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PubMed1992

Reductions in age-specific mortality among children and seniors in Canada and the United States, 1971-1989.

We compared mortality rates for children and seniors in Canada and the United States in 1971 and 1989. Children in Canada experienced a greater decrease in mortality during this period than did all children in the United States. In particular, while mortality rates for both boys and girls in Canada were higher than those for White children in the United States in 1971, in 1989 the rates for Canadian children were lower. Seniors in Canada experienced a similar or lesser reduction in age-specific mortality than did seniors in the United States. Even though senior women in the United States experienced a reduction in mortality comparable to that of senior women in Canada, Canadian senior women in general had lower level of mortality than their counterparts in the United States. Senior men in the United States experienced a relatively greater reduction than did their counterparts in Canada. The greater decline in mortality for senior men in the United States enabled them to catch up with the lower level of mortality for their Canadian counterparts in 1989. These general conclusions apply whether we compare the Canadian experience to that of the entire population or the White population in the United States. These trends in mortality reductions may reflect the fact that free universal Medicare is available for all ages in Canada, while most publicly-funded Medicare entitlements begin at age 65 in the United States.

Adolescent↗
PubMed2003

Hospitalization rates and length of stay for cardiovascular conditions in Canada, 1994 to 1999.

BACKGROUND: Cardiovascular diseases (CVDs) are a leading cause of hospitalization in Canada. An examination of recent trends in cardiovascular hospitalization rates across Canada is of considerable value and interest to health policy decision makers and administrators, clinicians and researchers. OBJECTIVES: To examine temporal trends and regional variation in hospitalization rates and length of stay for CVD conditions in Canada. METHODS: Hospital discharge data for fiscal years 1994/95 to 1999/2000 were used to identify all Canadians who were hospitalized with the most responsible diagnoses of acute myocardial infarction (AMI), congestive heart failure (CHF), angina and chest pain. Direct age- and sex-standardized hospitalization rates were calculated by province and health region. Length of stay (LOS) for episodes of hospital care were adjusted for age, sex and cardiac procedures using ordinary least squares regression. RESULTS: Overall, AMI, angina and chest pain hospitalization rates increased 6%, 8% and 11%, respectively, between fiscal years 1994/95 and 1999/2000 and decreased by 7% for CHF in Canada. There was wide regional variation in cardiovascular hospitalization rates in Canada, with the greatest variation seen in CHF, chest pain and angina, and the least seen in AMI. There was a modest downward trend in adjusted LOS between fiscal years 1994/95 and 1999/2000. In general, patients hospitalized in provinces in western Canada and Ontario had shorter LOS for all conditions when compared with those in Quebec and the eastern provinces. CONCLUSIONS: AMI, angina and chest pain hospitalization rates in Canada increased between fiscal years 1994/95 and 1999/2000, while CHF rates declined. There is considerable regional variation in the cardiovascular hospitalization rates across the country that may be amenable to further interventional strategies.

Adult↗
PubMed1998

Cardiac pacing in Canada in 1998: working towards optimal pacing therapy. Canadian Working Group on Cardiac Pacing.

The Canadian Working Group on Cardiac Pacing (CWGCP) was formed in 1996 with the primary goal of promoting optimal pacing therapy in Canada. In 1997, the CWGCP conducted a survey of pacing practices across Canada. Ninety-two of 125 implanting programs (74%) responded. Implant rates vary by province--from 39 per 100,00 population in Ontario to 63 per 100,000 population in Nova Scotia and Prince Edward Island. Variations in regional implant rates persist even after correcting for the age of the population. Physiological pacing was used for 35% of all implants in Canada in 1996/97. There were marked differences across Canada in the mode of pacing selected. In western Canada, 39.5% of pacing systems implanted were physiological compared with 18.2% in Atlantic Canada and 29% in Quebec. There were also differences in follow-up practices. Approximately 40% of centres follow patients with single chamber pacemakers annually, whereas most other centres still follow these patients every six months. Economic constraints, the size of pacing programs and the involvement of committed pacing physicians are factors that may influence the regional differences in cardiac pacing across Canada.

Canada↗
PubMed2005

Comparison of nicarbazin absorption in chickens, mallards, and Canada geese.

