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Background The COVID-19 pandemic has highlighted several issues among health care workers in Canada's long-term care and seniors' (LTCS) homes, including labour shortages, staff retention difficulties, overcrowding, and precarious working conditions. There is currently a lack of information on the health, well-being and working conditions of health care workers in LTCS homes--many of them immigrants--and a limited understanding of the relationship between them. This paper examines differences between immigrant and non-immigrant workers' health outcomes and precarious working conditions during the pandemic. Data and methods The data were from the 2021 Survey on Health Care Workers' Experiences During the Pandemic, which collected information on LTCS home health care workers' (n=2,051) health, employment or work experiences, and working environment during the COVID-19 pandemic. Summary statistics and multivariable logistic regressions were conducted to examine the association between precarious work and workers' health (life stress, mental health and general health), stratified by immigrant status. Selected working characteristics were included in the regression models as covariates, namely occupation, number of locations worked, facility ownership status and number of years worked. Results Immigrant health care workers were more likely than non-immigrant health care workers to experience precarious work in LTCS homes. Precarious work--characterized by income loss, reduced hours of work, and unpaid leave--was associated with stress and poor general health among immigrant and nonimmigrant workers in the sector. Employment precarity was also associated with poor mental health for immigrant workers, but there was no association for non-immigrant workers. Interpretation Employment precarity and the health and well-being of health care workers warrants further attention, in particular among immigrants employed in the LTCS residential care sector. [ABSTRACT FROM AUTHOR]

Introduction On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation. Methods Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation. Results More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity. Interpretation Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable. [ABSTRACT FROM AUTHOR]

Background At the onset of the COVID-19 pandemic, there was an overrepresentation of males in COVID-19 deaths worldwide, with Canada reporting more female COVID-19 deaths. This paper examines the overrepresentation of female COVID-19 deaths in Canada, with an immigration lens. Data and methods Data were extracted from the COVID-19 Sex-Disaggregated Data Tracker to compare the sex distribution of COVID-19 deaths in Canada with that of other countries. A linkage of deaths to the Longitudinal Immigration Database (IMDB) allows for the comparison of sex-specific COVID-19 death rates by immigrant status for age and geography, as well as by major employment sector among immigrants, using the tax data from the IMDB. Results While there were proportionately more female than male COVID-19 deaths in Canada in the early months of the pandemic, this trend was mainly a phenomenon among non-immigrants aged 85 and older. In addition, COVID-19-specific death rates for males were higher than those for females across age groups by immigrant status, except for those aged 85 and older among the non-immigrant population. Among immigrants, the death rate among health care and social assistance workers was higher among males than among females (10.7 vs. 2.9 per 100,000 population). The initially observed overrepresentation of female COVID-19 deaths to male COVID-19 deaths in Canada evened out in the summer of 2021. Interpretation The higher proportion of female COVID-19 deaths was likely related to the high concentration of COVID-19 deaths in long-term care facilities, where a lower institutionalization rate for immigrants had been observed. Since the implementation of vaccination targeting long-term care facility residents in Canada, the overrepresentation of female COVID-19 deaths ceased. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic has caused changes in health behaviours, including participation in physical activity and screen time. The purpose of this paper is to examine trends in physical activity and screen time among Canadian youth from January 2018 to February 2022. Methods The Canadian Community Health Survey asks Canadian youth (aged 12 to 17 years) to report the time they spend active by domain: recreation, transportation, school and household. Survey respondents are also asked to report their screen time on school days and non-school days. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (January to December; n=3,952), January to March 2020 (n=911), September to December 2020 (n=1,573), and January 2021 to February 2022 (n=3,501). Screen time is compared between 2018 and 2021/2022. Sub-annual descriptive analyses examine how physical activity and screen time varied within and between these years. Results Before the COVID-19 pandemic, half of Canadian youth met the physical activity recommendation (2018: 49.6%; January to March 2020: 53.7%). The percentage meeting the recommendation dropped in the first year of the pandemic (September to December 2020: 37.3%) and recovered slightly in 2021 (43.8%). From 2018 to 2021, total physical activity dropped by 8.3 minutes per day (58.1 minutes per week) among girls and by 2.1 minutes per day (14.7 minutes per week) among boys. The percentage of youth meeting the screen time recommendation on school days dropped from 40.7% in 2018 to 29.1% in 2021 and from 21.4% in 2018 to 13.2% in 2021 on non-school days. Interpretation The COVID-19 pandemic had a detrimental impact on the physical activity and screen time of youth, in particular among girls. This analysis provides an update on how the pandemic has continued to affect the physical activity and screen habits of youth in 2020, 2021, and early 2022. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to economics in Canada. Tembec Inc. announced the closure of several lumber and paper mills in Quebec, while Louisiana-Pacific stopped operations indefinitely at its board mill and Norampac Inc. shut its linerboard mill in Ontario. Work began in a $1 billion expansion of power generation at Niagara Falls, Ontario.

