Canadian Community Health Survey

Full text

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C

anadian

C

ommunity

H

ealth

S

urvey

Cycle 2.2 (2004) – Nutrition

ATLANTIC DLI TRAINING 2006

Wolfville, April 19 – April 21, 2006

Ingrid Ledrou

Health Statistics Division Statistics Canada

(2)

Presentation overview

CCHS design – “.1’s” & “.2’s”

CCHS 2.2 (2004) - Nutrition

general health component

24-hour recall component

Data files – releases, Web, PUMF

(3)

CCHS Design

“.1’s” vs “.2’s”

(4)

CCHS - objectives

Provide timely, consistent, cross-sectional

estimates of health determinants, health

status and health system utilization across

Canada

Sub-provincial geography (“.1’s”)

100++ health regions

Flexible survey instrument

meet specific health region data needs

quick response to emerging issues

(5)

CCHS - 2-year cycle design

Year 1 – “General”

130,000 respondents

stratified by health region

Content

common optional sub-sample

Estimates for health

regions, provinces, territories, Canada

Year 2 – “Focus”

30,000 respondents stratified by province Content focus correlates 60+ minutes

Estimates for provinces,

Canada (excluding territories)

(6)

CCHS - status

Cycle 1.1 (2000-2001)

General content

130 000+ sample

health region estimates initial release: May, 2002

PUMF ☻

Cycle 2.1 (2003)

General content

130 000+ sample

health region estimates initial release: June, 2004

PUMF ☻

Cycle 1.2 (2002) - focus

Mental health & well being

~30 000 sample

provincial estimates

initial release: Sept., 2003 PUMF ☻

Cycle 2.2 (2004) - focus

Nutrition

~30 000 sample

provincial estimates

Two-stage release: July 2005 &

(7)

CCHS - status

Cycle 3.1 (2005)

General content 130 000+ sample

health region estimates

6-mth data release: Dec, 2005 full release: June, 2006

PUMF ☺

Cycle ? 4.1 ? (2006+)

General content

130,000+ sample continuous ? HR estimates w/more flexibility staggered releases PUMF (24 months) ☺

Canadian Health

Measures Survey

(2006)

Cycle ? 4.2 ? (2008)

Focus content aging ?

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A brief history

Nutrition

Nutrition Canada, 1972

last national population based data on food

consumption and related nutrition assessment with physical and biological measurements

Health Canada’s provincial nutrition surveys,

1990’s

Physical measurements

Canada Health Survey, 1978-79, national

Canadian Heart Health Surveys, 1986 to 1992,

(10)

A brief history

CCHS 2.2 – Nutrition

feasibility study for CCHS focus content

on nutrition: initiated late 1999

development begins: Spring 2002

collection: Jan. – Dec. 2004

first results released: July, 2005

PUMF: December 2005

complete release: Feb, 2006

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CCHS 2.2 - goals

Provide

reliable, detailed,

and

timely

information on

dietary intake

,

nutritional well-being

and their

key

determinants

To inform and guide

programs,

policies and activities of federal and

provincial governments as well as

local health agencies

(12)

CCHS 2.2 - objectives

Estimate the distribution of usual dietary intake in terms of

foods, food groups, dietary supplements, nutrients and eating

patterns

for a representative sample of Canadians at provincial and

national levels

Measure the prevalence of household food insecurity among

various population groups in Canada

Gather anthropometric measurements

body height and weight

Collect correlate information

physical activity

selected health conditions

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Sample design - domains

Distribution of usual dietary intake for a representative

sample at provincial and national levels

15 key domains of interest = Dietary Reference Intakes (DRI), as

specified by the American Institute of Medicine

DRI age/sex groups:

– < 1 both sexes – 1 - 3 both sexes – 4 - 8 both sexes – 9 - 13 m - f separate – 14 - 18 m - f separate – 19 - 30 m - f separate – 31 - 50 m - f separate – 51 - 70 m - f separate – 71 + m - f separate

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Sample design - coverage

Target population

individuals, aged 0 +, living in private occupied dwellings

in each of the ten provinces

exclusions:

