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National Population Health Survey (national + population_health_survey)
Kinds of National Population Health Survey Selected AbstractsThe relationship between major depression and marital disruption is bidirectionalDEPRESSION AND ANXIETY, Issue 12 2009Andrew G. Bulloch Ph.D. Abstract Background: Marital status is important to the epidemiology of psychiatric disorders. In particular, the high prevalence of major depression in individuals with separated, divorced, or widowed status has been well documented. However, the literature is divided as to whether marital disruption results in major depression and/or vise versa. We examined whether major depression influences changes of marital status, and, conversely, whether marital status influences the incidence of this disorder. Methods: We employed data from the longitudinal Canadian National Population Health Survey (1994,2004), and proportional hazards models with time-varying covariates. Results: Major depression had no effect on the proportion of individuals who changed from single to common-law, single to married, or common-law to married status. In contrast, exposure to depression doubled the proportion of transitions from common-law or married to separated or divorced status (HR=2.0; 95% CI 1.4,2.9 P<0.001). Conversely an increased proportion of nondepressed individuals with separated or divorced status subsequently experienced major depression (hazard ratio, HR=1.3; 95% CI 1.0,1.5 P=0.04). Conclusion: The high prevalence of major depression in separated or divorced individuals is due to both an increased risk of marital disruption in those with major depression, and also to the higher risk of this disorder in those with divorced or separated marital status. Thus a clinically significant interplay exists between major depression and marital status. Clinicians should be aware of the deleterious impact of major depression on marital relationships. Proactive management of marital problems in clinical settings may help minimize the psycho-social "scar" that is sometimes associated with this disorder. Depression and Anxiety, 2009. © 2009 Wiley-Liss, Inc. [source] National and Regional Prevalence of Self-reported Epilepsy in CanadaEPILEPSIA, Issue 12 2004José F. Tellez-Zenteno Summary:,Purpose: To assess the point prevalence of self-described epilepsy in the general population nationally, provincially, and in different groups of interest. Methods: We analyzed data from two national health surveys, the National Population Health Survey (NPHS, N = 49,000) and the Community Health Survey (CHS, N = 130,882). Both surveys captured sociodemographic information, as well as age, sex, education, ethnicity, household income, and labor force status of participants. Epilepsy was ascertained with only one question in both surveys. "Do you have epilepsy diagnosed by a health professional?" (NPHS) and "Do you have epilepsy?" (CHS). Prevalences were age-adjusted by using national standard populations at the time of each survey. Exact 95% confidence intervals were obtained. Results: In the NPHS, 241 of 49,026 subjects described themselves as having been diagnosed with epilepsy, yielding a weighted point prevalence of 5.2 per 1,000 [95% confidence interval (CI), 4.9,5.4]. In the CHS, 835 of 130,822 subjects described themselves as having epilepsy, yielding a weighted point prevalence of 5.6 per 1,000 (95% CI, 5.1,6.0). Trends in differences in prevalence among some Canadian provinces were observed. Prevalence was statistically significantly higher in groups with the lowest educational level, lowest income, and in those unemployed in the previous year. Prevalence also was higher in nonimmigrants than in immigrants. Conclusions: The overall and group-specific results are in keeping with those obtained in other developed countries by using different ascertainment methods. We discuss methodologic aspects related to the ascertainment of epilepsy in both surveys, and to the validity and implications of our findings. [source] The effect of health changes and long-term health on the work activity of older CanadiansHEALTH ECONOMICS, Issue 10 2005Doreen Wing Han Au Abstract Using longitudinal data from the Canadian National Population Health Survey (NPHS), we study the relationship between health and employment among older Canadians. We focus on two issues: (1) the possible problems with self-reported health, including endogeneity and measurement error, and (2) the relative importance of health changes and long-term health in the decision to work. We contrast estimates of the impact of health on employment using self-assessed health, an objective health index contained in the NPHS , the HUI3, and a ,purged' health stock measure. Our results suggest that health has an economically significant effect on employment probabilities for Canadian men and women aged 50,64, and that this effect is underestimated by simple estimates based on self-assessed health. We also corroborate recent US and UK findings that changes in health are important in the work decision. Copyright © 2005 John Wiley & Sons, Ltd. [source] Self-reported use of mental health services versus administrative records: care to recall?