Data Sources
Canadian Community Health Survey (CCHS) CYCLE 1.1, 2000-2001 - Statistics Canada
The CCHS is a cross-sectional general population health survey that collects information related to health status, health care utilization and health determinants for the Canadian population. The CCHS (Cycle 1.1) has a large sample and was designed to provide reliable estimates down to the health region level.
The target population of the CCHS was people aged 12 years or older who were living in private dwellings in the 10 provinces and three territories. People living on Indian Reserves or Crown lands, clientele of institutions, full-time members of the Canadian Armed Forces and residents of certain remote regions were excluded. The overall response rate was 84.7%, and 130,827 individuals participated. Data for people aged 15 years and over were included in Chapter 2. All analyses performed on the CCHS data were weighted in order to ensure that derived estimates were meaningful or representative of the entire targeted Canadian population 15 years of age and older.
Canadian Joint Replacement Registry (CJRR) - Canadian Institute for Health Information (CIHI)
The CJRR is maintained by CIHI, which captures information on hip and knee joint replacements performed in Canada and follows joint replacement patients over time to monitor their revision rates and outcomes. Data are collected with patients' consent at the time they receive joint replacements and are submitted voluntarily by participating facilities and provincial registries (where established). This database contains data on hip and knee replacement patients. The database includes demographic and administrative information, the type of replacement, surgical approach, fixation modes and implant types.
Annual Mortality Data - Statistics Canada
Statistics Canada's annual mortality database is an administrative database that collects information annually from all provincial and territorial vital statistics registries on all deaths in Canada. Under a federal-provincial agreement, the registration of deaths is the responsibility of the provinces and territories. In most provinces and territories, the personal information part of the death registration form is completed by an informant, usually a relative of the deceased. The part of the form comprising the medical certificate of death is completed by the medical practitioner last in attendance or, if an inquest or enquiry was held, by the coroner. The database includes demographic information and the underlying cause of death as defined by the physician.
Discharge Abstract Database (DAD) - Canadian Institute for Health Information (CIHI)
DAD is maintained by CIHI. DAD contains data on hospital discharges across Canada and includes demographic, administrative and clinical data for hospital discharges (inpatient acute, chronic, rehabilitation) and day surgeries. CIHI receives data directly from participating hospitals. These include all hospitals in every province and territory, except Quebec and parts of Manitoba. Coverage represents roughly 75% of all hospital inpatient discharges in Canada, or about 4.3 million records annually.
Hospital Morbidity Database (HMDB) - Canadian Institute for Health Information (CIHI)
HMDB is maintained by CIHI and provides a count of patients separated (through discharge or death) from a hospital, listed by the primary morbidity (disease) diagnosed. In addition to demographic and administrative information, the database contains up to 16 diagnostic codes and some procedure codes. Data are downloaded from the Discharge Abstract Database (DAD) for participating provinces. Data files for the remaining provinces/territories are submitted by the appropriate provincial or territorial ministry of health. Data are received from general and allied special hospitals, including acute care, convalescence and chronic facilities (except in Ontario). Data do not include any outpatient services in any hospital, or services in psychiatric hospitals.
National Population Health Survey (NPHS) - Statistics Canada
Statistics Canada conducts the NPHS, a cross-sectional and longitudinal household-based survey, every two years. Designed to collect information about the health status of Canadians, the NPHS expands our knowledge of the determinants of health, including health behaviour, use of health services and socio-demographic information. It is composed of three components: the Household survey, the Health Care Institutions survey and the Northern Territories survey. The first cycle of data collection began in 1994.
The Household component includes household residents in all provinces, with the principal exclusion of populations on Indian Reserves, Canadian Forces Bases and some remote areas in Quebec and Ontario. The target population consists of household residents in all provinces, except people living on Native reserves, on Canadian Forces bases, or in some remote areas. The survey has specific components for individuals living in institutions (long-term residents of hospitals and residential care facilities) and in the territories.
Definitions
Aboriginal People Living Off-Reserve
The CCHS used the following question to define the Aboriginal population in Canada: “People living in Canada come from many different cultural and racial backgrounds. Are you…Aboriginal People of North America?” CCHS data do not include Aboriginal people living on reserves and settlements. Analyses were carried out comparing those with arthritis in both the off-reserve Aboriginal and non-Aboriginal populations.
Activity Limitations
Respondents to the 2000 CCHS were asked, “Because of a long-term physical or mental condition or a health problem, are you limited in the kind or amount of activity you can do: at home? at school? at work? in other activities?” (Yes/No).
Age-standardized Rates
The age-standardized rate represents what the crude rate would be if the population under study had the age distribution of the standard population. It is the weighted average of age-specific rates applied to a standard distribution of age.
Alternative or Complementary Medicine
Respondents to the 2000 CCHS were asked whether, in the previous 12 months, they had seen or talked to an alternative health care provider such as
about physical, emotional or mental health. (Yes/No).
Body Mass Index (BMI)
BMI is calculated as weight in kg divided by height in m2.
