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8/14/2019 To smoke or not to Smoke? That is the Question: Who uses the Canadian acute care system
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To Smoke or not to Smoke? That is the question:Who uses the Canadian acute care system.
GSPP 803 Quantitative MethodsProf Andrea Rounce
Sean McConnachie200 270 499
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Friday, April 10, 2009INDEX:Page
Introduction 1Methodology 1Background Analysis 3Analysis and Findings 4
Univariate Analysis 5Bivariate Analysis 13Multivariate Analysis 21
Recommendations 23Conclusion 24
INTRODUCTIONOver the past decade, there has been a constant and ever progressive
movement to influence the lifestyle choices of Canadians. Canadians are
constantly bombarded with initiative of moral suasion to change theyre
destructive life-styles in order to healthy. These massages are not only
transmitted to us through popular media, but through government
programming as well. In most instances we are provided with information on
the negative impacts of smoking and obesity in our lives and in others. One
of the main pieces of ammunition that is used in the attempts to change
social and individual habits is the personal and social monetary costs that are
associated with these life choices. We are consistently told that smoking and
obesity are a drain on the universal health care system in Canada based on
their level of access and the cost associated with access (SOURCE).
This paper will attempt to examine the extent to which smokers and the
obese use the acute care health care system in Canada. This will be
accomplished by analyzing the extent to which these groups of citizens
access the acute care system relative to those identified as healthy and other
individuals. The findings that will be derived from the analysis that is to
follow will add to previous research on this subject matter to improve the
discourse around the policy issues of smoking and obesity. It is hoped that
the findings of this research will provide new policy insight on this issue and
will assist governments in making better, more informed decisions.
It is hypothesised that there will be a significant relationships between these
cohorts and heath care usage. From this it is further hypothesised that those
identified as smokers and obese use the Canadian health care system to a
similar extent as those that are considered healthy.
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METHODOLOGYIn order to answer the research question previously proposed the Canadian
Community Health Survey 2005 (CCHS 3.1) has been selected as the dataset
for this analysis. Statistics Canada describes the CCHS 3.1 as cross-
sectional survey that collects information related to health status, health careutilization and health determinants for the Canadian population (Canada
2006, pp.1). This survey was conducted on a self-reporting basis, meaning
that status, utilization and determinants are described by the respondent and
are not based on observation or testing.
The survey itself was conducted by employees of Statistics Canada across all
121 health regions within the provinces and territories. The target population
of the CCHS 3.1 is all Canadians that are age 12 and above excluding those
on reserve, institutionalised, members of the armed forces, and living in veryremote regions. From this the CCHS 3.1 covers about 98% of the Canadian
population above the age of 12.
From the CCHS 3.1 variables have been selected that match the initial
research design. For this analysis one dependent, one independent, and four
control variables have been selected. All variables selected have been
recoded in order to fit the parameters of the analysis. The main recode that is
evident within all variables is the removal of all cases under the age of 18
years old as derived from the Body Mass Index classification (BMIC) that hasbeen used by Statistics Canada within the CCHS 3.1 (Canada 2006). Also the
independent variables have been created from the measurements of various
variables provided from the CCHS 3.1.
The dependent variable that has been selected to exemplify individual usage
of the acute care system in Canada is that of number of nights as patient
(heueg01a). Statistics Canada has grouped this variable from other questions
that were asked within the survey. This grouping consisted of the aggregation
of the number of nights an individual stayed at an acute care facility ranging
from 1 to 31. This variable has been recoded to include those that did not
stay over night as a patient in 2005.
In order to construct the population cohorts for the independent variable the
defining of the characteristics of smoking, obese, and healthy individuals is
based on those used by van Baal et al (2008). However this variable will be
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expand in order to increase its descriptive power through the inclusion of an
other category. The variables with the CCHS 3.1 that have been selected to
comprise this derived variable are BMCI (hwtegisw), age (dhhegage), and
type of smoker (smkedsty). Statistics Canada has derived both BMI and type
of smoker. The classification of each cohort is provided in Table 1. A more
thorough explanation of these cohorts will be provided below.
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Table1: Cohort CompositionMeasure CompositionHealthy Never-smoking 18 years ad above with a
body mass index of 18.5 BMI < 25.
Smoker Current daily smoker 18 years ad abovewith and body mass index of 18.5 BMI
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