2. Non-medical determinants of health

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Health behaviours
Living and working conditions
Personal resources
Environmental factors

2.1 Health behaviours

Type of smoker

Definition:
Population aged 12 and over who reported being either a current smoker (daily or occasional) or a non–smoker (former or never smoked). Does not take into account the number of cigarettes smoked.

Source (s):
Statistics Canada, Canadian Community Health Survey; Statistics Canada, National Population Health Survey, 1994/1995, 1996/1997 and 1998/1999, cross sectional sample, Households component, health file and North component.

Smoking initiation

Definition:
Population aged 12 and over who reported being either a current or former smoker and who reported the age when they smoked their first cigarette.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Changes over time in smoking behaviour

Definition:
Changes over time in the smoking behaviour of the 1994/1995 household population aged 12 and over, every two years, at each cycle of the National Population Health Survey. Population, age, sex and province are based on the first survey cycle in 1994/1995 (Cycle 1). Smokers are those who smoke on either a daily or an occasional basis.

Source (s):
Statistics Canada, National Population Health Survey, longitudinal data files 1996/1997, 1998/1999, 2000/2001, 2002/2003 and 2004/2005.

Frequency of drinking

Definition:
Population aged 12 and over who are current drinkers and who reported drinking 5 or more drinks on at least one occasion per month in the past 12 months."Heavy drinking" is defined as current drinkers who reported drinking 5 or more drinks on one occasion, 12 or more times a year.

Source (s):
Statistics Canada, Canadian Community Health Survey; Statistics Canada, National Population Health Survey, 1994/1995, 1996/1997 and 1998/1999, cross sectional sample, Households component, health file; Statistics Canada, National Population Health Survey, 1996/1997 and 1998/1999, North component.

Leisure-time physical activity

Definition:
Population aged 12 and over who reported a level of physical activity, based on their responses to questions about the frequency, nature and duration of their participation in leisure time physical activity.

Respondents are classified as active, moderately active or inactive based on an index of average daily physical activity over the past 3 months. For each leisure time physical activity engaged in by the respondent, an average daily energy expenditure is calculated by multiplying the number of times the activity was performed by the average duration of the activity by the energy cost (kilocalories per kilogram of body weight per hour) of the activity. The index is calculated as the sum of the average daily energy expenditures of all activities. Respondents are classified as follows: 3.0 kcal/kg/day or more = physically active; 1.5 to 2.9 kcal/kg/day = moderately active; less than 1.5 kcal per day = inactive.

Source (s):
Statistics Canada, Canadian Community Health Survey; Statistics Canada, National Population Health Survey, 1994/1995, 1996/1997 and 1998/1999, cross sectional sample, Households component,health file and North component

Changes over time in physical activity level

Definition:
Changes over time in the physical activity level of the 1994/1995 household population aged 12 and over, every two years, at each cycle of the National Population Health Survey. Population, age, sex and province are based on the first survey cycle in 1994/1995.

Source (s):
Statistics Canada , National Population Health Survey, longitudinal data files 1996/1997, 1998/1999, 2000/2001, 2002/2003, and 2004/2005.

Breastfeeding practices

Note(s): Definition change implemented in 2004 to conform with breastfeeding recommendations from Health Canada and the World Health Organization.

Definition:
The breastfeeding practices of women aged 15 to 55 who had a baby in the previous five years.

Categories include did not breastfeed, initiated breastfeeding, breastfed for at least four months, breastfed for at least four months exclusively, breastfed for six months, and breastfed for at least six months exclusively. These benchmarks are former (four months exclusive breastfeeding) and current (six months exclusive breastfeeding) Health Canada recommendations.

Initiated breastfeeding refers to women who breastfed or tried to breastfeed their last child even if only for a short time.

Exclusive breastfeeding refers to an infant receiving only breast milk, without any additional liquid (even water) or solid food.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Fruit and vegetable consumption

Definition:
Population aged 12 and over, by the average number of times per day that they consume fruits and vegetables.
Measure does not take into account the amount consumed.

Source (s):
Statistics Canada, Canadian Community Health Survey.

2.2 Living and working conditions

High school graduates

Definition:
Population aged 25 to 29 who have a secondary (high) school graduation certificate or equivalent.

A measure of educational attainment and socio-economic status

Source (s):
Statistics Canada, 2006 Census.

Post-secondary graduates

Definition:
Population aged 25 to 54 who have obtained a post-secondary certificate, diploma, or degree.

A measure of educational attainment and socio–economic status.

Source (s):
Statistics Canada, 2006 Census.

Adult and youth unemployment rate

Definition:
Proportion of the Labour force aged 15 and over (and for youths, aged 15 to 24 years) who did not have a job during the reference period.

The labour force consists of people who are currently employed and people who are unemployed but were available to work in the reference period and had looked for work in the past 4 four weeks. The reference period refers to a one-week period (from Sunday to Saturday) that usually includes the 15th day of the month.

The unemployment rate is a traditional measure of the economy. Unemployed people tend to experience more health problems.

Source (s):
Statistics Canada, Labour Force Survey (special tabulations).

Long-term unemployment rate

Definition:
Labour force aged 15 and over who did not have a job any time during the current or previous year (for example, the years 2005 and 2006 for the 2006 Census).

The labour force consists of people who are currently employed and people who are unemployed but were available to work in the reference period and had looked for work in the past four weeks.