3 territories

individuals living on Aboriginal Reserves and Crown Lands

residents of institutions

full-time members of the Canadian Forces

residents of some remote areas

Coverage

~98% of the Canadian population living in the provinces

Buy-ins

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Sample design - allocation

Initial target sample size: 30,000 responding units

Two-step approach

step 1

1,120 units to each province

80 for each of 14 DRI groups (minimum of 80 units is not a requirement for the < 1 age grp)

step 2

remaining 18,800 units allocated to the provinces using a power

allocation scheme (q = 0.70)

Two frames

LFS area frame CCHS 2.1 frame

Buy-ins from ON, PEI, MAN and Health Canada

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CCHS 2.2 content

Two components

24-hour dietary recall component

collect information on all foods & beverages during

24-hour period of reference

general health component

collect correlates & socio-demographics

– selected health conditions – physical / sedentary activity

– vitamins & minerals supplements

(17)

CCHS 2.2 content

24-hour dietary recall

All foods & beverages consumed during

24-hour period of reference

midnight to midnight the day prior to the

interview

details - what

amounts – how much

CAI application

developed by the United States Department of

Agriculture

(18)

CCHS 2.2 content

24-hour dietary recall

Modified to fit Canadian marketplace

to account for differences in foods available

beaver tails, poutine…

in collaboration with Health Canada

contains ~27,000 foods within look-up lists translated into French

Automated multiple pass methodology

5 steps designed to improve the respondent’s ability to

remember what foods and beverages were consumed during the 24-hour period of reference

1. Quick List – quick report

2. Forgotten Foods – anything else with that?

(19)

CCHS 2.2 content

24-hour dietary recall

Second recall

calculate intra-individual variability

subsample of 10,000 units (CATI)

3 to 10 days after the first interview, preferably a

different day of the week

minimum of 125 individuals for each of the 15

DRI/sex groupings by region

Atlantic, Quebec, Ontario, Prairies, BC

50 respondents ~ collapse by region not necessary

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CCHS 2.2 content

general health

General Health (12+)

Physical Activity (12+)

Children’s Physical Activity

(6 to 11)

Sedentary Activity (12 - 17)

Measured Height and

Weight (2+)

Self Reported Height and

Weight (10% sample, 18+)

Vitamin and Mineral

Supplements (all)

Household Food Security

(all)

Fruit and Vegetable

Consumption (6 mo.+)

Women’s Health (9+)

Chronic Conditions (all)

Smoking (12+)

Alcohol Consumption (12+)

Socio-Demographics (all)

Labour Force (15 - 75)

(21)

Data collection - design

Four quarterly samples

Jan. to Dec. 2004

60-minute CAPI interview

including the 1st 24-hour recall and physical measures anticipated response rate: 80%

85% for fresh sample

75% for 2.1 sample of households

Proxy interview protocols

Respondents aged 12+: non proxy

Aged 6 to 11: assisted proxy (respondent and parent) Aged 0 to 5: full proxy (parent only)

Responses rates

1st interview = 76.5% 2nd interview = 72.8 %

(22)

Data collection – sample sizes

1st interview 2nd interview Canada 35,107 10,786 NL 1,734 752 PE 1,430 860 NS 1,705 704 NB 1,633 683 PQ 4,780 1,964 ON 10,921 1,647 MB 4,194 921 SK 2,041 894 AB 3,021 767

(23)

Data release(s) – 2 steps

CCHS 2.2 data are being released in two

steps

Step 1: general health component

except vitamin & mineral supplements

Step 2: 24-hour recall (nutrition) component

including vitamin & mineral supplements

– pending validation

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Data release(s) – step 1

Step 1:

General health component

- July 6,

2005

Single flat file

2 sampling weights

general

measured body height & weight

PUMF - Dec. 5, 2005

Internet Publication

“Nutrition: Findings from the Canadian

Community Health Survey”

(25)

Data release(s) – step 1

I-Pub: “Nutrition: Findings from the

Canadian Community Health Survey”

2 analytical articles

“Adult obesity in Canada: Measured height and weight”, Michael Tjepkema, STC

“Overweight Canadian children and adolescents”, Margot Shields, STC

CANSIM tables

adult measured BMI, child measured BMI, food

insecurity, children’s physical activity, teenager’s sedentary activity

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Data release(s) – step 1

PUMF - Dec. 5, 2005

Single flat file

2 sampling weights

– general

– measured body height & weight

Documentation

user guide

data dictionary

derived variables

syntax files / layouts (SAS & SPSS)

B20/20 utility x 2

(36)

Data release(s) – step 2

Step 2:

Nutrition

– May 18, 2006

Assigning food codes to ~ 750,000 records

with Health Canada coding to Canadian Nutrient

File

calculate nutritional profiles for each food using

a processing system designed by Health

Canada for provincial nutrition surveys

Re-issue Step 1 data

Intake distribution software ?

