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Kin 2000 > Week 2 - Are Canadians Physically Healthy? > Flashcards

Week 2 - Are Canadians Physically Healthy? Flashcards

1
Q

How many risk behaviours are there?

A

5

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2
Q

what is the new risk behaviour added to the recommendations?

A

sedentary behaviour

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3
Q

what are the risk behaviours

A

1) smoking
2) physical inactivity
3) sedentary behaviour
4) unhealthy eating
5) harmful use of alcohol

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4
Q

how many risk conditions are there?

A

2

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5
Q

what are the risk conditions?

A

1) obesity
2) hypertension

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6
Q

what are the main chronic diseases?

A

FOUR MAIN:
1) cardiovascular diseases (HD and stroke)
2) cancer
3) chronic respiratory diseases (asthma and COPD)
4) diabetes

ALSO:
5) mood and anxiety disorders

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7
Q

Chronic Disease Multi morbidity

A

two or more of the four major chronic diseases

                                OR

mood and anxiety disorder co-morbid with at least one of the major four chronic diseases

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8
Q

Other Health Indicators

A

1) influenza immunization
2) neonatal and infant mortality
3) premature mortality
4) health-adjusted life expectancy and life expectancy

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9
Q

Regarding health, the average Canadian is HEALTHY

A
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10
Q

Chronic Disease

A

noncommunicable diseases (NCDs) are not passed from person to person; of long duration and generally slow progression

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11
Q

Four main types of Chronic Disease

A

1) Cancers
2) Cardiovascular Diseases
3) Diabetes
4) Chronic Respiratory Diseases

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12
Q

WHO definition of Physical Activity

A

any bodily movement produced by skeletal muscles that requires energy expenditure. PA refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work

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13
Q

Physical Activity

A
  • Significant health benefits for hearts, bodies, and minds
  • Contributes to preventing and managing NCDs, ie. CVD, cancers, diabetes
  • Reduces symptoms of depression and anxiety
  • Enhances thinking, learning, and judgement
  • Improves overall wellbeing
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14
Q

WHO Definition of Physical Inactivity

A

physical inactivity is a major, modifiable risk factor for chronic diseases

  • Globally, 1 in 4 adults do NOT meet the global recommendations of PA
  • Up to 5 millions deaths/year could be averted if the global population was more active
  • Inactive people have 20-30% increased risk of death compared to people who are sufficiently active
  • > 80% of the world’s adolescent population is insufficiently active…
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15
Q

“Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it”

A

Plato

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16
Q

Big Four Chronic Diseases Link

A

Physical Inactivity

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17
Q

Prevalence of IHD

A
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18
Q

Prevalence of Diabetes

A
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19
Q

10-year Prevalence of Cancer

A
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20
Q

Annual Prevalence Health Services Use for Mood & Anxiety Disorders

A
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21
Q

Prevalence of Arthritis

A

overall prevalence peaks ages 55-65
more women
increases with age

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22
Q

Prevalence of Osteoarthritis

A

more women
increases with age

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23
Q

Prevalence trends Major Chronic Diseases and Risk Conditions 2000-2012

A

Cancer — stayed roughly the same
Asthma — INCREASING
COPD — INCREASING
Diabetes — INCREASING
IHD — relatively the same
Stroke — relatively the same
Hypertension — INCREASING
Mood & Anxiety — relatively stable/very slight decline

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24
Q

Prevalence of Chronic Diseases among Canadian Adults

A

44% 20+ have at least 1 of 10 common chronic diseases

  • 25% hypertension
  • 14% osteoarthritis
  • 13% mood and anxiety
  • 12% osteoporosis
  • 11% diabetes
  • 11% asthma
  • 10% COPD
  • 8% IHD
  • 8% cancer
  • 7% dementia
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25
Q

Chronic Diseases in Ontario

A
  • over 7 in 10 deaths due to a chronic disease
  • 242,054 hospitalizations due to big four chronic diseases
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26
Q

Chronic Disease Risk Factors

A
  • tobacco smoking
  • alcohol consumption
  • physical inactivity
  • unhealthy eating

+ sedentary behaviour

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27
Q

how many adults have at least one of these risk factors

A

1 in 5

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28
Q

ontario high prevalence of tobacco smoking and alcohol consumption

A

13% self-report having NONE

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29
Q

we spend billions of dollars due to chronic disease

A
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30
Q

if major risk behaviours for chronic diseases were eliminated….