Unemployed people tend to experience more health problems. Long–term unemployment could extend ones' susceptibility to poor health.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Low income rate

Definition:
Population in "economic families" and unattached individuals with incomes below the Statistics Canada low–income cut-off (LICO). The cut offs represent levels of income where people spend disproportionate amounts of money for food, shelter, and clothing. LICOs are based on family and community size; cut offs are updated to account for changes in the consumer price index.

The term "economic family" refers to a group of two or more persons who live in the same dwelling and are related to each other by blood, marriage, common-law or adoption.

A widely used measure of socio-economic status. Higher income is associated with better health.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Children in low-income families

Definition:
Population of children aged 17 and under living in economic families with incomes below Statistics Canada's low-income cut-offs (LICO). The cut–offs represent levels of income where people spend disproportionate amounts of money for food, shelter, and clothing. LICOs are based on family and community size; cut-offs are updated to account for changes in the consumer price index.

The term "economic family" refers to a group of two or more persons who live in the same dwelling and are related to each other by blood, marriage, common-law or adoption.

A widely used measure of children at risk.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Average personal income

Definition:
Average personal income (pre–tax, post–transfer) for persons aged 15 and over who reported income.

Higher income is associated with better health.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Median share of income

Definition:
Proportion of income (from all sources, pre–tax, post–transfer) held by households whose incomes fall below the median household income.

A proportion of 50% would represent no inequality.

Source (s):
Statistics Canada, 1996 and 2001 Census, special tabulations

Government transfer income

Definition:
Proportion of all income that came from government transfers (for example, Canada or Quebec Pension Plan, Unemployment Insurance) for the population 15 years of age and over.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Housing affordability

Definition:
Households (renters, owners, and total) spending 30% or more of total household income on shelter expenses. Shelter expenses include payments for electricity, oil, gas, coal, wood or other fuels, water and other municipal services, monthly mortgage payments, property taxes, condominium fees and rent.

As a general rule, households are considered to have affordability problems if more than 30% of household income is spent on housing costs. At that level of spending, it is likely that inadequate funds will be available for other necessities such as food, clothing, and transportation. Housing affordability problems affect renters more than owners. Band housing on Indian reserves was not included in the calculation of housing affordability.

Source (s):
Statistics Canada, 1996 and 2001 Census.

Decision latitude at work

Definition:
Degree of control that individuals have over their work circumstances (who agree or disagree with the statement "I have a lot to say about what happens in my job." and "My job allows me the freedom to decide how I do my job."). Refers to population aged 15 to 74 who worked at a job or business at any point in the past 12 months before the interview.

Source (s):
Statistics Canada, Canadian Community Health Survey 2005, 2003, 2000/2001; Statistics Canada, National Population Health Survey, 1994/1995, cross sectional sample, Households component and health file.

Crime Incidents

Definition:
The number and rate (per 100,000 population) of total Criminal Code offences, violent crimes, property crimes, and other crimes.

Source (s):
Statistics Canada, Canadian Centre for Justice Statistics, Uniform Crime Reporting Survey.

Adults and Youth Charged

Definition:
The number and rate (per 100,000 population) of youths, aged 12 to 17 years, or adults, aged 18 and over, charged with Criminal Code offences by type of offence.

Source (s):
Statistics Canada, Canadian Centre for Justice Statistics, Uniform Crime Reporting Survey.

2.3 Personal resources

Sense of community belonging

Definition:
Population aged 12 and over who reported a sense of belonging to their local community as being very strong, somewhat strong, somewhat weak or very weak.

Research shows a high correlation of sense of community belonging with physical and mental health.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Social support (National Population Health Survey)

Definition:
Level of perceived social support reported by population aged 12 and over, based on their responses to four questions about having someone to confide in, someone they can count on in a crisis, someone they can count on for advice, and someone who makes them feel loved and cared for. In this publication, a score of 0 was classified as low social support, 1 to 3 as medium social support and 4 as high social support.

Source (s):
Statistics Canada, National Population Health Survey, 1994/1995 and 1996/1997, cross sectional sample, households component, health file; Statistics Canada, National Population Health Survey, 1994/1995 and 1996/1997, cross sectional sample, north component.

Social support (Canadian Community Health Survey)

Definition:
Level of perceived social support reported by population aged 12 and over, defined as having emotional or informational support when an individual needs someone to listen or needs to confide in someone. It is based on a list of eight questions that ask people how often they receive certain types of support in certain circumstances. In this publication, a score of 0 to 10 was classified as low social support, 11 to 20 as medium social support and 21 to 32 as high social support.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Perceived life stress

Definition:
Population aged 15 and over who reported perceived life stress, which refers to the amount of stress in the person’s life, on most days, as perceived by the person or, in the case of proxy response, by the person responding.

Source (s):
Statistics Canada, Canadian Community Health Survey.

2.4 Environmental factors

Note: Definition for exposure to second-hand smoke was changed in 2004 to reflect changes in questionnaire wording. Data from CCHS 2000/01 are therefore not comparable with data from CCHS 2003.

Exposure to second-hand smoke at home

Definition:
Non-smoking population aged 12 and over who reported that at least one person smoked inside their home every day or almost every day.

Source (s):
Statistics Canada, Canadian Community Health Survey.

Exposure to second-hand smoke in vehicles and public places

Definition:
Non-smoking population aged 12 and over who reported being exposed to second-hand smoke in private vehicles and/or public places everyday or almost every day during the past month.

Source (s):
Statistics Canada, Canadian Community Health Survey.