Deborah Creatura

U of T study finds food insecurity more than doubles the risk of developing Type 2 diabetes

noreen.rasbach — Wed, 23 May 2018 19:08:08 +0000

U of T study finds food insecurity more than doubles the risk of developing Type 2 diabetes

noreen.rasbach Wed, 05/23/2018 - 15:08

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"To date there have been no policy actions in Ontario with the explicit goal of reducing food insecurity, despite many poverty reduction strategies,” said Christopher Tait, the study’s lead author.

Deborah Creatura

Nicole Bodnar

Topic

Our Community

Dalla Lana School of Public Health

Diabetes

Food Security

Graduate Students

Research & Innovation

Subheadline

Adults in Ontario who live in food-insecure households had more than twice the risk of developing Type 2 diabetes, according to a new study by ��Ƶ researchers.

“Food insecurity is a stand-alone risk factor for diabetes,” said senior author Laura Rosella, assistant professor of epidemiology at the Dalla Lana School of Public Health.

“Even after adjusting for other factors that have also been linked to the development of diabetes like obesity, smoking and alcohol use, food insecurity was found to increase one’s risk of developing diabetes,” said Rosella (pictured left), who is also an adjunct scientist at the Institute for Clinical Evaluative Sciences (ICES) and site director at ICES UofT

Household food insecurity is described as uncertain, insufficient, or inadequate food access, availability, and utilization due to limited financial resources, and the compromised eating patterns and food consumption that may result. It’s a growing social and health problem in Canada: In 2004, approximately 9.2 per cent of Canadian households were food insecure; in 2014, the number swelled to 12 per cent, representing 3.2 million Canadians.

The study, “The association between food insecurity and incident Type 2 diabetes in Canada: A population-based cohort study,” was published Wednesday in PLOS ONE. It used data from nearly 5,000 Ontario adult respondents to the 2004 Canadian Community Health Survey and linked it to health administrative data housed at ICES.

Researchers explain that the findings underscore the importance of addressing poverty when designing policies and programs to reduce the population-wide growth of Type 2 diabetes – one of the most common chronic conditions in Canada. More than 11 million Canadians live with diabetes or pre-diabetes, an increase of 72 per cent in 10 years. The number of Canadians living with Type 2 diabetes is expected to rise to 13.9 million (33 per cent of Canadians) by 2026.

"To date there have been no policy actions in Ontario with the explicit goal of reducing food insecurity, despite many poverty reduction strategies,” said Christopher Tait, PhD candidate at Dalla Lana and the study’s lead author.

“Policy responses such as the Ontario Basic Income Pilot may better target the economic factors at the root of food insecurity, but additional efforts are needed to meaningfully address the broader systemic factors that shape food environments, access and availability," said Tait.

Read the research in PLOS ONE

Tait also explained that the study demonstrates the need to monitor food insecurity more regularly and comprehensively in Canada.

“Given the mounting evidence regarding adverse health risks associated with food insecurity in the Canadian population, allowing for its routine assessment to be optional is an incredible missed opportunity,” said Tait.

This study was supported by the Canada Research Chairs Program; the Project Initiation Fund, an annual competitive grant provided internally through Public Health Ontario; and the Institute for Clinical Evaluative Sciences, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care.

U of T study finds those who are dissatisfied with life need more high cost health care in future

noreen.rasbach — Fri, 18 May 2018 13:24:55 +0000

U of T study finds those who are dissatisfied with life need more high cost health care in future

noreen.rasbach Fri, 05/18/2018 - 09:24

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(photo by Piron Guillaume via Unsplash)

Deborah Creatura

Nicole Bodnar

Topic

Our Community

Dalla Lana School of Public Health

Health

Research & Innovation

Vivek Goel

Dissatisfaction with life is linked to future high cost health-care use, according to a new study by ��Ƶ researchers.

“We have known for many years that factors outside the health-care system contribute to health and health-care utilization. Our study suggests that these factors can reach even beyond traditional health behaviours and social determinants,” said Vivek Goel, U of T’s vice-president, research and innovation.

“As we look to manage rising health-care costs, we need to consider a broader range of social policies,” said Goel (pictured left), who is also a professor at the Dalla Lana School of Public Health and scientist emeritus at the Institute for Clinical Evaluative Sciences.

In health-care systems worldwide, high cost health-care users disproportionately account for a majority of spending. High cost health-care users are defined as those who rank in the top five per cent of annual health-care spending.