Nicarbazin (NCZ), a coccidiostat commonly used in the poultry industry, causes reduced hatchability and egg quality in layer hens at a concentration of 125 ppm (8.4 mg/kg) in the feed. Although this effect is undesirable in the poultry industry, NCZ could provide a useful wildlife contraception tool for waterfowl, particularly urban geese. We tested the absorption of NCZ in chickens (Gallus gallus), mallards (Anas platyrhynchos), and Canada geese (Branta canadensis) gavaged with 8.4 mg of NCZ/kg per bird each day for 8 d. Plasma levels of 4,4'-dinitrocarbanilide (DNC) differed significantly among species. Peak plasma DNC levels were 2.87 +/- 0.15 microg/mL, 2.39 +/- 0.15 microg/mL, and 1.53 +/- 0.15 microg/ mL in chickens, mallards, and Canada geese respectively. It took 6 d to obtain peak DNC levels in chickens as opposed to 8 d in mallards and Canada geese. The half life of DNC in plasma was 1.43 d in chickens, 0.72 d in mallards, and 1.26 d in Canada geese. Mallards eliminated 100% of plasma DNC 4 d post-treatment, whereas Canada geese eliminated 100% of plasma DNC 8 d post-treatment. Chickens had only eliminated 99% of plasma DNC 8 d post-treatment. Mallard plasma DNC levels were highly correlated with Canada goose plasma DNC levels. This research showed mallards are an ideal model species for the Canada goose for future reproductive studies on NCZ in a laboratory setting. However, levels higher than 8.4 mg/kg must be fed to waterfowl in order to obtain a plasma level comparable to chickens.

Animals↗
PubMed1998

Tuberculosis among immigrants: interval from arrival in Canada to diagnosis. A 5-year study in southern Alberta.

OBJECTIVE: To examine the pattern of tuberculosis (TB) occurring among immigrants and the interval from arrival in Canada to diagnosis of the disease. DESIGN: Study of all cases of TB diagnosed in foreign-born residents of southern Alberta during the 5-year period 1990-1994. SETTING: A centre for the diagnosis, management and control of all cases of TB in the southern half of the province of Alberta. METHODS: All foreign-born patients in whom TB was newly diagnosed between January 1990 and December 1994 were included in the study. The interval from their arrival in Canada to diagnosis, their country of birth and the site of their disease were documented. RESULTS: Immigrants to Canada accounted for 248 (70.6%) of the 351 cases of TB diagnosed in southern Alberta during the 5-year period. The majority of these immigrants (182/248 [73.4%]) were of Asian origin. Extrapulmonary TB accounted for 111 (61.0%) of the 182 cases of the disease in Asian immigrants. The mean period between immigration and diagnosis was 11.2 years (standard deviation [SD] 13.9 years). Half of the patients presented within 7 years of their arrival in Canada. The time to presentation was shortest for patients with superficial lymph node disease (mean 7.6 years [SD 6.9] after arrival), intermediate among those with extrapulmonary disease, excluding superficial disease of the lymph node (10.1 years [SD 12.1]), and longest for those with pulmonary disease (14.2 years [SD 17.2]). TB developed sooner after arrival in Canada among immigrants from Asian countries (mean 9.1 years) than among those from other countries (17.2 years) (p = 0.01). CONCLUSIONS: Given the low annual incidence of TB in Canada (7.1 per 100,000), it is probable that TB occurring among immigrants reflects infection acquired before arrival in Canada. Health care professionals need to be aware that immigrants from countries with a relatively high prevalence of TB remain at risk for the disease (often at an extrapulmonary site) for many years after they immigrate to low-prevalence countries.

Adult↗
PubMed2004

Prevalence of weather sensitivity in Germany and Canada.

