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Background: Social fragmentation has been theorized and empirically associated with suicide in prior research. However, less is known about whether social fragmentation is associated with deaths attributed to alcohol use or drug use. This research examined the association between social fragmentation and risk for deaths attributable to alcohol use, drug use, and suicide (collectively known as deaths of despair) among Canadian adults., Methods: A weighted sample representing 15,324,645 Canadians within 288 census divisions between 2006 and 2019 was used. Mortality data from the Canadian Vital Statistics Database (alcoholic liver disease, drug use, and suicide) was linked with census division socioeconomic data from the 2006 Canadian census using the Canadian Census Health and Environment Cohorts. Social fragmentation at the census division was created based on the Congdon Index. Cox-proportional hazard regression with survey weights and the sandwich estimator were used to account for clustering of individuals (level-1) nested within census divisions (level-2)., Results: After adjusting for individual and census division confounders, social fragmentation was positively associated with all-cause mortality (HR = 1.04; 95% CI: 1.02, 1.07), suicide (HR = 1.09; 95%CI: 1.01, 1.18), drug overdose related mortality (HR = 1.13; 95%CI: 1.03, 1.24), and deaths of despair (HR = 1.10; 95% CI: 1.04, 1.16), and not significantly associated with alcohol related liver disease (HR = 1.06; 95% CI: 0.91, 1.23)., Conclusion: Social fragmentation is associated with an increased hazard of deaths of despair among Canadian adults. Efforts to improve social cohesion in areas that are highly socially fragmented need to be evaluated., Competing Interests: Declaration of Competing Interest No conflict declared. This study was funded by Canadian Institutes of Health Research and the Institute of Population and Public Health (438740). RP is a Tier II Canada Research Chair in Social and Health Inequities. This research was supported by the Canadian Research Data Centre Network (CRDCN). Although the research and analysis are based on data from Statistics Canada, the opinions expressed do not represent the views of Statistics Canada or the Canadian Research Data Centre Network. ©This data includes information copied with permission from Canada Post Corporation., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: To examine associations between utilitarian walking, utilitarian cycling, leisure time physical activity and body mass index (BMI)., Methods: Participants from the National Population Health Survey (NPHS) of Statistics Canada were interviewed by telephone every two years from 1994 to 2010. Analysis includes data from 6894 living participants aged 18-64years. Fixed effects and random intercepts models examined the association between BMI, utilitarian walking, and utilitarian cycling, controlling for behavioral and sociodemographic factors., Results: The final adjusted fixed effects models showed no significant relationship between utilitarian walking and BMI. In the unbalanced sample utilitarian cycling for 1 to 5h per week (b=-0.15, 95% CI: -0.28 to -0.02), and more than 5h per week (b=-0.22, 95% CI: -0.44 to 0.00) was significantly associated with BMI over time. In the fully balanced sample utilitarian cycling for 1 to 5h per week (b=-0.12, 95% CI: -0.27 to 0.03), more than 5h per week (b=-0.16, 95% CI: -0.45 to 0.13) was not significantly associated with BMI over time., Conclusion: The results suggest that utilitarian walking is not related to BMI. The relationship between utilitarian cycling and BMI is less clear., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: To investigate if students who use of Active Transportation (AT) to and from school among urban and rural Canadian children are more likely to meet physical activity recommendations., Methods: The Raising healthy Eating and Active Living in Alberta (REAL Kids Alberta) study is a population-based health survey among Grade 5 students. In 2009, physical activity levels were measured using time-stamped pedometers (number of steps/hour) among 688 children. Parents reported mode of transportation to and from school (AT/non-AT). Multilevel multiple linear regression analyses with corresponding β coefficients were conducted to quantify the relationship between mode of transportation to and from school with (1) overall step count, and (2) the likelihood of achieving at least 13,500 steps per day recommended for optimal growth and development., Results: Among urban children, those who used AT to and from school accumulated more steps [β=1124(95% CI=170,2077)] and although not significant, were more likely to achieve the recommended 13,500 steps/day compared to those not using AT to and from school [OR=1.61(95% CI=0.93,2.81)]., Conclusion: Using AT to and from school appears to be beneficial to children by supplementing their physical activity, particularly those living in urban regions. Strategies to promote physical activity are needed, particular for children residing in rural regions and smaller towns., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: To determine the extent to which active transportation (AT) to and from school is associated with changes in body mass index (BMI) from kindergarten (6-year-olds) through grade 2 (8-year-olds)., Methods: The sample included 1170 children (50.4% of baseline participants) who were part of the Quebec Longitudinal Study of Child Development (QLSCD), a birth cohort established in 1998 in Quebec, Canada. Data were collected by trained interviewers using structured interviews and measuring height and weight in the home with the person most knowledgeable about the child's health. Relative weight was operationalized as age- and sex-adjusted BMI Z-scores., Results: Growth curve analyses showed that using AT to and from school both when in kindergarten and in grade 1 was predictive of a lower BMI Z-score (coeff=-0.18, SE=0.09, p=0.05) in grade 1. Using AT to and from school in kindergarten, grade 1, and grade 2 was predictive of a lower BMI Z-score (coeff=-0.30, SE=0.098, p=0.003) in grade 2. No other covariates were predictive of relative weight across time, although having an overweight or obese mother was associated with a BMI Z-score of 0.39 (SE=0.07, p<0.001) across all time points., Conclusion: Sustained AT is associated with more healthful trajectories of BMI across the early school years.

Objective: The purposes of this study were to describe the prevalence of modes of transportation to school and to identify socioeconomic correlates., Methods: Proportions of students using different modes of transportation were estimated among a population-based sample of 3613 youth aged 9, 13, and 16 years who participated in the 1999 Quebec Child and Adolescent Health and Social Survey., Results: Weighted analyses showed significant differences in the use of different modes of transportation to and from school across socioeconomic groups. For example, 40.3%, 15.2%, and 13.0% of 9, 13, and 16 year olds walked to school. In addition, 1.2%, 11.3%, and 13.8% of 9, 13, and 16 year olds used public transportation whereas 33.1%, 51.2%, and 55.6% of 9, 13, and 16 year olds took the school bus to school; 14.3%, 7.3%, and 5.0% of 9, 13, and 16 year olds were transported by car; finally, 10.7%, 14.1%, and 11.7% of 9, 13, and 16 year olds indicated they used multiple modes of transportation. Girls, higher income of children, children of immigrants, and rural-dwelling children were less likely to walk to school., Conclusion: Findings indicate that there are differing modes of transportation to and from school across socioeconomic groups.