Comparison of mortality hazard ratios associated with health behaviours in Canada and the United States: a population-based linked health survey study.

Autor: Fisher S; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; ICES, Ottawa and Toronto, Ontario, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada., Bennett C; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; ICES, Ottawa and Toronto, Ontario, Canada., Hennessy D; Statistics Canada, Ottawa, Ontario, Canada., Finès P; Statistics Canada, Ottawa, Ontario, Canada., Jessri M; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; ICES, Ottawa and Toronto, Ontario, Canada.; Statistics Canada, Ottawa, Ontario, Canada., Bader Eddeen A; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; ICES, Ottawa and Toronto, Ontario, Canada., Frank J; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom., Robertson T; Centre for Public Health and Population Health Research, Faculty of Health Sciences & Sport, University of Stirling, Stirling, Scotland., Taljaard M; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada., Rosella LC; ICES, Ottawa and Toronto, Ontario, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Sanmartin C; Statistics Canada, Ottawa, Ontario, Canada., Jha P; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; St Michael's Hospital, University of Toronto, Toronto, Canada., Leyland A; MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom., Manuel DG; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. dmanuel@ohri.ca.; ICES, Ottawa and Toronto, Ontario, Canada. dmanuel@ohri.ca.; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. dmanuel@ohri.ca.; Statistics Canada, Ottawa, Ontario, Canada. dmanuel@ohri.ca.; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada. dmanuel@ohri.ca.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2022 Mar 10; Vol. 22 (1), pp. 478. Date of Electronic Publication: 2022 Mar 10.
DOI: 10.1186/s12889-022-12849-y
Abstrakt: Background: Modern health surveillance and planning requires an understanding of how preventable risk factors impact population health, and how these effects vary between populations. In this study, we compare how smoking, alcohol consumption, diet and physical activity are associated with all-cause mortality in Canada and the United States using comparable individual-level, linked population health survey data and identical model specifications.
Methods: The Canadian Community Health Survey (CCHS) (2003-2007) and the United States National Health Interview Survey (NHIS) (2000, 2005) linked to individual-level mortality outcomes with follow up to December 31, 2011 were used. Consistent variable definitions were used to estimate country-specific mortality hazard ratios with sex-specific Cox proportional hazard models, including smoking, alcohol, diet and physical activity, sociodemographic indicators and proximal factors including disease history.
Results: A total of 296,407 respondents and 1,813,884 million person-years of follow-up from the CCHS and 58,232 respondents and 497,909 person-years from the NHIS were included. Absolute mortality risk among those with a 'healthy profile' was higher in the United States compared to Canada, especially among women. Adjusted mortality hazard ratios associated with health behaviours were generally of similar magnitude and direction but often stronger in Canada.
Conclusion: Even when methodological and population differences are minimal, the association of health behaviours and mortality can vary across populations. It is therefore important to be cautious of between-study variation when aggregating relative effect estimates from differing populations, and when using external effect estimates for population health research and policy development.
(© 2022. The Author(s).)
Databáze: MEDLINE
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