Background There are important information gaps concerning the prevalence and distribution of infection control practices (ICPs) within workplaces continuing to operate during the COVID-19 pandemic. Data and methods To address these gaps, this paper examines the prevalence of workplace ICPs among employed respondents to Statistics Canada's Labour Force Survey in the months of July, August and September 2020 (n = 53,316). The article also seeks to identify sociodemographic, occupational and workplace factors associated with the level and type of workplace ICPs. ICPs included the reorganization of the workplace to allow for physical distancing, increased access to hand sanitizer or handwashing facilities, enhanced cleaning protocols and access to personal protective equipment. Multivariable regression models were used to examine the number of ICPs in place and the absence of specific ICPs. Results Generally high levels of reported protections among workers (15% of the sample had three ICPs and 72% had four or more ICPs) were observed. However, certain subgroups of workers were less likely to have ICPs in place. These included workers who were male; those with lower levels of education, shorter job tenure, or non-permanent work; and those working in the agricultural, construction, transportation and warehousing, and education industries. Interpretation In a large sample of Canadian employees, generally high levels of workplace ICPs to reduce the transmission of COVID-19 were observed. Groups with lower levels of ICPs included workers at the start of their employment, workers with low levels of education, and certain industry groups. [ABSTRACT FROM AUTHOR]

Background The fitness levels of Canadian adults declined substantially between 1981 and the years 2007 to 2009, suggesting a reduction in population health. This paper updates the fitness trends of Canadians aged 20 to 69 years by extending the time period to 2017. Data and methods The Canadian Health Measures Survey is a repeated cross-sectional survey that is conducted to produce nationally representative health estimates. Descriptive statistics are presented for fitness measures in 2016 and 2017 by age and sex, and trends in fitness were calculated spanning a period of 10 years (2007 to 2017). The associations between fitness measures and meeting the 2020 Canadian physical activity recommendations were also assessed. Results From 2007 to 2017, there were few statistically significant changes in the fitness levels of Canadian adults. When all ages were combined, there were declining trends in predicted cardiorespiratory fitness, from 39.5 to 36.7 mL•kg-1•min-1 among men and 34.0 to 32.2 mL•kg-1•min-1 among women. Trends indicated declining flexibility among men. In general, meeting the current Canadian moderate-to-vigorous physical activity recommendation was associated with better fitness, particularly in the categories of predicted cardiorespiratory fitness and body composition. Interpretation The periodic assessment of fitness in Canadians provides valuable insight into population health. The present update provides evidence that fitness levels among adults have generally stabilized over the past 10 years. Taken with the reported declines in fitness that occurred from 1981 to the 2007-to-2009 period, this study shows that the fitness of Canadian adults remained low between 2007 to 2009 and 2016 to 2017. It is necessary to explore new ways to help improve the fitness levels of the Canadian population. [ABSTRACT FROM AUTHOR]

Background Veterans are more likely than other Canadians to have chronic health conditions, making access to health care an important issue. However, little research has addressed health care access and use among veterans. This paper examines access and use among veterans compared with other Canadians. Methods Health care access and use indicators were examined for Regular Force veterans using the 2016 Life After Service Survey. Information for male and female veterans was compared with information on the Canadian general population from the 2015 and 2016 Canadian Community Health Survey, using age-adjusted rates and 95% confidence intervals. Results More than 80% of male and female veterans reported having a regular medical doctor in the 12 months before the survey. The majority of veterans (71% of males and 81% of females) had consulted a family doctor, while a minority had been hospitalized (8% of males and females). These rates were similar to those in the Canadian general population. However, veteran consultation rates for mental health care and with audiologists, speech therapists or occupational therapists among both sexes were double to triple those of the Canadian general population. Among veterans, males reported lower rates of unmet needs compared with females. Conclusion Veterans had similar rates of access to a regular medical doctor and higher rates of use compared with other Canadians. However, these may be comparatively low, given previous findings on higher rates of disability and some chronic conditions among veterans. Noted differences between males and females highlight the importance of research and services that account for sex and gender. The extent to which health care needs explain health care use and barriers to care requires further research. [ABSTRACT FROM AUTHOR]

Background: National health surveys linked to vital statistics and health care information provide a growing source of individual-level population health data. Pooling linked surveys across jurisdictions would create comprehensive datasets that are larger than most existing cohort studies, and that have a unique international and population perspective. This paper's objectives are to examine the feasibility of pooling linked population health surveys from three countries, facilitate the examination of health behaviours, and present useful information to assist in the planning of international population health surveillance and research studies. Methods: The design, methodologies and content of the Canadian Community Health Survey (2003 to 2008), the United States National Health Interview Survey (2000, 2005) and the Scottish Health Survey (SHeS) (2003, 2008 to 2010) were examined for comparability and consistency. The feasibility of creating common variables for measuring smoking, alcohol consumption, physical activity and diet was assessed. Sample size and estimated mortality events were collected. Results: The surveys have comparable purposes, designs, sampling and administration methodologies, target populations, exclusions, and content. Similar health behaviour questions allow for comparable variables to be created across the surveys. However, the SHeS uses a more detailed risk factor evaluation for alcohol consumption and diet data. Therefore, comparisons of alcohol consumption and diet data between the SHeS and the other two surveys should be performed with caution. Pooling these linked surveys would create a dataset with over 350,000 participants, 28,424 deaths and over 2.4 million person-years of follow-up. Conclusions: Pooling linked national population health surveys could improve population health research and surveillance. Innovative methodologies must be used to account for survey dissimilarities, and further discussion is needed on how to best access and analyze data across jurisdictions. [ABSTRACT FROM AUTHOR]