Several studies have shown that atmospheric conditions can affect well-being or disease, and that some individuals seem to be more sensitive to weather than others. Since epidemiological data on the prevalence of weather-related health effects are lacking, two representative weather sensitivity (WS) surveys were conducted independently in Germany and Canada. The objectives of this paper are: (1) to identify the prevalence of WS in Germany and Canada, (2) to describe weather-related symptoms and the corresponding weather conditions, and (3) to compare the findings in the two countries. In Germany 1,064 citizens (age >16 years) were interviewed in January 2001, and in Canada 1,506 persons (age >18 years) were interviewed in January 1994. The results showed that 19.2% of the German population thought that weather affected their health "to a strong degree," 35.3% that weather had "some influence on their health" (sum of both = 54.5% weather sensitive), whereas the remaining 45.5% did not consider that weather had an effect on their health status. In Canada 61% of the respondents considered themselves to be sensitive to the weather. The highest prevalence of WS (high + some influence) in Germans was found in the age group older than 60 years (68%), which was almost identical in the Canadian population (69%). The highest frequencies of weather-related symptoms were reported in Germany for stormy weather (30%) and when it became colder (29%). In Canada mainly cold weather (46%), dampness (21%) and rain (20%) were considered to affect health more than other weather types. The most frequent symptoms reported in Germany were headache/migraine (61%), lethargy (47%), sleep disturbances (46%), fatigue (42%), joint pain (40%), irritation (31%), depression (27%), vertigo (26%), concentration problems (26%) and scar pain (23%). Canadian weather-sensitive persons reported colds (29%), psychological effects (28%) and painful joints, muscles or arthritis (10%). In Germany 32% of the weather-sensitive subjects reported themselves to be unable to do their regular work because of weather-related symptoms at least once in the previous year, and 22% of them several times. Co-morbidity was significantly higher in weather-sensitive subjects both in Germany and Canada. These results clearly showed the important impact of WS on public health and the economy. These findings prompted us to start studies on the causal factors of weather-related health effects.

Adolescent↗
PubMed2006

Organochlorines and mercury in waterfowl harvested in Canada.

Samples of breast muscle from 32 species of waterfowl collected from 123 sites across Canada were analyzed for chlorobenzenes (CBz), chlordane-related compounds (CHL), hexachlorocyclohexanes (HCH), DDT, mirex, dieldrin, PCBs and mercury. SigmaDDT, SigmaCBz and SigmaPCB were the compounds most frequently found above trace levels. SigmaHCH and SigmaMirex were detected the least often. Mercury was detected in all of the mergansers, over 50% of dabbling, bay and sea ducks, and in less than 2% of the geese analysed. The highest levels of contaminants were generally found in birds feeding at higher trophic levels such as sea ducks and mergansers. With the exception of a few samples of mergansers and long-tailed ducks from eastern Canada, which contained SigmaPCB concentrations of 1.0-2.4 mg kg(-1), SigmaPCB levels were less than 1 mg kg(-1) wet weight. Only one merganser from eastern Canada had a SigmaDDT concentration (2.6 mg kg(-1) ww) which was greater than 1 mg kg(-1) ww. The highest SigmaCHL (0.10 mg kg(-1) ww) was also found in mergansers from eastern Canada. Levels of total mercury in breast muscle were either low (< 1 mg kg(-1) ww) or below detection limits with the exception of a few samples of mergansers from eastern Canada which contained mercury concentrations of 1.0-1.5 mg kg(-1) ww. Health Canada determined that the organochlorine and mercury levels found in samples of breast muscle of ducks and geese analysed in this study did not pose a health hazard to human consumers and therefore these waterfowl were safe to eat.

Animals↗
PubMed2006

An overview of illegal opioid use and health services utilization in Canada.

OBJECTIVES: Systematic research on health and treatment services availability for and utilization by illegal opioid users in Canada are very limited. Comparative data across provinces and territories is almost entirely absent. This study was designed to provide an overview of illegal opioid use and health services utilization among illegal opioid users across Canada. METHODS: A combination of statistical data and key informant data was used. Surveys were sent to key informants in all provinces and territories of Canada. Survey questions covered the number of illegal opioid users in each province, the number of opioid users receiving methadone maintenance treatment (MMT), the number of physicians authorized to prescribe methadone, and the number of opioid users receiving other outpatient and inpatient treatment. In addition, relevant data were collected from several statistical sources, both provincial and federal. The number of substance-use-related overdose deaths was obtained from the provincial coroners' offices. RESULTS: It is estimated that there were more than 80,000 regular illegal opioid users in Canada in 2003. The most prevalent treatment utilized was MMT; about one-quarter (26%) of the estimated opioid users received this type of treatment in 2003. Other forms of outpatient and inpatient treatment were of only minor importance compared with MMT. The number of illegal drug-related overdose deaths in Canada was 958 in 2002. Rates of drug use, health services utilization and overdose deaths showed considerable variation by province. CONCLUSIONS: Although the opioid use treatment system in Canada has expanded in recent years, especially with respect to the availability of MMT, the treatment utilization rates are still lower than in most countries in Western Europe. Rates of current treatment utilization as well as the relatively high number of overdose deaths suggest that there is still room for improvement in the Canadian health and social care system with respect to opioid use.

