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This paper uses panel data for Canada from 1976 to 2018, across 10 provinces, to reassess the relationship between mortality rates and economic fluctuations. The key contribution of our paper lies in examining the extent to which this relationship is driven by the employment rate (extensive margin) versus average hours worked (intensive margin). We find evidence of procyclical mortality for females at the aggregate level; aggregate male mortality remains largely unaffected by economic fluctuations. Our findings also reveal temporal heterogeneity, as the extensive margin becomes the driving force for female mortality rates during the more recent period (1990 onwards). These findings remain robust when accounting for personal income and pollution. Finally, we find some support for a procyclical relationship for individuals in the working age groups, while mortality exhibits a countercyclical pattern for children (age 0 to 14) and the elderly (age 65 and above). [ABSTRACT FROM AUTHOR]

The article introduces papers published within the issue, including one on regional differences in wage inequality in Canada, another on consumption and income inequality patterns in Canada from 1997 to 2009 and a paper on provincial variation in marginal tax rates affecting the top earners.

The purpose of this discussion paper is to explore how nurses can be strategically poised to advocate for needed policy change in support of greater income equality and other social determinants of health. We adapted Bronfenbrenner's social‐ecological model to highlight how four broad pervasive subsystems shape the opportunities that nurses have to engage in advocacy at the policy level. These subsystems include organizations (the microsystem), professional bodies (the mesosystem), public policies (the exosystem), and societal values (the macrosystem). On the basis of this adapted model, we recommend changes among modifiable elements of the microsystem and mesosystem that can help position nurses (ecologically and collectively) to advocate for public policy change and use examples from a Canadian context to illustrate these points. We believe that the ideas arising from this model can be widely used where policy action on the social determinants of health is needed to inform, guide, and frame change efforts and advocacy work. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

While research on rural depopulation and urbanization to large cities has dominated the literature for decades, small city growth has been largely ignored. Yet, small cities are important to the regional systems in which they are located, including serving as centres to their rural surround. This paper is concerned about growth and change in small cities. Using Brandon, Manitoba as an example, citizen perceptions of a range of specific aspects of city growth are analyzed. The study is based on a household postal survey conducted in May and June 2010 in which 2,500 randomly selected households in Brandon, Manitoba received questionnaires. The results are based on the 518 useable, completed questionnaires that were returned. Differences in perceptions of the pace of change in a range of aspects of development were found based on income, age, educational attainment, employment status, and home ownership. No differences were found based on gender. The paper concludes with comments about how city governments need to be aware of citizen perceptions when pursuing and managing development. The paper also illustrated the importance of citizen perceptions in understanding the pace and direction of change in small cities. [ABSTRACT FROM AUTHOR]

Introduction: Students from low‐income backgrounds (LIB) have been under‐represented in Canadian medical schools for over fifty years. Despite our awareness of this problem, little is known about the experiences of aspiring physicians from LIB in Canada who are working towards medical school admission. Consequently, we have little insight into the barriers and facilitators that may be used to increase the representation of students from LIB in Canadian medical schools. Methods: This paper describes a qualitative description interview study aimed at understanding the experiences of aspiring physicians from LIB as they attempt to gain entry to medical school. We conducted semi‐structured interviews with 21 participants at different stages of their undergraduate, master's, and non‐medical professional education, and used the theories of intersectionality and identity capital as a theoretical framework for identifying barriers and facilitators to a career in medicine. Results: Participants experienced social, identity‐related, economic, structural and informational barriers to a career in medicine. Intrinsic facilitators included motivation, self‐confidence, attitude, strategy, information‐seeking and sorting, and financial literacy and increasing income. Extrinsic facilitators were social, informational, financial and institutional in nature. Conclusion: This study fills existing knowledge gaps in the literature by identifying the pre‐admissions barriers and facilitators encountered by aspiring physicians from LIB in Canada. The barriers and facilitators outlined in this study offer a framework for identifying target areas in developing support for admitting medical students from LIB. Given that medical students from LIB are more likely to serve underserved populations, our study is relevant to Canadian medical schools' social accountability commitment to producing physicians that meet the health needs of marginalised and vulnerable patients. Out of concern for socioeconomic diversity, the authors apply an intersectional approach to examine the barriers and facilitators faced by aspiring physicians from low‐income backgrounds. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Review of Sociology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Summary: Background: Many countries, including Canada, are considering regulations to restrict food and beverage marketing to children. However, little evidence is available outside of the US on how marketing exposure differs across sociodemographic subgroups. Objective: To investigate potential associations between child and adolescent sociodemographic characteristics and exposure to food and beverage marketing in Canada. Methods: Participants (n = 3780) aged 10–17 self‐reported exposure to food and beverage marketing across food categories, locations and marketing techniques. Logistic regression models tested relationships between sociodemographics (age, sex, ethnicity and income adequacy) and marketing exposure. Results: Among other differences identified, 13–17 years old were more likely than 10–12 years old to report seeing unhealthy food marketing online. Girls were more likely than boys to see such marketing online and in retail settings, while boys were more likely to see it in video games. Minority ethnicities (including Indigenous youth) and respondents with lower income adequacy generally reported more exposure than White and higher income respondents, respectively. Conclusions: This study highlights important differences in marketing exposure among youth of different sociodemographic groups in Canada, including greater exposure to marketing among those most disadvantaged and emphasizes the essential need to consider food marketing across equity groups when developing restrictions on marketing to kids. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We explored socioeconomic gradients in self‐rated overall health (SROH) using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial perspectives (subjective social status (SSS)) among adults living in countries with varying levels of income inequality, and the importance of psychosocial stress in mediating these associations. If psychosocial processes at the individual and societal levels correspond, associations between SSS and SROH should be higher among adults in countries with higher income inequality, and psychosocial stress should be a more important mediator of these associations. We used multigroup structural equation models to analyse cross‐sectional data from the International Food Policy Study of adults (n = 22,824) in Australia, Canada, Mexico, the UK and the United States. Associations between SSS and SROH were not higher in more unequal countries, nor was psychosocial stress a more important mediator of these associations. Inequities in SROH in more unequal countries may not predominantly reflect stress‐related pathways of social status differentiation. [ABSTRACT FROM AUTHOR]

