Suicidality and protective factors among sexual and gender minority youth and adults in Canada: a cross-sectional, population-based study.

BACKGROUND: Sexual and gender minority populations experience elevated risks for suicidality. This study aimed to assess prevalence and disparities in non-fatal suicidality and potential protective factors related to social support and health care access among sexual and gender minority youth and adults and their heterosexual and cisgender counterparts in Canada. The second objective was to examine changes in the prevalence of suicidal ideation and protective factors during the COVID-19 pandemic. METHODS: Pooled data from the 2015, 2016 and 2019 Canadian Community Health Surveys were used to estimate pre-pandemic prevalence of suicidal ideation, plans and attempts, and protective factors. The study also estimated changes in the prevalence of recent suicidal ideation and protective factors in fall 2020, compared with the same period pre-pandemic. RESULTS: The prevalence of suicidality was higher among the sexual minority populations compared with the heterosexual population, and the prevalence was highest among the bisexual population, regardless of sex or age group. The pre-pandemic prevalence of recent suicidal ideation was 14.0% for the bisexual population, 5.2% for the gay/lesbian population, and 2.4% for the heterosexual population. The prevalence of lifetime suicide attempts was 16.6%, 8.6%, and 2.8% respectively. More than 40% of sexual minority populations aged 15-44 years had lifetime suicidal ideation; 64.3% and 36.5% of the gender minority population had lifetime suicidal ideation and suicide attempts. Sexual and gender minority populations had a lower prevalence of protective factors related to social support and health care access. The prevalence of recent suicidal ideation among sexual and gender minority populations increased in fall 2020, and they tended to experience longer wait times for immediate care needed. CONCLUSIONS: Sexual and gender minority populations had a higher prevalence of suicidality and less social support and health care access compared to the heterosexual and cisgender populations. The pandemic was associated with increased suicidal ideation and limited access to care for these groups. Public health interventions that target modifiable protective factors may help decrease suicidality and reduce health disparities.

Adverse maternal outcomes in multifetal pregnancies.

In this retrospective cohort of 165,188 singleton pregnancies and 44,674 multiple-fetal pregnancies in Canada from 1984 to 2000, we compared the incidence of maternal complications. Multiple gestation pregnancies were associated with significant increases in cardiac morbidity, haematologic morbidity, amniotic fluid embolus, pre-eclampsia, gestational diabetes, postpartum haemorrhage, prolonged hospital stay, the need for obstetric intervention, hysterectomy and blood transfusion. Multiple gestation pregnancies are associated with an increased risk of morbidity for the mother. This should be taken into consideration in antenatal care of these women.

Residential proximity to industrial plants and non-Hodgkin lymphoma.

BACKGROUND: A U.S. analysis suggested a relation between self-reported residential proximity to industrial plants and non-Hodgkin lymphoma (NHL) risk. METHODS: Using lifetime residential histories collected from a population-based sample of 1499 Canadians with newly diagnosed, histologically confirmed NHL and 5039 population controls, we evaluated the association of residential proximity to 7 types of major heavy industry with NHL risk. RESULTS: Overall, having lived within 0.8 km or within 3.2 km of an industrial plant was not associated with increased NHL risk. For the follicular subtype of NHL, an odds ratio (OR) of 1.48 (95% confidence interval [CI] = 1.10-1.99) was observed for women who had lived within 3.2 km (83 cases/689 controls). ORs for NHL were elevated for proximity within 3.2 km of copper smelters (OR = 5.1; CI = 1.5-17.7; 7 cases, 4 controls) and within 0.8 km of sulfite pulp mills (OR = 3.7; CI = 1.5-9.4; 9 cases, 10 controls). CONCLUSIONS: We have identified possible associations between NHL and proximity to industrial plants, which could be the result of chance or other factors associated with proximity. Studies are needed to confirm these associations and to determine whether residential proximity can result in meaningful exposure.

Physical activity and the risk of lung cancer in Canada.

A population-based case-control study of 2,128 cases with histologically confirmed incident lung cancer and 3,106 population controls aged 20-76 years was conducted to assess the impact of recreational physical activity on lung cancer risk in Canada in 1994-1997. The multivariable-adjusted odds ratios and 95% confidence intervals for the second, third, and fourth quartiles versus the lowest quartile of total recreational physical activity were, respectively, 0.82 (95% confidence interval: 0.68, 0.98), 0.76 (95% confidence interval: 0.63, 0.92), and 0.73 (95% confidence interval: 0.60, 0.89) (p for trend=0.0008). The risk reduction was observed for both men and women and was attributed to both moderate and vigorous activities. A greater risk reduction was found for squamous cell carcinoma in women, small cell carcinoma in men, and other types/unspecified histologic subtypes in both genders. The physical-activity-associated risk reduction was more profound among smokers and those with low and medium body mass indexes. This study provides additional evidence that recreational physical activity reduces lung cancer risk. More studies are needed to confirm the differences between histologic subtypes and between genders and to address the underlying biologic mechanisms.

Physical inactivity, energy intake, obesity and the risk of rectal cancer in Canada.

We conducted a population-based case-control study of 1,447 incident rectal cancer cases and 3,106 population controls aged 20-76 years to assess the effect of recreational physical activity, energy intake and obesity on rectal cancer risk in 7 of 10 Canadian provinces in 1994-97. After adjustment for the effect of various potential confounding factors, total recreational physical activity in the highest quartile was associated with an odds ratio (OR) for rectal cancer risk of 0.88 (95% confidence interval [CI] = 0.64-1.20) in women and 1.15 (95% CI = 0.88-1.49) in men. Women and men in the highest quartile of caloric intake (> = 56,741 and > = 63,143 kJ/week) had ORs of 1.50 (95% CI = 1.00-2.25) and 1.61 (95% CI = 1.13-2.28), respectively. Total dietary fat intake was not associated with a risk of rectal cancer after adjustment for caloric intake. Obesity (BMI > = 30 kg/m(2)) was associated with an OR of 1.44 (95% CI = 1.06-1.95) for women and 1.78 (95% CI = 1.36-2.34) for men. Men and women with lifetime maximum body mass index (BMI) > = 30 kg/m(2) had respective ORs of 1.70 (95% CI = 1.30-2.23) and 1.26 (95% CI = 0.96-1.66). The greatest increase in rectal cancer risk was observed in men and women with simultaneous high energy intake, high BMI and low physical activity. Our study provides evidence that physical inactivity, high energy intake and obesity are associated with the risk of rectal cancer, and there is a probable synergic effect among the 3 risk factors.