Better Health for All
Health Status Reporting Series Six
Health Behaviours and Risk Conditions
A Message from Dr. Cory Neudorf
Chief Medical Health Officer
Saskatoon Health Region
Our Vision of Better Health for All
The Better Health for All Series highlights a number of key findings about the status of our health. We
envision a community in which everyone has a chance to live a healthy life and has the same
opportunities to reach their full health potential. Our series highlights what actions are being taken to
make this vision a reality and what more we can do to create better opportunities for all to achieve
better health.
Better Health for All Series 6: Health Behaviours and Risk Conditions
Health behaviours and risk conditions are not solely individual “choices,” but actions and circumstances
largely determined by the physical, social, cultural and policy environments in which we live, work, learn
and play. When we think about a person’s risk of getting sick, we must also consider the wider population
he or she is a part of. In this report, in addition to the question, “What makes us healthy or unhealthy?” we
ask “Why does our population have these behaviors and risks?”
Some of the most common health behaviours such as what food we eat, how physically active (or
inactive) we are, and whether we smoke or drink alcohol have a major influence on our health. It has
been estimated that up to 60% of all deaths and over 30% of all hospitalization days are caused by these
key factors.1,2 These health behaviours are linked to certain risk conditions, such as obesity and stress,
which in turn are associated with key indicators of overall health, including self-rated health and selfrated mental health.
Series 6 provides a snapshot of the health behaviours and risk conditions of people living in our Health
Region. It uses data from Canada’s Community Health Survey to show how we compare to the province
and the country and examines trends over time. In addition to reporting on the overall health of the
population, we dig deeper to show how patterns of behaviour and risk differ according to social
determinants of health, including gender, age, education level, household income, neighbourhood
deprivation, immigration status, and geography within the Region.
Manuel DG, Perez R, Bennett C, et al. Seven More Years: The Impact of Smoking, Alcohol, Diet, Physical Activity and Stress on
Health and Life Expectancy in Ontario. 2012. Toronto: Institute for Clinical Evaluative Sciences and Public Health Ontario.
2 Manuel DG, Perez R, Bennett C, Rosella L, Choi B. 900,000 Days in Hospital: The Annual Impact of Smoking, Alcohol, Diet and
Physical Activity on Hospital Use in Ontario.2014. Toronto, ON: Institute for Clinical Evaluative Sciences.
1
1
What did we find?3
Indicators of overall health in the Region were consistent over time between 2003 and 2012. Seven out
of 10 people reported that their mental health is “very good” or “excellent.” Similarly, about six out of 10
people reported that their overall health is “very good” or “excellent.”
Measures of risk conditions are less favourable. Overweight and obesity is a growing problem in the
Region, and more than half of the Region’s population (56.6%) is now overweight or obese. In addition,
more than 45,000 people, or 17% of the population, reported that most days were “quite a bit” or
“extremely” stressful.
We took a closer look at health behaviours linked to obesity and mental health. Physical activity rates
are slowly rising and are the highest they have been in a decade, but only slightly more than half of the
population in the Region is “moderately active” or “physically active.” In addition, over 60% of the
Region’s population is sedentary, meaning that more than two hours of their leisure time per day is
spent watching televisions or using computers – putting more than 160,000 people at increased risk for
chronic illness and premature death. Only about one in three Region residents (32.3%) reported eating
at least five vegetables and fruit per day, which is significantly worse than the Canadian average of
40.5%. The percentage of the Region’s households that are food insecure has increased over time.
There is some good news to report: Smoking rates in the Region decreased to 18.6%, which is slightly
lower than both the provincial and national averages. Second hand smoke exposure has also
decreased. Only about 3% of the population was exposed to second-hand smoke in their homes, a
significant decrease from 2003 when the rate was over 10%.
Heavy alcohol use, or binge drinking, is common. More than one in five people (22.2%) reported
drinking five or more drinks on one occasion at least once per month in the past year. About one in
seven (14.2%) reported using illicit drugs. Both rates are higher than the provincial and national rates.
Health inequalities and inequities persist:
Previous reports in the Better Health for All Series highlight very large gaps in health
between people living in the most and least advantaged areas of Saskatoon. In
this report, we found that people living in the most disadvantaged areas4 had
significantly poorer self-rated health and self-rated mental health. This inequity
existed for most indicators as well, including physical activity, sedentary behavior,
smoking, exposure to second hand smoke, illicit drug use, alcohol consumption
and food insecurity.
For more
information on
Health Equity see
our Better Health
for All Series 3:
Advancing
Health Equity in
Health Care—
What Is Health
Equity?
Our analyses by sub-group3 show that in addition to area deprivation, inequities
exist for other indicators. Older adults had poorer self-rated health and self-rated
mental health than youth and younger adults. Older adults were also more likely
to be overweight or obese and less likely to be physically active. People with
college or university degrees reported better self-rated health and self-rated mental health, but were
more likely to report high levels of daily stress than people with high school diplomas or less. Compared to
women, men were more likely to be overweight or obese, consume fewer vegetables and fruits, and
binge drink. Binge drinking and illicit drug use were more common in urban than rural areas, and binge
See CommunityView Collaboration www.communityview.ca/pdfs/2015_shr_series6_aboutthedata.pdf for detailed definitions of
these indicators.
3
4
Deprivation in Saskatoon was identified using an index of six socioeconomic variables (income, education, employment, marital
status, single-parent families, and living alone). The index divides the Saskatoon into five categories ranging from highest to lowest
deprivation and each area contains approximately one fifth of the population.
2
drinking was also more common among people with higher household incomes and higher education
levels. Rates of overweight and obesity and smoking were lower among new Canadians compared to
non-immigrants. People who are visible minorities were more likely to report high levels of daily stress. In
addition to these findings, the analyses show other differences by gender, age group, immigrant and
visible minority status, and geography within the Region.
What’s being done to create the conditions for
improved health behaviours and reduced risk
conditions?
Within Saskatoon Health Region, much is being done to
improve health behaviours and reduce risk conditions.
Previous health status reports call for action to reduce
poverty, address racism for First Nations and Metis people,
and meet the unique needs of newcomers to Canada in
order to reduce health inequities. Saskatoon Health Region
is taking action, within the health care system and with
community partners, to advance health equity. Provincially,
work is continuing on a poverty reduction strategy.
Reducing poverty will lay the foundation for improved
health in our community.
Primary prevention is the protection of health
and prevention of disease through personal
and community wide efforts, e.g., healthy
eating, physical fitness, immunizations, safe
environments.a
Secondary prevention aims to reduce the
prevalence of disease through early
detection and treatment, e.g., screening
programs.b
Tertiary prevention reduces disease severity or
disability by minimizing suffering and
maximizing life expectancy, e.g.,
rehabilitation services.a,b
a. Last, J. A Dictionary of Epidemiology. 3rd edition. 1995.
New York: Oxford University Press.
b. Porta, M. Dictionary of Epidemiology. 5th edition. 2008.
New York: Oxford University Press.
In this report, a variety of programs, services, strategies and
policies are profiled in the one-page summary documents
and recommendations. We chose to highlight, where possible, those initiatives that are focused on
primary prevention and supported by evidence (see sidebar). In addition, although not comprehensive,
we list other programs relevant to the indicators included in the report.
Achieving Better Health for All – A Call to Action for Saskatoon Health Region and its Partners
We envision a community in which everyone has a chance to live a healthy life and where everyone has
the same opportunities to reach their full health potential. The way forward depends on our answers to
the two questions asked in this report:
What makes a person healthy or unhealthy? Personal health behaviours matter, but they are only part of
the answer. Changing personal health behaviours can be difficult for many, and it may not be enough.
For example, cigarettes contain hundreds of chemicals known to be addictive and toxic to the body.
Stress can trigger unhealthy behaviours, such as smoking, but stress itself can be toxic. Hormones
associated with chronic stress cause changes in the brain and body that can further increase the risk of
disease. If a person stops smoking, some of these changes are reversible, but others are not. Some
changes are genetic, which means that the risk may be inherited by our children. The same health risk,
therefore, may have different consequences for different people.
Why does our population have these behaviors and risks? We’ve seen that health behaviours and risk
conditions do not occur randomly within the population. They follow patterns according to social and
economic circumstances, and behaviours and risks often cluster with each other. For example, many
people who drink heavily also smoke, and people who are physically active eat more vegetables and
fruits. In addition, these patterns often appear early in life and persist across a lifetime. Interventions must
address the physical, social, cultural and policy environments that shape these health behaviours and
risks, focusing on the needs of populations most at risk especially children and youth.
3
Ottawa Charter for Health Promotion
Health promotion is “the process of enabling people to increase
Strategies
control over, and to improve, their health.”5 The term health
 Build healthy public policy
promotion is sometimes used narrowly to refer to health
 Create supportive environments
education. However, health education alone may actually
6
widen health inequities between population sub-groups.
 Strengthen community action
Education is only one component (see side bar) of an overall
 Develop personal skills
strategy that targets individuals, families, schools, workplaces,
 Reorient health services
communities and governments that can increase an
intervention’s chance of success. To achieve our vision, we can first take an approach where
interventions benefit the whole population. Second, we can target interventions to those at greatest risk.
The greatest improvements in our health however, will result from doing a combination of both.
With this in mind, Saskatoon Health Region should continue to work with its partners to:
1. Sustain a comprehensive and coordinated approach to tobacco reduction.

Policy owners should expand policies to include outdoor public spaces, monitor compliance and
take necessary actions to ensure that these policies continue to be effective.
 Rationale: The introduction of smoke-free policies in public places, on school grounds, in
vehicles with children, and in workplaces and private settings has made a difference in
reducing smoking rates and exposure to second-hand smoke.7 The cities of Warman and
Martensville recently passed legislation to ban smoking in outdoor parks and playgrounds,
making these some of the most comprehensive smoke free bylaws in all of Canada.

Partners for tobacco reduction should advocate that Saskatchewan ensure continued tobacco
tax increases equivalent to or exceeding inflation.
 Rationale: Tobacco tax increases are among the most effective tobacco reduction measures.
Their impact is greatest among youth and people with low household incomes,8 two
population sub-groups at highest risk for smoking.

Health care providers should screen all individuals for tobacco use and offer appropriate
interventions.
 Rationale: Motivational interviewing is an effective tool to counsel people who smoke about
tobacco reduction.9 Health care professionals can educate patients and clients who use
tobacco about the effects of tobacco on their health, encourage them to consider quitting,
and either assist them through the process, or refer them to a tobacco cessation specialist
nearby.

Health care service and health insurance providers should expand the range of smoking
cessation medications offered at low- or no-cost to individuals, including non-prescription
nicotine replacement therapies and prescription medications.
World Health Organization. Ottawa Charter for Health Promotion. 1986.
http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
6 Lorenc T, Petticrew M, Welch V, Tugwell P. What types of interventions generate inequalities? Evidence from systematic reviews.
Journal of Epidemiology and Community Health 2013;67:190-193.
7 Hopkins DP, Razi S, Leeks KD, Priya Kalra G, Chattopadhyay SK, Soler RE. Smokefree policies to reduce tobacco use. A systematic
review. American Journal of Preventive Medicine 2010;38(2 Suppl):S275-89).
8
Brown T, Platt S, & Amos A. Equity impact of population-level interventions and policies to reduce smoking in adults: A systematic
review. Drug and Alcohol Dependence 2014;138: 7-16.
9 Partnership to assist with cessation of tobacco (PACT). Health Care. Regina, SK: Saskatchewan Ministry of Health and Pharmacists
Association of Saskatchewan. http://www.makeapact.ca/content/health-care
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
2.
Rationale: The high costs of smoking cessation can prevent people with low household
income from accessing support. Toll-free smokers’ help lines provide free counseling.
Prescription medications can be expensive but some, like Champix and Zyban, are listed on
the provincial formulary, which means that the costs can be partially covered for those with
health insurance.
Support initiatives that aim to decrease the prevalence of overweight and obesity.
Promote physical activity

Urban and rural municipal planners should continue incorporating best-practices10 to support
walking, bicycling and public transportation in new and retrofitted infrastructure and urban
design.
 Rationale: The population of Saskatoon Health Region continues to grow and with it increasing
vehicle use. Active transportation, any form of human powered transportation including
bicycling, walking, skateboarding etc., provides health, social, environmental and economic
benefits to individuals and communities.11,12

Urban and rural municipalities and community groups should expand programs that provide noor low-cost opportunities for physical activity and community connectivity, particularly for families
with children and older adults.
 Rationale: The cost of recreational and leisure programming can present a barrier to physical
activity for low income households, especially neighbourhoods where it may be unsafe to be
active outdoors13. Removing barriers to access to local facilities, such as skating rinks,
swimming pools and school gyms can increase opportunities for physical activity. For example,
the City of Saskatoon’s Community Development Branch offers free playground programs
during the summer months and provides access to leisure centres at a reduced cost for
eligible Saskatoon residents. Municipalities and groups should provide recreational
opportunities and experiences that are respectful and appropriate for various ages, abilities,
genders and ethnocultural groups.

Schools and workplaces should reduce sedentary behavior by providing regular activity breaks
and alternatives to sitting (e.g., standing desks and meetings) in addition to education through
information campaigns.14
 Rationale: Research is showing the health risks of being sedentary for extended periods of
time.15 Because schools and workplaces are venues accessed by most children, youth and
adults, interventions in these settings can reach vulnerable populations and help reduce
health inequities.
Heath GW, Brownson RC, Kruger J, et al. The effectiveness of urban design and land use and transport policies and practices to
increase physical activity: a systematic review. Journal of Physical Activity and Health 2006;3(Suppl 1):S55-76.
11 Woodcock J, Edwards P, Tonne C, Armstrong BG, Ashiru O, Banister D et al. Public health benefits of strategies to reduce
greenhouse gas emissions: urban land transport. Lancet 2009;374:1930-1943.
12 Rabl A, de Nazelle . Benefits of shift from car to active transport. Transport Policy 2012; 19(1):121-131.
13 Canadian Fitness and Lifestyle Research Institute. 2009. Physical Activity Monitor. Bulletin 15: Environmental Barriers.
http://www.cflri.ca/sites/default/files/node/606/files/PAM2009Bulletin15.pdf
14 http://www.in-motion.ca/news/article/hazards-of-sitting-infographic. http://www.inmotion.ca/uploads/tools/Stand_Up_for_Your_Health_~_Meeting_Table_Card.pdf
15 Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease
incidence, mortality, and hospitalization in adults: A systematic review and meta-analysis. Ann Intern Med 2015;162:123-132.
10
5

Health care professionals should use evidence-informed guidelines16 to screen all individuals for
overweight or obesity, physical activity and sedentary behaviour and provide appropriate
recommendations and referrals.
 Rationale: Exercise can be an effective prescription to prevent and reverse chronic illness,17
but one size will not fit all. Chronic disease management programs should ensure that
programming includes physical activities accessible for people of all ages, income levels,
place of residence, language and culture.
Encourage healthy food consumption

Municipal governments, schools and community organizations should continue to work together
to expand interventions and implement policies that promote healthy food consumption.
 Rationale: Food access research has identified “food deserts” in Saskatoon.18 The opening of
The Good Food Junction in the Riversdale neighborhood in 2012 addressed one such food
desert and increased vegetable and fruit consumption for its members. Community garden
programs and fresh food markets (such as those lead by CHEP), also improve local access to
healthy foods, and effective interventions can be adapted to urban and rural areas. Other
policies to promote healthy food consumption include pricing structures that favour healthy
food purchases and zoning that restricts fast food outlets around schools.

The Saskatoon Community Food Council, along with partners working to reduce food insecurity
across the Region, should collaborate for a food strategy and corresponding action plan for
Saskatoon and area, recognizing the interdependence of rural and urban communities.
 Rationale: The cost of healthy eating in Saskatchewan is increasing, and costs are higher in
rural areas.19 Many cities across Canada have conducted food assessments or adopted a
food strategy to provide sustainable and equitable access o healthy food. Saskatoon has a
Food Charter that was adopted in principle by City Council in 2002, and a Saskatoon Regional
Food System Assessment and Action Plan that was released in 2013.

Poverty reduction groups, including Poverty Costs and its supporters, should continue to work with
government towards a comprehensive poverty reduction strategy for Saskatchewan.
 Rationale: Food insecurity affects one in five low-income households in Saskatoon Health
Region, and the increasing cost of housing means that many more households are struggling
to pay for both food and rent. When poverty or near-poverty conditions exist, health suffers.
Analysis compiled by Poverty Costs estimates the cost of poverty at $3.8 billion for
Saskatchewan annually in increased health and social service use.
Canadian Taskforce on Preventive Health Care. Obesity in adults. 2015. http://canadiantaskforce.ca/ctfphc-guidelines/2015obesity-adults/.
Canadian Society for Exercise Physiology. Canadian physical activity guidelines and Canadian sedentary behaviour guidelines.
2015. http://www.csep.ca/english/view.asp?x=804
17 Chakravarthy MV, Joyner MJ, Booth FW. An obligation for primary care physicians to prescribe physical activity to sedentary
patients to reduce the risk of chronic health conditions. Mayo Clinic Proceedings 2002; 77(2):165-173.
18 Kershaw T, Creighton T, Markham T, Marko J. Food access in Saskatoon. 2010. Saskatoon: Saskatoon Health Region.
http://www.communityview.ca/Catalogue/Document/DownloadFile/1000269?docNumber=2
19 Saskatchewan Food Costing Task Group. The cost of healthy eating in Saskatchewan 2012. 2012.
http://www.dietitians.ca/Downloads/Public/Cost-of-Healthy-Eating-in-SK-2012.aspx
16
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
Health care professionals should screen all individuals for food insecurity and offer appropriate
interventions.
 Rationale: Chronic illness and disability are made worse by low income and food insecurity.20
Health care professionals can help their patients to access programs that provide income
supplements, type-specific food vouchers or other incentives for healthy food purchases.
3. Reduce harms of illicit drug use and heavy alcohol drinking.