Objectives: Oral health inequalities impose a substantial burden on society and the healthcare system across Canadian provinces. Monitoring these inequalities is crucial for informing public health policy and action towards reducing inequalities; however, trends within Canada have not been explored. The objectives of this study are as follows: (a) to assess trends in income‐related inequalities in oral health in Ontario, Canada's most populous province, from 2003 to 2014, and (b) to determine whether the magnitude of such inequalities differ by age and sex. Methods: Data representative of the Ontario population aged 12 years and older were sourced from the Canadian Community Health Survey (CCHS) cycles 2003 (n = 36,182), 2007/08 (n = 36,430) and 2013/14 (n = 41,258). Income‐related inequalities in poor self‐reported oral health (SROH) were measured using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII) and compared across surveys. All analyses were sample‐weighted and performed with STATA 15. Results: The prevalence of poor SROH was stable across the CCHS cycles, ranging from 14.1% (2003 cycle) to 14.8% (2013/14 cycle). SII estimates did not change (18.7‐19.0), while variation in RII estimates was observed over time (2003 = 3.85; 2007/08 = 4.47; 2013/14 = 4.02); differences were not statistically significant. SII and RII were lowest among 12‐ to 19‐year‐olds and gradually higher among 20‐ to 64‐year‐olds. RII was slightly higher among females in all survey years. Conclusion: Absolute and relative income‐related inequalities in SROH have persisted in Ontario over time and are more severe among middle‐aged adults. Therefore, oral health inequalities in Ontario require attention from key stakeholders, including governments, regulators and health professionals. [ABSTRACT FROM AUTHOR]

Background and Aims: Income assistance is critical to the health and wellbeing of socio‐economically marginalized people who use illicit drugs (PWUD). However, past literature paradoxically identifies unintended increases in drug‐related harm coinciding with synchronized payments that may magnify signals for drug use. The scope of such harm has not been fully characterized among non‐institutionalized populations. This study examined socio‐demographic, health and drug use‐related correlates of payment‐coincident drug‐related harm. Design This observational study uses data from prospective community‐based longitudinal cohorts of PWUD between December 2013 and May 2018. Setting: Vancouver, British Columbia, Canada. Participants: A total of 1604 PWUD receiving monthly income assistance. Our sample included 586 (36.5%) women, 861 (53.7%) non‐white participants and 685 (42.7%) people living with HIV. Measurements The primary outcome was a self‐reported composite measure of drug‐related harm in the past 6 months coinciding with income assistance, including higher‐frequency substance use, non‐fatal overdose and service barriers or interruptions. Subanalyses disaggregated this outcome. Findings Payment‐coincident drug‐related harm was reported among 77.7% of participants during the study period. In multivariable models, key correlates positively and significantly associated with payment‐coincident harm included: street‐based income generation [adjusted odds ratio (aOR) = 1.48, 95% confidence interval (CI) = 1.26–1.74, P < 0.001], sex work (aOR = 1.66, 95% CI = 1.35–2.04, P < 0.001), illegal income generation (aOR = 1.57, 95% CI = 1.35–1.83 P < 0.001), homelessness (aOR = 1.34, 95% CI = 1.13–1.58, P < 0.001), exposure to violence (aOR = 1.31, 95% CI = 1.03–1.66, P = 0.032), daily crack cocaine use (aOR = 1.99, 95% CI = 1.59–2.50, P < 0.001), heavy alcohol use (aOR = 1.64, 95% CI = 1.37–1.97, P < 0.001) and injection drug use (aOR = 2.55, 95% CI = 2.01–3.23, P < 0.001). In subanalyses, specific harms were more likely among individuals reporting social, structural and health vulnerabilities. Conclusions: In Vancouver, Canada, people who use illicit drugs who receive income assistance report high prevalence of payment‐coincident drug‐related harm, particularly people experiencing socioeconomic and structural marginalization or engaging in high‐intensity drug use. [ABSTRACT FROM AUTHOR]