Adolescent↗
PubMed2000

An inventory of historical mercury emissions in maritime canada: implications for present and future contamination.

Mercury is a longstanding concern in Maritime Canada due to high levels of contamination in a number of fish and bird species. The recycled component of past releases of anthropogenic mercury may be a significant source of ongoing pollution in many areas. Historical information on mercury releases can be used to quantify past and present anthropogenic contamination. We present an inventory of historical mercury emissions from anthropogenic sources in Maritime Canada for the years 1800-1995. Long-term trends in mercury emissions and the significance of the cumulative burden of mercury released from local sources are discussed. Emissions are calculated using both historical monitoring data and the application of emission factors. The nature of current anthropogenic sources of mercury is quite different than it was several decades ago when many of the existing policies governing mercury pollution were created. Our inventory illustrates that many of the most significant sources in the past such as the chlor-alkali industry, paint containing mercury additives, and pharmaceuticals, have been largely phased out with fossil fuel combustion and waste disposal remaining as the most significant modern sources. Atmospheric emissions in Maritime Canada peaked in 1945 (> 1,750 kg year-1), and again between 1965 and 1970 (> 2,600 kg year-1). Cumulative releases of mercury from anthropogenic sources for the years 1800-1995 were between 115 and 259 t to the atmosphere alone, and 327-448 t when discharges to wastewater and effluents were included. Assuming that only 0.2% (Nriagu, 1994.) of these releases become part of the recycled fraction of current fluxes, we estimate that between 570 and 900 kg Hg year-1 is deposited in Maritime Canada from past anthropogenic sources. Modern sources within Maritime Canada contribute at least 405 kg year-1 to the total annual deposition of 1.71 t over the provinces of New Brunswick, Nova Scotia and Prince Edward Island, leaving approximately 735 kg year-1 from natural sources and long-range contamination. Further study is needed to verify these estimates and clarify the significance of natural and long-range sources of mercury in Maritime Canada.

Canada↗
PubMed2003

Timeliness of review and approval of new drugs in Canada from 1999 through 2001: is progress being made?

BACKGROUND: The median time to approval of new drugs in Canada decreased considerably in the mid-1990s, although it continued to be longer than in such countries as Australia, Sweden, the United Kingdom, and the United States. Ongoing concern about approval times pointed to a need for a further international comparison. OBJECTIVE: This study was designed to assess whether there have been continuing improvements in drug approval times in Canada relative to these other countries. METHODS: Application and approval dates of new chemical or biological substances approved for marketing from 1999 through 2001 were requested from the Canadian, Australian, and Swedish regulatory agencies. Information for the United States was derived from publications of the Pharmaceutical Research and Manufacturers of America. The regulatory agency for the United Kingdom does not release application dates, although these were the same as the Swedish application dates for most drugs approved in both countries through the centralized European Union (EU) review procedure. Application dates for drugs licensed under the EU mutual-recognition arrangement or in the United Kingdom only were requested from the relevant pharmaceutical companies. RESULTS: One hundred eighty-six new drugs were approved in >/=1 of the countries studied between January 1999 and December 2001: 17 (9.1%) in all 5 countries, 25 (13.4%) in 4, 27 (14.5%) in 3, 39 (21.0%) in 2, and 78 (41.9%) in 1. Approval times were longer in Canada than in Australia, although not significantly so (median time, 645 and 551 days, respectively). Canadian and Australian approval times were significantly longer than those in Sweden (431 days), the United Kingdom (479 days), and the United States (371 days) (P < 0.001). The annual median approval time in Canada increased in each of the 3 years. The approval times of priority-reviewed drugs in Canada were significantly longer than in the United States (median 317 vs 232 days) but significantly shorter than in Australia (509 days) (both comparisons, P < 0.001). CONCLUSIONS: Overall approval times of new drugs in Canada were longer than those in Australia, Sweden, the United Kingdom, and the United States in the period studied. The findings warrant ongoing monitoring of Canadian drug approval times.

