1. Canadian Community Health Survey (CCHS) - Annual Component
Survey Overview - DLI Halifax Training
May 9th, 2019

2. Overview Survey Overview Content overview through the years
Important changes about 2015 redesign
CCHS PUMF1
Future modernizations
1 – Public Use Microdata File

3. Survey overview - history
Started with Health Information Roadmap -1999
Adoption of an indicator framework
Health behaviours
Health surveillance
Access to health care system
CCHS annual program and focus content program
Governing committee – Canadian Population Health Survey Program
Health Canada, Public Health Agency of Canada
Expert groups

4. Survey Overview - Objectives
Health surveillance at the national, provincial and sub-provincial levels
Analysis on small populations and rare characteristics 
Readily available data to a diversified user community in a timely fashion
Flexible survey instrument

5. Survey Overview: Design
Residents of private households aged 12 and over
Exclusions:
Aboriginal reserves / settlements
institutions (health institutions, prisons, religious institutions, convents, etc.)
members of Canadian Forces
Residents of certain very remote areas
Coverage (general) ~97% of targeted population
Designed to provide reliable estimates at the health region level with two years of data

6. Survey overview: Health Regions
Administration of health in the provinces is divided into health regions.
PEI and territories each are designated as their own single HR
For CCHS , data was collected for 104 HRs in the provinces, in PEI and in each territory, totalling 108 HRs
This is the lowest level of geography on the PUMF, after some grouping*
HRs are grouped on PUMFs to ensure a minimum population size that prevents disclosure. Because of uniqueness of the geography, La Région du Nord du Québec (HR 2410) is dropped from PUMFs entirely.

7. Survey overview: Collection
The CCHS is collected by interviewers using a computer based questionnaire:
20% in person, and
80% by telephone
Respondents aged interviewed alone with parental consent
2.5% of cases completed by proxy
The collection method (in person vs on the phone) is important to know, given that there can be bias in reporting when speaking to the interviewer for each mode.
The 2.5% proxy cases were only allowed for instances where the selected respondent was not able to answer, due to a physical or mental health condition. Some questions were not asked in proxy interviews. Users will see a higher rate of ‘not stated’ for these questions.

8. Survey overview: Data processing
During the interview, questions get skipped for various reasons and need coding:
Non-response
Interview incomplete
Question not relevant
“Other – specify” responses are sometimes recoded to a response category
Derived variables are added to the file based on responses
These cases are coded as “Not stated”
Coded as “Not applicable”
When a person says no or refuses to say if they have asthma (CCC_Q031), then the question on having asthma symptoms or attacks in the past year (CCC_Q035) is skipped. In the case of the ‘No’ asthma response, Q035 is coded as ‘not applicable’. For the refusal case, we don’t know if they have asthma, so Q035 is set to ‘Not stated’.

9. Survey overview: Weighting
Each respondent represents themselves and others in the population
The sample weight WTS_M indicates the population represented by each respondent
Weights have been adjusted for non-response and calibrated to match population estimates: HR*sex*age group
Age groups for calibration are 12-17, 18-34, 35-49, 50-64, 65+. If you are creating estimates with more refined age groups, just note that you may not align with population estimates from the census for the same geography.

10. Survey overview - content
Three main types of content in survey
Core: all years, all respondents
Theme: certain years, all respondents
Optional: certain years, certain provinces/territories
Other content not available through DLI:
Buy-ins
Rapid responses
Sub-samples

11. Survey overview – content plan

15. CCHS Redesign of 2015 Frame changes Collection methods
Household survey frame for adults
CCB for youth 12-17
Collection methods
More telephone interviews overall (incl. for all youth respondents)
Sample allocation more responsive to change
Territorial coverage only over 2-years

16. CCHS - PUMF details Previous two year PUMFs: Previous one year PUMFs:
Cycle 1.1 (2000/2001)
Cycle 2.1 (2002/2003)
Cycle 3.1 (2004/2005)
2007/2008
2009/2010
2011/2012
2013/2014
2015/2016
Previous one year PUMFs:
2010
2012
2014
Beginning with , the CCHS will release only two-year PUMFs to avoid the extra disclosure risk associated with releasing composite file PUMFs. Only in the case when important one-year theme modules arise in the future will the team consider reintroducing one-year PUMFs.

