2. Non-medical determinants of health

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Health behaviours
Living and working conditions
Personal resources
Environmental factors

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2.1 Health behaviours

Smoking

Definition:
Population aged 12 and over who reported being a current smoker, daily or occasional. Occasional smokers include former daily smokers who now smoke occasionally. Does not take into account the number of cigarettes smoked.

Smoking is a risk factor for lung cancer, heart disease, stroke, chronic respiratory disease, and other conditions. According to the World Health Organization, smoking is an important and preventable cause of death.

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

Heavy drinking

Note(s): Starting in 2009, the denominator includes all the population aged 12 and over. This change applies to rates from all years in this table. In data released before 2009, the denominator included only the population who reported having had at least one drink in the past 12 months. Increasing the population in the denominator reduces the estimate rates. This change was implemented to produce more comparable rates over time and is more consistent with methods used in calculating other indicators.

Definition:
Population aged 12 and over who reported drinking 5 or more drinks on at least one occasion per month in the past 12 months.

Heavy drinking refers to having consumed five or more drinks, per occasion, at least once a month during the past year. This level of alcohol consumption can have serious health and social consequences, especially when combined with other behaviours such as driving while intoxicated.

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

Physical activity during leisure time

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.

The health benefits of physical activity include a reduced risk of cardiovascular disease, some types of cancer, osteoporosis, diabetes, obesity, high blood pressure, depression, stress and anxiety.

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

Breastfeeding practices

Note: As of June 2010, the method of calculation for the rate of exclusive breastfeeding in the Annual estimates has been modified to produce more comparable rates over time.

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

"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.

Fruit and vegetables are an important source of vitamins, minerals and fibre. A diet rich in fruit and vegetables may reduce the risk of heart disease and some types of cancer.

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

Bicycle helmet use

Definition:
Population aged 12 and over who reported that they always wore a helmet when riding a bicycle in the last 12 months.

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

2.2 Living and working conditions

High school graduates

Note: Questions pertaining to education on the census questionnaire changed substantially between 2001 and 2006, principally to reflect developments in Canada's education system. The education portion of the questionnaire had not changed in many years, even though the education system had evolved considerably. For additional information, please refer to "Educational Portrait of Canada, 2006 Census: Substantial changes to census questions on education".

Definition:
Population aged 25 to 29 who have a secondary (high) school graduation certificate or equivalent. "High school certificate or equivalent" refers to the possession of a secondary (high) school graduation certificate or its equivalent, regardless of whether other educational qualifications are held or not. High school graduates exclude institutional residents.

A measure of educational attainment and socio-economic status.

Source (s):
Statistics Canada, 2006 Census.

Post-secondary graduates

Note: Questions pertaining to education on the census questionnaire changed substantially between 2001 and 2006, principally to reflect developments in Canada's education system. The education portion of the questionnaire had not changed in many years, even though the education system had evolved considerably. For additional information, please refer to "Educational Portrait of Canada, 2006 Census: Substantial changes to census questions on education".

Definition:
Population aged 25 to 54 who have obtained a post-secondary certificate, diploma, or degree. "Highest certificate, diploma or degree" refers to the highest certificate, diploma or degree completed based on a hierarchy which is generally related to the amount of time spent "in-class". For postsecondary completers, a university education is considered to be a higher level of schooling than a college education, while a college education is considered to be a higher level of education than in the trades. Although some trades requirements may take as long or longer to complete than a given college or university program, the majority of time is spent in on-the-job paid training and less time is spent in the classroom. Post-secondary graduates exclude institutional residents.

A measure of educational attainment and socio–economic status.

Source (s):
Statistics Canada, 2006 Census.

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, 2006 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. For 2006, foster children are considered economic family members. Note that as of 2001, same-sex partners are considered to be common-law partners. Thus they are considered related and members of the same economic family.

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

Source (s):
Statistics Canada, 2006 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. For 2006, foster children are considered economic family members. Note that as of 2001, same-sex partners are considered to be common-law partners. Thus they are considered related and members of the same economic family.

A widely used measure of children at risk.

Source (s):
Statistics Canada, 2006 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, 2006 Census.

Median share of income

Definition:
A median household income is the dollar amount that marks the midpoint of a distribution of households ranked by the size of household income. 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, 2006 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, 2006 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, 2006 Census.

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.

Household food insecurity

Definition:
Food security is commonly understood to exist in a household when all people, at all times, have access to sufficient safe and nutritious food for an active and healthy life. Conversely, food insecurity occurs when food quality and/or quantity are compromised, typically associated with limited financial resources.

Recognized as an important public health issue in Canada, household food insecurity has been associated with a range of poor physical, mental health outcomes, for example, self-assessed poor/fair health, multiple chronic conditions, obesity, distress, and depression.

Source (s):
Statistics Canada, Canadian Community Health 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 or somewhat strong.

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

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

Life satisfaction

Definition:
Population aged 12 and over who reported being satisfied or very satisfied with their life in general.

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

2.4 Environmental factors

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.

Smoking includes cigarettes, cigars and pipes.

'Passive smoking,' or exposure to second-hand smoke, has negative respiratory health effects. Two of the most common associated diseases are lung cancer in adults and asthma among children.

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.

Smoking includes cigarettes, cigars and pipes.

'Passive smoking,' or exposure to second-hand smoke, has negative respiratory health effects. Two of the most common associated diseases are lung cancer in adults and asthma among children.

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

Lead concentration

Definition:
Concentration of lead in the blood of the population aged 6 to 79.

Lead is a heavy metal (and known toxicant) that occurs naturally in the environment.

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

Bisphenol A concentration

Definition:
Concentration of bisphenol A in the urine of the population aged 6 to 79.

Bisphenol A (BPA) is an industrial chemical used primarily in the production of polycarbonate plastic (such as food containers and water bottles) and epoxy resins (commonly used in protective linings for canned food, coatings on metal lids of glass bottles/jars, and dental sealants).

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

Mercury concentration

Definition:
Concentration of mercury in the blood of the population aged 6 to 79.

Mercury is a heavy metal that occurs naturally in the environment and exists in three forms: elemental, inorganic and organic.

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

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