Approaches to Using Products from the Canadian Community Health Survey Vince Gray and Sylvie Lafortune Laurentian University & University of Western Ontario DLI National Training Day May 30, 2011

Overview Brief background to the CCHS Tips and tools for finding and using the CCHS

Background on CCHS Launched in 2000 as part of the Health Information Roadmap Initiative Includes partners at federal, provincial and health regions levels => content & collection changes are constant! Superseded the National Population Health Survey (NPHS) cross-sectional component For background and progress reports, see the Health Information Roadmap Initiative webpage on the Canadian Institute for Health Information websiteHealth Information Roadmap Initiative

Background on CCHS Persons aged 12 years and older living in private dwellings in the 10 provinces and 3 territories, self or proxy-reported Considerable evolution since launch, with major redesign in 2007 Provides data at Health Region level of geographic detail Survey consists of core components, and components selected by provinces & HRs

Purpose of CCHS Objectives until 2005 Provide timely and reliable estimates of – health status – health care utilization – health determinants Gather data at the sub- provincial levels of geography Revised objectives after 2005 Support health surveillance programs at nat/prov/reg levels Timely release of data easily accessible to diverse community of users Include rapid response option to address emerging issues Support health research on small populations and rare characteristics

Core content topics Alcohol Chronic conditions Exposure to second-hand smoke Fruit and vegetable consumption General health Health care utilization Height and weight Injuries Mammography Maternal experiences PAP smear test Physical activities Restriction of activities Smoking Two-week disability Income Socio-demographic characteristics Administration Labour Force (short form)

First tool:The Daily The most public and current of information sources

Searching The Daily Can use abbreviation (e.g., CCHS) in search box

The Daily results If sort by date, most recent appear first

Why use The Daily Can provide ‘answers’ – e.g., information about Canadians suffering chronic pain

Why else to use The Daily Articles may provide links to more detailed publications for further investigation

Second tool: CANSIM The Daily provides reports; CANSIM provides aggregated data

Accessing CANSIM: by survey Can browse the list of surveys, and pick out CCHS from the list

CANSIM: by survey results All tables with aggregated data derived from the survey are displayed

CANSIM selection results Once select a table, it’s easiest to go livelive

CANSIM data retrieval The ‘answer’ –osteoporosis among ‘young’ female seniors in Quebec and BC

Accessing CANSIM: searching More likely used, since users don’t know source of answers: look for ‘chronic pain’

CANSIM search results No indication whether CCHS or other source – the user probably doesn’t care

CANSIM table Health region may be a giveaway for CCHS, but also used for Cancer Registry

CANSIM results So, Ontario looks to have more chronic pain than Canada; Grey Bruce less, but?

CANSIM results: B20/20 Can download entire file as Beyond 20/20, and use locally

CANSIM in B20/20 Default when come into the system is top characteristic of each concept

CANSIM in B20/20 Manipulate rows and columns to get the desired information on screen

CANSIM results: B20/20 Can graph results, right click, and save to a file for inclusion in reports

CANSIM results: B20/20 Can save an extract or the entire file as Beyond 20/20 or other format (e.g.,.xls), and use locally

Third tool: Health Indicators Points to data from various sources Provides access to aggregated data

Health Indicators Single access point to jointly agreed upon comparable indicators for country

Health Indicators Type of data being provided identified in listing of tables

Don’t forget other departments! Canadian Institute for Health Research – 448 resultswww.cihr-irsc.gc.ca –Research Profile: How does keeping the peace affect a soldier's peace of mind? Parliament of Canada – 416 resultswww.parl.gc.ca –The Obesity Epidemic in Canada Public Health Agency of Canada – 340 resultswww.phac-aspc.gc.ca –What is the Impact of Sleep Apnea on Canadians? Health Canada – 183 resultswww.hc-sc.gc.ca –Canadian Community Health Survey, Cycle 2.2, Nutrition (2004). A Guide to Accessing and Interpreting the Data

And more … Canadian Armed Forces – 42 resultswww.forces.gc.ca –Statistics Canada CF Mental Health Survey: A "Milestone“ Veteran’s Affairs – 18 resultswww.vac-acc.gc.ca –Backgrounder: Veterans Affairs Canada Mental Health Strategy: Psychological Injuries and the Canadian Military Citizenship and Immigration Canada – 3 resultswww.cic.gc.ca –Health Status and Social Capital of Recent Immigrants in Canada

How to find these? Use Google advanced search

Summary of tools to date Provide access to reports and aggregated data tables Can provide ‘answers’ to questions What if the question isn’t easily answered with a ready-made table?

Tools for access to microdata Five tools provide access to microdata 1.DLI FTP Site and/or Nesstar server 2. - Nesstar-based, to be opened for subscription by Ontario colleges and non- Ontario universities 3.Equinox – joint UWO and CREPUQ initiative with subscribers from every province 4.SDA – run by University of Toronto 5.Research Data Centre program

DLI FTP site Access limited to DLI contact or designate Download entire file, documentation, and syntax files (as available) Receive file as received by Data Liberation Initiative unit – in whatever format(s) (raw data, SPSS system file, B20/20, etc.)

DLI Nesstar server Access limited to DLI contact or designate Files loaded in parallel in English and French – use one or the other Due to access limitations, provides alternate download site allowing export of system or portable files

Access limited to Ontario universities Access being expanded to offer subscriptions to other Canadian DLI member institutions Interface and data files in parallel systems in English & French – use one or the other

Access is available to individual users based on IP authentication for institution, may wish to use all features of Nesstar –Download complete file –Subset file (select variables and/or values) –Analyze data

Equinox Access provided through subscription, some files available to all users Interface and data files in parallel in English and French – flip between languages Mirror site under development in Quebec

Access is available to individual users based on IP authentication for institution –Download complete file –Subset file (select variables and/or values) –No analysis capability in system

and Equinox Rather artificial from a user’s point of view knowing that they want to use a particular file (e.g., CCHS) Are more likely to discover they want to use a file based on the contents of it –E.g., what data files contain questions on osteoporosis?

A final access point A user wants to look at osteoporosis among immigrants by place of birth

Custom tabs and the Master file PUMF records only two responses in variable SDCGCBG – “Canada” and “Other” Custom tabulations possible: Client Custom Support ( , Direct users to the master data file at their Research Data Centre or to Remote Access ( ,

Analysis & Interpretation As indicated before, will largely depend on local resources and policy Do you have one or more trained statistical consultants to assist users with questions about either analysis or interpretation?