Australia↗
PubMed2002

A pharmacoeconomic evaluation of results from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES) in Norway and Canada.

INTRODUCTION: The objective of this analysis was to evaluate the health economic benefits of using amlodipine in patients undergoing angioplasty procedures in Canada and Norway. METHODS: A decision tree model was constructed to find the total expected cost per patient for a 4-month time period following an initial angioplasty. The model used clinical data from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES), a prospective, randomized, double blind, placebo-controlled trial conducted to investigate the effects of amlodipine on restenosis and clinical events in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Outcomes of interest to this analysis included MI, repeat PTCA, CABG, and all-cause mortality. Clinical experts from Canada and Norway were enlisted and a modified Delphi study approach was used to quantify healthcare resources consumed for each clinical outcome. RESULTS: The use of amlodipine decreased the rates of MI, PTCA, and CABG by 2.0, 4.7, and 2.7%, respectively. The total expected cost per patient using amlodipine was $6,398.30 (US$4,323) in Canada and kr 59,993.27 (US$6,846) in Norway. The total expected cost per patient not using amlodipine was $6,519.37 (US$4,405) in Canada and kr 64,292.17 (US$7,337) in Norway. The model demonstrated potential cost-savings over a 4-month follow up period resulting from the improved clinical outcomes for patients using amlodipine with PTCA--$121,071 (US$81,844) per 1000 patients in Canada and kr 4,298,899 (US$490,074) per 1000 patients in Norway. CONCLUSIONS: The adjunctive use of amlodipine is a cost-effective therapeutic strategy to achieve more favorable clinical outcomes in patients undergoing PTCAs in Canada and Norway.

Amlodipine↗
PubMed2004

Availability of hormone replacement therapy products in Canada.

OBJECTIVES: To determine the availability in Canada of different types of hormone replacement therapy (HRT) products, and to compare the availability of HRT products in Canada to their availability in other countries. METHODS: A systematic review was conducted of the availability of products indicated for treatment of menopausal symptoms in Canada, the United States (US), the United Kingdom (UK), Sweden, and Australia. Products indicated for the treatment of menopausal symptoms were determined for each country by using on-line drug product databases. Products administered by injection and androgen products, unless combined with estrogens, were excluded from the analysis. RESULTS: There were 111 different brands identified in the 5 countries examined, with Canada having the lowest number of brands and active ingredients (28 and 22, respectively) compared to the other countries (Sweden and UK at 67 and 47 brands and 39 and 40 active ingredients, respectively). Not available in Canada are 34 active ingredients (either alone or in combination products) and 5 different types of formulations of HRT. There was a significant difference between the number of combination brand products available in Canada and in the UK (5 versus 29, P <.001, respectively). CONCLUSIONS: Canadian women have comparatively few options available to them for the management of menopausal symptoms. The wide range of HRT products available in other developed countries provides alternatives for managing side

Australia↗
PubMedDate not supplied

Terrorism in Canada.

This paper reviews terrorism in Canada, assessing the incidence and nature of terrorist activity, the potential targets of terrorist attacks, risk factors to Canadian nationals and institutions, and the responses of the Canadian government in dealing with the threat and the effectiveness of those responses. Despite the fact that there have been no recent high-profile terrorist events in Canada, this country has a serious terrorism problem, the key manifestation of which is the multitude of terrorist organizations that have designated Canada as a base of operations. In addition, Canadians have been attacked overseas and Canadian organizations, both local and abroad, are potential targets of terrorist activity. Canadian attempts to deal with terrorism through foreign and domestic policy have been ineffective, primarily because the policies have been poorly enforced. Until recently, terrorist organizations legally could raise funds in Canada, in direct contravention of international treaties signed by Canada. It is possible that the ineffectiveness in enforcing the anti-terrorism legislation stems from hope that placating terrorist organizations, and the countries that support them, will prevent Canada from becoming a target. Unfortunately evidence from other countries has shown this strategy to be ineffective.

Bioterrorism↗
PubMed2003

A survey of dental hygienist numbers in Canada, the European Economic area, Japan and the United States of America in 1998.