Chronic Conditions
The 2000 CCHS defined long-term conditions as those that have lasted or are expected to last six months or more and that have been diagnosed by a health professional. These included food allergies, any other allergies, asthma, fibromyalgia, arthritis or rheumatism (excluding fibromyalgia), back problems (excluding fibromyalgia and arthritis), high blood pressure, migraine headaches, chronic bronchitis, emphysema or chronic obstructive pulmonary disease (asked of those aged 30+), diabetes, epilepsy, heart disease, cancer, stomach or intestinal ulcers, effects of a stroke, urinary incontinence, bowel disorder such as Crohn's disease or colitis, Alzheimer's disease or any other dementia (asked of those aged 18+), cataracts (asked of those aged 18+), glaucoma (asked of those aged 18+), thyroid condition, Parkinson's disease, multiple sclerosis, chronic fatigue syndrome, multiple chemical sensitivities, any other long-term condition.
Depression
A subset of items from the Composite International Diagnostic Interview (CIDI) that measure major depressive episode, where the score is translated into a probability of “caseness” of depression. A score of >= 0.25 is considered to be indicative of a case depression.
Disability Days
The number of days in the previous 14 days in
which the respondent to the 2000 CCHS reported spending all or part
of the day in bed or, because of illness or
injury, having to reduce activities normally performed during the
day.
Education
Highest level of education attained, coded as less than secondary school graduation, secondary school graduation, some post-secondary or post-secondary graduation.
Health-adjusted Life Expectancy (HALE)
HALE is a measure of population health that takes into account both mortality and morbidity. HALE adjusts overall life expectancy, or life years lived according to the amount of time spent in less-than-perfect health or with disability. It sheds more meaning on longer life by determining whether an increase in the average lifespan is accompanied by better quality of life.
Health Care Provider Visits
The number of times in the previous 12 months that the respondent to the 2000 CCHS had seen or talked on the telephone about physical, emotional or mental health with a family doctor or general practitioner; any other medical doctor (such as a surgeon, allergist, orthopedist, gynecologist or psychiatrist) (referred to as a specialist); a nurse for care or advice; a chiropractor or a physiotherapist; a social worker or counsellor; or a psychologist.
Health Utility Index (HUI)
A generic health status measure designed to assess both quantitative and qualitative aspects of life, with scores ranging from 0.0 (worst health state, death) to 1.0 (best state, full health). HUI provides a description of an individual's overall functional health based on eight attributes: vision, hearing, speech, mobility (ability to get around), dexterity (use of hands and fingers), cognition (memory and thinking), emotion (feelings), pain and discomfort. The responses are weighted, and the derived score describes the individual's overall functional health status: a score < 0.830 was taken to indicate disability.
Help with Daily Activities
Using data from the CCHS, recoded for this report as needing help with at least one domestic activity (preparing meals and/or shopping for groceries and/or other necessities and/or housework), personal care (washing, dressing or eating and/or moving about in the house) or heavy household chores, versus needing no help.
ICD
International Classification of Diseases - 9th Revision, 1977.
Incidence
The number of instances of illness commencing, or of persons falling ill, during a given period in a specified population.
Income
For this report, a 5-level total household income variable designated by Statistics Canada was grouped into two categories. The lowest/lower middle/middle income category was defined as a household income of <= $29,999, <= $39,999 or <= $59,999 if there were 1-2, 3 or 4, or 5+ people in the household respectively. Otherwise, the household income was categorized as upper middle/highest income.
Medication Use
Information on medication use was taken from the National Population Health Survey (NPHS) 1998/99. Data are presented for people who reported taking in the previous month:
Overweight
Body mass index (BMI) >= 27, which was the accepted Canadian standard at time of analysis. Health Canada has since revised its standards with a BMI >= 25 indicating overweight, however. The 2000 CCHS calculated BMI only for individuals 64 years of age and under, excluding pregnant women.
Pain
Respondents to the 2000 CCHS were asked to identify which of the following four categories best described their situation with respect to pain: no pain or discomfort, mild pain, moderate pain, or severe pain.
Physical Activity Index
The energy expenditure (EE) in leisure activities* was estimated using the frequency and time per session of the physical activity as well as its MET value, a value of metabolic energy cost expressed as a multiple of the resting metabolic rate. The index was recoded with EE < 1.5 identified as “inactive” versus all other levels.
Prevalence
The number of instances of a given disease or other condition in a given population at a designated time. The term usually refers to the situation at a specified point in time.
Self-perceived Unmet Health Care Needs
Respondents to the 2000 CCHS were asked “During the past 12 months, have you felt that health care was needed but not received?” (Yes/No).
Self-rated Health
Respondents to the 2000 CCHS were asked to rate their health as either “excellent”, “very good”, “good”, “fair” or “poor”. Respondents were also asked to rate their health as compared with one year earlier (better, same, or worse).
Stress
The perceived amount of stress in daily life (not at all stressful, not very stressful, a bit stressful, quite a bit stressful, and extremely stressful).
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* Walking for exercise, gardening or yard work, swimming, bicycling, popular or social dance, home exercises, ice hockey, ice skating, in-line skating or rollerblading, jogging or running, golfing, exercise class or aerobics, downhill skiing or snowboarding, bowling, baseball or softball, tennis, weight-training, fishing, volleyball, basketball and other.