17. Included core content for CCHS 2015-2016 PUMF
Alcohol Use
Chronic Conditions
Contact with health professionals
Exposure to Second-hand Smoke
Flu Shots
Fruit and Vegetable Consumption
General Health
Height and Weight
Physical Activities for adults/youth
Primary Health Care Providers
Smoking
Maternal experiences
Administration
Age
Labour Force
Main occupation
Socio-demographics
Some masking is applied to variables in these modules. Consult the PUMF documentation (record layout) for more details.
One new variable loaded for will be sexual orientation (SDC).

18. Included theme content for CCHS 2015-2016 PUMF
Health behaviours
Alcohol past week
Drug methods*
Sexual behaviours*
Patient experience
Insurance
Home care*
Mental health
Consultation about mental health
Suicidal thoughts and attempts*
Health conditions
Chronic conditions
Theme 1
Modules not loaded – DRM (only releasing DV any drug use 12 months and lifetime). Some sensitive parts of SXB (age of first intercourse, most recent STI test). HMC now loaded for first time. SUI (only releasing lifetime and 12 month ideation).
Because we are only creating two-year PUMF, the one year theme is not available. Only in cases when the province/territory chose that module as optional in the non-theme year (will be available on for those P/Ts only).

19. Design for CCHS PUMF 2015/16 PUMF contains 109,659 records
1,199 variables
Geography variables
Province / territory of dwelling*
Health region of dwelling (grouped)
Canadian Active Living Environment (CANALE)
Territories are not grouped on the 2015/2016 PUMF which was a statcan first

20. Canadian Active Living Environnent (CANALE)
New variable for CCHS PUMF
Provides additional geospatial value to the file
Scores (1-5) each 2016 DA based on the active living environment (intersection/dwelling density, points of interest, and transit stops).
To link to CCHS, 2011 DAs from the file were linked with 2016 DAs in CANALE file. Multiple matches were dealt with random selection proportional to population size.
Included in pre-masking to prevent ungrouping of HRs

21. CCHS PUMF – disclosure control
Geography / HR population size
Minimum population size of 70,000 per health region
19 HRs grouped into 9
3 Territories not grouped this PUMF
Results in 98 Health Regions or HR groupings
Age of respondent
5 year age groups > 75-79
12-14, 15-17, 18-19
Supports research on Body Mass Index (BMI) and new physical activity content (PAA/PAY)
Other indirect identifiers grouped or masked to prevent disclosure
Industry is not included on the PUMF
Occupation collapsed to 5 broad categories

22. CCHS 15-16 PUMF: Poisson bootstrap weights
Previous PUMFs did not include bootstrap weights
PUMF includes Poisson bootstrap weights
Each weight for each replicate is generated independently
All bootstrap weights are strictly positive
The Poisson bootstrap does not pose confidentiality concerns
For the first time for the CCHS PUMF of , Poisson bootstrap weights are produced and will be disseminated for users to estimate their variances. The Poisson bootstrap does not pose confidentiality concerns. Each weights for each replicates are generated independently, and except for the initial survey weights step, the method does not use design information. This method have been approved and recommended by the HSMD technical committee. The effect on variance estimates will be negligible.

23. PUMF Package Data Bootstrap weights Documentation Beyond 2020
User guides
CV tables
Data Dictionary
Derived Variables
Errata
Questionnaire
Beyond 2020

24. 2021 CCHS Redesign Objectives
Transition to Electronic Questionnaires
Revisit content and develop a new content plan
Revisit the methodology
Increase administrative data holdings
Modernize with Statistics Canada
2020 Pilot

25. CCHS-Annual Contacts Content manager: Anne-Marie Vinette
Dissemination Manager: Shawn Brule
Collection Manager: Bernard Paquet
Project Manager: Amanda Wright
Redesign Manager: Ed Rama
Section Chief: José Gaudet

26. THANK YOU! For more information, please visit
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