Lifestyle Habits and Health Indicators of Québec Anglophones (PDF)

LANGUAGE AS A DETERMINANT OF HEALTH STATUS AND SERVICE QUALITY INSTITUT NATIONAL DE SANTÉ PUBLIQUE DU QUÉBEC Lifestyle Habits and Health Indicators of Québec Anglophones   Lifestyle Habits and Health Indicators of Québec Anglophones Vice-présidence aux affaires scientifiques July 2013  AUTHORS Marie-Hélène Lussier, Planning, Programming, and Research Agent Vice-présidence aux affaires scientifiques Normand Trempe, Project Manager Vice-présidence aux affaires scientifiques LAYOUT Hélène Fillion, Administrative Assistant Vice-présidence aux affaires scientifiques ACKNOWLEDGEMENTS This analysis was produced as part of the Official Language Minority Community Health Projects at Institut national de santé publique du Québec (INSPQ) with funding from the Community Health and Social Services Network (CHSSN) within Health Canada’s Official Languages Health Contribution Program. This document is available in its entirety in electronic format (PDF) on the Institut national de santé publique du Québec Web site at: http://www.inspq.qc.ca. Reproductions for private study or research purposes are authorized by virtue of Article 29 of the Copyright Act. Any other use must be authorized by the Government of Québec, which holds the exclusive intellectual property rights for this document. Authorization may be obtained by submitting a request to the central clearing house of the Service de la gestion des droits d’auteur of Les Publications du Québec, using the online form at http://www.droitauteur.gouv.qc.ca/en/autorisation.php or by sending an e-mail to [email protected]. Information contained in the document may be cited provided that the source is mentioned. LEGAL DEPOSIT – 3rd QUARTER 2013 BIBLIOTHÈQUE ET ARCHIVES NATIONALES DU QUÉBEC LIBRARY AND ARCHIVES CANADA ISBN: 978-2-550-62942-9 (FRENCH PDF [set]) ISBN: 978-2-550-68755-9 (FRENCH PDF) ISBN: 978-2-550-62944-3 (PDF [set]) ISBN: 978-2-550-68756-6 (PDF) © Gouvernement du Québec (2013)  Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec I ABSTRACT As part of an initiative to evaluate the health status of Québec anglophones, their lifestyle habits and certain health indicators were examined by area of residence and compared with those of francophones. The data was taken from the 2003, 2007−2008 and 2009−2010 cycles of the Canadian Community Health Survey (CCHS), with particular emphasis on the most recent data. The results show few statistically significant differences in lifestyle habits and health indicators between anglophones and francophones, regardless of survey cycle or area of residence. Among the few significant differences we did find, anglophones report eating less often fruits and vegetables and tended to be more prone to overweight than francophones, but were also more physically active. They also seem to have a stronger sense of community belonging. The sample of anglophones was relatively small in this survey, which reduces its statistical power and may partially account for the limited differences between the two linguistic groups. Québec’s anglophone population could certainly benefit from a larger-scale health survey using a bigger sample. This would provide more robust statistical results and a more reliable indication of whether anglophones differ from francophones in their lifestyle habits and other health indicators. It would also help determine specific actions that could be developed targeting anglophones.   Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec III TABLE OF CONTENTS LIST OF TABLES ................................................................................................................. V LIST OF FIGURES .............................................................................................................. VII INTRODUCTION .................................................................................................................... 1 1 METHODOLOGY ............................................................................................................ 3 1.1 Data source and time periods ............................................................................... 3 1.2 Language .............................................................................................................. 3 1.3 Areas studied ........................................................................................................ 3 1.4 Number of respondents ......................................................................................... 4 1.5 Selected indicators ................................................................................................ 5 1.6 Methodological notes and limitations ..................................................................... 6 1.7 Comparability ........................................................................................................ 7 1.8 Statistical tests ...................................................................................................... 7 2 RESULTS ....................................................................................................................... 9 2.1 Lifestyle habits ...................................................................................................... 9 2.2 Other health indicators ........................................................................................ 12 CONCLUSION ..................................................................................................................... 17 REFERENCES ..................................................................................................................... 19 APPENDIX 1 NUMBER OF CCHSS RESPONDENTS BY MOTHER TONGUE ............. 21 APPENDIX 2 DESCRIPTION OF SELECTED INDICATORS ......................................... 25 APPENDIX 3 DATA COMPARABILITY ......................................................................... 31 APPENDIX 4 CCHS INDICATORS FOR ANGLOPHONES AND FRANCOPHONES AND STATISTICAL COMPARISONS BETWEEN LINGUISTIC GROUPS BY AREA, 2003, 2007−2008 AND 2009−2010 ................................................................................................ 37 APPENDIX 5 RESULTS AND CONFIDENCE INTERVALS BY MOTHER TONGUE (TOTAL, FRENCH, ENGLISH, AND OTHER), 2003, 2007−2008 AND 2009−2010 ....................................................................................... 43   Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec V LIST OF TABLES Table 1 Number of CCHS respondents by mother tongue and area of residence: 2003, 2007−2008, and 2009−2010 .................................................................. 