A

80% of IHD, stroke, and T2DM would be prevented

40% of cancer

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31
Q

Prevalence of Risk Factors in Canada

A
  • MOST prevalent = physical inactivity then unhealthy eating
  • smoking decreases with age
  • obesity increases with age
  • physical inactivity HIGHEST 12-19 year olds
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32
Q

Percentages of Canadians with Risk Factors

A
  • 19.6% NONE
  • 34.8% ONE
  • 32.1% TWO
  • 11.2% THREE
  • 2.3% FOUR
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33
Q

BMI

A

ratio of body weight to height-squared
= mass (kg) / height (m squared)

ie. 75 kg individual 175 cm tall
- 75/1.75 = 24.5kg/m squared

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34
Q

Weight Status based on BMI

A

below 18.5 = underweight
18.5-24.9 = normal weight
25-29.9 = overweight
30-34.9 = obesity class I
35-39.9 = obesity class II
above 40 = obesity class III

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35
Q

Global Obesity Rates

A

Increasing across the globe (Canada, USA, Sweden, Zimbabwe)
- women more than men EXCEPT sweden

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36
Q

Canadian Childhood Obesity Rates

A

30% (1978 - 23%, increased to 35%, then decreased)

  • over 90% NOT meeting PA guidelines
  • 1 in 3 are overweight or obese
  • 18.6% are overweight
  • 12.5% are obese
37
Q

Waist Circumference and Health

A

Equal to or less than

Men SMALL 102 inch / 40 inch

Women 88 cm / 35 inch

Large is above

38
Q

Hypertension

A
  • Definition: chronic high blood pressure
  • Prevalence: 24.9% (2011/12) - 6.9 million Canadians >20 years old
    >70% of Canadians aged 65+ are affected
    Diagnostics:
    Accurate diagnosis begins with accurate measurement
39
Q

Blood Pressure Measurement Technique

A
40
Q

Treatment Hypertension Health Behaviour Recommendations

A

being more physically active, weight reduction, moderation in alcohol intake, eating healthier, relaxation therapies, smoking cessation

41
Q

Being More Physically Active

A

accumulation of 30-60 min of dynamic exercise of moderate intensity 4-7 days per week in addition to routine activities of daily living

  • higher intensities of exercise are no more effective at BP lowering but may produce other cardiovascular benefits
  • non-hypertensive resistance or weight training exercise does not adversely influence BP
  • prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively
42
Q

Weight Reduction

A
  • healthy BMI and waist circumference is recommended for non-hypertensive individuals to prevent hypertension and for hypertensive patients to reduce BP
  • encourage multidisciplinary approach to weight loss, including dietary education, increased PA, and behaviour modification
43
Q

Moderation in Alcohol Intake

A

limited consumption— 0-2 standard drinks/day

men: less than 14/week
women: less than 9/week

  • prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively
44
Q

Eating Behaviour

A

diet HIGH in fresh fruits, vegetables, dietary fibre, non-animal protein, and low-fat dairy products
- low in saturated fat in cholesterol
- to decrease BP, increase dietary potassium

  • prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively
45
Q

Relaxation Therapies

A

individualized CBT more likely to be effective when relaxation techniques are employed

  • prescribe for selected patients in whom stress plays a role in elevating BP
46
Q

Smoking Cessation

A

abstinence from smoking; smoke-free environment

  • GLOBAL cardiovascular risk reduction strategy
47
Q

3 Options for Measuring PA

A

1) SUBJECTIVELY
2) OBJECTIVELY — Accelerometer
3) OBJECTIVELY — Wearables

48
Q

Subjective Measures

A

Ie, questionnaire

Guthold, Stevens, Riley, Bull (2018) — worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1-9 million participants
- Insufficient pA is a leading risk factor for noncommunicable diseases and has a negative effect on mental health and quality of life
- Levels of insufficient PA across countries and estimate global and regional trends

49
Q

Objective Measurements Accelerometer

A

Colley et al (2018) Health Reports Vol. 29, no. 12, pp. 3- 15, December 2018
Statistics Canada
Comparison of self-reported and accelerometer-measured physical activity in Canadian adults Research Article

50
Q

Physical Activity Report Card

A

“Better with Age, Move more today for a healthier tomorrow”

by ParticipACTION

  • daily behaviours; individual characteristics; settings & sources of influence; strategies & investments
  • assigns overall grade
51
Q