Background Income-related food insecurity is an important determinant of health. Persons with disabilities are at a higher risk of experiencing household food insecurity (HFI) than those without disabilities. The main objectives of this study were to estimate the prevalence of HFI for persons with different types, numbers, and severity of disabilities, and to examine sociodemographic correlates of HFI among this group. Data and methods Data from the 2021 Canadian Income Survey (CIS) were used. Disability status was assessed using the short version of the Disability Screening Questions module for one randomly selected household respondent. The Household Food Security Survey Module measured HFI as marginal, moderate, or severe. Weighted descriptive and multivariable analyses were conducted to estimate the prevalence of HFI and analyze the association between various socioeconomic factors and HFI among the study sample. Results Among CIS participants with disabilities (30% of the total CIS sample: 31 million persons), 26% reported some level of HFI, including 8% with severe HFI. The prevalence of HFI was 13% among those without disabilities. The prevalence of HFI was highest among those with a learning, memory, or seeing disability, at around 36% for each of those types. Levels of HFI were higher for those with more severe disabilities and with a greater number of disabilities. For persons with disabilities, the odds of HFI were two times higher, compared with persons without disabilities (adjusted odds ratio [AOR]: 2.5 [95% confidence interval (CI): 2.2, 2.7]), after adjustment for a range of sociodemographic covariates. Persons with disabilities who were in the lowest income quintile (AOR: 4.0 [95% CI: 3.2, 4.9]) and aged 45 to 54 (AOR: 2.9 [95% CI: 2.1, 4.1]) had the highest odds of HFI, compared with other persons with disabilities living in wealthier households and those aged 65 and older, respectively. Other risk factors included being in a one-parent household, living in the Prairies, and living in a dwelling not owned by the household. Interpretation HFI prevalence among CIS participants with disabilities was higher than for persons without disabilities, even after adjustment for well-documented sociodemographic risk factors. Consistent monitoring of HFI among persons with disabilities can help inform any ongoing or newly developed poverty reduction strategies for this population. [ABSTRACT FROM AUTHOR]

Background An extensive literature documents substantial variations in life expectancy (LE) between countries and at various levels of subnational geography. These variations in LE are significantly correlated with socioeconomic covariates, though no analyses have been produced at the finest feasible census tract (CT) level of geographic disaggregation in Canada or designed to compare Canada with the United States. Data and methods Abridged life tables for each CT where robust estimates were feasible were estimated comparably with U.S. data. Cross-tabulations and graphical visualizations are used to explore patterns of LE across Canada, for Canada's 15 largest cities, and for the 6 largest U.S. cities. Results LE varies by as much as two decades across CTs in both countries' largest cities. There are notable differences in the strength of associations with socioeconomic status (SES) factors across Canada's largest cities, though these associations with income-poverty rates are noticeably weaker for Canada's largest cities than for the United States' largest cities. Interpretation Small area geographic variations in LE signal major health inequalities. The association of CT-level LE with SES factors supports and extends similar findings across many studies. The variability in these associations within Canada and compared with those in the United States reinforces the importance for population health of better understanding differences in social structures and public policies not only at the national and provincial or state levels, but also within municipalities to better inform interventions to ameliorate health inequalities. [ABSTRACT FROM AUTHOR]

Background Mental health disparity is associated with diverse characteristics, such as gender, socioeconomic status, Indigenous identity, immigrant status, race, disability, and sexual orientation. However, intersectional studies on women's mental health have been rare, particularly during the COVID-19 pandemic period. Methods Using data from two cycles of the Canadian Community Health Survey (2019 annual data and data from September to December 2020), self-reported mental health outcomes before the COVID-19 pandemic (sample size was 64,880) and during the second wave of the pandemic in the fall of 2020 (sample size of 27,246) were analyzed. Results After sociodemographic factors were controlled for, women and girls had higher odds of poorer self-perceived mental health and worsened mental health compared with before the COVID-19 pandemic than men and boys. Compared with 2019, the gender gap in negative self-perceived mental health increased during the pandemic. The number and type of intersections of specific socioeconomic characteristics also had an impact on mental health outcomes. During the pandemic, women and girls with the following characteristics were more likely to report low self-perceived mental health, compared with women and girls with no intersections: those with a disability (7.8 times); or who are lesbian, gay, or bisexual or have another sexual orientation than heterosexual (5.6); or who are Indigenous (3.6). Interpretation The intersections of gender and other sociodemographic characteristics increased the odds of negative self-perceived mental health. [ABSTRACT FROM AUTHOR]