Partners for alcohol harm reduction should work to expand pricing policies to private liquor stores
and ensure continued alcohol tax increases are equivalent to or exceed inflation.
 Rationale: Price policies are effective for reducing consumption of alcohol at the population
level. Raising the price of alcohol through taxation significantly reduces heavy alcohol drinking
among people at all income levels more than lighter drinking.21 Minimum pricing standards
are in place at provincially owned and operated SLGA retail establishments. Off-sale and
private liquor retailers use an open pricing system and can adjust their prices as they choose.

Municipal governments and community partners should review locally available data and work
together to implement strategies to reduce heavy alcohol consumption and related social harms.
 Rationale: In Prince Albert, community data collected by the Hub and COR at Community
Mobilization Prince Albert (CMPA) helped make a case for a regional alcohol strategy22.
Examples of evidence-informed policies include: limit hours of operation and days of the week
when alcohol can be sold, regulate the location and number of alcohol outlets permitted
through zoning or licensing processes, minimize the privatization of alcohol sales and sales
promotion through advertising and price specials, and restrict access to minors.

For success and sustainability, harm reduction programs should be driven by community needs.
 Rationale: Community coalition risk prevention strategies enable local communities to plan
and implement evidence-based programs designed to prevent substance abuse and its
related harms. Examples include the Lighthouse Stabilization Unit, a partnership between the
Lighthouse, MD Ambulance and Saskatoon Health Region that provides a 20-bed dorm with
paramedic emergency health services for individuals under the influence of drugs or alcohol.

Developers of education and awareness campaigns should collaborate with populations most at
risk, such as youth and young adults, to increase likelihood that messages will resonate with the
target audience.
 Rationale: A number of public education campaigns have been initiated in Saskatchewan
over the years23,24. Public education alone is unlikely to reduce harms related to illicit drug use
and binge drinking,6 but can be effective as part of a comprehensive risk prevention strategy.
For example, What's Your Cap?25 is a student run, research based initiative at the University of
Saskatchewan that aims to raise awareness and knowledge of the risks involved with over
consumption of alcohol and promote a culture of moderation on campus.
Tarasuk V, Mitchell A, Dachner N. Household food insecurity in Canada, 2012. 2014. Toronto: Research to identify policy options to
reduce food insecurity (PROOF). http://nutritionalsciences.lamp.utoronto.ca/wpcontent/uploads/2014/05/Household_Food_Insecurity_in_Canada-2012_ENG.pdf
21 Thomas, G. Price policies to reduce alcohol-related harm in Canada. (Alcohol Price Policy Series: Report 3). Ottawa, ON:
Canadian Centre on Substance Abuse. 2012. http://www.ccsa.ca/Resource%20Library/CCSA-Price-Policies-Reduce-Alcohol-HarmCanada-2012-en.pdf
22 Community Mobilization Prince Albert. The Case for a Regional Alcohol Strategy: A call to action for all community sectors to
collectively develop and implement a comprehensive alcohol strategy. 2013. Prince Albert: Community Mobilization Prince Albert.
23 http://www.health.gov.sk.ca/campaign-rites-of-passage
24 http://www.health.gov.sk.ca/what-else-got-wasted-campaign
25 http://www.whatsurcap.ca/
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
Expand access to drug and alcohol addiction treatment services and ensure cultural
appropriateness.
 Rationale: Saskatchewan residents have stated that timely access to mental health and
addictions services was a top priority.26 Services need to be designed to respond to people’s
language needs, cultural preferences and ways of life.

Health care professionals should promote a culture of moderation and reduce harms by
screening all individuals for drug and alcohol use27 and providing appropriate counseling or
referrals.
 Rationale: Some people use illicit drugs and alcohol to self-treat chronic illness, including
chronic pain and mental health disorders. The majority of people with a mental health issue,
and a sizeable portion of those with addictions, issues first seek help from their family doctor,
walk in clinic, or emergency department. This provides an excellent opportunity to intervene.
4. Support actions that improve mental health in the community.

Partners involved in promoting mental health should fully support the recommendations contained
in the provincial mental health and addictions action plan.
 Rationale: Good mental health is a foundational aspect of good overall health. Achieving
health for all will not occur unless we recognize good mental health as an essential
component. Individuals who struggle with poor mental health have a reduced ability to be
productive at work, be available for their families and contribute to their communities. Poor
mental health is often associated with alcohol or substance misuse.
In 2013, the Government of Saskatchewan commissioned a review of the state of mental
health services in the province. Using a cross-sectoral approach, input was gathered from
public consultations, questionnaires, focus groups and stakeholder meetings. The final report,
released in December 2014, is a 10 year mental health action plan detailing a number of key
recommendations aimed at improving mental health and addictions for the people of
Saskatchewan.
5. Monitor impact of health promotion interventions to ensure they promote health equity.

Partners should work across sectors, utilize data to inform planning, and evaluate interventions to
ensure actions contribute to closing the gap between the most and least advantaged segments of
our population.
 Rationale: Improvement in many of the health behaviours and risk conditions examined in this
report depends on improvement in health equity and the social determinants of health. A
previous health status release put forth recommendations for how the health sector can help
improve health equity.
Learn More about the Better Health for All Series
We invite you to consider the information that we have presented in this message and through
CommunityView. It is our hope that you will use the Better Health for All series to inform the decisions you
make towards advancing the vision of a community in which everyone has the opportunity to live
healthy lives. Available reports include:
Stockdale Windor, F. Working together for change: A 10 year mental health and addictions action plan for Saskatchewan. 2014.
Regina: Author.
27 Moyer A, Finney JW. Brief interventions for alcohol misuse. CMAJ, 2015;doi:10.1503/cmaj.140254
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 Series 1, March 26 2014
Our Population- A high level look at who lives in our Region. Differences in health outcomes by
socioeconomic conditions will be released in upcoming series.
 Series 2, May 21 2014
Immunization- Examines a selected set of immunization indicators to report on progress and gaps
in coverage rates. Proposes further action to ensure equal opportunities for access to
immunization.
 Series 3, June 23 2014
Advancing Health Equity in Health Care- Examines a range of health inequalities and proposes
health care system action to create equal opportunities for all to achieve better health.

Series 4, July 28, 2014
Bloodborne and Sexually Transmitted Infections - Focuses on communicable disease such as
human immunodeficiency virus (HIV), and sexually transmitted infections (STIs).

Series 5, Sept 19, 2014
HIV – Focuses on HIV in particular and the role of the health sector in reducing its occurrence.
Upcoming Planned Releases Include:
Release date to be determined: A report on Community Wellbeing- Developed in partnership with the
Saskatoon Regional Intersectoral Committee discusses, in greater detail, the social determinants of
health and wellbeing.
Acknowledgements:
Many people were involved in the production of this report. The authors wish to thank the following for
their insight and suggestions:
Within Saskatoon Health Region:
Population and Public Health
Primary Health Care including Chronic Disease Management Department
Mental Health and Addiction Services
Rural Community Therapy Services
Primary Health Team, Duck Lake
Saskatchewan Cancer Agency
Canadian Mental Health Association
Saskatchewan Lung Association
Canadian Diabetes Association, Saskatchewan Regional Office
Heart and Stroke Foundation of Saskatchewan
Suggested Citation:
Neudorf, C., Kryzanowski, J., Marko, J., Ugolini C., Brown A., Fuller D., Murphy L.(2015). Better Health for All
Series 6: Health behaviours and risk conditions. Saskatoon: Saskatoon Health Region. Available from:
CommunityView Collaboration
9
Self-rated Health
Why Is This Important?
Highlights
Self-rated health is a
person's state of physical,
mental and social wellbeing, as reported by that
person. Self-rated health is
an excellent predictor of
the overall health status of
the population and is
associated with
population rates of
disease and premature
death. People with poor
self-rated health are more
likely to have symptoms of
chronic illness and use
health care services. Selfrated health tends to
decrease with age. Higher
income and more
education are linked to
better self-rated health.
Individuals with higher incomes, more education and residing in less
deprived neighbourhoods enjoy better self-rated health.
Figure 1: Individuals Reporting Self-rated Health as “Very Good“ or
Excellent,” in Saskatoon Health Region, Saskatchewan, and Canada,
2003 to 2012
70
60
Percent (%)
What Is Being Done?
About six in ten (60.3%) people reported their health as “very good” or
“excellent” in 2011/12 (Figure 1). This is consistent from previous years and
equivalent to provincial and national rates. There are about 110,000
Hep
people in the region who do not rate their health this well.
 People living in the least deprived areas were significantly more likely to
rate their health as “very good” or “excellent” compared to residents living
in the most deprived areas (72.0% compared to 47.2%; Figure 2).
 Self-rated health varies by sub-group, including age, household income,
neighbourhood deprivation, and education.

50
40
HealthLine 811 provides
health information and
access to professional
advice.
Measuring Equity in
Saskatoon Health Region
Plans and Strategies.
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health
Officer’s Call to Action
2005
2007/8
2009/10
2011/12
SHR
62.2
61.7
56.9
62.2
60.3
SK
59.2
58.2
55.2
58.1
56.9
Canada
58.4
60.1
59.3
60.3
59.9
Source: Statistics Canada
Figure 2: Individuals Reporting Self-rated Health as “Very Good“ or
“Excellent” by Deprivation Index Quintile, Saskatoon, 2008 to 2012
80
10
Percent
(%) (%)
Percent
LiveWell provides chronic
disease management
programs and services.
2003
70
8
7.8
60
6
50
4
5.7
40
2
30
0
20
10
0
4.3
47.2
Saskatoon
50.5
Rural SHR
5.3
5.9
61.0
64.6
SHR
SK
72.0
Canada
Geography
Most Deprived
Second Most
Middle Areas
lth Region, Saskatchewan
and Areas
Canada, 2011
Areas
Deprived
Second Least
Deprived Areas
Least Deprived
Areas
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan.
The analyses are based on data from Statistics Canada and the opinions expressed do not represent
the views of Statistics Canada.
Health Status Reporting
March 2015
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For more information: www.communityview.ca
Self-rated Health by Sub-group
Highlights


Self-rated health is highest among those in the youngest age group 12 to 19 years (68.7%), with the
highest incomes (71.3%), living in the least deprived areas (72.0%), those with some post-secondary
(64.5%) or post-secondary graduates (62.7%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Reporting Self-rated Health as “Very good” or “Excellent,” by Sub-group,
Saskatoon Health Region, 2008 to 2012
Number
Percent
Reporting V ery
Reporting
Good to
V ery Good to
Excellent Self- Excellent Selfrated Health
rated Health
157,937
60.0
Total Saskatoon Health Region
Sex
Male
77,926
Female
80,010
Age Group (Years)
12-19
22,801
20-44
76,101
45-64
44,619
65+
14,416
Household Income Level
Lowest income quintile
24,556
Second lowest income quintile
26,802
Middle income quintile
31,925
Second highest income quintile
30,204
Highest income quintile
32,540
Socio-economic status by deprivation index
Most Deprived Areas
17,140
Second Most Deprived Areas
15,733
Middle Areas
21,477
Second Least Deprived Areas
20,976
Least Deprived Areas
37,317
Education Level
Less than high school
22,468
High school graduate
30,993
Some post-secondary
16,975
Post-secondary graduate
86,332
Lower CI
57.2
Upper CI
62.8
59.9
60.1
56.0
56.9
63.7
63.4
68.7
66.9
56.8
38.2
62.7
62.7
51.0
34.4
74.7
71.1
62.5
42.1
49.0
54.8
67.0
62.4
71.3
42.6
49.4
61.5
56.6
65.4
55.5
60.1
72.6
68.2
77.2
47.2
50.5
61.0
64.6
72.0
38.7
43.5
53.0
58.0
66.4
55.7
57.6
69.0
71.3
77.5
47.5
63.2
64.5
62.7
42.3
57.1
56.4
58.8
52.8
69.2
72.5
66.6
Health Status Reporting
March 2015
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Table 1 (continued): Individuals Reporting Self-rated Health as “Very Good” or “Excellent,”
by Sub-group, Saskatoon Health Region, 2008 to 2012
Number
Percent
Reporting Very Reporting
Good to
Very Good to
Excellent Self- Excellent Selfrated Health rated Health Low er CI Upper CI
Ethnicity
White
135,008
60.6
57.8
Visible Minority
21,501
56.7
47.3
I mmigrant status
Recent immigrant
10,711
73.1
59.2
Long term immigrant
7,014
56.3
46.0
Non-immigrant
139,411
59.3
56.5
Geography
Rural Saskatoon Health Region
32,524
60.8
56.2
Urban Saskatoon city
125,413
59.8
56.6
Geography by Rural Planning Zones
Humboldt and Area
5,819
53.2
45.2
Rosthern and Area
6,452
57.0
48.6
Watrous and Area
5,512
62.1
52.8
Saskatoon Area
14,741
65.9
58.3
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
All estimates are w eighted to the Saskatoon Health Region population.
63.5
66.2
87.0
66.6
62.2
65.5
63.0
61.1
65.4
71.5
73.6
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Self-rated Mental Health
Why Is This Important?
Highlights
Self-rated mental health is
a person's state of
psychological well-being
as reported by that
person. Good mental
health is more than the
absence of mental illness,
but also the presence of
factors such as ability to
enjoy life, balance, and
flexibility. Poor self-rated
mental health is
associated with poor selfrated health, physical and
mental illness, and
increased health care
service use. Higher
income and more
education are linked to
better self-rated mental
health.
Self-rated mental health is worse than in past years.
Figure 1: Individuals Reporting Self-rated Mental Health as “Very Good“ or
“Excellent” in Saskatoon Health Region, Saskatchewan, and Canada,
2003 to 2012
75
70
Percent (%)
What Is Being Done?
 More than two in three (69.2%) people reported their mental health as “very
good” or “excellent” in 2011/12 (Figure 1). This is slightly worse than in
previous years and roughly equivalent to provincial and national rates. This
means that there are about 90,000 people in the region who do not rate
their mental health this well.
Hep
 People living in the most deprived areas of Saskatoon were significantly less
likely to rate their mental health as “very good” or “excellent“ compared to
residents in the least deprived areas (59.8% compared to 81.6%; Figure 2).
 Self-rated mental health varies by sub-group, including age, household
income, neighbourhood deprivation and education.
65
60
55
50
Saskatchewan 211
provides access to mental
health services and
supports.
Working Together for
Change: A 10-year
Mental Health and
Addictions Action plan for
Saskatchewan.
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health
Officer’s Call to Action
2005
2007/8
2009/10
2011/12
71.8
72.6
72.1
73.4
69.2
SK
73.0
72.2
71.9
71.5
67.7
Canada
73.4
74.4
74.6
73.9
72.2
Source: Statistics Canada
Figure 2: Individuals Reporting Self-rated Mental Health as “Very Good“ or
“Excellent” by Deprivation Index Quintile, Saskatoon, 2008 to 2012
90
10
(%) (%)
Percent
Percent
Saskatoon Health Region’s
Mental Health and
Addictions intake line.
2003
SHR
80
8
70
606
504
40
2
30
7.8
5.7
81.6
4.3
73.3
5.9
5.3
71.3
68.1
59.8
200
10
Saskatoon
Rural SHR
SHR
SK
Canada
Geography
0
Least Deprived
Areas
Second Least
Deprived Areas
Middle Areas
lth Region, Saskatchewan and Canada, 2011
Second Most
Deprived Areas
Most Deprived
Areas
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan.
The analyses are based on data from Statistics Canada and the opinions expressed do not represent
the views of Statistics Canada.
Health Status Reporting
March 2015
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Self-rated Mental Health by Sub-group
Highlights


