1. Canadian Health Measures Survey
New Health Data Source
Research Data Centre Workshop Presentation
Colleen Bolger
Physical Health Measures Division
Presentation to Conference on Health over the Life Course, University of Western Ontario, London, Ontario, October 2009

2. Statistics Canada • Statistique Canada
The CHMS goals…
CHMS is the newest national health survey that adds scientific data to existing self-report data sources like CCHS/NPHS
Conduct direct physical measures of Canadians’ health in a mobile clinic, including:
Heart and lung health, weight, etc.
Laboratory tests of blood and urine samples
Important health issues (obesity, environmental toxins, physical inactivity, undiagnosed disease) cannot be monitored without direct measures.
Statistics Canada • Statistique Canada
22/11/2018

3. CHMS preliminary results
Blood lead, mercury and cadmium
0.7
0.6
0.5
0.4
Blood Level (ug/L)
0.3
0.2
0.1
Cadmium
Source: Health Reports, Statistics Canada, Nov. 2008
National Exposure Report: Summer 2010
Statistics Canada • Statistique Canada
22/11/2018

4. Statistics Canada • Statistique Canada
The mobile clinic experience
Urine Collection
Anthropometry
Spirometry
Phlebotomy
Blood Pressure
Statistics Canada • Statistique Canada
22/11/2018

5. Statistics Canada • Statistique Canada
More physical measures
Fitness Measures
Oral Health
Lab Measures
Activity Monitor
Statistics Canada • Statistique Canada
22/11/2018

6. Statistics Canada • Statistique Canada
Survey parameters
Initial budget (with buy-ins) $37 million over 6 yrs, now permanent funding for ongoing collection
National estimates
Atypical sample design (cost, logistics)
24 months of data collection,
Direct measures completed in mobile clinic
Cycle 1: 2007 to 2009, 5,500 sample, age 6 to 79
Cycle 2: 2009 to 2011, 5,700 sample, ages 3 to 79
Statistics Canada • Statistique Canada
22/11/2018

7. Statistics Canada • Statistique Canada
Participants and data sources
Randomly selected to represent national population
All participation is voluntary
1-hour health questionnaire in home
2-3 hour visit to mobile clinic for physical measures
Activity monitor and indoor air sampler 1 week post
Receive their own reports of measurements
Are asked to participate in biosample storage for future study, data-sharing with HC/PHAC, data-linking at StatCan, longitudinal follow-up
Statistics Canada • Statistique Canada
22/11/2018

8. Statistics Canada • Statistique Canada
Analytical potential
46 questionnaire modules containing 722 questions
Approximately 50 physical measures variables
Over 120 biospecimen analytes
About a dozen Environment Canada weather / pollution indicators
Potential linkage to health records
Statistics Canada • Statistique Canada
22/11/2018

9. Statistics Canada • Statistique Canada
Questionnaire content
Health status
General health, sleep, height and weight, weight change, health utility index, chronic conditions, hepatitis, family medical history, oral health status, phlegm, pregnancy, birth, breastfeeding information
Nutrition and food
Grain, fruit and vegetable consumption, meat and fish, dietary fat, salt, water and soft drink, milk and dairy products
Medication use
Medications, other health products and herbal remedies
Health behaviours
Physical activities, sedentary activities, smoking, alcohol use, illicit drug use, sexual behaviour, maternal breast-feeding, strengths and difficulties
Environmental factors
Exposure to second-hand smoke, sun exposure, housing characteristics, hobbies, grooming-product use
Socio-economic information
Socio-demographic characteristics, education, labour force activity, income
Statistics Canada • Statistique Canada
22/11/2018

10. Statistics Canada • Statistique Canada
The mobile clinic
Statistics Canada • Statistique Canada
22/11/2018

11. Statistics Canada • Statistique Canada
CHMS sites
Clarington, ON
Montérégie, QC
Moncton, NB
Toronto (North York), ON
Montréal centre, QC
Kitchener-Waterloo, ON
Vancouver, BC
Red Deer, AB
Williams Lake and Quesnel, BC
Edmonton, AB
South Mauricie, QC
Québec, QC
Northumberland County, ON
St. Catharines-Niagara, ON
Toronto (Don Valley), ON
Statistics Canada • Statistique Canada
22/11/2018

12. Statistics Canada • Statistique Canada
Physical measures
Anthropometry
Height, weight, waist and hip circumference, sitting height
5 skinfolds
Cardiorespiratory Fitness
Blood pressure, resting heart rate
Modified Canadian Aerobic Fitness Test (step test)
Spirometry
Musculoskeletal Fitness
Hand grip strength
Sit-and-reach flexibility
Curl-ups
Physical Activity
Accelerometry
Oral Health Exam
Statistics Canada • Statistique Canada
22/11/2018

