Comparison of the estimated prevalence of mood and/or anxiety disorders in Canada between self-report and administrative data.

BACKGROUND: To compare trends in the estimated prevalence of mood and/or anxiety disorders identified from two data sources (self-report and administrative). Reviewing, synthesising and interpreting data from these two sources will help identify potential factors that underlie the observed estimates and inform public health action. METHOD: We used self-reported, diagnosed mood and/or anxiety disorder cases from the Canadian Community Health Survey (CCHS) across a 5-year span (from 2003 to 2009) to estimate the prevalence among the Canadian population aged ≥15 years. We also estimated the prevalence of mood and/or anxiety disorders using the Canadian Chronic Disease Surveillance System (CCDSS), which identified cases using ICD-9/-10-CA codes from physician billing claims and hospital discharge records during the same time period. The prevalence rates for mood and/or anxiety disorders were compared across the CCHS and CCDSS by age and sex for all available years of data from 2003 to 2009. Summary rates were age-standardised to the Canadian population as of 1 October 1991. RESULTS: In 2009, the prevalence of mood and/or anxiety disorders was 9.4% using self-reported data v. 11.3% using administrative data. Prevalence rates obtained from administrative data were consistently higher than those from self-report for both men and women. However, due to an increase in the prevalence of self-reported cases, these differences decreased over time (rate ratios for both sexes: 1.6-1.2). Prevalence estimates were consistently higher among females compared with males irrespective of data source. While differences in the prevalence estimates between the two data sources were evident across all age groups, the reduction of these differences was greater among adolescent, young and middle-aged adults compared with those 70 years and older. CONCLUSIONS: The overall narrowing of differences over time reflects a convergence of information regarding the prevalence of mood and/or anxiety disorders trends between self-report and administrative data sources. While the administrative data-based prevalences remained relatively stable, the self-reported prevalences increased over time. These observations may reflect positive societal changes in the perceptions of mental health (declining stigma) and/or increasing mental health literacy. Additional research using non-ecological data is required to further our understanding of the observed findings and trends, including a data linkage exercise permitting a comparison of prevalence estimates and population characteristics from these two data sources both separately and merged.

Report summary. Diabetes in Canada: facts and figures from a public health perspective.

"Diabetes in Canada: facts and figures from a public health perspective" is the first comprehensive diabetes surveillance report published by the Public Health Agency of Canada. The report aims to support public health professionals and organizations in developing effective, evidence-based public health policies and programs to prevent and manage diabetes and its complications. The report, developed in collaboration with provincial and territorial governments, the Canadian Diabetes Association, Juvenile Diabetes Research Foundation, CNIB, Health Canada and the academic community, uses data from national health surveys and vital statistics, as well as population-based administrative data from the Canadian Chronic Disease Surveillance System (CCDSS). For the first time, the CCDSS contains data from all 13 Canadian jurisdictions. Using CCDSS data representing cases of diagnosed diabetes among Canadians aged one year and older, Diabetes in Canada presents prevalence and incidence national rates from the fiscal year 2008/2009 and national trends from 1998/1999 onwards. The report also outlines sub-populations at higher risk, ways of reducing the risks of developing the disease and its complications, and estimates of related economic costs. In addition, it contains sections on specific populations, including children and youth and First Nations, Inuit and Métis populations.

A review of screening mammography participation and utilization in Canada.

INTRODUCTION: Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. METHODS: Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. RESULTS: Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. CONCLUSION: Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.

A fall-off in cervical screening coverage of younger women in developed countries.

OBJECTIVES: To analyse cervical screening coverage data by age over time in a number of developed countries throughout the world, with specific emphasis on trends for younger women and on age differentials between younger and older women. METHODS: Routinely collected cervical screening statistics and survey data were collected on the proportion of women who have undergone cervical screening with cytology in seven countries in the period 1995 to 2005. RESULTS: Data for the 25-29 age group were examined. Coverage fell in most countries, in three by more than 5 percentage points. In two countries while overall coverage rose in the period, the rise was not as steep in the youngest group of women. Data for each available 5-year age group for the different countries shows a similar gradient in most, regardless of the absolute level of coverage. Although the trend is not uniform in every country, it appears that generally the gap between coverage of younger women and coverage of older women increased, sometimes dramatically, between the mid-1990s and the mid-2000s. CONCLUSIONS: There is a general trend in developed countries towards lower coverage in young women (25-29 years old). No common underlying cause has been clearly identified and there is a need for further studies to investigate the possible reasons for this phenomenon.