5 Table 2 CCSS lifestyle habit and health indicators for anglophones and francophones and comparisons between the two groups, all of Québec, 2003, 2007−2008, and 2009−2010 .................................................................. 9 Table 3 CCSS health indicators for anglophones and francophones and comparisons between the two groups, all of Québec, 2003, 2007−2008 and 2009−2010 .............................................................................................. 13 Table 4 Total number of CCHS respondents by mother tongue and area of residence, 2003, 2007−2008, and 2009−2010 ............................................... 23 Table 5 Table summarizing variable comparability (between cycles 2.1 and 4.1) according to Infocentre de santé publique du Québec ................................... 33 Table 6 CCHS indicators for anglophones and francophones and comparisons between the two groups, 2003, 2007−2008, and 2009−2010, Montréal CMA .............................................................................................................. 39 Table 7 CCHS indicators for anglophones and francophones and comparisons between the two groups, 2003, 2007−2008 and 2009−2010, other CMAs ..... 40 Table 8 CCHS indicators for anglophones and francophones and comparisons between the two groups, 2003, 2007−2008 et 2009−2010, Non-CMAs .......... 41 Table 9 Results and confidence intervals by mother tongue, 2003, 2007−2008, and 2009−2010, all of Québec ....................................................................... 45 Table 10 Results and confidence intervals by mother tongue, 2003, 2007−2008, and 2009−2010, Montréal CMA ..................................................................... 47 Table 11 Results and confidence intervals by mother tongue, 2003, 2007−2008, and 2009−2010, other CMAs ......................................................................... 49 Table 12 Results and confidence intervals by mother tongue, 2003, 2007−2008, and 2009−2010, non-CMAs ........................................................................... 51   Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec VII LIST OF FIGURES Figure 1 Map of areas studied: Montréal CMA, other CMAs (Québec City, Sherbrooke, Trois-Rivières, Saguenay, Gatineau) and the rest of Québec (non-CMAs) ........................................................................................ 4 Figure 2 CCHS lifestyle indicators for anglophones and francophones and statistical comparisons between the two groups, Montréal CMA, other CMAs, and Non-CMAs, 2009−2010 ............................................................... 10 Figure 3 CCSS health indicators in anglophones and francophones and comparisons between the two groups, Montréal CMA, other CMAs, and non-CMAs, 2009−2010 .................................................................................. 14   Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec 1 INTRODUCTION This analysis is part of an initiative to improve our knowledge about the health status of Québec anglophones. The project is being conducted by Institut national de santé publique du Québec (INSPQ) in cooperation with Réseau communautaire de santé et de services sociaux (RCSSS) and Ministère de la Santé et des Services sociaux (MSSS). Its objective is to analyze the health status of anglophones from various perspectives, including socioeconomic status, considered a health determinant; access to care and services, which is assessed using avoidable mortality rates; and hospitalization rates for conditions amenable to ambulatory care. This report explores another important aspect of health, namely lifestyle habits and a number of health indicators, based on data from the Canadian Community Health Survey (CCHS). Examining lifestyle habits is an important part of healthcare planning because it enables us to anticipate future risks to population health. This report also examines other health-related indicators such as perceived health and activity limitations, which provide a more immediate measure of these communities’ current state of health. This is the first analysis to profile the health of anglophone Quebecers based on survey data. Québec anglophones are an official language minority community, just like francophones living outside Québec. It has been shown that minority group health indicators, such as perceived health, may differ from those of the majority (Bélanger et al., 2011; Bouchard et al., 2009). In this light, it is important to assess whether Québec anglophones display different health behaviors than Québec francophones.   Lifestyle Habits and Health Indicators of Québec Anglophones Institut national de santé publique du Québec 3 1 METHODOLOGY 1.1 DATA SOURCE AND TIME PERIODS Data was taken from the Canadian Community Health Surveys (CCHS) conducted in 2003 (cycle 2.1), 2007−2008 (cycle 4.1), and 2009−2010. The CCHS is a sample survey with a cross-sectional design, and is conducted by Statistics Canada. 1.2 LANGUAGE We use mother tongue as the variable determining membership in the anglophone or francophone community. It is defined as the first language learned at home in childhood and still understood by the person in question, and its CCHS variable code is SDCDFL1. Mother tongue is more closely bound to the cultural and ethnic identity of individuals and their ancestors than the language spoken at home or at work or the first official language spoken. It is considered here as a determinant of health status or as a factor acting on other determinants. In this text, the terms francophone and anglophone refer to the mother tongue of the persons so designated. 1.3 AREAS STUDIED For purposes of analysis, Québec was divided into three general geographical areas: the Montréal Census Metropolitan Area (CMA), the five other metropolitan areas combined (Québec City, Trois-Rivières, Sherbrooke, Saguenay, and Gatineau), which are designated as “other CMAs,” and the rest of the province. This third group comprises all villages, towns, and rural areas that are not part of a metropolitan area, and is designated “non-CMAs” or “non-metropolitan areas.” These geographical groupings were necessary because the anglophone population would otherwise be too small to allow for statistically reliable thematic analysis. Figure 1 maps out the areas of residence examined. Census metropolitan areas (CMAs) are the geographical units used by Statistics Canada. A census metropolitan area is the area consisting of one or more neighboring municipalities situated around a major urban core. A CMA must have a population of at least 100,000, of whom 50,000 must live in the urban core (Statistics Canada, 2008).