13. Statistics Canada • Statistique Canada
Lab measures (selected examples)
BLOOD
Diabetes (Fasting glucose, Fasting insulin, HbA1c)
Cardiovascular (HDL, LDL, total cholesterol, triglycerides, Homocysteine)
Nutritional Status (RBC folate, Vitamin B12, Vitamin D, Calcium)
Infectious Disease Markers (Hepatitis A/B/C, HPV, Herpes, Chlamydia)
General (CBC, Blood chemistry panel, Surplus blood, DNA sample)
Environmental exposure
Metals (Metals like Lead, Cadmium, Mercury, Arsenic, Nickel, Copper, Zinc, Selenium, Uranium, Molybdenum, Manganese)
PCBs, pesticides
URINE
Phthalates and metabolites (11)
Organophosphate pesticides and metabolites (6)
Phenoxy Herbicide (2,4-D)
Bisphenol A
Cotinine, Microalbumin, Creatinine, Iodine
Statistics Canada • Statistique Canada
22/11/2018

14. Biological Specimen Flow
National Microbiology
Laboratory
Infectious Disease
Biorepository
Health Canada
Chronic Disease
Nutrition
INSPQ (Institut
national de santé
publique du Québec)
Environmental
Biomarkers
CHMS Mobile
Clinic
CBC, Blood chemistry panel,
Storage samples
Statistics Canada • Statistique Canada
22/11/2018

15. Statistics Canada • Statistique Canada
Biorepository
Storage of blood and urine for future health studies: all consenting participants
Storage of DNA: 20 years and above with consent
National Microbiology Laboratory (NML) in Winnipeg selected as biorepository for indefinite storage
Access controlled by Statistics Canada
Fall 2010 availability to researchers
Statistics Canada • Statistique Canada
22/11/2018

16. Statistics Canada • Statistique Canada
Response chart (cycle 1)
Met targets by age and sex…
7500 people selected
6600 complete household interview (88%)
5600 complete clinic measures (85% of b, 75% of a)
High participation at the clinic…
Over 95% participation in all measures except mCAFT exercise test at 91% participation
Consent remains high
Data linking and sharing consent over 99%
Storage consent: Blood & urine 97%, DNA (20+) 94%
Statistics Canada • Statistique Canada
22/11/2018

17. Statistics Canada • Statistique Canada
Cycle 1 data dissemination
Wave 1
Household questionnaire & physical measures data
2 articles on fitness
1 article on blood pressure
January 2010
February 2010
Wave 2
Laboratory data (nutrition, chronic and infectious disease markers)
1 article on Vitamin D
March 2010
Wave 3
Laboratory data (environmental measures)
1 article - TBD
July 2010
Wave 4
Activity monitoring data
1 article on physical activity
November 2010
Statistics Canada • Statistique Canada
22/11/2018

18. Statistics Canada • Statistique Canada
Data products and services
Master files in Research Data Centres
Supporting documentation (Data dictionary with variable frequencies, full User Guide)
Data tables available for each release wave
Capacity building workshops for researchers
Custom tables
CHMS Biobank access planned for fall 2010
Statistics Canada • Statistique Canada
22/11/2018

19. Statistics Canada • Statistique Canada
Studies underway
Vitamin D, by Health Canada examining Dietary Reference Intake levels in collaboration with USA, food fortification policies
Lead, mercury and cadmium levels in Canadian population, in support of the federal Chemicals Management Plan.
Fitness-Child/Adult, Blood Pressure, Obesity
Organohalogens in Leftover Pooled Serum Specimens (e.g., PCBs, dioxins and furans)
Volatile organic compounds in samples of indoor air in Canadian Households (from Cycle 2 dress rehearsal)
Nicotine and its metabolites, NNAL
Statistics Canada • Statistique Canada
22/11/2018

20. Statistics Canada • Statistique Canada
CHMS has the support of…
the Canadian Medical Association
the Canadian Dental Association
the Canadian Red Cross
The Canadian Lung Association
Dietitians of Canada
the Heart and Stroke Foundation of Canada
the Canadian Hypertension Society
the Canadian Public Health Association
the College of Family Physicians of Canada
Statistics Canada • Statistique Canada
22/11/2018

21. Statistics Canada • Statistique Canada
Additional information
For more information on the CHMS, please contact :
Colleen Bolger at ,
or send an to
Detailed information on the CHMS can also be found at
Statistics Canada • Statistique Canada
22/11/2018