Background: While the incidence of active tuberculosis (TB) in Canada is among the lowest in the world, the rates of TB among immigrants and Indigenous people remain high. In fact, the majority of new active TB cases are disproportionately found among immigrants. This study profiles TB-related acute care hospitalizations among new immigrants to Canada by selected characteristics. Data and methods: This study is based on the 2000-to-2013 Longitudinal Immigration Database (IMDB) linked to the Canadian Institute for Health Information's Discharge Abstract Database (DAD) from 2001/2002 to 2013/2014. It examines the timing of first TB-related acute care hospitalization occurring from the fiscal year 2001/2002 to the fiscal year 2013/2014 among immigrants who landed in Canada from 2000 to 2013 outside of Quebec and the territories. Mean and median hospital days and the percentage of total TB hospitalizations incurred by these new immigrants are calculated to measure the burden of hospital care among recent immigrants. Results: From 2001/2002 to 2013/2014, 1,120 out of 2.7 million immigrants arriving between 2000 and 2013 were found to have, in total, 1,340 TB-related hospital discharges. The majority of cases (97%) were among immigrants from the Immigration, Refugees and Citizenship Canada (IRCC) designated country list for TB, in which about three quarters of the cases were from the World Health Organization (WHO) list of high TB-burden countries. Approximately half (45%) of immigrants hospitalized for TB were aged 18 to 34 at the time of hospitalization. Around 10% of all TB patients had been hospitalized before formally landing as immigrants. Mean and median length of hospital stay were 17 days and 11 days, respectively (22 days and 14 days, respectively, for the overall population in Canada). While new immigrants who landed between 2000 and 2013 represent 7% of the overall population of Canada, they incurred 17% of all TB-related hospital discharges occurring during this period. Interpretation: This paper demonstrates the value of linked administrative data to understanding immigrant health and is important for future work in this area. Current immigration protocols surrounding TB involve screening for active pulmonary TB and identifying some migrants with latent TB. Results of this study, linking TB-related hospitalizations to immigrant landing files, provide unique information that can inform public health action, as well as migration policy and program development to contribute to the efforts to eliminate TB. [ABSTRACT FROM AUTHOR]

Background This study investigates the association between dental insurance, income, and dental care access for Canadian children and youth aged 1 to 17 years. It contributes to a baseline understanding of oral health care use before the implementation of the Canadian Dental Care Plan (CDCP). Data and methods This study used data from the 2019 Canadian Health Survey on Children and Youth (n=47,347). Descriptive statistics and logistic regression models were employed to assess the association of dental insurance, adjusted family net income, and other sociodemographic factors on oral health care visits and costrelated avoidance of oral health care. Results A large percentage of children under the age of 5 had never visited a dentist (79.8% of 1-year-olds to 16.4% of 4-year-olds). Overall, 89.6% of Canadian children and youth aged 5 to 17 had visited a dental professional within the past 12 months: 93.1% of those who were insured and 78.5% of those who were uninsured. Insured children and youth had a 4.5% cost-related avoidance of dental care, contrasting with 23.3% for uninsured children and youth. After adjustment for sociodemographic variables, children and youth with dental insurance were nearly three times more likely (odds ratio [OR]: 2.94; 95% confidence interval [CI]: 2.60 to 3.33) to have visited a dental professional in the past 12 months than uninsured children and youth. Having dental insurance (OR: 0.19; 95% CI: 0.16 to 0.21) was protective against barriers to seeing a dental professional because of cost. There was a strong income gradient for both dental service outcomes. Interpretation The study emphasizes the significant association of dental insurance and access to oral health care for children and youth. It highlights a significant gap between insured and uninsured children and youth and points out the influence of sociodemographic and income factors on this disparity. [ABSTRACT FROM AUTHOR]

The article focuses on the renewal of Canada’s manufacturing base from 1961-1999. This paper indicates that job turnover in manufacturing has a substantial long-term component. Moreover, it quantifies the size of this process decade by decade. Over a decade, almost 40% of jobs are renewed. Using a 20-year time frame, over 65% of the economy is renewed, over a 30 year period, renewal amounts to just over 75%; and by 40 years, just over 85% of jobs are new. The rates of renewal are closely related to growth.

Background Canada is experiencing rapid population aging, which has a wide range of implications, including an increased need for health care services. However, very few studies have examined use of specialized health care services (e.g., visits to medical specialists, non-emergency tests, and surgeries) among older Canadians. Data and methods Data from the Canadian Health Survey on Seniors - 2019/2020 were used to examine specialized health care service use among older Canadians. Latent class analysis was calibrated using a nationally representative sample of 39,047 Canadians aged 65 years or older to identify distinct patterns of need factors related to health care service use. Multivariable logistic regression, stratified by gender, was used to examine the association of predisposing characteristics, enabling resources, and need factors with specialized health care service use. Results In 2019/2020, an estimated 2.6 million older Canadians (43.4%) visited medical specialists, 1.4 million (23.2%) got non-emergency tests, and 0.6 million (10.4%) had non-emergency surgeries. Among those, 15.6% reported experiencing difficulties accessing services. Women were less likely than men to have visited medical specialists and have received non-emergency tests. Lower education was consistently associated with lower odds of specialized health care service use. Individuals in the multimorbidity, high stress--multimorbidity--disability, and poor physical and mental health classes were more likely than those in the comparatively healthy class to use specialized health care services and to experience difficulties accessing them. Interpretation Findings of this study highlight gender differences and the importance of considering multidimensional need factors--ranging from physical health to mental health to psychosocial factors--in examining use of specialized health care services. [ABSTRACT FROM AUTHOR]