Objective Measurement — Wearables

A

Althoff et al. (2017)
- Study of 700,000+ people, 111 countries, using smartphones with built-in accelerometry (Azumio Argus App) to track activity

  • Canadians walked an average of 5000 steps/day.
  • HALF THE RECOMMENDED
  • Main finding: Physical activity levels did not predict obesity rates as much as _activity inequality_
  • Walkability predicts activity inequality

More walkable city, more activity throughout the day and age
- Across age groups, gender, BMI
- Because of built environment

52
Q

The Gender Gap

A
  • Female activity is reduced in areas with high gender activity inequality
53
Q

7 Facts about Physical Activity “Pulse” in Canada

A
  1. Canadians know physical inactivity is a problem. 93% said it’s a more serious health problem than tobacco and alcohol use.
  2. Canadians are aware people need to be more active.
  3. Canadians have positive feelings about being active. 74% said they enjoy being active.
  4. Canadians think that a more active life is within reach. 61% said they wouldn’t need to change too much to be more active.
  5. Canadians think everyone contributes to the physical inactivity problem. (social factors ie. gov, schools, industry, parents, etc.)
  6. Canadians think individuals are at the heart of the issue. 88% believe individuals are the solution.
  7. Canadians support public policy to encourage increased physical activity.
54
Q

PA Report Card 2020 Key Findings

A
  • 39% meet PA recommendations within 24 hour movement guidelines
  • no sig changes overtime
  • boys encage in more physical activity than girls and children (5-11) engage more than youth (12-17)
  • 25% 10-17 year olds are meeting the PA recommendations
  • 41% 5-9 year olds take 12 000 steps daily - meets guideline
  • 5-19 year olds take 11 300 steps daily
55
Q

PA Report Card 2020 Grades

A
56
Q

Canadian PA Guidelines

A
  • ONLY 16% Canadian adults are getting the recommended amount of PA (15 min moderate-vigorous PA/week)
  • 84% is NOT active enough

8 in 10 Canadian adults are not active enough to reap the health benefits of a physically active lifestyle. Your neighbour, mother, brother, daughter, coworker, or maybe even you could be part of the physical inactivity crisis in Canada.

57
Q

Activity Declines during COVID-19

A

Sebastiano, Chulak-Bozzer, Vanderloo, and Faulkner, 2020. Don’t Walk So Close to Me: Physical Distancing and Adult Physical Activity in Canada.

58
Q

PA Report Card 2021

A

F — Active Transportation
C+ — Light Physical Activity
F — Sedentary Behaviours

59
Q

The Problem?

A

in many ways, people have never been less healthy

  • main reason is physical inactivity
60
Q

BMI of 24.0 implies the person is

A

normal weight

61
Q

which new modifiable risk factor was included in the How Healthy Are Canadians report?

A

Sedentary behaviour

62
Q

Survey data suggests __% of Canadian adults are meeting PA guidelines

A

16%

63
Q

Which is not on our list of top 4 chronic diseases with strong links to physical inactivity?

A

Arthritis

64
Q

T/F

We will be using the WHO definition of health in this class

A

TRUE

65
Q

T/F Physical Activity Reduces symptoms of depression and anxiety

A

TRUE

66
Q

T/F Obesity is a disease

A

FALSE

  • is a risk condition
67
Q

Smoking

A
  • Negative impacts on nearly every organ of body and reduction in overall health

Trend = significant decrease in the age-standardized rate of daily or occasional smokers
- Declined in all age groups but declined most in younger age groups

  • Greater proportion of males
  • Rates highest among 20-34 year olds
  • Older adults significantly lower
  • BC lowest; NWT nearly double rates and Nunavut more than 3X of Canadian average
68
Q

Physical Inactivity

A
  • More than 3/4 are not meeting guidelines
  • PH concern — 4th leading cause for global mortality and linked to a number of chronic diseases including CVDs, cancer, and diabetes
  • Trend = no significant change in proportion of children but small decrease in mean number of steps taken
  • Proportion of adults not meeting had not changed sig; self-report small increase reported being active or moderately active
  • Greater proportion girls do not meet levels; men and women don’t differ sig
  • Adherence to guidelines diminishes with age
69
Q