OBJECTIVE: The aims of this study were to establish how many dental hygienists were licensed to practice in Canada, Japan, USA and the 18 member states of the European Economic Area (EEA) and to compare these with the populations and numbers of dentists practising in the countries concerned. METHOD: Data for the overall populations, numbers of 'active' dentists, of dental hygienists and of employed dental hygienists in the member states of the EEA in 1998 were taken from the responses to a Council of European Chief Dental Officers survey carried out in 2000/2001. Data for these variables for Canada, Japan and the USA in 1998 were accessed from published reports. The ratios of population: active dentist; population: dental hygienist; and active dentist: dental hygienist were calculated and compared. RESULTS: The overall populations and total number of active dentists in the 18 EEA member states and Canada plus Japan plus the USA were broadly similar in 1998 (EEA overall population 381 million with 245169 active dentists: Canada/Japan/USA overall population 421 million with 253825 active dentists). However, there were only 13295 dental hygienists in the EEA as opposed to a total of 215435 in Canada, Japan and the USA. In terms of population:dental hygienist and active dentist: dental hygienist ratios the UK was found to have proportionally far fewer dental hygienists than Canada, Japan, USA or the four Nordic members of the EEA. CONCLUSION: The survey revealed that relative to overall populations and numbers of dentists, there are far fewer dental hygienists in the EEA than in Canada, Japan and the USA and that scope for the UK to import dental hygienists from other EEA member states is probably very limited.

Canada↗
PubMed1993

Hospital expenditures in the United States and Canada.

BACKGROUND: Expenditures per capita for hospitals are higher in the United States than in Canada. If the United States had the same spending pattern as Canada, the annual savings in 1985 would have exceeded $30 billion. METHODS: We used data from published sources, computer files, and institutional reports to compare 1987 costs for acute care hospitals on three levels: national (the United States vs. Canada), regional (California vs. Ontario), and institutional (two California hospitals vs. two Ontario hospitals). Expenditures per admission were adjusted for the case mix of patients, prices of labor and other resources, and outpatients visits. RESULTS: The United States had proportionately fewer hospital beds than Canada (3.9 vs. 5.4 per 1000 population), fewer admissions (129 vs. 142 per 1000 population), and shorter mean stays (7.2 vs. 11.2 days). Higher costs per admission in the United States were explained in part by a case mix that was more complex by 14 percent and by prices for labor, supplies, and other hospital resources that were higher by 4 percent. Hospitals in the United States provided relatively less outpatient care, particularly in emergency departments (320 vs. 677 visits per 1000 population). After all adjustments, the estimate of resources used for inpatient care per admission was 24 percent higher in the United States than in Canada and 46 percent higher in California than in Ontario. The estimated differences between the two pairs of California and Ontario hospitals were 20 and 15 percent. CONCLUSIONS: Canadian acute care hospitals have more admissions, more outpatient visits, and more inpatient days per capita than hospitals in the United States, but they spend appreciably less. The reasons include higher administrative costs in the United States and more use of centralized equipment and personnel in Canada.

California↗
PubMed1993

Physicians' perspectives on caring for patients in the United States, Canada, and West Germany.

BACKGROUND: The United States is considering enacting a national health plan and global health care budget similar to those in other countries. There are few data on the effects of such policies on physicians and patients. METHODS: We conducted a telephone survey of 602 physicians in the United States, 507 physicians in Canada, and 519 physicians in the former West Germany from February through May 1991; the response rates were 44 percent, 49 percent, and 41 percent, respectively. Among other topics, the questionnaire included measures of satisfaction with the health care system and with medical practice. RESULTS: In the United States, 23 percent of the physicians surveyed thought the health care system worked well, as compared with 33 percent in Canada and 48 percent in West Germany. Seventy-three percent of U.S. physicians reported that patients' inability to afford necessary treatment was a serious problem, as compared with 25 percent in Canada and 15 percent in West Germany. Seventy-seven percent of West Germany physicians, 56 percent of Canadian physicians, and 54 percent of U.S. physicians said the shortage of competent nurses was a serious problem. In Canada, 50 percent of the respondents cited the lack of well-equipped medical facilities as a problem, as compared with 14 percent in the United States and 20 percent in West Germany. CONCLUSIONS: Programs of universal coverage and cost containment necessitate important trade-offs. In Canada and West Germany, physicians do not report serious problems of access to care for the poor and uninsured. In the United States, doctors do not face the limited access to sophisticated forms of medical technology that was reported in Canada or the diminished quality of some services reported in West Germany.