Background Small area estimation refers to statistical modelling procedures that leverage information or "borrow strength" from other sources or variables. This is done to enhance the reliability of estimates of characteristics or outcomes for areas that do not contain sufficient sample sizes to provide disaggregated estimates of adequate precision and reliability. There is growing interest in secondary research applications for small area estimates (SAEs). However, it is crucial to assess the analytic value of these estimates when used as proxies for individual-level characteristics or as distinct measures that offer insights at the area level. This study assessed novel area-level community belonging measures derived using small area estimation and examined associations with individual-level measures of community belonging and self-rated health. Data and methods SAEs of community belonging within census tracts produced from the 2016-2019 cycles of the Canadian Community Health Survey (CCHS) were merged with respondent data from the 2020 CCHS. Multinomial logistic regression models were run between area-level SAEs, individual-level sense of community belonging, and self-rated health on the study sample of people aged 18 years and older. Results Area-level community belonging was associated with individual-level community belonging, even after adjusting for individual-level sociodemographic characteristics, despite limited agreement between individual- and area-level measures. Living in a neighbourhood with low community belonging was associated with higher odds of reporting being in fair or poor health, versus being in very good or excellent health (odds ratio: 1.53; 95% confidence interval: 1.22, 1.91), even after adjusting for other factors such as individual-level sense of community belonging, which was also associated with self-rated health. Interpretation Area-level and individual-level sense of community belonging were independently associated with self-rated health. The novel SAEs of community belonging can be used as distinct measures of neighbourhood-level community belonging and should be understood as complementary to, rather than proxies for, individual-level measures of community belonging. [ABSTRACT FROM AUTHOR]

Background: Immunization against vaccine-preventable diseases such as shingles and pneumococcal disease is especially pertinent among older Canadians. However, vaccine uptake remains low. Data and methods: Data from the Canadian Health Survey on Seniors (CHSS) - 2019/2020 were used to examine receipt of shingles and pneumococcal vaccines among Canadians aged 65 and older living in the community. Multivariable logistic regression was used to identify individual predisposing, enabling and needs-related factors associated with receipt of each type of vaccination. Reasons reported for not getting vaccinated were also examined. Results: Based on the 2019/2020 CHSS, an estimated 36.3% of Canadians aged 65 and older (2.3 million people) had received the shingles vaccine, while 51.1% (3.1 million) had received the pneumococcal vaccine. Being a woman, having higher socioeconomic status, having had the flu shot and having a regular health care provider were associated with increased odds of vaccination. Being an immigrant, living outside large population centres, and belonging to South Asian or Chinese population groups were associated with lower odds of vaccination. Over one-third of unvaccinated people did not think the shingles vaccine (39.7%) or the pneumococcal vaccine (36.6%) was necessary. Other frequently reported reasons for non-vaccination were not having heard of the vaccine or the doctor not mentioning it; for the shingles vaccine, 12% cited cost as a reason. Interpretation: Understanding factors associated with uptake of vaccines and reasons for not obtaining them among older Canadians will help to inform policy and programs aimed at preventing the burden of these diseases. [ABSTRACT FROM AUTHOR]

Background: A surveillance tool was developed to assess dietary intake collected by surveys in relation to Eating Well with Canada's Food Guide (CFG). The tool classifies foods in the Canadian Nutrient File (CNF) according to how closely they reflect CFG. This paper describes the validation exercise conducted to ensure that CNF foods determined to be "in line with CFG" were appropriately classified. Methods: With statistical modelling, 8,000 simulated diets (500 for each of the 16 Dietary Reference Intake [DRI] age/sex groups) were generated using commonly consumed foods classified as "in line with CFG." Criteria for assessing the energy content and nutrient distributions of the simulated diets were based on factors considered in the development of CFG, including Estimated Energy Requirement (EER) and Dietary Reference Intake (DRI) values. Results: The median energy content of the simulated diets was at or below reference EERs. Most age/sex group distributions had macronutrient profiles that met the assessment criterion of 80% of the distribution within the Acceptable Macronutrient Distribution Range, and almost all age/sex group distributions had a low prevalence (less than 10%) of micronutrient profiles below the Estimated Average Requirements. Overall, the findings indicate that diets consisting of foods that are commonly consumed by Canadians and that are "in line with CFG" have a low probability of energy excess and nutrient inadequacy. Interpretation: The classification of foods in the CNF accurately reflects CFG recommendations and can be used to assess surveillance data. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to describe the exercise and changes in screen time habits, and their relationship with health, among participants of the Canadian Perspectives Survey Series (CPSS). Data and methods: Between March 29th and April 3rd 2020, CPSS participants (n = 4,524) reported whether they were exercising outdoors or indoors and whether they increased, decreased or maintained their TV, Internet and video game use. Participants also reported their self-perceived general and mental health. Results: More women reported very good or excellent mental health if they were exercising outdoors (54%) compared with those who were not (41%). More women reported very good or excellent general health if they were exercising outdoors (75%) compared with those who were not (49%), with the same trend evident for those exercising indoors (69%) compared to those who were not (62%). More men (65%) and women (62%) rated their mental and general health as very good or excellent if they maintained or decreased TV time compared with those who increased TV time (57% and 43%, respectively), with the same evident for Internet use in women only (maintained/decreased: 61% versus increased: 44%). More men (63%) and women (52%) rated their mental health as very good or excellent if they maintained or decreased video game time compared with those who increased video game time (48% and 29%, respectively). More men and women reported very good or excellent mental and general health if they increased none or one type of screen and/or were exercising outdoors compared with those who increased 2 or 3 types of screens and who were not exercising outdoors, with the exception of general health among men. Interpretation: Maintaining opportunities for outdoor exercise and limiting screen time may promote better mental and general health during periods of confinement. [ABSTRACT FROM AUTHOR]