Self-rated mental health is highest among those in the youngest age category 12 to 19 years (78.2%),
those with the highest income (79.6%), those living in the least deprived areas of Saskatoon (81.6%) and
those with at least a high school education (72.3% to 81.1%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Reporting Self-rated Mental Health as “Very good” or “Excellent,” by Sub-group,
Saskatoon Health Region, 2008 to 2012
Total Saskatoon Health Region
Sex
Male
Female
Age Group (Years)
12-19
20-44
45-64
65+
Household Income Level
Lowest income quintile
Second lowest income quintile
Middle income quintile
Second highest income quintile
Highest income quintile
Socio-economic status by deprivation index
Most Deprived Areas
Second Most Deprived Areas
Middle Areas
Second Least Deprived Areas
Least Deprived Areas
Education Level
Less than high school
High school graduate
Some post-secondary
Post-secondary graduate
Number Reporting Percent Reporting
V ery Good to
V ery Good to
Excellent Self-rated Excellent Self-rated
Mental Health
Mental Health
Lower CI
184,708
71.6
69.3
Upper CI
73.8
91,650
93,058
71.8
71.3
68.4
68.2
75.2
74.4
25,309
83,766
53,488
22,144
78.2
74.7
68.4
62.6
72.2
71.0
63.9
58.2
84.3
78.3
72.9
66.9
27,363
32,206
36,603
36,931
35,621
56.9
67.2
77.6
76.8
79.6
50.4
61.9
72.4
71.8
74.7
63.3
72.5
82.7
81.8
84.5
20,943
20,931
24,781
23,318
41,453
59.8
68.1
71.3
73.3
81.6
52.4
61.4
64.8
67.6
76.7
67.2
74.9
77.8
79.0
86.5
27,971
34,933
21,213
99,163
62.6
73.4
81.1
72.3
57.1
68.2
75.3
69.1
68.0
78.6
87.0
75.5
Health Status Reporting
March 2015
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Table 1 (continued): Individuals Reporting Self-rated Mental Health as “Very Good” or “Excellent,”
by Sub-group, Saskatoon Health Region, 2008 to 2012
Number
Percent
Reporting Very
Reporting Very
Good to Excellent Good to Excellent
Self-rated Mental Self-rated Mental
Health
Health
Low er CI Upper CI
Ethnicity
White
157,516
72.2
Visible Minority
25,971
69.5
I mmigrant status
Recent immigrant
10,987
75.8
Long term immigrant
8,625
70.6
Non-immigrant
164,698
71.5
Geography
Rural Saskatoon Health Region
36,581
69.2
Urban Saskatoon city
148,127
72.2
Geography by Rural Planning Zones
Humboldt and Area
7,323
67.3
Rosthern and Area
7,702
69.8
Watrous and Area
5,873
67.2
Saskatoon Area
15,682
70.7
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
All estimates are w eighted to the Saskatoon Health Region population.
69.8
63.6
74.6
75.3
64.0
60.8
69.1
87.6
80.4
74.0
65.0
69.5
73.4
74.8
59.5
61.3
56.5
63.2
75.2
78.3
78.0
78.2
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
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Vegetable and Fruit Consumption
Why Is This Important?
What Is Being Done?
Canada’s Food Guide
provides consumption
guidelines for all ages.
Highlights
Most people do not eat five or more vegetables or fruit daily, and
consumption is decreasing over time.
Roughly one in three people in Saskatoon Health Region (32.3%) ate five or
more vegetables or fruit daily in 2011/12 (Figure 1). This is worse than the
Canadian average of 40.5%. Almost 170,000 people report low vegetable
`Hep
or fruit consumption.
 People with more education are more likely to consume five or more
vegetables or fruit daily. A significantly lower percentage of individuals
with high school diplomas ate at least five vegetables and fruit per day
compared to those with at least some post-secondary education (26.5%
compared to 41.2%; Figure 2).
 Vegetable and fruit consumption varies by sub-group, including sex,
household income and education level.

Figure 1: Individuals Eating at Least Five Vegetables and Fruit per Day,
Saskatoon Health Region, Saskatchewan, and Canada, 2003 to 2011/12
45
40
35
30
25
20
15
10
5
0
Percent (%)
Vegetables and fruit are
important sources of
vitamins, minerals and
fibre. Their sufficient daily
consumption can help
prevent chronic illness,
such as heart disease and
certain cancers. Low
consumption is linked to
obesity, smoking and
sedentary behaviour.
Women and people living
in urban areas consume
more vegetables and fruit.
Consumption is lower in
households with no
children and households
with low income.
CHEP’s Fresh Food Markets
and Saskatoon Food
Bank’s Garden Patch
increase access to
vegetables and fruit.
Nutrition Positive and
Nourishing Minds promote
healthy eating in
Saskatchewan schools.
Chief Medical Health
Officer’s Call to Action
2007/8
2009/10
2011/12
SHR
38.1
41.1
40.6
32.3
SK
37.1
36.7
38.8
38.5
35.3
Canada
41.4
43.6
43.8
44.2
40.5
Figure 2: Individuals Eating at Least Five Vegetables and Fruit per Day, by
Educational Attainment, Saskatoon Health Region, 2010 to 2012
45
40
35
30
25
20
15
29.8
10
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
2005
Source: Statistics Canada
Percent (%)
Saskatoon Food Council
provided
recommendations for a
regional food strategy.
2003
41.2
40.5
Some postsecondary*
Post-secondary
graduate
26.5
5
0
Less than high
school
High school
graduate
*High variability. Use with caution. Source: Statistics Canada. This study was conducted, in part, with data
provided by the Saskatchewan Ministry of Health to the Health Quality Council. The interpretations and
conclusions herein do not necessarily represent those of the Saskatchewan Ministry of Health or
Government of Saskatchewan. The analyses are based on data from Statistics Canada and the opinions
expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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For more information: www.communityview.ca
Vegetable and Fruit Consumption by Sub-group
Highlights


Vegetable and fruit consumption is highest among females (43.3%) and post-secondary graduates
(40.5%) (Table 1).
To learn more about how these numbers were compiled, click here.
Table 1: Individuals Eating at Least Five Vegetables and Fruit per Day, by Sub-group, Saskatoon
Health Region, 2010 to 2012
Number eating
at least five
vegetables and
fruit per day
88,145
Percent eating
at least five
vegetables and
fruit per day
35.9
Lower CI
32.4
Upper CI
39.4
34,264
53,880
28.4
43.3
23.8
38.6
32.9
48.0
11,852
39,065
25,423
11,805
39.7
35.7
33.5
39.2
30.0
30.1
27.6
33.8
49.4
41.3
39.4
44.6
16,496
11,590
16,893
21,147
17,201
36.8
24.7
35.0
43.8
37.0
29.5
17.6
26.4
36.1
28.4
44.1
31.7
43.7
51.6
45.5
9,949
9,235
15,504
11,316
20,848
27.0
28.4
41.1
37.6
42.0
19.0
19.3
30.8
26.5
30.9
35.0
37.5
51.4
48.7
53.0
11,194
12,944
8,372
55,073
29.8
26.5
41.2
40.5
21.5
19.9
27.3
35.2
38.1
33.0
55.0
45.7
Total Saskatoon Health Region
Sex
Male
Female
Age Group (Years)
12-19
20-44
45-64
65+
Household Income Level
Lowest income quintile
Second lowest income quintile
Middle income quintile
Second highest income quintile
Highest income quintile
Socio-economic status by deprivation index
Most deprived areas
Second most deprived areas
Middle areas
Second least deprived areas
Least deprived areas
Education Level
Less than high school
High school graduate
Some post-secondary*
Post-secondary graduate
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Table 1 (continued): Individuals Eating at Least Five Vegetables and Fruit per Day, by Sub-group,
Saskatoon Health Region, 2010 to 2012
Number eating Percent eating
at least fiv e
at least fiv e
v egetables and v egetables and
fruit per day
fruit per day
Low er CI Upper CI
Ethnicity
White
74,212
36.2
32.4
Visible Minority
13,045
34.9
25.7
I mmigrant status
Recent immigrant*
5,374
36.8
21.3
Long term immigrant*
6,400
56.3
37.5
Non-immigrant
76,090
34.9
31.4
Geography
Rural Saskatoon Health Region
16,404
36.3
30.2
Urban Saskatoon City
71,741
35.9
31.8
Geography by Rural Planning Zones
Humboldt and Area*
3,627
36.7
23.4
Rosthern and Area*
2,751
35.1
22.4
Watrous and Area*
3,150
35.7
22.9
Saskatoon Area
6,876
36.9
26.6
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
Estimates hav e been w eighted to the Saskatoon Health Region population.
40.0
44.2
52.4
75.1
38.3
42.3
39.9
50.0
47.8
48.4
47.1
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Food Insecurity
Why Is This Important?
What Is Being Done?
Highlights
Food insecurity is increasing in Saskatoon Health Region.
More than 7% of Region residents reported either moderate or severe food
insecurity in 2011/12. This is close to the Canadian average of 7.8% and has
increased since 2007/08 (Figure 1). This means almost 20,000 people
reported food insecurity.
`Hep
Households in the lowest income quintiles had much higher food insecurity
rates (19.5%) than the regional average of 7.3% (Figure 2).
 Food insecurity varies by sub-group, including household income and
neighbourhood deprivation.

Figure 1: Prevalence of Household Food Insecurity (Moderate or Severe),
Saskatoon Health Region, Saskatchewan and Canada, 2007/08 to 2011/12
Call to Action
2011/12
SHR
5.2
5.9
7.3
SK
5.8
5.6
7.4
Canada
7.1
7.8
20
Percent (%)
15
10
5
19.5
9.1
0
Lowest income Second lowest Middle income
Second
quintile*
income
quintile*
highest income
quintileF
quintileF
What More Can Be
Done?
Chief Medical Health Officer’s
2009/10
Figure 2: Prevalence of Household Food Insecurity (Moderate or Severe) by
Household Income Quintile, Saskatoon Health Region, 2010 to 2012
Poverty Costs calls for a
comprehensive provincial
poverty reduction plan
What is Health Equity? A Primer
for the Health Care System
2007/08
Source: Statistics Canada.
PROOF provides information
and research about food
insecurity in Canada
CHEP and the Food Bank &
Learning Centre lead
community programs to
reduce food insecurity in
Saskatoon
8
7
6
5
4
3
2
1
0
Percent (%)
A household is food insecure
if a lack of money prevents
consistent access to enough
nutritious food. While food
insecurity affects everyone in
a household, it may affect
individuals differently. Adults
are more likely to report poor
self-rated health and selfrated mental health, and
chronic illnesses such as
diabetes, heart disease,
depression and HIV.
Household food insecurity
also affects people’s ability
to manage their chronic
illnesses. Adults and
adolescents in food-insecure
households have lower
vegetable and fruit
consumption. Households
with the lowest incomes are
most likely to be food
insecure.
Highest
income
quintileF
*High variability. Use with caution. F value too low to publish.
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan. The
analyses are based on data from Statistics Canada and the opinions expressed do not represent the views
of Statistics Canada.
Health Status Reporting
March 2015
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Food Insecurity by Sub-group
Highlights


Food insecurity is highest among those in lowest income (19.5%), living in areas of highest
deprivation (19.7%) and among visible minority populations (18.4 %). See Table 1.
To learn more about how these numbers were compiled, click here.
Table 1: Prevalence of Household Food Insecurity (Moderate or Severe), by Sub-group, Saskatoon
Health Region, 2010 to 2012
Number Food
Insecure
19,795
Total Saskatoon Health Region*
Sex
Male*
8,682
Female*
11,112
Age Group (Years)
12-19*
2,890
20-44*
12,597
45-64
NR
65+
NR
Household Income Level
Lowest income quintile*
9,958
Second lowest income quintile
NR
Middle income quintile*
4,617
Second highest income quintile
NR
Highest income quintile
NR
Socio-economic status by deprivation index
Most deprived areas*
8,080
Second most deprived areas
NR
Middle areas
NR
Second least deprived areas
NR
Least deprived areas
NR
Education Level
Less than high school*
5,791
High school graduate
NR
Some post-secondary
NR
Post-secondary graduate*
10,246
Percent Food
Insecure
Lower CI
7.5
5.0
Upper CI
10.1
6.6
8.4
3.6
5.4
9.7
11.5
9.4
10.9
NR
NR
4.0
6.4
NR
NR
14.9
15.4
NR
NR
19.5
NR
9.1
NR
NR
11.8
NR
4.1
NR
NR
27.1
NR
14.2
NR
NR
19.7
NR
NR
NR
NR
9.5
NR
NR
NR
NR
29.9
NR
NR
NR
NR
13.4
NR
NR
7.2
7.1
NR
NR
4.3
19.7
NR
NR
10.0
Health Status Reporting
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Table 1 (continued): Prevalence of Household Food Insecurity (Moderate or Severe), by Sub-group,
Saskatoon Health Region, 2010 to 2012
Number Food
Insecure
Percent Food
Insecure
Lower CI
Ethnicity
White*
12,423
5.6
3.5
V isible Minority*
7,149
18.4
10.7
Immigration
Recent Immigrant
NR
NR
NR
Long-Term Immigrant
NR
NR
NR
Non-immigrant*
18,065
7.7
5.1
Geography
Rural Saskatoon Health Region*
3,167
6.3
3.1
Urban Saskatoon city*
16,628
7.8
4.8
Geography by Rural Planning Zones
Humboldt and Area
NR
NR
NR
Rosthern and Area
NR
NR
NR
Watrous and Area
NR
NR
NR
Saskatoon Area
NR
NR
NR
* Use estimate with caution, high sampling variability.
NR=not reportable due to low sample size.
Estimates have been weighted to the Saskatoon Health Region population.
Upper CI
7.7
26.1
NR
NR
10.3
9.5
10.9
NR
NR
NR
NR
This study was conducted, in part, with data provided by the Saskatchewan Ministry of
Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of
Saskatchewan. The research and analysis are based on data from Statistics Canada and
the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Physical Activity
Why Is This Important?
Highlights
Physical activity is movement
that increases heart rate and
breathing. Benefits include
prevention and control of
chronic illnesses like cancer,
stroke, heart disease and
diabetes, optimal childhood
growth and development
and continued independent
living in later life. Physical
activity is positively linked to
self-rated health and selfrated mental health. Physical
activity tends to decrease
with age. Women are less
likely to be physically active
than men. People with low
incomes are more likely to
report barriers that prevent
them from being physically
active.
More people are getting physically active during their leisure time.
A little more than half of people (55.7%) reported that they were “moderately
active” to “physically active” during their leisure time in 2011/12. These rates are
very similar to Saskatchewan and Canadian averages (Figure 1). This equates to
almost 152,000 people in the Region, but means that nearly 120,000 people are
not getting enough physical activity.
Those in the lowest income quintile were significantly less physically active (41.8%)
than those in the highest income quintile (70.6%; Figure 2).
Physical activity varies by sub-group, including age, household income and
education level.

Hep


Figure 1: Individuals “Moderately Active” or “Physically Active” During Leisure
Time in Saskatoon Health Region, Saskatchewan and Canada, 2003 to 2012
60
55
Percent (%)
50
45
40
35
30
What Is Being Done?
2003
2005
2007/8
2009/10
2011/12
SHR
51.9
49.5
50.1
51.3
55.7
Canada’s Physical Activity
Guidelines and Report card by
Active Healthy Kids Canada.
SK
50.9
50.4
48
51.2
53.1
Canada
51.8
52.2
50.5
52.3
53.8
in Motion programs in
Saskatoon and area.
Source: Statistics Canada
Figure 2: Individuals “Moderately Active” or “Physically Active” During
Leisure Time by Household Income Quintile, Saskatoon, 2008 to 2012
City of Saskatoon’s Leisure
Access Program.
Percent (%)
What More Can Be
Done?
Percent (%)
Active transportation in City
of Saskatoon and Humboldt’s
municipal plans.
10
80
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health Officer’s
Call to Action
70
8
7.8
60
6
50
4
5.7
4.3
40
2
10
5.9
70.6
30
0
20
5.3
Saskatoon
41.8
52.4
Rural SHR
57.5
SHR
55.2
SK
Canada
Geography
lth Region,
Saskatchewan and Canada, 2011
0
Lowest income Second lowest Middle income Second highest Highest income
quintile
income quintile
quintile
income quintile
quintile
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan.
The analyses are based on data from Statistics Canada and the opinions expressed do not represent
the views of Statistics Canada.
Health Status Reporting
March 2015
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Physical Activity by Sub-group
Highlights


Physical activity levels are highest among those in the youngest age group 12 to 19 years
(66.7%), those in the highest income quintile (70.6%), and post-secondary graduates (57.7%)
(Table 1).
To learn more about the data, click here.
Table 1: Individuals “Moderately Active” or “Physically active” During Leisure Time, by Sub-group,
Saskatoon Health Region, 2008 to 2012
Number
moderately or
physically
active
139,599
Total Saskatoon Health Region
Sex
Male
73,990
Female
65,609
Age Group (Years)
12-19
21,618
20-44
66,982
45-64
36,086
65+
14,913
Household Income Level
Lowest income quintile
20,162
Second lowest income quintile
25,174
Middle income quintile
27,160
Second highest income quintile
26,551
Highest income quintile
31,588
Socio-economic status by deprivation index
Most deprived areas
17,772
Second most deprived areas
14,968
Middle areas
19,329
Second least deprived areas
18,090
Least deprived areas
33,479
Education Level
Less than high school
21,511
High school graduate
22,748
Some post-secondary
15,428
Post-secondary graduate
79,145
Percent
moderately or
physically
active
54.0
Lower CI
50.8
Upper CI
57.2
57.9
50.2
53.4
46.5
62.4
54.0
66.7
59.7
46.1
41.9
59.7
54.8
41.6
37.2
73.7
64.6
50.7
46.5
41.8
52.4
57.5
55.2
70.6
36.4
46.3
50.7
49.4
64.5
47.2
58.5
64.4
61.1
76.7
50.7
48.7
55.5
56.8
65.8
42.2
40.7
49.1
49.4
58.5
59.1
56.6
61.9
64.3
73.2
47.9
47.8
58.8
57.7
42.4
42.0
50.7
53.6
53.5
53.6
66.8
61.8
Health Status Reporting
March 2015
Page 1 of 2
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For more information: www.communityview.ca
Table 1 (continued): Individuals “Moderately Active” or “Physically Active” During Leisure Time, by
Sub-group, Saskatoon Health Region, 2008 to 2012
Number
Percent
moderately or moderately or
physically
physically
activ e
activ e
Low er CI Upper CI
Ethnicity
White
117,850
54.0
50.7
Visible Minority
20,323
54.3
47.5
I mmigrant status
Recent immigrant
8,400
58.0
44.4
Long term immigrant
5,844
47.6
36.6
Non-immigrant
124,861
54.2
51.0
Geography
Rural Saskatoon Health Region
25,507
48.3
43.1
Urban Saskatoon city
114,091
55.5
51.9
Geography by Rural Planning Zones
Humboldt and Area
4,460
41.0
30.1
Rosthern and Area
4,727
42.8
30.9
Watrous and Area
4,043
46.3
34.8
Saskatoon Area
12,278
55.3
46.7
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
Estimates hav e been w eighted to the Saskatoon Health Region population.
57.2
61.1
71.5
58.5
57.4
53.4
59.1
51.9
54.8
57.9
64.0
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
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For more information: www.communityview.ca
Sedentary Behaviour
Why Is This Important?
Highlights
The majority of the Region’s residents are sedentary.
 Over 60% of people in Saskatoon Health Region (62.6%) were sedentary
(screen time) more than two hours per day in their leisure time in 2011/12
(Figure1). This is about the same as Saskatchewan and Canada and means
that more than 160,000 people are sedentary.
Hep
People living in households in the highest income quintile were less likely to
be sedentary (55.4%) compared to people living in other household
income quintiles (Figure 2).
 Sedentary behaviour is common across sub-groups, but lowest in high
income households.
Figure 1: Individuals Sedentary More than 2 Hours Daily During Leisure Time in
Saskatoon Health Region, Saskatchewan, and Canada, 2011/12
70
60
50
40
30
Percent (%)
Sedentary behaviours are
activities that need little
physical activity, including
watching television and using
computers. Sedentariness
increases the risk of chronic
illnesses like diabetes,
cardiovascular disease and
some cancers. Sedentariness
is linked to obesity and to
lower rates of physical
activity and vegetable and
fruit consumption.
Sedentariness is also
associated with poor selfrated health and self-rated
mental health in adults and
adolescents. Children living in
low income household are
more likely to be sedentary.
Canadian Society for Exercise
Physiology’s sedentary
behaviour guidelines.
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health Officer’s
Call to Action
61.8
SHR
SK
Canada
Source: Statistics Canada
Figure 2: Percent of Individuals Sedentary More than 2 Hours Daily During
Leisure Time by Income Quintile, Saskatoon Health Region, 2011/12
10
80
(%)
Percent
(%)
Percent
in Motion programming in
Saskatoon and area.
61.1
20
10
0
What Is Being Done?
Participaction’s Make Room
for Play campaign.
62.6
8
70
7.8
6
60
4
50
5.7
4.3
2
40
30
0
20
10
64.3
Saskatoon
73.1
Rural SHR
5.3
65.4
SHR
5.9
56.5
SK
55.4
Canada
Geography
lth Region,
Saskatchewan and Canada, 2011
0
Lowest income Second lowest Middle income Second highest Highest income
quintile
income quintile
quintile
income quintile
quintile
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan.
The research and analysis are based on data from Statistics Canada and the opinions expressed do not
represent the views of Statistics Canada.
Health Status Reporting
March 2015
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Sedentary Behaviour by Sub-group
Highlights


Sedentary behaviour (screen time) is lowest among those in highest income (55.4%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Sedentary More than 2 Hours Daily During Leisure Time, by Sub-group,
Saskatoon Health Region, 2011/2012
Number
Reporting
Greater Than
Two Hours Per
Day Sedentary
166,974
Percent
Reporting
Greater Than
Two Hours Per
Day Sedentary
63.0
Lower CI
58.5
Upper CI
67.5
83,780
83,193
63.7
62.3
57.5
56.0
70.0
68.5
21,212
78,311
45,133
22,318
66.6
66.5
56.6
62.6
55.0
59.7
48.2
55.4
78.3
73.3
64.9
69.7
33,982
39,174
34,851
30,381
28,585
64.3
73.1
65.4
56.5
55.4
55.3
63.7
56.0
47.4
47.1
73.2
82.4
74.9
65.5
63.6
31,757
26,032
28,489
16,403
30,371
68.1
63.9
68.1
49.0
62.3
58.9
50.3
53.4
38.1
51.8
77.2
77.4
82.7
59.9
72.9
28,923
36,107
9,880
89,036
64.9
67.6
63.7
60.6
54.7
57.9
46.5
55.2
75.1
77.4
80.9
65.9
Total Saskatoon Health Region
Sex
Male
Female
Age Group (Years)
12-19
20-44
45-64
65+
Household Income Level
Lowest income quintile
Second lowest income quintile
Middle income quintile
Second highest income quintile
Highest income quintile
Socio-economic status by deprivation index
Most Deprived Areas
Second Most Deprived Areas
Middle Areas
Second Least Deprived Areas
Least Deprived Areas
Education Level
Less than high school
High school graduate
Some post-secondary
Post-secondary graduate
Health Status Reporting
March 2015
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Table 1 (continued): Individuals Sedentary More than 2 Hours Daily During Leisure Time,
by Sub-group, Saskatoon Health Region, 2011/2012
Number
Percent
Reporting
Reporting
Greater Than Greater Than
Tw o Hours Per Tw o Hours Per
Day Sedentary Day Sedentary Low er CI Upper CI
Ethnicity
White
137,609
63.1
Visible Minority
27,531
65.7
I mmigrant status
Recent immigrant
11,884
72.1
Long term immigrant
7,688
72.9
Non-immigrant
146,856
62.2
Geography
Rural Saskatoon Health Region
29,585
61.3
Urban Saskatoon city
137,388
63.4
Geography by Rural Planning Zones
Humboldt and Area
8,627
73.7
Rosthern and Area
4,167
62.7
Watrous and Area
5,206
66.9
Saskatoon Area
11,585
52.4
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
All estimates are w eighted to the Saskatoon Health Region population.
58.2
54.7
68.0
76.7
52.3
58.3
57.5
91.9
87.4
66.9
54.3
58.1
68.3
68.6
63.8
46.5
50.7
39.0
83.5
78.8
83.1
65.7
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The research and analysis are based on data from Statistics
Canada and the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Overweight and Obesity
Highlights
Why Is This Important?
Overweight and obesity continue to increase in the Region.

Overweight and obesity rates have increased in the Saskatoon Health Region as
well as in Saskatchewan and Canada. In 2011/12, the Region’s rate increased to
56.6% (Figure 1), meaning that over 130,000 people were estimated to be
overweight or obese.
Overweight and obesity rates were lower among people who recently
immigrated to Canada compared to people who are non-immigrants (33.5%
compared to 56.5%; Figure 2).
Overweight and obesity rates vary by sub-group, including gender and age.
Weight status for four year olds in the Region can be found here.
Hep


Figure 1: Individuals Overweight or Obese, Saskatoon Health Region,
Saskatchewan, and Canada, 2003 to 2012
60
50
Percent (%)
Body mass index (BMI) is a
calculation of weight-forheight (kg/m2) used to
classify overweight (≥25) and
obesity (≥30) in adults.
Obesity increases the risk of
chronic illness including
diabetes, heart disease,
stroke, and osteoarthritis.
Obesity decreases self-rated
health, even in the absence
of chronic illness. Overweight
and obesity are influenced
by vegetable and fruit
consumption, physical
activity and sedentariness.
The link between obesity and
self-rated mental health
depends on age, gender
and ethnicity. Weight tends
to increase with age, but
seniors who are slightly
overweight may be healthier.
Among females, obesity
tends to decrease when
income and education
increase, while the opposite
is true for men.
10
2003
2005
2007/8
2009/10
2011/12
SHR
52.5
55.1
53.1
53.6
56.6
SK
56.8
57.7
58
58.7
59.5
Canada
49.4
50
50.9
52
52.3
Figure 2: Individuals Overweight or Obese by Immigrant Status, Saskatoon
Health Region, 2008 to 2012
60
50
What More Can Be
Done?
40
30
20
48.5
56.5
33.5
10
0
What is Health Equity? A
Primer for the Health Care
System
The Chief Medical Health
Officer’s Call to Action
20
Source: Statistics Canada
Percent (%)
LiveWell and MEND
programs.
30
0
Examples of Action
Being Taken
Pan Canadian Public Health
Network Progress Report on
healthy weights.
40
Recent immigrant*
Long term immigrant
Non-immigrant
*High variability. Use with caution. Source: Statistics Canada. This study was conducted, in part, with data
provided by the Saskatchewan Ministry of Health to the Health Quality Council. The interpretations and
conclusions herein do not necessarily represent those of the Saskatchewan Ministry of Health or
Government of Saskatchewan. The analyses are based on data from Statistics Canada and the opinions
expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Overweight or Obese by Sub-group
Highlights


Overweight or obese is lowest among females (45.9%), those 18 to 24 years (25.9%), and among
those who are recent immigrants (33.5%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Overweight or Obese, by Sub-group, Saskatoon Health Region, 2008 to 2012
Number
overweight or
obese
124,977
Total Saskatoon Health Region
Sex
Male
73,315
Female
51,662
Age Group (Years)
18-24
9,337
25-44
46,770
45-64
46,966
65+
21,904
Household Income Level
Lowest income quintile
22,093
Second lowest income quintile
22,514
Middle income quintile
22,406
Second highest income quintile
25,586
Highest income quintile
23,768
Socio-economic status by deprivation index
Most deprived areas
17,871
Second most deprived areas
17,638
Middle areas
16,645
Second least deprived areas
13,990
Least deprived areas
23,606
Education Level
Less than high school
15,131
High school graduate
24,909
Some post-secondary
10,886
Post-secondary graduate
73,264
Percent
overweight or
obese
54.7
Lower CI
52.0
Upper CI
57.4
63.3
45.9
59.6
42.0
66.9
49.7
25.9
57.2
61.7
63.4
19.4
52.3
57.1
59.3
32.4
62.1
66.3
67.6
52.3
53.0
55.0
58.8
56.9
45.0
46.2
48.8
52.6
49.4
59.6
59.7
61.2
64.9
64.4
57.8
62.7
51.5
49.4
52.7
50.3
54.4
43.8
41.7
45.1
65.3
71.1
59.1
57.1
60.2
63.3
54.3
44.5
55.2
55.5
47.5
37.2
51.6
71.2
61.1
51.7
58.9
Health Status Reporting
March 2015
Page 1 of 2
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For more information: www.communityview.ca
Table 1 (continued): Individuals Overweight or Obese, by Sub-group, Saskatoon Health Region,
2008 to 2012
Number
ov erw eight or
obese
Percent
ov erw eight
or obese
Low er CI Upper CI
Ethnicity
White
108,723
55.6
53.0
Visible Minority
15,647
49.6
37.9
I mmigrant status
Recent immigrant*
4,216
33.5
14.7
Long term immigrant
5,737
48.5
37.3
Non-immigrant
114,790
56.5
53.7
Geography
Rural Saskatoon Health Region
25,773
57.6
53.0
Urban Saskatoon city
99,204
54.0
50.8
Geography by Rural Planning Zones
Humboldt and Area
5,478
59.2
48.7
Rosthern and Area
5,243
53.8
44.3
Watrous and Area
4,711
69.0
58.9
Saskatoon Area
10,342
54.8
46.9
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
Estimates hav e been w eighted to the Saskatoon Health Region population.
58.2
61.3
52.2
59.6
59.3
62.3
57.1
69.7
63.4
79.0
62.6
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Weight Status of Four-Year-Old Children
Why Is This Important?
Highlights
The prevalence of excess
weight is increasing
among Canadian
preschool children. The
likelihood of losing weight
diminishes with increasing
age and therefore,
prevention at a young
age is essential. Obesity
and overweight is linked to
a number of diseases and
conditions which include
high blood pressure,
coronary heart disease,
type 2 diabetes and
stroke.
 Approximately one in three (34.2% males and 32.7% females) four-year-olds
are obese, overweight or at risk of becoming overweight (Figure 1). Risk of
overweight is most prevalent at over 22% for both males and females.
 The percentage of four year old children that are obese, overweight or at
risk of becoming overweight is higher in urban than in rural areas of the
Hep
region (Figure 2).
 For more information about weight categories, click here.
What Is Being Done?
MEND program.
25
Percent (%)
Children from low income
families are more likely to
be overweight or obese.
These children generally
have less access to
healthy foods and
opportunities for physical
activity. To understand
more about how health
equity affects people’s
health, click here.
Figure 1: Weight Status of Four-year-old Children, Males and Females,
Saskatoon Health Region, 2013
22.8
22.6
20
15
10
5
1.3
0
Males
8.3
7.9
3.5
0
Wasting
Risk of
Overweight
Overweight
Females
1.8
Obese
Weight Status
Source: Population and Public Health
Figure 2: Weight Status of Four-year-old Children, Urban and Rural Areas,
Saskatoon Health Region, 2013
Saskatchewan inmotion.
Physical Activity
environment assessed
Smart Cities Healthy Kids.
25
23.7
20.4
20
Percent (%)
Canada’s Physical Activity
Guidelines and Report
card by Active Healthy
Kids Canada.
What More Can Be
Done?
Chief Medical Health
Officer’s Call to Action
15
9.1
10
Urban
6
5
0.6
3.5
0.7
Rural
0.7
0
Wasting
Risk of
Overweight
Overweight
Obese
Weight Status
Source: Population and Public Health
Health Status Reporting
March 2015
pho@saskatoonhealthregion.ca │306.655.4679
For more information: www.communityview.ca
Smoking
Why Is This Important?
Highlights
Tobacco misuse is the nontraditional, recreational
and/or habitual use of
tobacco products. Smoking
cigarettes is the most
common form of tobacco
misuse. Smoking increases
the risk of cancer and
chronic illnesses like chronic
obstructive pulmonary
disease, asthma and heart
disease and causes >1,500
deaths in Saskatchewan
annually. Smoking is strongly
linked to poor self-rated
health and self-rated mental
health, and daily smoking is
linked to decreased physical
activity, increased sedentary
behaviour and daily alcohol
drinking. Saskatchewan has
the highest youth smoking
rates in Canada. Men are
more likely than women to
smoke, and smoking is
associated with social and
economic deprivation.
Smoking has decreased over time in the Saskatoon Health Region.
 Almost one in five (18.6%) people in Saskatoon Health Region reported daily
or occasional tobacco misuse in 2011/12 (Figure 1). This is about the same
as Saskatchewan and Canadian rates and equates to more than 47,000
people who smoke.
Hep
 The smoking rates among individuals who live in the most deprived areas of
Saskatoon were more than double (26.0% vs. 9.9%) the rates in the least
deprived areas (Figure 2).
 Smoking rates vary by sub-group, including age, area deprivation, and
immigrant status.
Figure 1: Individuals Reporting Daily or Occasional Smoking in Saskatoon
Health Region, Saskatchewan, and Canada, 2003 to 2012
30
Percent (%)
25
What More Can Be
Done?
Call to Action
5
2003
2005
2007/8
2009/10
2011/12
SHR
24.0
23.4
24.6
20.0
18.6
SK
24.0
23.9
25.7
22.2
21.9
Canada
23.0
21.8
21.7
20.4
20.1
Figure 2: Individuals Reporting Daily or Occasional Smoking by Deprivation
Index Quintile, Saskatoon, 2008 to 2012
10
30
8
25
6
20
4
7.8
5.7
4.3
15
2
5.9
5.3
25.7
10
0
5
Saskatoon
9.9
Rural SHR
9.5
19.4
SHR
SK
26.0
Canada
Geography
0
lth Region,Least
Saskatchewan
and Canada,
2011
Deprived
Second Least
Middle Areas*
Areas*
What is Health Equity? A Primer
for the Health Care System
Chief Medical Health Officer’s
10
Source: Statistics Canada
Percent
(%) (%)
Percent
Canadian Cancer Society
offers a Smokers’ Helpline.
15
0
What Is Being Done?
PACT provides smoking
cessation help for individuals,
training for health
professionals and information
about sacred tobacco use.
20
Deprived Areas*
Second Most
Deprived Areas
Most Deprived
Areas
*High variability. Use with caution. Source: Statistics Canada. This study was conducted, in part, with
data provided by the Saskatchewan Ministry of Health to the Health Quality Council. The
interpretations and conclusions herein do not necessarily represent those of the Saskatchewan Ministry
of Health or Government of Saskatchewan. The analyses are based on data from Statistics Canada
and the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Smoking by Sub-group
Highlights


Smoking is highest among those in the 40 to 49 year age group (25.5%) and those living in the most
deprived areas (26.0%). See Table 1.
To learn more about the data, click here.
Table 1: Percent Daily or Occasional Smokers, by Sub-group, Saskatoon Health Region, 2008 to 2012
Number of
Current
Smokers
46,883
Total Saskatoon Health Region
Sex
Male
23,735
Female
23,148
Age Group (Years)
12-19*
3,447
20-29
9,008
30-39
8,916
40-49
9,442
50-59
9,484
60+
6,586
Household Income Level
Lowest income quintile
11,862
Second lowest income quintile
8,764
Middle income quintile
8,883
Second highest income quintile
7,085
Highest income quintile
7,325
Socio-economic status by deprivation index
Most Deprived Areas
9,420
Second Most Deprived Areas
7,963
Middle Areas*
6,842
Second Least Deprived Areas *
3,037
Least Deprived Areas*
5,108
Education Level
Less than high school
7,744
High school graduate
10,751
Some post-secondary*
4,496
Post-secondary graduate
22,865
Percent
Current
Smokers
17.9
Lower CI
15.4
Upper CI
20.3
18.3
17.4
14.8
14.4
21.7
20.5
10.4
17.3
19.8
25.5
22.3
12.5
6.1
12.9
13.9
18.5
16.6
9.2
14.7
21.8
25.7
32.4
28.0
15.7
23.7
18.0
18.8
14.6
16.1
17.9
13.3
13.7
10.2
11.1
29.5
22.7
23.8
19.0
21.0
26.0
25.7
19.4
9.5
9.9
18.6
19.8
12.5
5.3
4.6
33.3
31.6
26.3
13.6
15.1
16.4
22.0
17.0
16.6
12.1
16.4
10.6
13.5
20.7
27.6
23.4
19.8
Health Status Reporting
March 2015
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Table 1 (continued): Percent Daily or Occasional Smokers, by Sub-group, Saskatoon Health Region,
2008 to 2012
Number of
Current
Smokers
Percent
Current
Smokers
Low er CI
Upper CI
Ethnicity
White
37,845
17.0
14.6
Visible Minority
8,830
23.3
17.0
I mmigrant status
Recent immigrant
NR
NR
NR
Long term immigrant*
812
6.5
2.3
Non-immigrant
44,843
19.1
16.7
Geography
Rural Saskatoon Health Region
9,448
17.7
14.4
Urban Saskatoon city
37,434
17.9
15.0
Geography by Rural Planning Zones
Humboldt and Area*
2,086
19.1
9.6
Rosthern and Area*
2,001
17.7
10.9
Watrous and Area*
1,458
16.4
8.9
Saskatoon Area
3,903
17.5
13.3
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
All estimates are w eighted to the Saskatoon Health Region population.
19.5
29.6
NR
10.7
21.6
20.9
20.8
28.7
24.5
24.0
21.7
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
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Second-Hand Smoke
Why Is This Important?
Highlights
Exposure to second-hand
smoke is associated with an
increased risk of lung
diseases, cancers and heart
disease in people who have
never smoked or who have
quit smoking. No amount of
second-hand smoke is safe.
Exposure to second-hand
smoke may be linked to
lower self-rated health and
self-rated mental health,
especially for people who
have never smoked.
Exposure rates vary by age
and peak in young
adulthood. People with lower
education and income level
are more likely to be
exposed to second-hand
smoke.
Exposure to second-hand smoke is decreasing over time.
 In 2011/12, 3.3% of households in Saskatoon Health Region reported
exposure to tobacco smoke (Figure 1). This is significantly less than provincial
and Canadian rates. The rates have decreased with time, but about 19,000
people in the Region are still exposed to tobacco smoke in their home.
Hep
People in the youngest age category (12 to 19 years) were significantly
more likely to report second-hand smoke exposure in the home compared
to those 60 years and over (10.1% compared to 3.2%; Figure 2).
 See here for additional data on tobacco smoke exposure by sub-group
and for more information about exposure in vehicles and public places.
Figure 1: Individuals Regularly Exposed to Tobacco Smoke in the Home in
Saskatoon Health Region, Saskatchewan, and Canada, 2003 to 2012
15
Percent (%)
10
5
What Is Being Done?
0
The Saskatchewan Coalition
for Tobacco Reduction has
recommendations for
reducing tobacco use.
Tobaccotoolkit.ca offers
resources for smoke-free
communities.
What More Can Be
Done?
2007/8
2009/10
2011/12
SHR
10.2
6.4
6.6
4.7
3.3
SK
10.7
7.8
8.1
6.6
5.4
Canada
10.6
8.8
7.0
6
5.1
Source: Statistics Canada
10
12
108
86
6
4
4
22
00
What is Health Equity? A Primer
for the Health Care System
Chief Medical Health Officer’s
Call to Action
2005
Figure 2: Individuals Regularly Exposed to Tobacco Smoke in the Home, by
Age-group, Saskatoon Health Region, 2008 to 2012
Percent (%)
(%)
Percent
Métis Nation of
Saskatchewan supports
smoke-free homes through its
green light project.
2003
7.8
5.7
10.1
4.3
5.3
5.9
8.2
5.2
12-19*
Saskatoon
20-29*
Rural SHR 30-39F SHR 40-49F
Age-groups
in Years
Geography
3.2
SK50-59*
60+*
Canada
lth Region, Saskatchewan and Canada, 2011
*High variability. Use with caution. F: sample too small to report. Source: Statistics Canada. This study
was conducted, in part, with data provided by the Saskatchewan Ministry of Health to the Health
Quality Council. The interpretations and conclusions herein do not necessarily represent those of the
Saskatchewan Ministry of Health or Government of Saskatchewan. The analyses are based on data
from Statistics Canada and the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Second-Hand Smoke Exposure by Sub-group
Highlights




People in the youngest age category (12 to 19 years) were significantly more likely to report second-hand
smoke exposure in the home compared to those 60 years and over (10.1% compared to 3.2%) (Table 1)
Exposure to tobacco smoke in public places has been decreasing in Saskatoon Health Region. Figure 1 shows
that the percent of individuals exposed to second-hand smoke in public places has decreased significantly
from 2003 (almost 24%) to 2005 (almost 8%) and has stayed stable since then.
Similarly the percent of individuals exposed to tobacco smoke in vehicles has been steadily decreasing in
Saskatoon Health Region. From a high of nearly 10%, the percent of individuals exposed to second-hand
smoke in the Region was at 5.1% in 2012. See Figure 2.
To learn more about the data, click here.
Table 1: Percent of Individuals Regularly Exposed to Tobacco Smoke in the Home, by Sub-group,
Saskatoon Health Region, 2008 to 2012
Number Exposed
to Second-Hand
Smoke
10,022
Total Saskatoon Health Region
Sex
Male
4,176
Female
5,846
Age Group (Years)
12-19*
2,909
20-29*
2,107
30-39*
NR
40-49*
NR
50-59
2,655
60+*
1,449
Household Income Level
Lowest income quintile*
2,149
Second lowest income quintile*
NR
Middle income quintile*
1,740
Second highest income quintile*
2,291
Highest income quintile*
NR
Socio-economic status by deprivation index
Most Deprived Areas*
NR
Second Most Deprived Areas*
NR
Middle Areas*
NR
Second Least Deprived Areas*
NR
Least Deprived Areas*
NR
Education Level
Less than high school
2,689
High school graduate*
2,474
Some post-secondary*
NR
Post-secondary graduate
3,638
Percent Exposed
to Second-Hand
Smoke
4.8
Lower CI
3.5
Upper CI
6.1
4.1
5.5
2.6
3.5
5.5
7.4
10.1
5.2
NR
NR
8.2
3.2
6.0
2.1
NR
NR
3.5
0.8
14.2
8.2
NR
NR
12.9
1.6
5.8
NR
4.6
5.7
NR
2.7
NR
1.8
2.8
NR
8.9
NR
7.4
8.6
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
NR
7.0
6.8
NR
3.2
4.3
2.6
NR
1.7
9.7
11.0
NR
4.8
Health Status Reporting
March 2015
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Table 1 (continued): Percent of Individuals Regularly Exposed to Tobacco Smoke in the Home, by
Sub-group, Saskatoon Health Region, 2008 to 2012
Number Exposed
to Second-Hand
Smoke
Percent Exposed
to Second-Hand
Smoke
Ethnicity
White
8,225
4.6
V isible Minority*
NR
NR
Immigrant status
Recent immigrant
NR
NR
Long term immigrant
NR
NR
Non-immigrant
10,022
5.4
Geography
Rural Saskatoon Health Region
1,801
4.2
Urban Saskatoon city
8,221
4.9
Geography by Rural Planning Zones
Humboldt and Area*
NR
NR
Rosthern and Area
NR
NR
Watrous and Area*
NR
NR
Saskatoon Area*
NR
NR
* Use estimate with caution, high sampling variability.
NR=not reportable due to low sample size.
All estimates are weighted to the Saskatoon Health Region population.
Lower CI
Upper CI
3.2
NR
5.9
NR
NR
NR
4.0
NR
NR
6.9
2.4
3.4
6.0
6.5
NR
NR
NR
NR
NR
NR
NR
NR
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Figure 1: Percent of Individuals Regularly Exposed to Second-hand Smoke in Public Places, Saskatoon
Health Region, Saskatchewan, and Canada 2003 to 2012
30
Percent (%)
20
10
0
2003
2005
2007/8
2009/10
2011/12
SHR
23.9
7.9
7.6
3.3
7.4
SK
23.8
9.8
7.6
7.5
9.2
Canada
19.7
14.8
10.5
10.5
12.7
Source: Statistics Canada
Figure 2: Percent of Individuals Regularly Exposed to Second-hand Smoke in Private Vehicles,
Saskatoon Health Region, Saskatchewan, and Canada 2003 to 2012
15
Percent (%)
10
5
0
2003
2005
2007/8
2009/10
2011/12
SHR
9.8
8.5
7.3
4.7
5.1
SK
11.3
9.4
9.4
7.9
7.3
Canada
10.2
8.1
7.8
7
6.4
Source: Statistics Canada
Health Status Reporting
March 2015
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Alcohol Binge Drinking
What Is Being Done?
Canadian Centre on
Substance Abuse’s low risk
drinking guidelines
University of Saskatchewan’s
What's your Cap program
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health
Officer’s Call to Action
Binge drinking is common and increasing in Saskatoon Health Region.
 More than one in five (22.2%) Regional residents reported drinking five or
more alcoholic drinks on one occasion at least once per month in 2011/12
(Figure 1). This is significantly higher than the Canadian rate of 18.2% and
equates to over 60,000 people in the Region.
Hep
People living in the highest income households were significantly more likely
to binge drink compared to those in the lowest income households (27.2%
compared to 15.7%; Figure 2).
 Binge drinking varies by sub-group , including sex, age, education level and
geography.
Figure 1: Individuals Having Five or More Drinks on One Occasion at Least
Once a Month, Saskatoon Health Region, Saskatchewan, and Canada, 2003
to 2011/12
25
20
15
Percent (%)
Episodic heavy drinking, or
binge drinking, means
consuming ≥5 drinks per day.
Heavy drinking increases the
short-term health and social
risks of drinking alcohol such
as seizures, injuries and
poisoning, as well as longterm risks of cancer, liver
disease, high blood pressure,
stroke and dementia.
Drinking alcohol during
pregnancy can cause low
birth weight and fetal alcohol
spectrum disorder (FASD).
Binge drinking is associated
with poor self-rated health
and self-rated mental health
and higher levels of stress.
Binge drinking is also linked to
episodic heavy smoking.
Binge drinking is common
among young adults but
decreases with age. Binge
drinking is more common
among men and individuals
with higher household
incomes and education
levels.
Highlights
10
5
0
2003
2005
2007/8
2009/10
2011/12
SHR
18.5
20.4
19.3
19.9
22.2
SK
17.6
19.8
18.9
18.8
19.8
Canada
16.6
17.3
16.9
17.3
18.2
Source: Statistics Canada
Figure 2: Individuals Having Five or More Drinks on One Occasion at Least
Once a Month by Income Quintile, Saskatoon Health Region, 2008 to 2012
10
30
8
25
6
Percent
(%) (%)
Percent
Why Is This Important?
20
4
7.8
5.7
4.3
15
2
10
0
5
5.9
5.3
27.2
21.1
15.7
Saskatoon
Rural SHR
20.2
20.0
SHR
SK
Canada
Geography
0
income Second
lowest
Middle2011
income
lth Region,Lowest
Saskatchewan
and
Canada,
quintile
income quintile
quintile
Second highest Highest income
income quintile
quintile
Source: Statistics Canada. This study was conducted, in part, with data provided by the Saskatchewan
Ministry of Health to the Health Quality Council. The interpretations and conclusions herein do not
necessarily represent those of the Saskatchewan Ministry of Health or Government of Saskatchewan. The
analyses are based on data from Statistics Canada and the opinions expressed do not represent the views
of Statistics Canada.
Health Status Reporting
March 2015
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Alcohol Binge Drinking by Sub-group
Highlights


Alcohol binge drinking is pronounced among males (25.6%), those 20 to 44 years (28.9%), those
with the highest self-reported income (27.2%), and those that are living in Saskatoon city (21.9%)
(Table 1).
To learn more about the data, click here.
Table 1: Percent of Individuals Having Five or More Drinks on One Occasion at Least Once a Month
by Sub-group, Saskatoon Health Region, 2008 to 2012
Number binge
drinking
53,470
Total Saskatoon Health Region
Sex
Male
33,295
Female
20,175
Age Group (Years)
12-19
6,996
20-44
32,925
45-64
12,392
65+*
1,158
Household Income Level
Lowest income quintile
7,868
Second lowest income quintile
10,350
Middle income quintile
9,537
Second highest income quintile
9,791
Highest income quintile
12,393
Socio-economic status by deprivation index
Most deprived areas*
5,333
Second most deprived areas
8,598
Middle areas of deprivation
11,129
Second least deprived areas*
5,218
Least deprived areas
11,292
Education Level
Less than high school
5,568
High school graduate
12,292
Some post-secondary
8,789
Post-secondary graduate
25,932
Percent binge
drinking
Lower CI Upper CI
20.3
17.7
22.9
25.6
15.2
21.9
11.6
29.2
18.8
21.1
28.9
15.8
3.1
15.5
24.8
11.3
1.6
26.7
33.1
20.2
4.5
15.7
21.1
20.0
20.2
27.2
11.0
14.6
15.0
14.9
21.2
20.4
27.6
25.0
25.6
33.1
14.7
27.1
31.5
16.1
21.7
9.1
20.1
22.8
10.4
16.8
20.2
34.2
40.3
21.8
26.7
11.8
25.0
33.3
18.8
8.1
18.8
24.3
15.8
15.5
31.3
42.3
21.8
Health Status Reporting
March 2015
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Table 1 (continued): Percent of Individuals Having Five or More Drinks on One Occasion at Least
Once a Month by Sub-group, Saskatoon Health Region, 2008 to 2012
Number binge Percent binge
drinking
drinking
Low er CI Upper CI
Ethnicity
White
47,116
21.1
18.3
Visible Minority*
5,838
15.4
9.6
I mmigrant status
Recent immigrant*
2,157
14.7
5.4
Long term immigrant
NR
NR
NR
Non-immigrant
50,435
21.5
18.6
Geography
Rural Saskatoon Health Region
7,543
14.1
10.4
Urban Saskatoon city
45,928
21.9
18.8
Geography by Rural Planning Zones
Humboldt and Area*
1,753
16.0
7.9
Rosthern and Area*
1,608
14.2
7.0
Watrous and Area*
1,029
11.6
4.8
Saskatoon Area*
3,153
14.1
8.4
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
Estimates hav e been w eighted to the Saskatoon Health Region population.
24.0
21.2
24.0
NR
24.3
17.8
25.0
24.1
21.4
18.4
19.8
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
Page 2 of 2
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Illicit Drug Use
Why Is This Important?
Highlights
Illicit drugs are those that are
illegal. Abuse is a pattern of
recurrent use despite health
or social problems. Health
risks depend on the drug, but
include addiction, poisoning,
injury and death. Injection
drug use can transmit bloodborne infections like HIV and
hepatitis C. Illicit drug use is
linked to low self-rated health
and self-rated mental health
and with the use of legal
drugs, including smoking and
heavy alcohol drinking. Rates
are highest among youth
and decrease with age.
Other patterns of illicit drug
use vary by gender, income,
education, neighbourhood
deprivation and geography.
Illicit drug use has increased slightly in Saskatoon Health Region.
 About one in seven (14.2%) people in Saskatoon Health Region reported
using illicit drugs in the past 12 months in 2011/12 (Figure 1). This is slightly
higher than Saskatchewan and Canadian rates. This means that almost
39,000 people in the Region used illicit drugs.
 People living in the most deprived areas reported significantly higher rates
of illicit drug use compared to people in the least deprived areas (26.2%
and 9.6%; Figure 2).
 Illicit drug use varies by sub-group.
Figure 1: Individuals Using Illicit Drugs at least Once in the Past 12 Months,
Excluding One-time Use of Cannabis, in Saskatoon Health Region,
Saskatchewan, and Canada, 2003 and 2011/12
15
Percent (%)
10
5
0
What Is Being Done?
Saskatoon’s Lighthouse
Supported Living offers a
stabilization shelter for
people with addictions.
Ministry of Health provides
resource guides for
prevention education.
Chief Medical Health Officer’s
Call to Action
SHR
10.0
14.2
SK
7.8
10.8
Canada
11.9
11.1
Figure 2: Individuals Using Illicit Drugs at Least Once in the past 12 Months,
Excluding One-time Use of Cannabis, by Deprivation Index Quintile,
Saskatoon, 2011/12
lth Region, Saskatchewan and Canada, 2011
30
25
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
2011/12
Source: Statistics Canada
Percent (%)
Saskatchewan’s HIV Strategy
includes harm reduction,
methadone clinics and
needle exchange programs.
2003
20
15
26.2
21.0
10
5
15.2
9.6
0
Least deprived
areas*
Second least
deprived areasF
Middle areas of
deprivation*
Second most
deprived areas*
Most deprived
areas*
*High variability. Use with caution. F value too low to publish. Source: Statistics Canada. This study was
conducted, in part, with data provided by the Saskatchewan Ministry of Health to the Health Quality
Council. The interpretations and conclusions herein do not necessarily represent those of the Saskatchewan
Ministry of Health or Government of Saskatchewan. The analyses are based on data from Statistics Canada
and the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Illicit Drug Use by Sub-group
Highlights


Illicit drug use is highest among those living in the most deprived areas of Saskatoon (26.2%),
and those living in Saskatoon compared to rural areas of the Region (16.3%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Using Illicit Drugs at Least Once in the Past 12 Months, Excluding One-time Use of
Cannabis, by Sub-group, Saskatoon Health Region, 2011/2012
Number using
illicit drugs in
the past year
excluding one
time cannabis
38,958
Total Saskatoon Health Region
Sex
Male
20,470
Female
18,487
Age Group (Years)
12-19
NR
20-44
30,406
45-64
NR
65+
NR
Household I ncome Lev el
Low est income quintile*
10,138
Second low est income quintile*
8,205
Middle income quintile*
5,826
Second highest income quintile*
6,393
Highest income quintile*
8,395
Socio-economic status by depriv ation index
Most depriv ed areas*
12,005
Second most depriv ed areas*
8,663
Middle areas*
6,345
Second least depriv ed areas
NR
Least depriv ed areas*
4,705
Education Lev el
Less than high school
NR
High school graduate*
5,214
Some post-secondary*
5,522
Post-secondary graduate
21,531
Percent using
illicit drugs in
the past year
excluding one
time cannabis Low er CI Upper CI
14.7
11.9
17.5
15.4
13.9
11.2
9.7
19.7
18.1
NR
26.0
NR
NR
NR
20.2
NR
NR
NR
31.8
NR
NR
18.9
15.2
11.1
11.9
16.2
10.6
7.6
5.8
6.3
7.9
27.2
22.8
16.4
17.5
24.6
26.2
21.0
15.2
NR
9.6
16.0
12.2
5.9
NR
3.5
36.3
29.9
24.5
NR
15.7
NR
9.6
35.6
14.7
NR
3.6
18.5
10.3
NR
15.6
52.6
19.2
Health Status Reporting
March 2015
Page 1 of 2
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Table 1 (continued): Individuals Using Illicit Drugs at Least Once in the Past 12 Months, Excluding
One-time Use of Cannabis, by Sub-group, Saskatoon Health Region, 2011/2012
Number using
illicit drugs in
the past year
excluding one
time cannabis
Percent using
illicit drugs in
the past year
excluding one
time cannabis Low er CI Upper CI
Ethnicity
White
27,993
12.8
9.8
Visible Minority*
9,861
24.0
13.0
I mmigrant status
Recent immigrant
NR
NR
NR
Long term immigrant
NR
NR
NR
Non-immigrant
37,748
16.0
12.8
Geography
Rural Saskatoon Health Region*
3,583
7.4
3.0
Urban Saskatoon city
35,375
16.3
12.8
Geography by Rural Planning Zones
Humboldt and Area
NR
NR
NR
Rosthern and Area
NR
NR
NR
Watrous and Area
NR
NR
NR
Saskatoon Area
NR
NR
NR
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
Estimates hav e been w eighted to the Saskatoon Health Region population.
15.8
34.9
NR
NR
19.1
11.8
19.8
NR
NR
NR
NR
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The research and analysis are based on data from Statistics
Canada and the opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Injection Drug Use
Why Is This Important?
Street-involved youth face
unstable living conditions,
poverty and complex social
factors that promote high-risk
behaviours and exposures to
sexually transmitted infections,
blood borne infections, and
drug and alcohol use.2






In 2013, 850 needle exchange clients were supported by Population and Public
Health’s Street Health services (not shown), a 9% decrease from 2010 (when data
was first available About the Data).
In 2013, 564,374 clean needles were distributed and 536,509 used needles returned,
an exchange rate of 95.1%, which is a slight decrease from the previous year (99%).
In the past five years, the number of needles issued has decreased steadily (Figure
1).
In 2009, 33% of street-involved youth participants in the Saskatoon Street Youth
Study used injection drugs one or more times, compared to 36% in 2005 (Figure 2),
indicating a fairly stable proportion of street youth using injection drugs.
In 2009, of the youth who used injection drugs, a greater percent (66%) had used a
condom at the last sexual encounter (66%) than in 2005 (33%) (Figure 2).
In 2009, the reasons for injection drug initiation among street-involved youth were
curiosity (45%), family or friend using (39%) or “to help cope” (16%) (Figure 3).
Figure 1: Needle Exchange Services through Street Outreach Programs,
Saskatoon Health Region, 2009 to 2013
Enhanced Street Youth Study
(ESYS 2009)
The Front Line: “A more robust
Mental Health and Addictions
Program”
The Front Line: “Responding to
the challenge
Chief Medical Health Officer’s
Call to Action
100.0
1000000
8
98.0
6
800000
96.0
5.7
4
600000
5.9
95.1
5.3
4.3
94.0
564374
2
400000
92.0
0
Rural SHR
SHR
Geography
0
2009
2010
2011
2012
lth Region, Saskatchewan and Canada, 2011
Figure 2: Street-Involved Youth with Injection
Drug Use (IDU), Saskatoon, 2005 to 2009
70
60
536509
7.8
Exchange rate
Canada
Source: Population and Public Health
Figure 3: Reason for IDU
Initiation among StreetInvolved Youth, Saskatoon,
2009
66.0
To help
cope
16%
50.0
36.0
2005
2009
20
10
Returned
88.0
2013
40
30
Issued
90.0
SK
50
Percent
To Learn More:
10
200000Saskatoon
What’s Being Done:
Street Health Program.
1200000
Percent (%)
The 2014 Harm Reduction
survey of needle exchange
clients1 found a high degree of
client awareness that needle
sharing was unsafe (98.4%). In
Saskatoon, drug use may
occur within families, where
drug and needle sharing
becomes normative. Among
those who shared, 61% cited
sharing with family as the
reason for sharing needles. The
most frequently cited drugs of
choice were morphine (73%),
marijuana (53.4%) and crystal
meth (51.7%), although polydrug use including
methamphetamine was
common (60%). The majority of
clients injected one to five
times daily.
Needle volumes have decreased since 2009 in Saskatoon.
Number
Percent (%)
Injection drug use (IDU) is the
leading risk for hepatitis C and
HIV in our Region. Needle
exchange programs are
intended to reduce
transmission of blood-borne
illnesses by reducing needle
sharing among users.
Highlights
33.0
0
Street-involved
IDU using
youth using ID condom at last
sexual
encounter
Curiosity
45%
Friend
using
19%
Family
using
20%
Source: Enhanced Street Youth Study
Health Status Reporting
March 2015
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Chronic Stress
Highlights
Why Is This Important?
Fewer people are reporting high levels of daily stress.
 More than one in six (17.1%) people reported that most days were “quite a
bit” or “extremely” stressful in 2011/12 (Figure 1). While the rate is
significantly lower than the Canadian rate of 23.2%, this means that over
45,000 people in the Region feel stressed most days.
Hep
Those with at least some post-secondary education were significantly more
likely to report high stress levels compared to those with less than a high
school education (21.4% compared to 11.2%; Figure 2).
 Stress levels vary by sub-group, including age and education.
Figure 1: Individuals Reporting High Levels of Stress, Saskatoon Health Region,
Saskatchewan, and Canada, 2003 to 2012
25
20
Percent (%)
Stress is a fact of life. Sources
of social stress include life
events, daily hassles and
personal conflicts. Stress can
be short-term (acute) or can
build up over a long period
of time and become
chronic. Although mild
amounts of stress can
increase productivity,
chronic stress is related to
poor self-rated health and
self-rated mental health.
Both physical and mental
illness can cause stress, and
stress can cause illness by
affecting the body and
mind directly, or by indirectly
affecting health risks and
behaviours such as smoking,
heavy drinking, and
sedentariness. Men and
women who are socially
disadvantaged generally
report higher levels of stress.
15
10
What Is Being Done?
Working Together for
Change: A 10-year Mental
Health and Addictions
Action plan for
Saskatchewan.
What More Can Be
Done?
What is Health Equity? A
Primer for the Health Care
System
Chief Medical Health
Officer’s Call to Action
2007/8
2009/10
2011/12
20.0
19.8
18.9
17.1
SK
20.3
20.9
19.1
19.2
19.0
Canada
24.1
22.9
22.4
23.4
23.2
Source: Statistics Canada
1025
8
20
6
Percent (%)
Saskatoon Crisis Intervention
Service.
2005
19.7
Figure 2: Individuals Reporting High Levels of Stress by Educational
Attainment, Saskatoon Health Region, 2008 to 2012
Percent (%)
Canadian Mental Health
Association stress checklist.
2003
SHR
415
7.8
5.7
5.9
5.3
4.3
2
10
0
5
21.4
Saskatoon
11.2
Rural SHR 12.7
SHR
SK
Canada
Geography
0 Saskatchewan and Canada, 2011
lth Region,
Less than high
school
17.1
High school
graduate*
Some postsecondary*
Post-secondary
graduate
*High variability. Use with caution. Source: Statistics Canada. This study was conducted, in part, with
data provided by the Saskatchewan Ministry of Health to the Health Quality Council. The interpretations
and conclusions herein do not necessarily represent those of the Saskatchewan Ministry of Health or
Government of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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Chronic Stress by Sub-group
Highlights


Stress levels are highest among those in the 20 to 44 year (19.6%) and 45 to 64 year (21.9%) age groups,
post-secondary graduates (21.4%) and those considered visible minorities (25.8%) (Table 1).
To learn more about the data, click here.
Table 1: Individuals Reporting High Levels of Stress, by Sub-group, Saskatoon Health Region,
2008 to 2012
Number
Percent
Reporting
Reporting
Quite a Bit or Quite a Bit or
Extreme Stress Extreme Stress Low er CI Upper CI
46,123
17.8
15.8
19.8
Total Saskatoon Health Region
Sex
Male
21,840
Female
24,283
Age Group (Years)
12-19*
3,336
20-44
22,249
45-64
17,113
65+
3,425
Household I ncome Lev el
Low est income quintile
11,054
Second low est income quintile
9,654
Middle income quintile*
7,028
Second highest income quintile
7,828
Highest income quintile
7,756
Socio-economic status by depriv ation index
Most Depriv ed Areas
7,467
Second Most Depriv ed Areas
6,194
Middle Areas*
4,116
Second Least Depriv ed Areas
4,950
Least Depriv ed Areas
9,022
Education Lev el
Less than high school
5,060
High school graduate*
6,177
Some post-secondary*
4,449
Post-secondary graduate
29,311
17.0
18.5
13.9
15.9
20.1
21.1
10.8
19.6
21.9
9.2
6.7
16.7
17.4
6.8
14.9
22.5
26.3
11.6
22.4
20.1
14.9
16.3
17.1
16.9
14.9
9.2
11.8
12.6
27.9
25.2
20.7
20.8
21.5
20.7
20.0
11.9
15.5
17.6
14.0
14.1
7.4
10.7
12.0
27.3
25.9
16.3
20.2
23.2
11.2
12.7
17.1
21.4
7.8
7.7
10.7
18.7
14.6
17.6
23.4
24.0
Health Status Reporting
March 2015
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Table 1 (continued): Individuals Reporting High Levels of Stress, by Sub-group, Saskatoon Health
Region, 2008 to 2012
Number
Percent
Reporting
Reporting
Quite a Bit or Quite a Bit or
Extreme Stress Extreme Stress Low er CI Upper CI
Ethnicity
White
35,868
16.3
14.2
Visible Minority
9,573
25.8
19.4
I mmigrant status
Recent immigrant*
4,088
28.3
16.4
Long term immigrant*
1,454
11.9
6.0
Non-immigrant
40,260
17.4
15.4
Geography
Rural Saskatoon Health Region
8,995
17.1
14.1
Urban Saskatoon city
37,128
17.9
15.5
Geography by Rural Planning Zones
Humboldt and Area*
1,674
15.7
8.3
Rosthern and Area*
1,858
16.9
10.3
Watrous and Area*
1,245
14.4
7.7
Saskatoon Area
4,219
19.0
13.6
* Use estimate w ith caution, high sampling v ariability.
NR=not reportable due to low sample size.
All estimates are w eighted to the Saskatoon Health Region population.
18.4
32.3
40.3
17.9
19.3
20.2
20.4
23.1
23.4
21.0
24.4
This study was conducted, in part, with data provided by the Saskatchewan Ministry
of Health to the Health Quality Council. The interpretations and conclusions herein do
not necessarily represent those of the Saskatchewan Ministry of Health or Government
of Saskatchewan. The analyses are based on data from Statistics Canada and the
opinions expressed do not represent the views of Statistics Canada.
Health Status Reporting
March 2015
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What’s Being Done in Saskatoon Health Region to
Improve Health Behaviours and Risk Conditions?
Food Security
 Food security working groups are established in rural SHR, with community dietitians providing
support with groups working on food security initiatives.
Vegetable and Fruit Consumption
 Primary Health implemented a Community Peer Leader Program, which supports 8 to 10
Community volunteer members, primarily Aboriginal, to support chronic disease prevention and
management programming.
 The Fitness Food Fun Program – is a free drop-in adult exercise and health education program
offered 3 times per week at White Buffalo Youth Lodge and St. Mary’s Education Centre.
 A Food Experience Program – a skill development cooking and nutrition program offered at the
Saskatoon Food Bank and Learning Centre.
 Early detection of diabetes in First Nations population adults aged 20 – 39 years is underway.
When validated, a tool will be used to assess risk for diabetes in First Nations population and the
general population.
Physical Activity and Obesity
 Urban pediatric obesity program called PAC (Parents as Agents of Change), 8 sessions.
 Urban and rural adult obesity education modules, co-delivery between Chronic Disease
Management and Primary Health along with other partners.
 Rural Chronic Disease Management offers Community Walking Programs.
Smoking
 Saskatoon Health Region offers a Tobacco Cessation program which provides counseling services
for individuals 18 years and older. Community education and outreach are a part of the activities
of the Tobacco Cessation program.
 Tobacco Intervention Training is offered for professionals who wish to obtain knowledge on how to
approach clients about tobacco use.
Mental Health
 HUB is a new initiative to Saskatoon. The focus of the HUB is to provide immediate coordinated
and integrated response of resources to address situations facing individuals, families with acutely
elevated risk factors.
 Police and Crisis Team is a new initiative for Saskatoon, the goal of which is to enhance
immediate response and service to persons experiencing mental health and addiction crisis in the
community.
 Violence Threat Risk Assessment-Community partners have signed on to a protocol to respond to
student behaviors that may pose a potential risk for violence to students, staff and community
members.
 Aboriginal Case Management and Outreach to increase accessibility of Mental Health services to
Aboriginal children and their families.
 Children's Therapeutic Classroom is offered for children ages 6 to 12 who are experiencing
significant mental health issues. Assessment, individual programming and intervention that involve
the child's parents/caregivers are offered.
 Lighthouse integrated health and shelter initiative has Mental Health nursing and Primary Health
Nurse Practitioner services along with health bus programming.
Health Status Reporting
March 2015
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Alcohol and Illicit Drug Use
 Mental Health and Addictions run education sessions for those struggling with addictions. Session
theme areas focus on alcohol and drug information, relapse, self-esteem in recovery, balance,
triggers and cravings, healthy relationships and First Nations, Métis and Inuit women.
 Expansion of Methadone Assisted Recovery services to the Mayfair location in Saskatoon.
 Saskatoon Action Accord designed to improve care of persons in detention due to intoxication.
Self-rated Mental Health/Chronic Stress
 Mental Health and Addictions programming includes the Outcome Rating Scale/Session Rating
Scale tools. This is a client self-rating tool that allows them to “rate” four areas of their functioning;
Individually (personal well-being), Interpersonally (relationships), Socially (work, school, etc) and
Overall (General sense of well-being).
 Effective Sept 2014, a Peer Support program was launched that aims to increase knowledge and
awareness of the benefits of peer support.
 Canadian Mental Health Association offers Mental Health First Aid, Living Life to the Full, Mental
Health Works, and the mental health recovery WRAP program.
Health Status Reporting
March 2015
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Technical Appendix
Health Status Reporting Series SixHealth Behaviours and Risk Conditions
Saskatoon Health Region
Table of Contents
The Canadian Community Health Survey
Alcohol Use
6
Food Insecurity
7
Illicit Drug Use
8
Injection Drug Use
8
Overweight or Obesity 9
Weight status for four year olds
Physical Activity
10
11
Second-hand smoke (home) 12
Sedentary Behaviour
13
Self-Rated Mental Health
Self-Rated Health
Smoking
14
14
15
Chronic Stress
16
Vegetable and Fruit Consumption
17
1
The Canadian Community Health Survey
All health behavior indicators come from the Canadian Community Health Survey (CCHS).
Data source: Statistics Canada.
http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=3226
Definition: The CCHS is a cross-sectional survey that collects information related to health status,
health care utilization and health determinants for the Canadian population. The target
population is all Canadians aged 12 and over, (approximately 130,000 people per year).
Starting in 2007, cycles were completed annually instead of every two years in case provinces
or regions wanted more timely data. In Saskatoon Health Region, because of a relatively small
sample size, we report findings from two year blocks to keep the SHR sample at approximately
1,200 per year.
Table 1 below shows the SHR sample characteristics for the 2011/12 cycles, though multiple
cycles were used in the analysis (see section “Combining CCHS cycles” below).
Table 1. Characteristics of Saskatoon Health Region sample of Canadian Community Health
Survey, 2011/12
Total SHR
Sex
Male
Female
Age group in years
Total N
1170
%*
100
515
655
44.0
56.0
12-19
20-29
30-39
40-49
50-59
60+
Self reported income quintiles
130
168
145
140
171
416
11.1
14.4
12.4
12.0
14.6
35.6
Lowest income quintile
Second lowest income quintile
Middle income quintile
Second highest income quintile
Highest income quintile
Ethnic minority
266
265
195
225
219
22.7
22.6
16.7
19.2
18.7
1031
52
87
88.1
4.4
7.4
123
51
10.5
4.4
White
Visible Minority
Missing
Rural planning zones
Humboldt and Area
Rosthern and Area
1
Watrous and Area
Saskatoon Area
62
116
5.3
9.9
Rural SHR
352
Saskatoon
818
Deprivation index quintile Saskatoon only
30.0
70.0
Least deprived quintile
Second least deprived quintile
Middle quintile
Second most deprived quintile
Most deprived quintile
Rural SHR and other quintile^
Immigration
Recent immigrant
Long term immigrant
Non-immigrant
160
156
149
145
188
372
13.7
13.3
12.7
12.4
16.1
31.8
36
57
1071
3.1
4.9
91.5
6
0.5
243
220
64
628
15
20.8
18.8
5.5
53.7
1.3
Missing
Educational attainment
Less than high school
High school graduate
Some post-secondary
Post-secondary graduate
Missing
*Totals may not add to 100 because of rounding.
^Other quintile refers to some areas in Saskatoon not being given a deprivation index score because of small
population size in a particular dissemination area.
There were 10 different subgroups used in the analysis.
Sex – Respondents were asked if they were male or female. No other choices were allowed.
Age group –Respondents were asked their age in years. From this single year of age, two
different age groupings were used. For most of the indicators, four broad age categories were
used 12-19, 20-44, 45-64 and 65+). For smoking and second hand smoke, six age categories
were used to better understand smoking exposure among younger age groups.
Income – Respondents were asked their total household income from all sources before taxes
and deductions in the past 12 months. This value was then divided by the low income cut off
corresponding to the number of people in the household and the size of the community (i.e.
urban or rural) which resulted in a household income ratio. This ratio was then divided by the
highest ratio for all respondents which then placed all household ratios within a range from 0 to
1. Within the health region, these adjusted ratios were placed in deciles. The deciles (10 groups)
were then converted into quintiles (five groups).
Deprivation Index – This index is based on six census questions from the 2006 census. See here for
more information on how the deprivation index was derived for Saskatoon.
2
Education Level – Respondent were asked their highest level of education completed.
Ethnicity – Respondent were asked what racial or cultural group they belonged to on a multiple
choice list. Given the small number of respondents who selected a group other than White (e.g.
South Asian, Black, Arab etc.), all non-white racial groups, were combined together and
considered a visible minority.
Immigrant Status – Respondents were asked the length of time they have been in Canada,
excluding non-immigrants. Anyone who responded less than 10 years was considered a recent
immigrant and anyone 10 years or more was considered a long term immigrant.
Rural/Urban – Respondents were considered from urban if they lived within the boundary of the
City of Saskatoon. Anyone living outside this boundary but within the Saskatoon Health Region
boundary was considered a rural SHR resident.
Rural Planning Zones – The Saskatoon Health Region is broken up into four rural planning zones,
each with a population of approximately 15,000. See here for a map of these zones.
3
Inclusions/exclusions: Excluded from the sampling frame are individuals living on Indian
Reserves and on Crown Lands, institutional residents, full-time members of the Canadian Forces,
and residents of certain remote regions. The CCHS coverage is in the range of 98% in the
provinces.
Types of CCHS data files: The CCHS comes with two types of files. The first is the Public Use
Microdata File (PUMF) which protects individual respondent anonymity by grouping sensitive
variables and suppressing socio-demographic variables. All trend analysis comparing Saskatoon
Health Region with either the Province of Saskatchewan or Canada estimates comes from the
PUMF.
The second type of file is called the Share file and only includes values from respondents who
stated that their information could be shared with other agencies. Grouping of sensitive
variables and suppressing socio-demographic variables is limited in the Share file. All analysis
that compares different sub-groups within Saskatoon Health Region comes from the Share files.
Combining CCHS cycles: For this report, 10 stratifiers were used within Saskatoon Health Region.
Because each cycle had a small sample, multiple cycles of the CCHS were combined to
provide a larger total sample for stratification. Cycle 1.1 from 2000/01 did not include enough of
the indicators and was dropped from the analysis. The cycles from 2003 to 2007 were combined
in “Wave 1” analysis and 2008 to 2012 were combined in “Wave 2” analysis. The method for
combining cycles was the pooled approach as outlined in Thomas and Wannell (2009). Note
that in this report, only results from wave 2 are shown, as this is the most recent time period.
To conduct the pooled approach for combining cycles we first examined the variable names
associated with each indicator and made sure that these were represented in each of the
cycles. Variables were consistently named throughout all cycles. Cycles were appended and
wave variables were created. Eight of the 12 indicators examined were represented in each
cycle for both wave periods. For sedentary behaviour and illicit drug use, the 2011 and 2012
cycles were used; for vegetable and fruit consumption and food security, the 2010, 2011 and
2012 cycles were used (see Table 2).
Table 2. CCHS cycles for wave analysis time periods
2000/1
2002/3
2004/5
CCHS Cycle
Wave 1
Dropped
OK
OK
Chronic Stress
Dropped
OK
OK
Binge Drinking
Dropped
OK
OK
Current Smoking
OK
OK
Second hand smoking home Dropped
Dropped
OK
OK
Physical activity
Dropped
OK
OK
Self-rated mental health
4
2007
2008
2009
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
2010
Wave 2
OK
OK
OK
OK
OK
OK
2011
2012
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
OK
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Self-rated health
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Overweight or obese
Missing
Missing
Missing
Wave 2
Food security
Wave 1
Vegetable and fruit
Missing Dropped Missing
Wave 2
consumption
Wave 1
Dropped Missing Dropped
Wave 1
Missing Missing
Wave 2
Sedentary behaviour
Dropped
Missing Dropped Dropped
Wave 2
Illicit Drug Use
Wave 1
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Education
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Income adequacy*
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Ethnicity
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Immigration
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
Deprivation Index
Dropped
OK
OK
OK
OK
OK
OK
OK
OK
RPZ (Rural Planning Zones)
* Income adequcy has a caveat that in Cycle2 the quintiles are not derived in the same way as cycle 3.1 to 9.1
After pooling the data we created derived variables for the indicators of interest (e.g. we
regrouped single year of age values into age groups; we took individual census sub-divisions
and regrouped in rural planning zones etc.). Once the derived variables were created,
unweighted and weighted bivariate analysis was performed.
Weighting: Each respondent in the survey represents several other persons not in the survey
sample. This is called weighting and all analysis shown is weighted based on Statistics Canada
methods. For the combined cycle analysis, all weights were multiplied by the inverse of the
number of cycles in that time period. So for Wave 2 analysis, each weight among the eight
indicators that were represented in all 5 cycles, was multiplied by 1/5=0.2. For sedentary
behaviour and illicit drug use, the weights were multiplied by ½=0.5 because they were
included in 2 cycles. For vegetable and fruit consumption and food insecurity, the weights were
multiplied by 1/3=0.33 because they were included in 3 cycles. After recoding the weights to
account for combining cycles into waves, we compared the summed weights to the census
population for the Saskatoon Health Region. Summed weights were close the population
estimates and suggest the weight recoding was done correctly.
Variance estimation: All estimates have degrees of variability and given the complex sampling
nature of the CCHS, Statistics Canada recommends that confidence intervals and coefficients
of variation be calculated by the bootstrap method. In addition to the weights described
above, each record in the CCHS includes bootstrap weights. The bootstrap weights are used to
calculate coefficient of variation and confidence intervals. The method used for bootstrap
analysis was based on Gagne, Roberts and Keown (2014) using SAS 9.2.
References:
Thomas S, Wannell B. Combining cycles of the Canadian Community Health Survey. Health Reports
2009;20(1) [cited 2015 Jan 19];Available from: URL: http://www.statcan.gc.ca/pub/82-003x/2009001/article/10795-eng.pdf
5
Gagne C, Roberts G, Keown L. Weighted estimation and bootstrap variance estimation for analyzing
survey data: How to implement in selected software. Statistics Canada. Research Data Centres
Information and Technical Bulletin 2014;6(1) [cited 2015 Jan 19];Available from: URL:
http://www.statcan.gc.ca/pub/12-002-x/2014001/article/11901-eng.pdf
Statistics Canada. (2012). Canadian Community Health Survey. Annual component – 2010 questionnaire.
[cited 2015 Jan 19]; Available from: URL: http://www23.statcan.gc.ca/imdbbmdi/pub/instrument/3226_Q1_V7-eng.pdf
Statistics Canada. (2012). Canadian Community Health Survey. Annual component, 2009-2010 Common
Content. Derived Variable Specifications. [cited 2015 Jan 19]; ]; Available from: URL:
http://www23.statcan.gc.ca/imdb-bmdi/pub/document/3226_D71_T9_V1-eng.pdf
Alcohol Use
Definition: Binge drinking has been shown to be detrimental to a person’s health. Adults having
reported drinking five or more drinks on one occasion at least once a month in the past year
are considered to be binge drinkers.
Calculation: Percent binge drinkers = individuals 12 years of age and older who report drinking
five or more drinks on one occasion at least once a month in the past year divided by the total
population 12 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No rates for children less than 12 years of age available. Individuals living on First
Nations Reserves and Crown lands; residents of institutions; full-time members of the Canadian
Armed Forces; and residents of certain remote areas were excluded from the survey.
References:
Butt P, Beirness D, Gliksman L, Paradis C, Stockwell T. Alcohol and health in Canada: a summary of
evidence and guidelines of low-risk drinking. Ottawa: Canadian Centre on Substance Abuse; 2011.
Available from: URL: http://www.ccsa.ca/Resource%20Library/2011-Summary-of-Evidence-andGuidelines-for-Low-Risk%20Drinking-en.pdf
Canadian Institute for Health Information. Reducing gaps in health: a focus on socio-economic status in
urban Canada. Ottawa: CIHI; 2008.
Grzywacz JG, Almeida DM. Stress and binge drinking: a caily process examination of stressor pile-up and
socioeconomic status in affect regulation. International Journal of Stress Management 2008;15(4):364-380.
Harrison ELR, Desai RA, McKee SA. Nondaily smoking and alcohol use, hazardous drinking, and alcohol
diagnoses among young adults: Findings from the NESARC. Alcoholism: Clinical and Experimental
Research 2008;32(12):2081-2087.
6
Rehm J, Baliunas D, Borges GL, et al. The relation between different dimensions of alcohol consumption
and burden of disease: an overview. Addiction 2010;105(5):817-843.
Stokowski LA. No amount of alcohol is safe. Medscape 2014 Apr 30. Available from: URL:
http://www.medscape.com/viewarticle/824237_5
Wen XJ, Kanny D, Thompson WW, Okoro CA, Town M, Balluz LS. Binge drinking intensity and health-related
quality of life among US adult binge drinkers. Preventing Chronic Disease 2012;9:E86.
Food Insecurity
Definitions:
A household`s experience of food insecurity or the inadequate or insecure access to adequate
food due to financial constraints. Food insecurity is assessed based on an 18 question food
security module. A household is deemed moderately food insecure if there are 2 to 5 positive
responses on the 10 question adult food security scale and 2 to 4 positive responses on the 8
question child food security scale. A household is deemed severely food insecure if there are 6
or more positive responses on the adult food security scale and 5 or more positive responses on
the child food security scale.
Calculation:
Percent of households indicating some level of food insecurity (moderate or severe) divided by
the total households with individuals 12 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: Statistics Canada does not include marginal levels of food insecurity which have
been reported by others (Tarasuk et al. 2014). The omission of marginal food insecurity (no more
than 1 positive response on either the adult or child food security scale) likely underestimates
the total food insecure population. In Saskatchewan in 2012, roughly 4.4% of the population was
considered marginally food insecure compared to 8.1% who answered moderate to severe
food insecurity. Food security is only comparable since 2005 when the food security module
questions were standardized. Individuals living on First Nations Reserves and Crown lands;
residents of institutions; full-time members of the Canadian Armed Forces; and residents of
certain remote areas were excluded from the survey.
References:
Kirkpatrick SI, Tarasuk V. Food insecurity is associated with nutrient inadequacies among Canadian adults
and adolescents. Journal of Nutrition 2008;133(3):604-612.
Tarasuk V, Mitchell A, Dachner N. Household food insecurity in Canada, 2012. Toronto: PROOF; 2014.
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Vozoris NT, Tarasuk VS. Household food insufficiency is associated with poorer health. Journal of Nutrition
2003;133(1):120-126.
Illicit Drug Use
Definition: Percentage of individuals reporting illicit drug use at least once in the past 12 months,
excluding one-time use of cannabis. Illicit drugs in this case mean illegal and include the
following eight listed: cannabis, cocaine or crack, speed (amphetamines), ecstasy (MDMA),
hallucinogens (PCP, LSD), sniffed glue, gasoline or other solvents, heroin, or steroids.
Calculation: Percent of individuals who report using illicit drugs at least once in the past 12
months excluding one-time use of cannabis =Number of persons 12 years of age and older
reporting having used an illicit drug in the past 12 months excluding one-time use of cannabis
divided by the total number of individuals 12 and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: Illicit drug use is subject to the possibility of under-reporting, as some respondents
may be reluctant to share information about their drug use. Individuals living on First Nations
Reserves and Crown lands; residents of institutions; full-time members of the Canadian Armed
Forces; and residents of certain remote areas were excluded from the survey.
References:
Canadian Public Health Association. A new approach to managing psychoactive substances in
Canada. CPHA 2014. Available from (cited 2015 March 10): URL:
http://www.cpha.ca/uploads/policy/ips_2014-05-15_e.pdf
Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global
burden of disease. Lancet 2012;379:55-70.
Daniel JZ, Hickman M, Macleod J, et al. Is socioeconomic status in early life associated with drug use? A
systematic review of the evidence. Drug and Alcohol Review 2009;28(2):142-153.
Fischer B, Rehm J, Brissette S, Brochu S, Bruneau J et al. Illicit opioid use in Canada: Comparing social,
health, and drug use characteristics of untreated users in five cities (OPICAN study). Journal of Urban
Health 2005;82(2):250-266.
Injection Drug Use
Population and Public Health’s Street Health Needle Exchange Program does not include
needles issued and collected through Saskatoon Tribal Council(STC). The decrease in the
numbers of needles distributed may be offset by STC needle exchange to Saskatoon clients.
8
The Enhanced Street Youth Study (ESYS) is part of a national surveillance project which began in
1997. It is supported by the Public Health Agency of Canada. Saskatoon joined the study in
1999.
The purpose of the ESYS is to better understand risk behaviors in street involved youth, especially
risks associated with sexually transmitted infections and blood borne infections. The study
contains much information about education, income, interaction with the justice system and
social services and homelessness.
References:
Diwaker G. Inspiring change through community voices; a survey of clients using the Street Health Needle
Exchange Program. Population & Public Health practicum. Saskatoon Health Region (unpublished).
Public Health Agency of Canada 2006. Filling in the Gaps in Our Knowledge of Youth Health: Enhanced
Surveillance of Canadian Street Youth (E-SYS) http://www.phac-aspc.gc.ca/sti-its-surv-epi/qf-fr/qa-qreng.php (cited January 2015)
Wright J. Drug Use Fact Sheet: preliminary results from the Enhanced Street Youth Study (ESYS) 2009. Public
Health Observatory. Saskatoon Health Region 2011. Available from: URL:
http://www.communityview.ca/Catalogue/ResourceList/Search?phrase=esys
Overweight or Obesity
Definition: Overweight individuals are adults aged 18 and over (excluding pregnant women)
who have a body mass index (BMI) between 25 to 29.9. Obese individuals are adults aged 18
and over (excluding pregnant women) who have a BMI over 30. Body Mass Index is calculated
by taking a person’s weight in kilograms and dividing it by their height in metres squared.
Calculation: Percent overweight or obese = individuals 18 years of age and older with BMI of 25
and above divided by the total population 18 years of age an older.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: BMI represents an estimate of fatty tissue based on weight and height. In the CCHS,
there is no direct measure of body fat. Using self-report BMI can lead to misclassification of
health risk. For example, a person with greater muscle or bone mass might be categorized as
overweight based on their BMI, but the actual health risk for that person would be lower than
someone with the same BMI who has more fat mass. BMI also has limitations in accurately
accounting for different musculature or bone mass among or across ethnocultural groups.
Other measures of obesity such as waist to hip ratio, waist circumference and skinfold
measurements could be used. Individuals living on First Nations Reserves and Crown lands;
residents of institutions; full-time members of the Canadian Armed Forces; and residents of
certain remote areas were excluded from the survey.
9
References:
Devaux M, Sassi F. Social inequalities in obesity and overweight in 11 OECD countries. European Journal
of Public Health 2012;23(3):464-469.
Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity
using standard body mass index categories: a systematic review and meta-analysis. Journal of the
American Medical Association 2013 Jan 2;309(1):71-82.
Guh D, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and
meta-analysis. Public Health 2009;9(88).
Herman KM, Hopman WM, Rosenberg MW. Self-rated health and life satisfaction among Canadian
adults: Association of perceived weight status versus BMI. Quality of Life Research 2013; 22(10):2693-2705.
Kaplan MS, Huguet Nathalie, Newsom JT, McFarland BH, Lindsay J. Prevalence and correlates of
overweight and obesity among older adults: Findings from the Canadian National Population Health
Survey. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2003;58(11):M1018M1030.
Public Health Agency of Canada and CIHI. Obesity in Canada. 2011. Available from: URL:
https://secure.cihi.ca/free_products/Obesity_in_canada_2011_en.pdf
Statistics Canada. Body composition of adults, 2012 to 2013. 2014. Available from: URL:
http://www.statcan.gc.ca/pub/82-625-x/2014001/article/14104-eng.htm
Weight status for four year olds
Definitions:
Children were measured and weighed at their four year old appointment when they came in
to population and public health. Their height and weight were used to calculate Body Mass
Index which is weight in kilograms divided by their height in metres squared. Weight status refers
to the grouping of BMI relative to a growth reference or standard and is used to identify
individuals or groups at risk. For children up to five years of age, the World Health Organization
Child Growth Standards were used. The Dietitians of Canada adopted the WHO standards and
recommended a set of BMI-for-age cut-off points to classify over- or under-nutrition of children.
Calculation: Dietitians of Canada recommended BMI for age cut-off points in percentiles.
Classification
2–5 years
Percentiles
Wasting
<3rd
Risk of Overweight >85th
Overweight
>97th
Obesity
>99.9th
10
Source: Saskatoon Health Region, Population and Public Health.
Limitations: The Ministry of Health in their weight status report used a Z score approach to classify
weight status. This is the most commonly used approach and uses standard deviations to
classify BMI into categories. For our report, percentiles are used. While not as accurate as using
the z-scores, percentiles are increasingly being used to classify weight status and are generally
more easily understood by clinicians (Preedy, 2012).
References:
Wang Y, Chen HJ. Chapter 2 in Handbook of Anthropometry: physical measures of human form in health
and disease. Preedy V.F (ed). 2012:34.
Physical Activity
Definitions: Individuals are classified as physically active, moderately active and inactive based
on an index (the Leisure Time Physical Activity Index) of average daily physical activity over the
past 3 months. For each leisure time activity engaged in by the individual, an average daily
energy expenditure is calculated. This multiplies the number of times the activity was performed
by the average duration of the activity by the energy cost of the activity. The index is
calculated as the sum of the average daily energy expenditures of all activities. If the daily
energy expenditure value is 1.5 -2.9 kcal/kg/day = moderately active. If the daily energy
expenditure is 3.0 or higher = physically active. The combination of moderately and physically
active together is what is reported.
Calculation: Percent moderately or physically active = individuals 12 years of age and older
classified as moderately active or active according to the Leisure Time Physical Activity Index
divided by the total population 12 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No rates for children less than 12 years of age available at this time. The index does
not include physical activity outside of leisure time (e.g. activity used to get to and from work),
but is considered a proxy of total physical activity. Individuals living on First Nations Reserves and
Crown lands; residents of institutions; full-time members of the Canadian Armed Forces; and
residents of certain remote areas were excluded from the survey.
References:
Canadian Fitness and Lifestyle Research Institute. 2014-2015 Physical Activity Monitor. Bulletin 1: Physical
activity levels of Canadians. 2015 [cited 2015 March 9]; Available from: URL:
http://www.cflri.ca/sites/default/files/node/1374/files/CFLRI_Bulletin%201_PAM%202014-2015.pdf
11
Canadian Fitness and Lifestyle Research Institute. 2009 Physical Activity Monitor. Bulletin 15: Environmental
Barriers. 2009 [cited 2015 March 9]; Available from: URL:
http://www.cflri.ca/sites/default/files/node/606/files/PAM2009Bulletin15.pdf
Herman KM, Hopman WM, Sabiston CM. Physical activity, screen time and self-rated health and mental
health in Canadian adolescents. Preventive Medicine 2015;73:112-116.
Warburton DE, Charlesworth S, Ivey A, Nettlefold L, Bredin SS. A systematic review of the evidence for
Canada’s Physical Activity Guidelines for Adults. International Journal of Behavioral Nutrition and Physical
Activity 2010 May;7:39. doi:10.1186/1479-5868-7-39.
Public Health Agency of Canada and CIHI. Obesity in Canada. 2011. Available from: URL:
https://secure.cihi.ca/free_products/Obesity_in_canada_2011_en.pdf
Public Health Agency of Canada. Physical activity. PHAC 2011 [cited 2014 Sept 18];Available from: URL:
http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/pa-ap/index-eng.php
Public Health Agency of Canada. Risk Factor Atlas. 2013. Available from [cited 10 March 2015]: URL:
http://www.phac-aspc.gc.ca/cd-mc/atlas/index-eng.php
Second-hand smoke (home)
Definition: Percentage of households with at least one person smoking inside their home
regularly (every day or almost every day).
Calculation: Percent of households regularly exposed to environmental tobacco smoke
=Number of households with at least one person smoking inside their home regularly divided by
the total number of households.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No adjustment for households with children less than 12 years of age. Individuals
living on First Nations Reserves and Crown lands; residents of institutions; full-time members of the
Canadian Armed Forces; and residents of certain remote areas were excluded from the survey.
Note that exposure to second hand smoke in public places and in vehicles are also asked in the
CCHS. In these cases, the calculation is the percent of people in the past month, exposed to
second hand smoke every day or almost every day a) in a car or other private vehicle or b) in
public places such as bars, restaurants, shopping malls, arenas, bingo halls and bowling alleys.
References:
Canadian Cancer Society. Second hand smoke is dangerous. 2014 [cited 2014 Dec 31];Available from:
URL: https://www.cancer.ca/en/prevention-and-screening/live-well/smoking-and-tobacco/secondhand-smoke-is-dangerous/?region=sk
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Nakata A, Takahashi M, Swanson NG, Ikeda T, Hojou M. Active cigarette smoking, secondhand smoke
exposure and work and home, and self-rated health. Public Health 2009;123(10):650-656.
Tager IB. The effects of second-hand and direct exposure to tobacco smoke on asthma and lung
function in adolescence. Pediatric Respiratory Reviews 2008;9(1):29-37.
Treyster Z, Glitterman B. Second hand smoke exposure in children: environmental factors, physiological
effects and interventions within pediatrics. Reviews of the Environment and Health 2011;26(3):187-195.
Vozoris N, Lougheed MD. Second-hand smoke exposure in Canada: prevalence, risk factors, and
association with respiratory and cardiovascular diseases. Canadian Respriatory Journal 2008;15(5):263269.
Sedentary Behaviour
Definition: The Canadian Sedentary Behaviour Guidelines establish that children age 5 to 17 be
restricted to no more than 2 hours per day of recreational screen time. While adult guidelines
have not been established in Canada, the 2 hour per day threshold is seen as appropriate for
determining chronic disease risk. Therefore the proportion of people 12 years of age and older
who report spending more than 14 hours per week watching television and/or using computers
during leisure time is reported.
Calculation: Percent sedentary = individuals 12 years of age and older who report spending
more than 14 hours per week watching television and/or using computers during leisure time
divided by the total population 12 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No estimates for children less than 12 years of age available at this time. No rates
are available for those living in Saskatchewan in 2009/10 which limits the ability to produce
trend information. Therefore only the last year (2011/12) is shown. Individuals living on First
Nations Reserves and Crown lands; residents of institutions; full-time members of the Canadian
Armed Forces; and residents of certain remote areas were excluded from the survey.
References:
Shields M, Tremblay MS. Sedentary behavior and obesity. Statistics Canada, Catalogue 82-003 Health
Reports 2008;19(2):1-13.
Stamatakis E, Hamer M, Dunstan DW. Screen-based entertainment time, all-cause mortality, and
cardiovascular events. Journal of the American College of Cardiology 2011;57(3):292-299.
Public Health Agency of Canada and CIHI. Obesity in Canada. 2011. Available from: URL:
https://secure.cihi.ca/free_products/Obesity_in_canada_2011_en.pdf
13
Katzmarzyk PT, Church TS, Craig CL, Bouchard C. Sitting time and mortality from all causes, cardiovascular
disease and cancer. Med Sci Sports Exerc 2009;41(5):998-1005.
Herman KM, Hopman WM, Sabiston CM. Physical activity, screen time and self-rated health and mental
health in Canadian adolescents. Preventive Medicine 2015;73:112-116.
Canadian Cancer Society. Sedentary behaviour. 2014 [cited 2014 Sept 5];Available from: URL:
https://www.cancer.ca/en/cancer-information/cancer-101/what-is-a-risk-factor/sedentarybehaviour/?region=sk
Betancourt MT, et al. Monitoring chronic diseases in Canada: the Chronic Disease Indicator Framework.
Chronic Diseases and Injuries in Canada 2014;34(Suppl 1):1-30.
Self-Rated Mental Health
Definition: Percentage of individuals reporting their mental health as “very good” or “excellent”.
Calculation: Percent of individuals who report their mental health as very good or excellent
=Number of persons 12 years of age and older reporting their mental health as very good or
excellent divided by the total number of individuals 12 and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: Individuals living on First Nations Reserves and Crown lands; residents of institutions;
full-time members of the Canadian Armed Forces; and residents of certain remote areas were
excluded from the survey.
References:
Ahmad F, Jhajj AK, Stewart DE, Burghardt M, Bierman AS. Single item measures of self-rated mental
health: a scoping review. BMC Health Services Research 2014;14:398.
Mawani H, Gilmour H. Validation of self-rated mental health. Health Reports 2010;21(3). Catalogue no:82003-XPE.
Canadian Mental Health Association, Ontario. What is the fit between mental health, mental illness and
Ontario’s approach to chronic disease prevention and management? Toronto: Canadian Mental Health
Association, Ontario; 2008. Available from: URL: http://ontario.cmha.ca/public_policy/what-is-the-fitbetween-mental-health-mental-illness-and-ontarios-approach-to-chronic-disease-prevention-andmanagement/#.VDa6wvldVC0
Canadian Institute for Health Information. Improving the health of Canadians: exploring positive mental
health. Ottawa: CIHI; 2009 [cited 2015 Jan 6];Available from: URL: http://www.cihi.ca/cihi-extportal/pdf/internet/improving_health_canadians_en
14
Self-Rated Health
Definition: Percentage of individuals reporting their health as “very good” or “excellent”.
Calculation: Percent of individuals who report their health as very good or excellent =Number of
persons 12 years of age and older reporting their health as very good or excellent divided by
the total number of individuals 12 and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No estimates for children less than 12 years of age available. Individuals living on First
Nations Reserves and Crown lands; residents of institutions; full-time members of the Canadian
Armed Forces; and residents of certain remote areas were excluded from the survey.
References:
Statistics Canada. Perceived health. 2010. Available from: URL: http://www.statcan.gc.ca/pub/82-229x/2009001/status/phx-eng.htm
Bowling A. Just one question: if one question works, why ask several? Journal of Epidemiology and
Community Health 2005;59(5):342-345.
Cott CA, Gignac MAM, Badley EM. Determinants of self rated health for Canadians
with chronic disease and disability. Journal of Epidemiology and Community Health 1999;53:731–736.
Eriksson I, Unden A & Elofsson S. Self-rated health. Comparisons between three different measures. Results
from a population study. International Journal of Epidemiology 2001;30 (2):326-333.
Subramanian SV, Huijts T & Avendano M. Self-reported health assessments in the 2002 World Health
Survey: how do they correlate with education? Bulletin of the World Health Organization 2010;88:131-138.
Available from: URL: http://www.who.int/bulletin/volumes/88/2/09-067058/en/
Smoking
Definition: Percentage of population who report being current smokers (daily or occasional)
among those 15 years of age and older.
Calculation: Percent of individuals who are current smokers = individuals 15 years of age and
older who report that at the present time they smoke cigarettes daily and occasionally divided
by the total population 15 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No rates for children less than 15 years of age available. Does not include the
amount of tobacco smoked. Individuals living on First Nations Reserves and Crown lands;
15
residents of institutions; full-time members of the Canadian Armed Forces; and residents of
certain remote areas were excluded from the survey.
References:
Health Canada. Smoking and your body. 2011 [cited 2014 Sept 18];Available from: URL: http://www.hcsc.gc.ca/hc-ps/tobac-tabac/body-corps/index-eng.php
Health Canada. Smoking prevalence: Canadian Tobacco Use Monitoring Survey. [cited 2015 Jan 26];
Available from: URL: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/research-recherche/stat/_ctumsesutc_prevalence/prevalence-eng.php
Kirkland S, Greaves L, Devichand P. Gender differences in smoking and self reported indicators of health.
BMC Women’s Health 2004;4(Suppl 1):S7.
World Health Organization. WHO report on the global tobacco epidemic, 2013. WHO: Luxembourg 2013
[cited 2014 Sept 18];Available from: URL: http://www.hc-sc.gc.ca/hc-ps/tobac-tabac/body-corps/indexeng.php
Saskatchewan Coalition for Tobacco Reduction. Building on success: continuing to reduce tobacco use
in Saskatchewan 2013-14. Saskatchewan Coalition for Tobacco Reduction: Regina; 2013.
Strine TW, Okoro CA, Chapman DP, Balluz LS, Ford ES et al. Health-related quality of life and health risk
behaviours among smokers. American Journal of Preventive Medicine 2005;28(2):182-187.
Chronic Stress
Definition: Chronic stress has been shown to be detrimental to a person’s health. Those having
reported that most days last year were “quite a bit” stressful or “extremely” stressful are
considered to have chronic stress.
Calculation: Percent of individuals with chronic stress = individuals 12 years of age and older
who reported in the last year most days were quite a bit stressful or extremely stressful divided by
the total population 12 years of age and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations: No rates for children less than 12 years of age available. Individuals living on First
Nations Reserves and Crown lands; residents of institutions; full-time members of the Canadian
Armed Forces; and residents of certain remote areas were excluded from the survey.
References:
Canadian Mental Health Association. Stress. 2014 [cited 2014 Sept 12];Available from: URL:
http://www.cmha.ca/mental_health/stress/#.VBMmSPldVC0
16
Cohen S, Janicki-Deverts D, Doyle WJ, et al. Chronic stress, glucocorticoid receptor resistance,
inflammation and disease risk. Proceedings of the National Academy of Sciences of the United States of
America 2012;109(16):5995-5999.
Steptoe A, Kivimaki M. Stress and cardiovascular disease. Nature Reviews Cardiology 2012;9(6):360-370.
Gryzywacz JG, Almeida DM, Neupert SD, Ettner SL. Socioeconomic status and health: a micro-level
analysis of exposure and vulnerability to daily stressors. Journal of Health and Social Behaviour 2004;45:116.
Vegetable and Fruit Consumption
Definitions: Individuals are asked how many vegetables and fruit they eat each day. Those that
answered at least five or more are reported.
Calculation: Percent individuals eating at least five vegetables and fruit per day = individuals
eating at least five vegetables and fruit per day divided by the total population 12 years of age
and over.
Source: Statistics Canada, Canadian Community Health Survey.
Limitations:
Serving size is not reflected in the answers, so individuals eating at least five vegetables and
fruits per day does not necessarily mean that they are eating five or more servings per day. The
Canada Food Guide also recommends that adults eat a minimum of seven servings of
vegetables and fruit per day. Any estimates of healthy eating reported here will overestimate
the proportion of healthy eaters if the Canada Food Guide is taken as the standard. Individuals
living on First Nations Reserves and Crown lands; residents of institutions; full-time members of the
Canadian Armed Forces; and residents of certain remote areas were excluded from the survey.
References:
Mirmiran P, Noori N, Zavareh MB, Azizi F. Fruit and vegetable consumptions and risk factors for
cardiovascular disease. Metabolism 2009;58(4):460-468.
Azagba S, Sharaf MF. Disparities in the frequency of fruit and vegetable consumption by sociodemographic and lifestyle characteristics in Canada. Nutrition Journal 2011;10:118.
Public Health Agency of Canada and CIHI. Obesity in Canada. 2011. Available from: URL:
https://secure.cihi.ca/free_products/Obesity_in_canada_2011_en.pdf
Public Health Agency of Canada. Risk Factor Atlas. 2013. Available from [cited 10 March 2015]: URL:
http://www.phac-aspc.gc.ca/cd-mc/atlas/index-eng.php
17