Sedentary Behaviour

A
  • Half fail to meet guidelines
  • Health risks — obesity and decreased fitness
  • Association is independent of physical inactivity
  • Limiting recreational screen time to no more than 2hr/day
  • Remained stable since 2007 — 8.5 hours per day
  • Younger children spend less time being sedentary than older children and youth
70
Q

Unhealthy eating

A
  • More than 1 in five eat less than recommendation
  • Adult = 7-10 servings; children = 4-8 servings
  • Those who do not eat fruit and veg five or more times per day as a measure of unhealthy eating
  • More men do not consume
  • Proportion exceeded the national average by more than 20% in Newfoundland and Labrador and Nunavut
71
Q

Harmful use of alcohol

A

1 in 6 15+ exceeded guidelines; more than 1 in- 6 heavy drinking at least once a month

  • Immediate health risks are associated with “binge” or heavy
  • 4+ one night for women, 5+ men
  • Long-term linked chronic liver disease, certain cancers, CVDs, and premature death
  • Trend = increased
  • More males exceed; diff even greater heavy drinking
  • High among 25-34 year olds, low 50+
  • No geographical difference regarding guidelines but greater NS, NB, NFL, Yukon, NWT for heavy drinking
72
Q

Male vs Women Risk Factors

A

Overall rates among females statistically lower in females

73
Q

Aging

A

Proportion of those reporting at least one risk factor increased with age

74
Q

Obesity

A
  • Strongest predictor of being obese as adult = being obese as a child
  • Dramatic increase in last few decades; no sig diff since 2007
  • Obesity rate for children peaked 2007-2009
  • Men and women similar
  • Boys higher than girls
  • Highest age 35-49 and 50-64
75
Q

hypertension

A
  • Can cause heart attacks, stroke, heart failure, dementia, renal failure and blindness
  • Canada has the world’s highest reported national blood pressure control rate
  • Trends = PREVALENCE increased, INCIDENCE decreased
  • Similar between males and females
  • Increased with increasing age
  • Highest prevalence NFL, lowest prevalence NWT
76
Q

Ischemic Heart Disease

A
  • Second leading cause of death after cancer and leading cause of hospitalization
  • Heart muscle is damaged or works inefficiently because the absence or relative deficiency of its blood supply
  • IHD is number one cause of years of life lost (YLL) due to premature mortality and the second leading cause of disability-adjusted life years (DALYs)
  • Prevalence increased then has stayed stable
  • Incidence has decreased
  • Men more
  • Prevalence increases with age; white males had higher rates than females in all age groups
  • NB has highest; Nunavut lowest
77
Q

Stroke (cerebrovascular disease)

A
  • sudden loss of brain function that occurs when blood flow supplying oxygen to a part of the brain is interrupted
  • Stroke is third leading cause of death
  • Fourth leading cause of years of life lost due to premature mortality and the tenth largest contributor to disability adjusted life years (DALYs)
  • Hospitalizations and deaths steadily declined over the past few decades but absolute number of living with the effects of strokes is increasing
  • Burden is increasing among younger adults
    – Mean age of stroke is decreasing; burden of stroke is likely to increase even further
  • Age-standardized prevalence increasing but incidence has decreased
  • Males and females equally affected
  • Increased with increasing age
  • Highest PEI, lowest Newfoundland and Labrador
78
Q

Cancer

A
  • Not just one disease, but a large group of almost 100 diseases
  • Two main characteristics:
    1) Uncontrolled growth of the cells in the human body
    2) Ability of cells to migrate from the original site and spread to distant sites
  • Cancer has been leading cause of death in Canada
  • prostate, breast, colorectal cancers account for over half of all prevalent cases in Canada
  • 2 in 5 Canadians are expected to be diagnosed with cancer in Canada in their lifetime, and one in four will die from cancer
  • Age standardized prevalence increased but incidence rate decreased
  • Higher prevalence in men, higher incidence in men
  • Nearly 90% diagnosed, over the age of 50, 40% over age of 70
  • Cancer incidence rates are higher in eastern Canada and lower in western Canada
    Lowest = Yukon
79
Q

Chronic Obstructive Pulmonary Disease (COPD)

A
  • Chronic and progressive condition characterized by gradual airway obstruction, shortness of breath, cough and sputum production
  • Cigarette smoking main cause
  • 7th leading cause of years of life lost due to premature mortality and 9th leading contributor to DALY
  • Age-standardized prevalence increased but incidence decreased
  • Very similar males and females
  • Prevalence rates steadily increase with age
  • High in Nunavut, NS and the three territories all had rates more than 20% higher than national average
80
Q