Background: Physical fitness during childhood is an important indicator of current and future health. This paper provides an overview of the fitness of Canadian children and youth aged 6 to 19 years. Data and methods: Data are from three cycles of the Canadian Health Measures Survey (CHMS) spanning a 10-year period: 2007 to 2009 (n = 2,081), 2009 to 2011 (n = 2,133) and 2016 to 2017 (n = 2,070). The CHMS is a comprehensive direct health measures survey conducted on a nationally representative sample of Canadians. Descriptive statistics for measures of cardiorespiratory fitness, muscular strength and power, flexibility, and body composition are provided by age group and sex. Physical fitness measures are presented for participants who met and did not meet the physical activity and screen time recommendations. Results: Few changes in the fitness measures occurred over the past decade. Cardiorespiratory fitness decreased between 2007-2009 and 2016-2017 in 8 to 10 (52.1 to. 51.0 mL•kg-1•min-1) and 11 to 14 (50.8 to 49.8 mL•kg-1•min-1) year old boys. Girls generally had lower levels of fitness compared to boys, except for flexibility which was higher in girls. Cardiorespiratory fitness was higher in children and youth who met the current Canadian recommendations for physical activity and screen time. Grip strength was higher in boys who met the current Canadian screen time recommendation. Interpretation: Ongoing and periodic surveillance of fitness through the CHMS is important to monitor trends, assess future interventions designed to improve fitness levels at the population level and to increase our understanding of the relationships between fitness and health. [ABSTRACT FROM AUTHOR]

Background Canadian and international research has shown that the COVID-19 pandemic led to changes in health behaviours, including participation in physical activity and screen time. Methods The Canadian Community Health Survey asks Canadian adults (aged 18 to 64 years) and older adults (aged 65 and older) to report the time they spend active by domain: recreation, transportation, and household and/or occupation. Survey respondents are also asked to report their screen time on days they worked and days they did not work. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (n=50,093), January to mid-March 2020 (n=13,933), September to December 2020 (n=25,661) and January 2021 to February 2022 (n=45,742). Screen time is compared between 2018 and 2021. Sub-annual analyses examine how physical activity and screen time varied within and between years. Results The percentage of 18- to 64-year-old women meeting the physical activity recommendation did not change from 2018 (54.3%) to 2021 (55.1%), while a slight decrease was observed among men (63.0% in 2018 to 59.8% in 2021). The percentage of adults aged 65 years and older meeting the recommendation increased from 2018 to 2021 among both men (40.7% to 43.8%) and women (33.4% to 36.9%). Total physical activity decreased by 17.5 minutes per week among 18- to 64-year-old men and increased by 8.4 minutes per week among 18- to 64-year-old women. Men and women aged 65 and older increased their total physical activity by about 30 minutes per week from 2018 to 2021. The percentage of 18- to 64-year-old adults in the lowest screen time category decreased from 53.9% in 2018 to 45.0% in 2021 on work days and from 37.8% in 2018 to 28.0% in 2021 on non-work days. The percentage of adults aged 65 and older in the lowest screen time category decreased from 49.4% in 2018 to 37.8% in 2021 on work days and from 29.4% in 2018 to 21.5% in 2021 on nonwork days. Interpretation Physical activity among men aged 18 to 64 years decreased from 2018 to 2021, while women of this age group maintained their physical activity. Older adults increased their physical activity from 2018 to 2021. Many Canadian adults shifted from the lowest screen time category (two hours or less per day) to the highest screen time category (four hours or more per day) during the 2020 and 2021 pandemic years. It is unknown whether the short-term impact of the COVID-19 pandemic on physical activity and screen time will persist over time. Ongoing surveillance of the longer-term impacts of the pandemic on the health behaviours of Canadians is important. [ABSTRACT FROM AUTHOR]

Background Several organizations recommend the use of measures of abdominal obesity in conjunction with body mass index (BMI) to assess obesity-related health risk. Recent evidence suggests that waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) are increasing within BMI categories. This shift may have affected the usefulness of abdominal obesity measures. Data and methods Data are from respondents aged 18 to 79 to the 2007 to 2009 Canadian Health Measures Survey. Using logistic regression, this paper examines cardiovascular disease (CVD) risk factors in relation to WC, WHR and WHtR within BMI healthrisk categories. CVD risk factors considered include components of the metabolic syndrome. Results Among men in the normal and overweight BMI categories, WHR and WHtR were positively associated with having at least two CVD risk factors. All three abdominal obesity measures were associated with increased odds of having at least two CVD risk factors among normal-weight women. Abdominal obesity was not associated with CVD risk factors for people in obese class I. Interpretation Among men and women in the normal BMI category, measures of abdominal obesity are associated with increased odds of CVD risk factors. This underscores the importance of measuring and monitoring abdominal obesity in normal-weight men and women. [ABSTRACT FROM AUTHOR]