Aims: To examine whether norms towards nicotine vaping product (NVP) use varied between Australia, Canada, England and the United States and by socio‐demographics, smoking and NVP status. Design Cross‐sectional data from the 2016 ITC Four Country Smoking and Vaping Survey. Setting: Four countries with distinct regulatory policies relating to the sale and advertising of NVPs: Australia (most restrictive), Canada (restrictive), England and the United States (least restrictive). Participants: A total of 10900 adult (age 18+) current smokers, former smokers, or at least weekly NVP users. Respondents were from Australia (n = 1366), Canada (n = 3309), England (n = 3835) and the United States (n = 2390). Measurements Questions permitted the categorization of respondents as current smokers, former smokers, NVP users and socio‐demographic categories (sex, age, country, ethnicity, income and education). Further questions were asked regarding the frequency of exposure to NVPs in public, whether they had a partner or close friends who vaped and whether they believed society or those considered important to them approved of NVPs. Findings Adjusting for relevant covariates, compared with Australian respondents, those in England, Canada and the United States were more likely to report frequent exposure to NVPs in public (83.1%, 57.3% and 48.3%, respectively, compared to 19.8% in Australia; P < 0.0001), having a partner who vaped (13.8%, 7.1% and 7.7%, respectively, compared to 2.1% in Australia; P < 0.0001) and having close friend(s) who vaped (31.7%, 25.3%, 20.9%, respectively, compared to 10.0% in Australia; P < 0.0001). Compared with Australian respondents, respondents from England were more likely to report that society (27.6% compared to 12.3% in Australia; P < 0.0001) and people important to them approved of NVP use (28.9% compared to 14.3% in Australia; P < 0.0001). Conclusions: Norms towards nicotine vaping product (NVP) use appear to vary among countries with different regulatory contexts regarding sales and advertising. [ABSTRACT FROM AUTHOR]

Abstract: We construct the ratio of the post‐fisc to the pre‐fisc variance of the transitory component of family incomes in Canada from 1993 to 2008. The ratio measures how much the tax and transfer system attenuates market income instability. It is shown that the ratio of variances is equivalent theoretically to the concept of residual income progression (squared). The fiscal system became less stabilizing beginning in the late 1990s, especially for families headed by main earners with less than high school education. The trend is attributable to personal income tax reforms and reductions in transfers for lower income families. Résumé: Instabilité des revenus et progressivité fiscale. On construit le ratio de la variance de la composante transitoire des revenus des familles au Canada de1993 à 2008 après fiscalité par rapport à avant fiscalité. Ce ratio mesure comment le système de taxes et de transferts atténue l’instabilité des revenus du marché. On montre que le ratio des variances est théoriquement équivalent au concept de progression (au carré) du revenu résiduel. Le système fiscal est devenu moins stabilisant à partir de la fin des années 1990, en particulier pour les familles dont les chefs de famille et sources des principaux gains ont moins qu’un niveau d’éducation secondaire. La tendance est attribuable aux réformes dans l’impôt sur le revenu personnel et aux réductions des transferts vers les familles aux revenus moins élevés. [ABSTRACT FROM AUTHOR]

Objective To illustrate the use of National Transfer Accounts ( NTA) for understanding ageing and the economic life cycle in Australia. Methods The NTA methodology is applied utilising a range of unit record, demographic and administrative data sets from 1981 to 2010. Results During early and later life, total consumption (public and private) is greater than labour income. On a time series and cohort basis, we show that each successive generation has improved their level of well-being (as measured by consumption) relative to the previous years or previous cohorts from 1981 to 1982 onwards. We also show a substantial increase in labour income earned by mature age workers over this period. International comparisons show Australia to have consumption and labour income age profiles very similar to those of Canada but dissimilar to many other countries, driven by differences in demographic and policy settings. Conclusion The NTA approach provides a powerful framework to track differences in the economic life cycle across age groups, across time, across cohorts and across countries. [ABSTRACT FROM AUTHOR]