The study, “The relationship between life satisfaction and health care utilization: a longitudinal study,” was published Thursday in the American Journal of Preventive Medicine. It examined more than 85,000 healthy Ontario adults whose self-reported life satisfaction was measured at baseline and then followed up for six years to determine if they had enough health-care use to put them in the highest category of health-care costs.

After accounting for other factors associated with high health-care use, like demographic factors, co-morbidity (having two or more chronic diseases or conditions) and socioeconomic factors, the researchers found that those studied with the lowest level of life satisfaction were three times more likely to be in the highest category of health-care costs compared to those who were satisfied with their life.

Read the research in the American Journal of Preventive Medicine

“There’s increasing focus on the upstream factors and health behaviours that influence health, and this study is the first to identify life satisfaction as a predictor of future high cost health-care users,” said co-author Laura Rosella (pictured left), an assistant professor of epidemiology at Dalla Lana and an adjunct scientist and site director at ICES U of T. She also holds a Canada Research Chair in Population Health Analytics.

Rosella and Goel found that the top five per cent of high cost health-care users used $27,636 in average annual health care costs, compared to $3,393 for those in the top six to 50 per cent and $386 for those in the bottom 50 per cent.

These findings suggest that addressing broader factors that influence well-being and happiness – such as strong social networks and community engagement – will have a positive impact on the health system.

This research was supported by the Ontario Ministry of Health and Long-Term Care.

Almost all Ontarians accumulate multiple chronic conditions over their lifetime: U of T study

noreen.rasbach — Mon, 05 Mar 2018 21:02:59 +0000

Almost all Ontarians accumulate multiple chronic conditions over their lifetime: U of T study

noreen.rasbach Mon, 03/05/2018 - 16:02

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"We identified 18 chronic conditions that individuals accumulated up to the time of their death and examined how these trends differed over time and by socioeconomic status,” says Assistant Professor Laura Rosella (photo by Jackie Atlas)

Deborah Creatura

Topic

Our Community

Dalla Lana School of Public Health

Health

Research & Innovation

The proportion of Ontarians who died with two or more chronic conditions increased from 79.6 per cent in 1994 to 95.3 per cent in 2013, according to a new study from the Dalla Lana School of Public Health and the Institute for Clinical Evaluative Sciences.

The study, published March 5 in the journal Health Affairs, examined more than 1.6 million deaths that were registered in Ontario from 1994 to 2013, and linked each to health administrative data from Ontario’s single-payer health-care system.

“By looking back in the linked data, we identified 18 chronic conditions that individuals accumulated up to the time of their death and examined how these trends differed over time and by socioeconomic status,” says Laura Rosella, assistant professor of epidemiology at the Dalla Lana School of Public Health.

The 18 chronic conditions the researchers identified were acute myocardial infarction, asthma, cancer, cardiac arrhythmia, chronic coronary syndrome, chronic obstructive pulmonary disorder, congestive heart failure, Crohn’s disease or colitis, dementia, diabetes, hypertension, mood disorder, osteo- and other arthritis, osteoporosis, other mental health disorder, renal failure, rheumatoid arthritis and stroke.

The study showed that almost all Ontarians accumulate multiple chronic conditions over their lifetime. The total number of chronic conditions that Ontarians died with increased over time. In 1994, about one-quarter (24.6 per cent) of Ontarians died with five or more chronic conditions – this increased to two-thirds of all Ontario deaths (65.7 per cent) in 2013.

Read the research in Health Affairs

The researchers found that the types of chronic conditions that Ontarians accumulated varied by socioeconomic groups. Individuals who lived in materially deprived neighbourhoods were more likely to die with chronic obstructive pulmonary disease (COPD), mental health disorders and diabetes, while cancer and dementia at time of death were more common among individuals who lived in high income neighbourhoods.

“The observed trends underscore the importance of integrated health-care planning and delivery that can meet the health-care needs of Ontarians with multiple and complex chronic conditions, as well as the need for chronic disease prevention and socioeconomic interventions that can address the inequities in the types of conditions Ontarians accumulate,” added Rosella, who is also adjunct scientist and site director at U of T's Institute for Clinical Evaluative Sciences.

But there were some health gains across the board, including the decline in the presence of chronic coronary syndrome, congestive heart failure and stroke at time of death, which decreased by almost two per cent each from 2004 to 2013.

The study was funded by the Canadian Institutes for Health Research.