Background Administrative datasets often lack information about individual characteristics such as Aboriginal identity and income. However, these datasets frequently contain individual-level geographic information (such as postal codes). This paper explains the methodology for creating Geozones, which are area-based thresholds of population characteristics derived from census data, which can be used in the analysis of social or economic differences in health and health service utilization. Data and methods With aggregate 2006 Census information at the Dissemination Area level, population concentration and exposure for characteristics of interest are analysed using threshold tables and concentration curves. Examples are presented for the Aboriginal population and for income gradients. Results The patterns of concentration of First Nations people, Métis, and Inuit differ from those of non- Aboriginal people and between urban and rural areas. The spatial patterns of concentration and exposure by income gradients also differ. Interpretation The Geozones method is a relatively easy way of identifying areas with lower and higher concentrations of subgroups. Because it is ecological-based, Geozones has the inherent strengths and weaknesses of this approach. [ABSTRACT FROM AUTHOR]

Background The fitness of Canadian children and youth has not been measured in more than two decades, a period during which childhood obesity and sedentary behaviours have increased. This paper provides up-to-date estimates of the fitness of Canadians aged 6 to 19 years. Data and methods Data are from the 2007-2009 Canadian Health Measures Survey (CHMS), the most comprehensive direct health measures survey ever conducted on a nationally representative sample of Canadians. Descriptive statistics for indicators of body composition, aerobic fitness and musculoskeletal fitness are provided by sex and age group, and comparisons are made with the 1981 Canada Fitness Survey (CFS). Results Fitness levels of children and youth have declined significantly and meaningfully since 1981, regardless of age or sex. Significant sex differences exist for most fitness measures. Fitness levels change substantially between ages 6 and 19 years. Youth aged 15 to 19 years generally have better aerobic fitness and body composition indicators than 20- to 39-year-olds. Interpretation This decline in fitness may result in accelerated chronic disease development, higher health care costs, and loss of future productivity. [ABSTRACT FROM AUTHOR]

The article presents a paper that informs the trend in the use of imported inputs (IIs) by industries in Canada. It notes that industries had reduced their use of IIs in the late 1990s due to IIs's slow performance. It likewise mentions some firms that increase their use of IIs in 2003, particularly in the manufacturing sector. Further, it informs that import use in the country rose in 2004 for the first time since 1998.

This paper examines whether cross-border shopping has taken flight with the loonie. It fi nds that measured by the number of trips to the US, the average spent per trip or even online purchases, the recent increase in crossborder shopping has been minimal, especially outside of Ontario. More notable is the drop in US visitors to Canada. Meanwhile, overseas travel in and out of Canada continues to grow rapidly. [ABSTRACT FROM AUTHOR]

The article reprints the article "Emerging Patterns in the Labour Market: A Reversal from the 1990s," by P. Cross, which was published in the March 2005 issue of "Canadian Economic Observer." The paper examined whether the labor market trends reversed since 2000 continued in 2005. Notable developments include the resurgence of construction and resource jobs, the disappearance of factory jobs, notably high technology and automotive jobs. Computer services flattened out while public services were restores after reductions in the 1990s. The resurgence of multinational resource companies and government also favored job growth in large establishments. Meanwhile older workers supplied the increasing demand for labor.

The article presents a list of papers that appeared in previous issues of the journal "Canadian Economic Observer." The papers include "Provincial income disparities through an urban-rural lens," that appeared in the August 2005 issue, "Canada's trade and investment with China," that appeared in the June 2005 issue, "The output gap between Canada and the US: The role of productivity 1994-2002," that appeared in the January 2005 issue, "Canada's imports by country," that appeared in the September 2004 issue, and "Canada's Trade with China," that appeared in the June 2004 issue.

The article presents information on various papers that were previously published in the journal "Canadian Economic Observer." The paper "Canada's Imports by Country," was published in the September 2004 issue. The paper "The Impact of Self-Employment on Productivity Growth in Canada and the US," was published in the August 2003 issue. The paper "Electronic Commerce and Technology Use in Canadian Business," was published in the October 2001 issue. The paper "An Updated Look at the Computer Services Industry," was published in the February 2001 issue.

The terms of international trade have a major effect on Canada's economic performance. They directly affect the nominal trade balance, which reflects not only the volume of trade flows but also their prices. Indirectly, changes in the terms of trade also influence the composition of domestic demand through their impact on prices and profits in different sectors. This paper looks at the reasons for the recent sharp shift in Canada's terms of trade and its impact on different sectors of the economy. It also looks to the recent American experience with a sharply rising dollar as a guide to how different sectors of the economy could gain or lose from these changes. The focus of this article is not on the overall net effect, which is likely to be small, but on the distributional effects, which have already been considerable.

