults and older adults; previous guidelines were released in 2002, 2002, 1998 and 1999 respectively. Several background papers from this project were published recently and provide foundation evidence upon which to base new guidelines. Furthermore, comprehensive systematic reviews were completed to ensure a rigorous evaluation of evidence informing the revision of physical activity guidelines for asymptomatic populations. The overall guideline development process is being guided and assessed …

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

The Determinants Of First Nation And Inuit Health: A Critical Population Health Approach, Chantelle A.M. Richmond, Nancy A. Ross

Aboriginal Policy Research Consortium International (APRCi)

Environmental dispossession disproportionately affects the health of Canada’s Aboriginal population, yet little is known about how its effects are sustained over time. We use a critical population health approach to explore the determinants of health in rural and remote First Nation and Inuit communities, and to conceptualize the pathways by which environmental dispossession affects these health determinants. We draw from narrative analysis of interviews with 26 Community Health Representa- tives (CHRs) from First Nation and Inuit communities across Canada. CHRs identified six health determinants: balance, life control, education, material resources, social resources, and environmental/ cultural connections. CHRs articulated the role …

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …