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Abstract Objective Despite Canada being an important energy producer, not all Canadians can access or afford adequate levels of energy services at home to meet their needs, maintain healthy indoor temperatures, and live a decent life—a situation known as energy poverty. Depending on the measure, 6–19% of Canadian households face energy poverty. Health risks associated with energy poverty are documented in countries with milder climates. This study explores, for the first time in the Canadian context, the association between energy poverty and health. Methods Cross-sectional data are from the 2018 Canadian Housing Survey. Analyses are conducted on a sample weighted to represent 14 million Canadian households. The associations between expenditure-based and self-reported measures of energy poverty and self-rated general and mental health were assessed using logistic regression models, adjusted for potential confounding variables. Results The odds of rating one’s general (OR: 1.48; 95%CI: 1.29, 1.70) and mental (OR: 1.21; 1.04, 1.41) health as poor are significantly higher for Canadian adults in households with a high share of energy expenditure to income. The likelihood of poor general and mental health was significantly higher for those dissatisfied with the energy efficiency of their dwelling, and with their ability to maintain a comfortable temperature both in the winter and in the summer. Conclusion Exposure to energy poverty is associated with significantly increased likelihood of poor general and mental health. Given the high proportion of Canadian households facing energy poverty, with demonstrated implications for population health, tackling energy poverty is essential for an equitable energy transition and for climate resilience. , Résumé Objectif Bien que le Canada soit un important producteur d’énergie, entre 6 % et 19 % des ménages canadiens, selon la mesure retenue, sont en précarité énergétique, une situation qui survient lorsqu’un ménage n’a pas les moyens ou l’accès à des services énergétiques résidentiels adéquats pour maintenir une température ambiante confortable, répondre à ses besoins et vivre dans la dignité. Les risques socio-sanitaires associés à la précarité énergétique sont documentés dans des pays au climat tempéré. Cette étude explore, pour la première fois dans le contexte canadien, l’association entre la précarité énergétique et la santé. Méthodes Les données transversales proviennent de l’Enquête canadienne sur le logement de 2018. Les associations entre différentes mesures de précarité énergétique (mesures basées sur les dépenses des ménages et auto-rapportées) et la santé générale et mentale perçue sont estimées à l’aide de modèles de régression logistique ajustés pour des variables de confusion potentielles. Les analyses sont réalisées sur un échantillon pondéré pour représenter 14 millions de ménages. Résultats Les probabilités de déclarer une mauvaise santé générale (OR : 1,48; IC95% : 1,29-1,70) et mentale (OR : 1,21; 1,04-1,41) sont significativement plus élevées pour les adultes canadiens dont le ménage consacre une part importante de son revenu aux coûts énergétiques. Elles sont aussi significativement plus élevées pour ceux qui déclarent être insatisfaits avec l’efficacité énergétique de leur logement et de leur capacité à maintenir une température confortable en hiver et en été. Conclusion Vivre en situation de précarité énergétique est associée à des probabilités accrues de déclarer une mauvaise santé générale et mentale chez les adultes canadiens. En raison de la proportion élevée de ménages canadiens confrontés à la précarité énergétique et des effets socio-sanitaires que cette situation engendre, lutter contre la précarité énergétique est essentiel pour une transition énergétique équitable et pour la résilience climatique.

Background: Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in Canada. Methods: We analyzed objectively-measured sedentary behavior and physical activity at 16–18, 24–26, and 32–24 weeks pregnancy in a sociodemographically diverse cohort of 70 women in Montreal, Canada. Participants completed the Perceived Stress Questionnaire and wore an accelerometer for 3 days that quantified sitting time and steps per day. We used univariate general linear models to analyze relationships between perceived stress with sedentary behavior and physical activity at each evaluation. To assess generalizability, we analyzed relationships between psychological distress with self-reported leisure-time sedentary behavior and daily energy expenditure in transportation and leisure physical activities among a sample representative of 166,095 women in the Canadian Community Health Survey. Results: In the Montreal cohort, we observed a positive association between perceived stress and sitting time, with small to moderate effect sizes (partial η2 = 0.08–0.16). We observed negative relationships between perceived stress and steps per day at the first two evaluations only, with small to moderate effect sizes (partial η2 = 0.08–0.11). Relationships for sedentary behavior were similar in the nationwide sample, but with smaller effect sizes (partial η2 = 0.02). There were no relationships between distress and physical activity in the nationwide sample. Conclusion: Psychosocial stress represents one risk factor for sedentarity, with relationships evident throughout pregnancy and at the population level. Relationships with physical activity are less consistent, but stress might represent a risk factor for low physical activity in early to mid-pregnancy. Results might guide the development of more comprehensive interventions targeting stress, sedentarity, and physical activity. In particular, integrating psychosocial health into interventions to reduce sedentarity, and including concrete guidelines on sedentary behavior in psychosocial health interventions, might be prioritized.

Social participation is a modifiable health determinant influenced by physical and social aspects of the environment. Little is known about aging women’s and men’s community activities and barriers according to region and population size. This study compared social participation, desire to participate more, and perceived barriers of aging women and men by Canadian region and population size.

L’Organisation mondiale de la Santé (OMS) soutient que les changements climatiques représentent la plus grande menace pour la santé dans le monde au 21e siècle. Ceux-ci influencent négativement plusieurs déterminants sociaux et environnementaux de la santé comme l’accessibilité à la nourriture et la qualité de cette dernière, l’eau et l’air. Blessures, impacts psychosociaux, aggravation de maladies respiratoires, malnutrition, maladies infectieuses, décès : les conséquences sanitaires sont susceptibles d’affecter les populations sur tous les continents. Le Canada se réchauffe deux fois plus rapidement que la moyenne mondiale en raison de sa proximité au pôle Arctique, où le réchauffement est accéléré comparativement à l’équateur (Bush et Lemmen, 2019). Ainsi, le Québec n’est certainement pas à l’abri des changements climatiques. Dans le Sud de la province, les températures moyennes observées ont augmenté de plus d’un degré depuis 1970 et des répercussions se font déjà sentir dans notre environnement. Ce réchauffement, accompagné d’une plus grande variabilité du climat (augmentation du risque d’orages, de tempêtes et d’extrêmes hydrométéorologiques en général), représente un défi grandissant pour les professionnel.le.s de la santé. Dans la région de l’Estrie, les professionnel.le.s de santé publique ont effectué une analyse qui leur ont permis d’identifier quatre principaux problèmes environnementaux associés aux changements climatiques, soit : les vagues de chaleur; les inondations; les tiques à pattes noires; le pollen de l’herbe à poux. Ces problèmes ont des impacts importants sur la santé, c’est-à-dire potentiellement graves ou qui touchent un grand nombre de personnes. Le stress et les pertes (humaines et matérielles) engendrées par ces différents problèmes environnementaux peuvent aussi représenter une source majeure de problèmes psychologiques significatifs pouvant persister dans le temps. De plus, ces impacts sont variables selon les différents contextes sociaux des individus et des communautés, générant des inégalités sociales de santé.

Introduction: In July 2013, a train derailment caused the death of 47 people and destroyed the downtown area in the city of Lac-Mégantic (Quebec, Canada). This tragedy had several impacts on this small community. Method: Three years after this disaster, we used a representative population-based survey conducted among 800 adults (including 265 seniors aged 65 or above) to assess the physical and mental health of seniors. Results: Several differences were observed in seniors’ physical and mental health based on their level of exposure to the tragedy. Nearly half of seniors highly exposed to the train derailment (41.7%) believe that their health has deteriorated in the past 3 years. The majority of seniors highly exposed to the train derailment (68.7%) also show symptoms of posttraumatic stress disorders. Seniors highly or moderately exposed to the tragedy were also more likely to have found positive changes in their personal and social life as compared with nonexposed seniors. Discussion: A technological disaster such as a train derailment still had negative impacts on seniors’ physical and mental health 3 years later. Conclusion: Public health authorities must tailor prevention and promotion programs to restore health and well-being in this population.

Abstract. Large-scale socioeconomic studies of the impacts of floods are difficult and costly for countries such as Canada and the United States due to the large number of rivers and size of watersheds. Such studies are however very important for analyzing spatial patterns and temporal trends to inform large-scale flood risk management decisions and policies. In this paper, we present different flood occurrence and impact models based upon statistical and machine learning methods of over 31 000 watersheds spread across Canada and the US. The models can be quickly calibrated and thereby easily run predictions over thousands of scenarios in a matter of minutes. As applications of the models, we present the geographical distribution of the modelled average annual number of people displaced due to flooding in Canada and the US, as well as various scenario analyses. We find for example that an increase of 10 % in average precipitation yields an increase in the displaced population of 18 % in Canada and 14 % in the US. The model can therefore be used by a broad range of end users ranging from climate scientists to economists who seek to translate climate and socioeconomic scenarios into flood probabilities and impacts measured in terms of the displaced population.

The article describes a quantitative cross-sectional study of a sample of 674 university students enrolled in social work programmes in four countries: Belgium, Canada, Chile and Switzerland. The study aimed to assess HIV/AIDS knowledge and attitudes among participants. The median HIV-KQ-18 score for the sample was 14.0, which Carey and Schroder classify as indicating borderline low levels of knowledge. Based on the results, the authors argue that social work education and training programmes should more comprehensively address HIV/AIDS within their curricula to better equip future social workers to challenge stigmatising and exclusionary practices rooted in long-standing lack of knowledge and erroneous beliefs about the disease.

Support from caregivers is an important element of mental health recovery. However, the mechanisms by which social support influences the recovery of persons with depressive, anxiety, or bipolar disorders are less understood. In this study, we describe the social support mechanisms that influence mental health recovery. A cross-sectional qualitative study was undertaken in Québec (Canada) with 15 persons in recovery and 15 caregivers—those having played the most significant role in their recovery. A deductive thematic analysis allowed for the identification and description of different mechanisms through a triangulation of perspectives from different actors. Regarding classic social support functions, several of the support mechanisms for mental health recovery were identified (emotional support, companionship, instrumental support, and validation). However, informational support was not mentioned. New mechanisms were also identified: presence, communication, and influence. Social support mechanisms evoke a model containing a hierarchy as well as links among them.

Introduction:Public health emergency management involves the timely translation of relevant evidence and effective coordination of diverse actors. In practice, this can be challenging in the absence of a common framework for action among diverse actors.Aim:To apply an Integrated Knowledge Translation (iKT) approach throughout the development of a conceptual framework and performance measurement indicators for public health emergency preparedness (PHEP), to ensure knowledge generated is relevant and useful to the field.Methods:The iKT approach was initiated by identifying a research question based on priorities from the field. The two phases of the study used participatory research methods as well as active engagement with potential end users at key study milestones. The Structured Interview Matrix (SIM) facilitation technique for focus groups and an expert panel using Delphi methodology were used to define the PHEP framework and performance measurement indicators, respectively. An advisory committee was assembled consisting of potential end-users of the research, in senior positions in applied and decision-making roles.Results:iKT was an essential component for this applied public health project, contributing to and enhancing the relevance of the knowledge generated. iKT contributed to the following: broad national engagement and interest in the study, successful recruitment in both phases, and engagement with decision-makers. This multi-dimensional participatory approach successfully generated knowledge that was important to the field demonstrated by relevance to practice and policy in jurisdictions across Canada. Furthermore, the approach fostered building resilience in local and national communities through collaboration.Discussion:The iKT approach was essential to generating knowledge that is relevant and useful to the field, mainly to promote health system preparedness and resilience. Future research to study the implementation of knowledge will be important to continue addressing the knowledge-to-action gap in health emergency management research.

Abstract Objective To examine mental health and community cohesion in women living in Calgary after a natural disaster considering previously collected mental health data. Methods Data from an ongoing longitudinal cohort, the All Our Families study, were used to examine mental health and community cohesion 5 months after a major flood in Calgary, Canada. Participants who had completed a baseline questionnaire before the flood were eligible for inclusion in this study (N=923). Four multivariable logistic regression models were built to examine predictors of post-traumatic stress, depression, anxiety, and community cohesion. Results Elevated anxiety before the flood was associated with 2.49 (95% CI: 1.17, 5.26) increased odds of experiencing high levels of post-traumatic stress, regardless of whether respondents lived in a flood-risk community or not. Women who experienced damage to property, or who provided help to others, were more likely to perceive an increased sense of community cohesion (adjusted ods ratio (AOR): 1.67; 95% CI: 1.09, 2.54 and AOR: 1.68; 95% CI: 1.13, 2.52, respectively). Conclusions Women with underlying mental health conditions may be more vulnerable to the psychological impacts of a natural disaster regardless of their level of exposure. Natural disasters may bring communities together, especially those who were more tangibly impacted. ( Disaster Med Public Health Preparedness . 2018;12:470–477)

Introduction:In July 2013, a train carrying 72 cars of crude oil derailed in the town of Lac-Mégantic (Eastern Townships, Quebec, Canada). This disaster provoked a major conflagration, explosions, 47 deaths, the destruction of 44 buildings, the evacuation of one-third of the local population, and an unparalleled oil spill. Notwithstanding the environmental impact, many citizens of this town and in surrounding areas have suffered and continue to suffer substantial losses as a direct consequence of this catastrophe.Problem:To tailor public health interventions and to meet the psychosocial needs of the community, the Public Health Department of Eastern Townships has undertaken repeated surveys to monitor health and well-being over time. This study focuses on negative psychosocial outcomes one and two years after the tragedy.Methods:Two cross-sectional surveys (2014 and 2015) were conducted among large random samples of adults in Lac-Mégantic and surrounding areas (2014: n = 811; 2015: n = 800), and elsewhere in the region (2014: n = 7,926; 2015: n = 800). A wide range of psychosocial outcomes was assessed (ie, daily stress, main source of stress, sense of insecurity, psychological distress, excessive drinking, anxiety or mood disorders, psychosocial services use, anxiolytic drug use, gambling habits, and posttraumatic stress symptoms [PSS]). Exposure to the tragedy was assessed using residential location (ie, six-digit postal code) and intensity of exposure (ie, intense, moderate, or low exposure; from nine items capturing human, material, or subjective losses). Relationships between such exposures and adverse psychosocial outcomes were examined using chi-squares and t-tests. Distribution of outcomes was also examined over time.Results:One year after the disaster, an important proportion of participants reported human, material, and subjective losses (64%, 23%, and 54%, respectively), whereas 17% of people experienced intense exposure. Participants from Lac-Mégantic, particularly those intensely exposed, were much more likely to report psychological distress, depressive episode, anxiety disorders, and anxiolytic drug use, relative to less-exposed ones. In 2015, 67% of the Lac-Mégantic participants (76% of intensely exposed) reported moderate to severe PSS. Surprisingly, the use of psychosocial services in Lac-Mégantic declined by 41% from 2014 to 2015.Conclusion:The psychosocial burden in the aftermath of the Lac-Mégantic tragedy is substantial and persistent. Public health organizations responding to large-scaling disasters should monitor long-term psychosocial consequences and advocate for community-based psychosocial support in order to help citizens in their recovery process.

Canada regularly faces environmental public health (EPH) disasters. Given the importance of evidence-based, risk-informed decision-making, we aimed to critically assess the integration of EPH expertise and research into each phase of disaster management. In-depth interviews were conducted with 23 leaders in disaster management from Canada, the United States, the United Kingdom, and Australia, and were complemented by other qualitative methods. Three topics were examined: governance, knowledge creation/translation, and related barriers/needs. Data were analyzed through a four-step content analysis. Six critical success factors emerged from the analysis: blending the best of traditional and modern approaches; fostering community engagement; cultivating relationships; investing in preparedness and recovery; putting knowledge into practice; and ensuring sufficient human and financial resources. Several promising knowledge-to-action strategies were also identified, including mentorship programs, communities of practice, advisory groups, systematized learning, and comprehensive repositories of tools and resources. There is no single roadmap to incorporate EPH expertise and research into disaster management. Our findings suggest that preparation for and management of EPH disaster risks requires effective long-term collaboration between science, policy, and EPH practitioners at all levels in order to facilitate coordinated and timely deployment of multi-sectoral/jurisdictional resources when and where they are most needed.

This study presents the first nationwide spatial assessment of flood risk to identify social vulnerability and flood exposure hotspots that support policies aimed at protecting high-risk populations and geographical regions of Canada. The study used a national-scale flood hazard dataset (pluvial, fluvial, and coastal) to estimate a 1-in-100-year flood exposure of all residential properties across 5721 census tracts. Residential flood exposure data were spatially integrated with a census-based multidimensional social vulnerability index (SoVI) that included demographic, racial/ethnic, and socioeconomic indicators influencing vulnerability. Using Bivariate Local Indicators of Spatial Association (BiLISA) cluster maps, the study identified geographic concentration of flood risk hotspots where high vulnerability coincided with high flood exposure. The results revealed considerable spatial variations in tract-level social vulnerability and flood exposure. Flood risk hotspots belonged to 410 census tracts, 21 census metropolitan areas, and eight provinces comprising about 1.7 million of the total population and 51% of half-a-million residential properties in Canada. Results identify populations and the geographic regions near the core and dense urban areas predominantly occupying those hotspots. Recognizing priority locations is critically important for government interventions and risk mitigation initiatives considering socio-physical aspects of vulnerability to flooding. Findings reinforce a better understanding of geographic flood-disadvantaged neighborhoods across Canada, where interventions are required to target preparedness, response, and recovery resources that foster socially just flood management strategies.

Après les nombreuses crues printanières qui ont affecté le sud du Québec depuis 2011, le gouvernement du Québec a annoncé en avril 2019 une refonte importante de son programme d’aide financière aux sinistrés. Le programme introduit désormais une couverture limitée à vie de 100 000 $ pour les inondations successives, une mesure unique au Canada. L’objectif de cet article est d’analyser le coût des inondations successives et les impacts financiers de cette limite de couverture pour les ménages.