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2004Anne E. Rhodes Abstract Estimates of the level of unmet need for mental health treatment often rely on self-reported use of mental health services. However, depressed persons may over-report their use in relation to administrative records if they are highly distressed. This study seeks to replicate and explicate the finding that persons at a high level of distress report more mental health service use than recorded in their healthcare records. The study sample, N=36,892, 12 years and older, was drawn from the 1996/97 Ontario portion of the Canadian National Population Health Survey. Respondents were individually linked to their administrative mental healthcare records 12 months backward in time. Of these, 96.5% agreed to the link and 23,063 (62.5%) were linked. Almost two-thirds of those who were depressed in the past year were currently at a high level of distress. Differential reporting of use for highly distressed persons in excess of 100% remained in the use of different types of physician providers after adjustments for other potential determinants of use. Telescoping was also not an explanation. The patterns of differential reporting between groups expected to diverge and converge in their recall ability were consistent with a recall bias. As this study was not able to rule out a recall bias, it further accentuates concerns about the impact of bias in the measurement of mental health-service use and inferences made concerning the determinants of use. Copyright © 2004 Whurr Publishers Ltd. [source] Self-reported use of mental health services versus administrative records: should we care?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2002Dr Anne E. Rhodes Abstract Studies of mental health services have emphasized that people in need are not receiving treatment. However, these studies, based on self-reported use, may not be consistent with administrative records. This study compared self-reports of mental health service use with administrative records in a large representative sample. Respondent reports within the Ontario portion of the 1994/95 Household Component of the National Population Health Survey (NPHS) were individually linked to the provincial mental-health physician reimbursement claims. A total of 5,187 Ontarians, aged 12 years or more, reported on their use of mental healthcare within the NPHS and 4,621 (89%) consented and were successfully linked to administrative records. Comparisons between the two sources identified that the agreement for any use and volume of use was moderate to low and varied according to select respondent characteristics. These differences affected estimates of the associations with use and volume of use. People who reported high levels of distress reported more visits than those who did not and this effect was stronger in the self-reported data. These results suggest that recall bias may be present. Regardless of the definition of care, access for those in need remains a concern despite universal medical insurance coverage. Copyright © 2002 Whurr Publishers Ltd. [source] The geographies of crisis: exploring accessibility to health care in CanadaTHE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2002KATHLEEN WILSON There is increasing concern in Canada that the health care system is in a state of crisis. It is argued that reductions in federal government transfers to the provinces have resulted in a health care system characterized by under-funding in key areas and policy decisions based more on provincial fiscal concerns than the health needs of their constituents. Provincial governments have responded to reduced levels in federal funding by undertaking aggressive restructuring tactics such as the closure of hospitals and the deinsuring of medical services from provincial health plans. The end result of this restructuring, as argued by the media, consumer groups and indeed some health researchers, is a state of crisis' (i.e., lower levels of accessibility, long waiting lists, overcrowding in hospitals and increasing costs of medication). One crisis theme often mentioned is that fiscal decisions of various kinds are reducing economic and geographic accessibility, one of the five principles of the Canada Health Act (CHA) that defines the very essence of the Canadian health care