U of T research confirms link between flu and heart attack

noreen.rasbach — Fri, 02 Feb 2018 15:57:43 +0000

U of T research confirms link between flu and heart attack

noreen.rasbach Fri, 02/02/2018 - 10:57

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“Our findings are important because an association between influenza and acute myocardial infarction reinforces the importance of vaccination,” says U of T's Dr. Jeff Kwong (photo by Justin Sullivan/Getty Images)

Deborah Creatura

Topic

Our Community

Dalla Lana School of Public Health

Faculty of Medicine

Health

Research & Innovation

Chances of a heart attack are increased six-fold during the first seven days after detection of laboratory-confirmed influenza infection, according to a new study by researchers at the ��Ƶ.

“Our findings are important because an association between influenza and acute myocardial infarction reinforces the importance of vaccination,” says Dr. Jeff Kwong, associate professor of epidemiology and clinical public health at the Dalla Lana School of Public Health and lead author of the study.

In the study published on Jan. 25 in the New England Journal of Medicine, the researchers found a significant association between acute respiratory infections, particularly influenza, and acute myocardial infarction, a heart attack.

The risk may be higher for older adults, patients with influenza B infections, and patients experiencing their first heart attack. The researchers also found elevated risk – albeit not as high as for influenza – with infection from other respiratory viruses.

Read about the study in the New York Times

Read a Reuters article on the study

“Our findings, combined with previous evidence that influenza vaccination reduces cardiovascular events and mortality, support international guidelines that advocate for influenza immunization in those at high risk of heart attacks,” says Kwong, who is also an associate professor in the department of family and community medicine.

Interested in publicly funded research in Canada? Learn more at U of T’s #supportthereport advocacy campaign

The researchers looked at nearly 20,000 Ontario adult cases of laboratory-confirmed influenza infection from 2009 to 2014 and identified 332 patients who were hospitalized for a heart attack within one year of a laboratory-confirmed influenza diagnosis.

“People at risk of heart disease should take precautions to prevent respiratory infections, and especially influenza, through measures including vaccinations and handwashing,” says Kwong (right), who is also a scientist at the Institute for Clinical Evaluative Sciences and Public Health Ontario.

The researchers add that patients should not delay medical evaluation for heart symptoms, particularly within the first week of an acute respiratory infection.

The research was supported by the Canadian Institutes of Health Research, Public Health Ontario and by the Institute for Clinical Evaluative Sciences, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care.

Read the research in the New England Journal of Medicine

Read about the study in USA Today

Read about the study in the Daily Mail

Poverty is a significant risk factor for premature death, U of T researcher finds

ullahnor — Wed, 15 Mar 2017 20:22:56 +0000

Poverty is a significant risk factor for premature death, U of T researcher finds

ullahnor Wed, 03/15/2017 - 16:22

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New study by U of T researcher found that mortality is impacted by poverty (VancouverBC Food Bank via Flickr)

Deborah Creatura

Author legacy

Deborah Creatura

Topic

Poverty is one of the strongest determinants of health, regardless of immigration status, according to a new study from U of T's Dalla Lana School of Public Health and the Institute for Clinical Evaluative Sciences (ICES).

“What our study found was despite the healthy immigrant effect, those living in the most deprived areas, irrespective of immigration status had the highest mortality rates,” says Laura Rosella (pictured below), the study’s lead author who is an assistant professor of epidemiology at U of T and a scientist at ICES.

“These findings support the need to better examine the factors that drive these inequalities to ensure equitable health for the totality of the population.”

The “healthy immigrant effect” refers to a trend where new immigrants to Canada are healthier than the Canadian population, but over time and successive generations, their health as well as that of their children and grandchildren tends to decline.

In the study, published today in Journal of Epidemiology & Community Health, the researchers examined data representing all deaths in Ontario from 2002 to 2012 to analyze how socioeconomic factors impact mortality according to immigration status.

The study found:

All-cause and premature mortality were about 60 per cent lower among immigrants compared to Canadian or long-term residents. Over the 10-year study period, this translated into 42,700 fewer deaths overall and 18,400 fewer premature deaths in immigrants compared to Canadian-born or long-term residents.
The average age at death for female and male immigrants was approximately six years younger than that of female and male long-term residents.
For both immigrants and non-immigrants, those living in the most deprived areas had higher rates of all-cause and premature mortality, although immigrant mortality was lower across all levels.
The advantage in all-cause and premature mortality among male immigrants over male long-term residents was slightly more pronounced than the advantage among female immigrants over female long-term residents.