No

(37)

Data release(s) – step 2

4 flat files

general health and nutritional summary data file

1 record per respondent

vitamin and mineral supplements file

1 record per supplement reported

Pending validation

Release postponed

food details file

1 record per food reported

day 1 and 2 intake summary file

1 record per intake day

– 1 record for 2/3 of respondents, 2 records for 1/3 of

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General Health and Nutrition Summary File

Sample ID GEN

1111 x 1112 x

1113 x 15

Day 1 plus usual daily vitamin and mineral details (A + B)

x x x

Day 1 Food Detail summary (B) 1 40 VMD Summary (A) 2 3 0

Vitamin and Mineral Details

Sample ID # VMD 1111 1 x 1111 2 x 1112 1 x 1112 2 x 1112 3 x Food Details

Sample ID # Day Details

1111 1 1 x 1112 1 1 x 1112 … 1 x 1112 40 1 x 1112 1 2 x 1112 … 2 x Roll Up

Intake Day Summary

Sample ID Day Details

1111 1 1

1112 1 40

1112 2 25

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Data release(s) – step 2

nutrition variables

Protein

Fat (total lipids) Carbohydrate, total Energy (kilocalories) Alcohol Mositure Caffeine Energy (kilojoules) Sugars (total)

Fibre, total dietary Calcium Iron Magnesium Phosphorous Potassium Sodium Zinc Vitamin D (IU) Viitmin D (micrograms) Vitamin C Thiamin Riboflavin

Total Niacin Equivalent Vitamin B6

Total Folacin Vitamin B12 Folic Acid Cholesterol

Fatty Acids, Saturated, Total

Fatty Acids, Polyunsaturated, 18:2,

Linoleic

Fatty Acids, Polyunsaturated, 18:3,

Linolenic

Fatty Acids, Monounsaturated, Total Fatty Acids, Polyunsaturated, Total Naturally Occuring Folate

Retinol, Activity Equivalents Dietary Folate Equivalent

(40)

Training & support

Proper use of data / files

Use of intake distribution software

Health Canada – interpretation guide

STC / CIHR RFA funding research

(41)

Data release(s) – obesity

Body Mass Index (BMI)

a measure of person’s weight in relation to

his/her height

highly correlated with body fat and is widely

used to indicate a person’s potential health risks

Measuring BMI

metric:

BMI = weight (kg) / height (m)2

imperial:

(42)

Data Release(s) – Obesity

Body Mass Index (BMI)

Canadian guidelines

in keeping with those of the WHO, classifies BMI into six

categories, each representing a certain level of risk to one’s health

Category BMI value Risk level

underweight BMI < 18.5 increased normal weight 18.5 < BMI < 24.9 least

overweight 25.0 < BMI < 29.9 increased obese class I 30.0 < BMI < 34.9 high

(43)

Measured Obesity Rates by Age

Canada Health Survey (1978/79) and CCHS (2004)

0 5 10 15 20 25 30 35 2-5 6-11 12-17 18-24 25-34 35-44 45-54 55-64 65-74 75+ p er ce n t 1978/79 2004

F

F

*

*

*

*

*

*

*

*

(44)

Obesity Rate Over Time, Age 18+

1978/79 – 2004

0 5 10 15 20 25 /79 85 89 90 /95 /97 /99 /01 03 04 p er ce n t

Measured

Self-reported

(45)

Contact Info

Mario Bédard Ingrid Ledrou

(613) 951-8933 (613) 951-6567

mario.bedard@statcan.ca ingrid.ledrou@statcan.ca

Data Access Unit

Population Health Surveys (NPHS, CCHS)

Health Statistics Division

Statistics Canada

cchs-escc@statcan.ca nphs-ensp@statcan.ca

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