Objectives: This paper compares immigrants with the Canadian-born population in terms of depression and alcohol dependence. It explores whether the "healthy immigrant effect" observed for physical health holds for mental health. Several sources of diversity among immigrants are also considered. Data source: The data are from the 2000/01 Canadian Community Health Survey, which collected information on health status and health care utilization from over 131,000 respondents aged 12 or older in all provinces and territories. Analytical techniques: Age- and sex-adjusted prevalence rates of depression and alcohol in immigrants and the Canadian-born population were compared. Variation by length of residence in Canada and country of birth was examined. Multivariate logistic regression models were run separately for depression and alcohol dependence, with adjustment for age, sex, marital status, income, and education. The model was elaborated to consider language barriers, employment status, and sense of belonging. Main results: Immigrants had lower rates of both depression and alcohol dependence than the Canadian-born population. This "healthy immigrant effect" was strongest among recent immigrants and among immigrants from Africa and Asia. These two trends are related, since recent immigrants have tended to come from Africa and Asia, whereas the majority of long-term immigrants came from Europe. Long term immigrants have similar rates of depression as the Canadian-born. The lower rates observed for immigrants were not due to demographic or socio-economic differences (age, sex, marital status, income, and education) between immigrants and the Canadian-born population. After adjustment for all of these factors, recent immigrants still had the lowest risk for both depression and alcohol dependence. Furthermore, language barriers, immigrants' higher unemployment rates, and their lower sense of belonging to the local community did not diminish the gap between immigrants an... INSETS: Methods;Canada's immigrant population;Definitions. [ABSTRACT FROM AUTHOR]

Focuses on the gross domestic product (GDP) and business cycles. Behavior of household demand and business investment; Role of inventories in GDP and business cycles; Details on export demand.

Background The Public Health Agency of Canada monitors the psychological and social well-being of Canadian youth using the Children's Intrinsic Needs Satisfaction Scale (CINSS). Validation analyses of the CINSS have been conducted, but not in the 2019 Canadian Health Survey on Children and Youth (CHSCY), a more recent and representative national survey with a different sampling frame, collection method and other measured outcomes. This study tested the validity of the CINSS in the 2019 CHSCY. Data and methods Data were collected in all provinces and territories from February 11 to August 2, 2019. The CINSS was administered to respondents aged 12 to 17 years and was designed to assess relatedness, autonomy and competence at home, at school and with friends. Descriptive statistics for CINSS items and subscales were obtained. Confirmatory factor analysis (CFA) was conducted to test how well a correlated traits correlated uniqueness (CTCU) model fit the CINSS data. Associations with mental health and other psychosocial variables were examined. Results In general, items within the CINSS were correlated in expected ways, and support was found for a CTCU model in the CFA. While response distributions on the CINSS items were skewed, the CINSS subscales had acceptable internal consistency and were associated with self-rated mental health, happiness, life satisfaction, perceived stress, bullying victimization and behaviour problems in line with expectations. Interpretation This study supports the validity of the CINSS. Inclusion of the CINSS in future youth health surveys would allow for continued public health surveillance of the psychological and social well-being of youth in Canada. [ABSTRACT FROM AUTHOR]

Background Prevalence of loneliness among Canadians has become an important concern because of its wider consequences on health and well-being. However, there are limited Canadian studies about loneliness disaggregated by gender and across various subgroups of older Canadians, particularly immigrant subgroups. Data and methods Data from the Canadian Health Survey on Seniors (CHSS) – 2019/2020 were used to estimate the prevalence of loneliness among older Canadians in a nationally representative sample of 38,941 Canadians aged 65 and older. The association between immigrant status and loneliness was assessed using multivariable logistic regression adjusted for demographic, socioeconomic and health characteristics. Analyses were conducted for men and women combined and separately. Results In 2019/2020, an estimated 1.1 million older Canadians (19.2%) experienced loneliness, with women having significantly higher likelihood of being lonely than men. Among men, both European and non-European immigrants were more likely to experience loneliness than the Canadian-born population. Among women, the likelihood of loneliness was higher among European immigrants than among those born in Canada. For both men and women, immigrants who migrated as adults (from ages 18 to 44) and long-term immigrants (20 years or more in Canada since immigration) were at higher risk of loneliness than the Canadianborn population. The likelihood of being lonely was higher among people living with multimorbidity or experiencing barriers to social participation. Interpretation The findings underscore the importance of considering immigrant subgroups and gender in examining loneliness among older Canadians and when developing policies and programs to address loneliness. [ABSTRACT FROM AUTHOR]

Background Online digital media are a central part of adolescents' lives, providing opportunities for social connection. However, some research has suggested that online digital media use may be negatively associated with mental health. Little population-based research has examined associations between various types of online digital media use and adolescent mental health. Data and methods Data from 13,600 adolescents aged 12 to 17 were drawn from the 2019 Canadian Health Survey on Children and Youth. Adolescents reported on how frequently they used social media, video or instant messaging, and online gaming, as well as their general mental health, eating disorder symptoms and, for those aged 15 to 17, suicidal ideation and attempt. Logistic regression was used to estimate the odds of each outcome from the frequency of each type of digital media use, stratified by sex. Results Associations were noted between the frequency of social media and video and instant messaging use, and general mental health, eating disorder symptoms, and suicidal ideation and attempt. After cybervictimization and sleep adequacy were accounted for, associations with eating disorder symptoms remained significant for girls and boys. Never participating in online gaming was associated with lower odds of lower general mental health and suicidal ideation among girls, but not boys. Interpretation Different types of online digital media use are differentially associated with mental health outcomes, and associations differ between sexes. The associations between social media and video or instant messaging, and mental ill health may be partially explained by the experience of cybervictimization and sleep adequacy. More research on online gaming, particularly among girls, is needed to clarify associations with mental health. [ABSTRACT FROM AUTHOR]