system. Using data from the 1998-99 National Population Health Survey (NPHS), this paper explores the extent to which an accessibility crisis exists within the Canadian health care system by examining access to health care services and the barriers encountered in trying to access services in each of the ten provinces. The results show that approximately 6.0 percent of Canadians report access problems, with values ranging from 4.5 percent in Newfoundland to 8.3 percent in Manitoba. Regional variations in barriers to accessing care were also observed. In particular, geographic accessibility appears to be a main barrier to care in Atlantic Canada while economic accessibility emerges as a main barrier to care in Western Canada. We discuss these findings in the context of the current debates on the Canadian health care system ,crisis'. De plus en plus de Canadiens s'inquiétent que leur systéme de soins de santé soit en état de crise. On défend l'idée selon laquelle la réduction des paiements de transfert aux provinces par le gouvernement fédéral serait responsable de l'état d'un systeme de santé caractérisé par un sous-financement dans les domaines-clés et des décisions politiques de santé basées, non pas sur les besoins des membres de la société canadienne, mais sur la fiscalité provinciale. Les gouvernements provinciaux ont réagi à la réduction du financement fédéral par une tactique de restructuration agressive (fermeture d'hôpitaux et retrait de services médicaux des programmes d'assurance de santé provinciaux). Selon les médias, les groupes de consommateurs et même les chercheurs en soins de santé, cette restructuration a eu pour effet un système en état de ,crise' (diminution de l'aecès aux services, longues fetes d'attente, hôpitaux surchargés, augmentation des coûts des médicaments etc). Un des thèmes récurrent est celui des décisions flscales de toutes sortes qui entraînent une baisse de l'accessibilité financière et géographique. Cette accessibilité est pourtant un des cinq principes de la Loi canadienne sur la santé définissant l'essence même du système de santé au Canada. Utilisant les données tirèes de l'Enquête nationale sur la santé de la population, 1998-99 et examinant l'accès aux services de santé et les obstacles rencontrés dans les 10 provinces canadiennes, cet article évalue dans quelle mesure une crise d'accessibilité existe au sein du système de santé canadien. Les résultats démontrent qu'environ 6.0 pour cent des Canadiens ont rencontré des problèmes d'accessibilité, avec des variantes allant de 4.5 pour cent à Terre-Neuve jusqu'à 8.3 pour cent au Manitoba. On observe aussi des variantes régionales dans les obstacles rencontrés. L'accessibilité géographique en particulier semble un obstacle mqjeur dans les régions de l'Atlantique, alors que l'accessibilite financière semble être un obstacle majeur dans l'Ouest du Canada. Ces résultats sont présentés dans le contexte des débats actuels sur l'existence dune, ,crise' dans le système de santé au Canada. [source] Psychiatric Comorbidity in Epilepsy: A Population-Based AnalysisEPILEPSIA, Issue 12 2007Jose F. Tellez-Zenteno Summary Purpose: The estimated prevalence of mental health disorders in those with epilepsy in the general population varies owing to differences in study methods and heterogeneity of epilepsy syndromes. We assessed the population-based prevalence of various psychiatric conditions associated with epilepsy using a large Canadian national population health survey. Methods: The Canadian Community Health Survey (CCHS 1.2) was used to explore numerous aspects of mental health in persons with epilepsy in the community compared with those without epilepsy. The CCHS includes administration of the World Mental Health Composite International Diagnostic Interview to a sample of 36,984 subjects. Age-specific prevalence of mental health conditions in epilepsy was assessed using logistic regression. Results: The prevalence of epilepsy was 0.6%. Individuals with epilepsy were more likely than individuals without epilepsy to report lifetime anxiety disorders or suicidal thoughts with odds ratio of 2.4 (95% CI = 1.5,3.8) and 2.2 (1.4,3.3), respectively. In the crude analysis, the odds of lifetime major depression or panic disorder/agoraphobia were not greater in those with epilepsy than those without epilepsy, but the association with lifetime major depression became significant after adjustment for covariates. Conclusions: In the community, epilepsy is associated with an increased prevalence of mental health disorders compared with the general population. Epilepsy is also associated with a higher prevalence of suicidal ideation. Understanding the psychiatric correlates of epilepsy is important to adequately manage this patient population. [source] | ||||||||||