Asthma

A
  • Characterized by cough, shortness of breath, chest tightness and wheezing
  • Two out of three Canadians with active asthma do not have good control of their condition
  • Age-standardized prevalence increased but incidence decreased
  • Slightly higher among females
  • Highest ages 1-19 and 20-34 declined until age 65 when began increasing again
  • High in Ontario; 3 territories had rates more than 20% lower than canadian average
81
Q

Diabetes

A
  • Body is either unable to sufficiently produce or properly use insulin
  • Age standardized prevalence increased
    – Incidence increased then dropped
  • More males living with diabetes (type 1 and 2 combined)
  • Prevalence increased by age group; highest = 65-79 and 80+
  • Low in Nunavut, high in Yukon but did not differ by more than 20% from national average
82
Q

Mood and Anxiety Disorders (health services use)

A
  • Mood disorders = lowering or elevation of a person’s mood
  • Anxiety disorders = excessive and persistent feelings of apprehension, worry and even fear
  • Mood and anxiety disorders are most common types of mental illnesses
  • Major depressive disorder was ranked as second leading cause of years of life lost due to disability; anxiety 8th
  • Higher among females
  • Rates highest between 35-64, decreased slightly with increasing age
  • Highest in NS, lowest Nunavut, Newfoundland and Labrador, Quebec, NWT
83
Q

Multi-morbidity

A
  • Greater risk of adverse health outcomes and have increased health care needs
  • 65+, prevalence rates have slightly increased
  • Females (65+) had significantly higher rates
  • Increases dramatically with age
  • Highest prevalence Yukon and Alberta, lowest rates BC and Manitoba
  • Rates differ by at least 20% from the Canadian rate
84
Q

Mood and Anxiety Disorders Comorbidity

A
  • Early onset of depressive and anxiety disorders has been shown to be associated with an increased risk of developing heart disease, asthma, arthritis, chronic back pain and chronic headaches in adult life
  • Can lead to unhealthy behaviours that increase the risk of developing or exacerbating other chronic diseases or conditions
  • May result from the burden of living with a chronic disease or condition
  • Significant increase in prevalence
  • Females significantly higher rates
  • High prevalence in 50-64 age group
  • Highest NS and NB; lowest BC, SK, MB
85
Q

Influenza Immunization

A
  • Chronic diseases are at high risk from complications and death due to influenza infection
    – May trigger an exacerbation and deterioration of pre-existing conditions
  • Vaccine rate has fluctuated over last decade
  • Females with chronic disease slightly higher
  • Immunization rate among those with chronic disease generally increased with age
  • NS had a rate at least 20% higher than national average
86
Q

Neonatal and Infant Mortality

A

Infant mortality = number of deaths of live-born babies in first year (per 1000)

Neonatal mortality = first 28 days

  • Infant mortality declined, neonatal stayed stable
  • Infant and neonatal higher in boys — genetic and biological makeup; boys in general are more susceptible to disease and premature death
  • Nunavut 3X canadian average
87
Q

Premature Mortality

A
  • Deaths that occur at a younger age than expected and, therefore, reflect the potential for avoidable deaths
  • Decrease from the four main NCDs was observed
    – Mainly due to decrease in mortality from cardiovascular diseases and from cancer
  • Probability of dying between ages 30-64 from any of the 4 main chronic diseases was higher in males
    – Particularly for cardiovascular diseases which were 2.5 times more likely for males
  • Nunavut 2X greater than Canadian average
  • Very high premature mortality for chronic respiratory diseases (8X) and cancer (2X)
  • NWT, Yukon, Newfoundland risk 20% higher than Canada as a whole
88
Q

Life Expectancy

A

LE = describes the overall health status of a population and is defined as the average number of years a person of a certain age would be expected to live given current mortality rates

Health adjusted life expectancy (HALE) = average number of years that a person is expected to live in full health

  • Both LE and HALE steadily increasing (due to decrease in mortality)
  • Females have higher LE and HALE
  • Nunavut and NWT low, high BC for LE
  • Nunavut, NWT, and Yukon lowest HALE, Quebec highest
89
Q
A

Kin 2000 (8 decks)

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