Ontario Works is a provincial income assistance programme of last resort, operating under a workfare policy structure. Based on interviews with clients and staff (case managers, supervisors, managers and administrators), as well as an examination of policy directives, this article explores the work of workfare including claims making, training and resocialization, and employment internships. This article asks particularly how the work of workfare and the complex and costly workfare infrastructure is justified in the face of its failure to lead to employment. Findings include a contrast between the official story of an employment-focused programme and workers' reports of spending far more time on eligibility than employment readiness. In addition, applying Gramsci's notion of 'common sense', an argument is developed that the normative justification for workfare is based not on the effectiveness of workfare programmes, but on the belief that clients need to exchange their work for welfare and self-improvement so that they appear 'employment ready' even if not employed. [ABSTRACT FROM AUTHOR]

Background and Aims Previous research indicates that minimum alcohol pricing (MAP) is associated negatively with alcohol-attributable (AA) hospitalizations. Modeling studies predict that this association will be stronger for people on lower incomes. The objective of this study was to test whether the association between MAP and AA hospitalizations is greater in low-income regions. Design Cross-sectional versus time-series analysis using multivariate multi-level effect models. Setting All 89 Local Health Areas in British Columbia (BC), Canada, 2002-13 (48 quarters). Participants BC population. Measurements Quarterly rates of AA hospital admissions, mean consumer price index-adjusted minimum dollars per standard alcoholic drink and socio-demographic covariates. Findings Family income was related inversely to the effect of minimum prices on rates of some types of AA morbidity. A 1% price increase was associated with reductions of 3.547% [95% confidence interval (CI) = -5.719, −1.377; P < 0.01] in low family-income regions and 1.64% (95% CI = -2.765, −0.519; P < 0.01) across all income regions for 100% acute AA hospital admissions. Delayed (lagged) effects on chronic AA morbidity were found 2-3 years after minimum price increases for low income regions and all regions combined; a 1% increase in minimum price was associated with reductions of 2.242% (95% CI = -4.097, −0.388; P < 0.05) for 100% chronic AA and 2.474% (95% CI = −3.937, −1.011; P < 0.01) for partially chronic AA admissions for low-income regions. Conclusion In Canada, minimum price increases for alcohol are associated with reductions in alcohol attributable hospitalizations, especially for populations with lower income, both for immediate effects on acute hospitalizations and delayed effects on chronic hospitalizations. [ABSTRACT FROM AUTHOR]

Aims To examine whether early endocrinologist care reduces the risk of cardiovascular complications among newly diagnosed patients with diabetes of differing complexity. Methods We conducted a population-based propensity score-matched cohort study using provincial health data from Ontario, Canada. Adults (≥ 30 years) diagnosed with diabetes between 1 April 1998 and 31 March 2006 who received endocrinologist care in the first year of diagnosis were matched to a comparison group receiving primary care alone (N = 79 020) based on propensity scores and medical complexity (assigned using information on chronic conditions). Individuals were followed for 3- and 5-year outcomes, including non-fatal acute myocardial infarction or coronary heart disease death (primary endpoint), major cardiovascular events (acute myocardial infarction, stroke) or all-cause death, amputation and end-stage renal disease. Results Among medically complex patients, early endocrinologist care was associated with a lower 3-year incidence of the primary endpoint (hazard ratio 0.89, 95% CI 0.78-1.01) and major cardiovascular events or all-cause death (hazard ratio 0.91, 95% CI 0.85-0.97). These effects persisted after accounting for a higher incidence of end-stage renal disease on follow-up and were greatest in those with ≥ 3 visits to an endocrinologist (primary endpoint: hazard ratio 0.69, 95% CI 0.56-0.86 and 0.61, 95% CI 0.45-0.82, for unadjusted and end-stage renal disease adjusted analyses, respectively). In contrast, no benefit was observed in the non-medically complex subgroup. Overall effects were similar at 5 years. Conclusions Early endocrinologist care is associated with a lower incidence of cardiovascular events and death among newly diagnosed patients with diabetes who have comorbid medical conditions. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Economics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Review of Sociology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this research was to explore the role of masculinity and heterosexual gender relations in new and expectant fathers' explanations of their continued smoking. We conducted a secondary analysis of in-depth interviews with 20 fathers. Two themes were identified: (1) reconciling with partners to maintain a smoke-free family home; and (2) smoking to self-regulate emotions and maintain relationships. Fathers' decisions to smoke and changes in smoking behavior were shaped by ideals of masculinity and by partner relationships and family and social contexts, including division of domestic duties and childcare. Recognizing the influence of both masculinity and gender relations could provide new directions for supporting men's smoking cessation efforts during early parenthood. © 2014 The Authors. Research in Nursing & Health Published by Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]