Public Health

Correction to: Availability of legalized cannabis reduces demand for illegal cannabis among Canadian cannabis users: evidence from a behavioural economic substitution paradigm The published version of Fig. 1 contained a mistake in the colour scale for the vertical lines and corresponding labels for the Pmax values.

Weight stigma and physical health: an unconsidered ‘obesity’ cost

Convergence of chronic and infectious diseases: a new direction in public health policy

A “buck a beer,” but at what cost to public health? Abstract Alcohol use leads to a substantial number of hospitalizations, and to increased health and social harms as well as economic costs in Ontario and across Canada. The effects of alcohol price changes on consumption and resulting harms have been firmly established; changes in the minimum price of alcohol have the greatest effect on consumption among people who for reasons of affordability consume low-priced alcoholic beverages, typically adolescents, people with lower socio-economic status, and people with harmful alcohol use. Decreases in inflation-adjusted minimum pricing in British Columbia from 2002 to 2006 have been associated with increases in deaths wholly attributable to alcohol. Furthermore, decreases in alcohol prices have been previously associated with increases in drink-driving, decreases in life expectancy, increases in road traffic injuries, violence, and alcohol poisonings, and long-term increases in deaths from infectious diseases, circulatory diseases, and digestive diseases. Based on the findings of previous studies, lowering the cost of alcohol will negatively impact the health of Ontarians and further strain a healthcare system with limited resources. Accordingly, Ontario should be strengthening alcohol policies to improve public health, including raising the minimum price of alcohol, rather than weakening alcohol policies.

The need for political will to reduce poverty in Canada

Will district health centres use preloaded cell phones for pre-referral phone calls for women in labour: a randomized pilot study at Mbarara Regional Referral Hospital in southwest Uganda

Postpartum depression prevalence and risk factors among Indigenous, non-Indigenous and immigrant women in Canada Abstract Objectives The social position of different minority groups in contemporary societies suggests different risk factors for postpartum depression (PPD). In this study, we used two cut-offs of the Edinburgh Postpartum Depression Scale (EPDS) to examine prevalence and risk factors for PPD among mothers participating in the Canadian Maternity Experiences Survey (MES), and to compare Indigenous, Canadian-born non-Indigenous and immigrant mothers. Methods We used cross-sectional nationwide data from the 2006 MES (unweighted N = 6237, weighted N = 74,231) and conducted multivariate logistic regression models for EPDS ≥ 10 and EPDS ≥ 13 to explore risk factors for the total sample of mothers and in each study group. Results Prevalence (%, 95 % CI) of EPDS ≥ 10 and EPDS ≥ 13 was significantly higher among immigrant (12.2 %, 10.2–14.2 and 24.1 %, 21.5–26.7) and Indigenous (11.1 %, 7.5–14.7 and 21.2 %, 16.5–25.9) compared to Canadian-born non-Indigenous mothers (5.6 %, 4.9–6.3 and 12.9 %, 11.9–13.9). Multivariate analysis of the total sample showed similar risk factors for EPDS ≥ 10 and EPDS ≥ 13 (ethnicity, low education, ≥ low income cut-off, taking antidepressants, experiencing abuse, low social support). Stratification by study group revealed differing risk factors in each group for EPDS ≥ 10 and EPDS ≥ 13. Indigenous mothers had the most distinct risk factors, followed by immigrant mothers. Non-indigenous Canadian-born mothers had risk factors most similar to the total sample. Conclusion Differing prevalence and risk factors for PPD within and across study groups suggest that instead of a universal approach, tailored programs and services to prevent PPD in Indigenous, immigrant and non-Indigenous Canadian-born groups could better protect the mental health of Canadian mothers.

Is social assistance boosting the health of the poor? Results from Ontario and three countries Abstract Intervention Social assistance programs supplement incomes of the most income-insecure. Because income is a fundamental source of health, income supplementation is expected to result in a boost to health status. As Canada finds itself in the midst of heated debate regarding the structuring (and restructuring) of social assistance programs, there is little evidence available for policymakers about the effectiveness of current social assistance programs in improving the health of the income-insecure. Research question In this paper, we evaluate the health effects of social assistance programs in Ontario, Canada-wide and in peer programs from the United States and the United Kingdom. Methods We used nationally representative household panel surveys (e.g., Canadian Survey of Labour and Income Dynamics) which follow individuals over time. Using fixed effects modelling, which controls for time-invariant characteristics of individuals, and further controlling for key time-varying characteristics, we modelled change in health status associated with change in receipt of social assistance in these societies. Health status was measured using self-rated health (fair/poor versus good/very good/excellent). Results Our results suggest that the health of social assistance recipients was worse (Ontario, Canada, UK) or no different (US) than the health of non-recipients. For example, in Canada, receipt of social assistance was associated with 52.5% higher odds of reporting fair or poor health. Conclusion Social assistance programs in Canada and peer countries are currently inadequate for improving the health of the income-insecure. This is likely due to insufficient benefits, exposure to precarious job conditions, or selection factors.

Association of immigrant generational status with asthma Abstract Objective We sought to examine whether asthma risk is lower in second-generation immigrants (i.e., Canadian-born children with at least one foreign-born parent) and first-generation immigrants (i.e., foreign-born children) compared with non-immigrants (i.e., Canadian-born children to Canadian-born parents). Methods Data were obtained from the Canadian National Longitudinal Survey of Children and Youth from 1994 to 2008, which measured child health and developmental factors from birth to early adulthood. The sample included 15,799 participants aged 2–26 years. Asthma was defined as diagnosis by a health professional as having asthma, having wheezing or whistling in the chest, or use of medication for asthma. Results Prevalence of asthma (defined as a combination of any three factors) was lower in first-generation (32%) and second-generation (34%) immigrants compared with non-immigrants (46%). After controlling for covariates, first- and second-generation immigrants had 0.21 (AOR = 0.21; 95% CI = 0.07–0.67) and 0.19 (AOR = 0.19; 95% CI = 0.09–0.39) lower odds of reporting asthma compared with non-immigrants, respectively. For every year the parent(s) of second-generation immigrants resided in Canada, the odds for asthma increased by 5% (AOR = 1.05; 95% CI = 1.02–1.06). Conclusion Immigrant children and youth in Canada, regardless of whether they are first- or second-generation, have lower odds for asthma compared with non-immigrants.

Cannabis legalization in the provinces and territories: missing opportunities to effectively educate youth? Abstract Cannabis is now legal in Canada, yet important questions remain regarding how the provinces and territories are approaching cannabis education and messaging aimed at youth. Although widespread education and awareness campaigns are long considered cornerstones of substance use and related harm prevention, there is limited evidence to support the effectiveness of such campaigns. We continue to see examples of cannabis-related messaging that focus on risk and harm and often adopt a narrow view of the ways in which young people may use cannabis. This traditional risk-based messaging does not resonate with how many youth experience cannabis use. We have further observed that most provinces and territories have yet to fully reveal concrete details regarding what they are and have been planning in terms of youth engagement in the development and delivery of educational initiatives. As Canadian youth desire reliable, evidence-based educational material on cannabis, and can be credible key partners in the development of such materials, we hope that all levels of government will see the value of promoting balanced cannabis discussions and co-designing resources with youth.