Adult↗
PubMed2004

Blindness registrations and socioeconomic factors in Canada: an ecologic study.

PURPOSE: To investigate the socioeconomic factors associated with blindness registration in Canada and its regions using an ecologic approach. METHODS: Canadian National Institute for the Blind (CNIB) blindness registration data for 1996 were divided into units of analysis using postal codes and correlated with demographic and socioeconomic information collected by the 1996 Census of Canada. A total of 1250 units were analyzed representing 28,429,519 persons (98.55% of the population of Canada). Six socioeconomic factors were examined using weighted linear multivariate regression analysis: I) Percentage of the population aged 65 years and over; 2) Median household income; 3) Percentage of the population with university education; 4) Percentage of income derived from government transfer payments; 5) Recent immigrants; and 6) Visible minorities (blacks, Chinese, South Asians). Regression models were created for Canada as well as five geographic regions within Canada. RESULTS: For Canada as a whole, blindness registration prevalence was positively correlated with age distribution and percentage of recent immigrants, and negatively correlated with level of government assistance income and percentage ethnic Chinese population. For five regional regression models, the common predictor variables were age distribution, median household income and percentage of the population who are black. None of the regional models produced an identical set of correlations. CONCLUSIONS: Socioeconomic factors associated with blindness registration prevalence varied across different regions. Median household income was the second most common factor after age distribution, suggesting that areas with lower incomes tend to utilize more blind services. Higher blindness registration rates were associated with areas that had a higher percentage of the population who were black. Differences in blindness registration rates may reflect under-utilization of blind services and/or variations in disease and treatment rates in different populations.

Aged↗
PubMed2006

Assessment and management of residential radon health risks: a report from the health Canada radon workshop.

Epidemiologic studies of uranium miners and other underground miners have consistently shown miners exposed to high levels of radon to be at increased risk of lung cancer. More recently, concern has arisen about lung cancer risks among people exposed to lower levels of radon in homes. The current Canadian guideline for residential radon exposure was set in 1988 at 800 Bq/m(3). Because of the accumulation of a considerable body of new scientific evidence on radon lung cancer risks since that time, Health Canada sponsored a workshop to review the current state-of-the-science on radon health risks. The specific objectives of the workshop were (1) to collect and assess scientific information relevant to setting national radon policy in Canada, and (2) to gather information on social, political, and operational considerations in setting national policy. The workshop, held on 3-4 March 2004, was attended by 38 invited scientists, regulators, and other stakeholders from Canada and the United States. The presentations on the first day dealt primarily with scientific issues. The combined analysis of North American residential radon and lung cancer studies was reviewed. The analysis confirmed a small but detectable increase in lung cancer risk at residential exposure levels. Current estimates suggest that radon in homes is responsible for approximately 10% of all lung cancer deaths in Canada, making radon the second leading cause of lung cancer after tobacco smoking. This was followed by a perspective from an UNSCEAR (United Nations Scientific Committee on the Effects of Atomic Radiation) working group on radon. There were two presentations on occupational exposures to radon and two presentations considered the possibility of radon as a causative factor for cardiovascular disease and for cancer in other organs besides the lung. The possible contribution of environmental tobacco smoke to lung cancers in nonsmokers was also considered. Areas for future research were identified. The second day was devoted to policy and operational issues. The presentations began with a perspective from the U.S. Environmental Protection Agency, followed by a history of radon policy development in Canada. Subsequent presentations dealt with the cost-effectiveness of radon mitigation, Canadian building codes and radon, and a summary of radon standards from around the world. Provincial representatives and a private consultant were given opportunities to present their viewpoints. A number of strategies for reducing residential radon exposure in Canada were recognized, including testing and mitigation of existing homes (on either a widespread or targeted basis) and changing the building code to require that radon mitigation devices be installed at the time a new home is constructed. The various elements of a comprehensive national radon policy were set forth.

Air Pollutants, Radioactive↗