Diabetes News

Urban Canadians tend to report lower weights than rural, suburban Canadians—and higher income adults are less likely to be inactive than lower income adults.

February 15, 2006—Helping Canadians fight the “battle of the bulge” involves more than simply prescribing diet and exercise—social and environmental factors can also play a role in promoting healthy weights, according to a new report from the Canadian Population Health Initiative (CPHI) at the Canadian Institute for Health Information (CIHI).

Data in the report show that adults in the highest-income households are less likely to be inactive, compared to adults in the lowest, lower-middle, middle and upper-middle income households. Overall, less than one-fifth (18%) of Canadians report being active, and one-quarter (25%) report being moderately active. Adults living in Canada’s urban cores report being less overweight and obese.

Improving the Health of Canadians: Promoting Healthy Weights offers a comprehensive overview of the factors that play a role in Canadians’ body weights and takes a close look at some of the policy options for promoting healthy weights in the community, at work, at home and at school.

“People struggling to maintain healthy weights are often told that the solution is simple: just eat better and exercise more,” says Dr. Richard Lessard, Director of Prevention and Public Health for the Agence de développement de réseaux locaux de santé et de services sociaux de Montréal (Montréal-Centre Regional Health and Social Services Board). “The reality is that there are many social and environmental factors that can make it easier—or harder—for Canadians to make healthy choices. The community where we live may make a difference to our health; being able to walk or bike on safe streets is just one example of this.”

Residents of areas where more people bike or take public transit to work are less likely to report being overweight or obese

The report shows that Canadians living in areas where residents are more likely to bike or take public transit to work are less likely to report being overweight or obese. More specifically, Canadians living in neighbourhoods where the majority of residents drive to work are more likely to report being overweight and obese than those living in areas where fewer people drive to work. For example, research conducted by the National Institutes of Health in the U.S. found that residents living in urban or suburban homes built before 1974 are more likely to walk one mile or more (1.6 kilometres+) 20 times or more per month. Neighbourhoods built before 1946 tend to have more sidewalks and a greater mix of easy-to-access housing, shops and services.

The report also assesses potential links between self-reported overweight and obesity (body mass index, or BMI) and the geographical area where people live. These new analyses show that adults living in urban cores are less likely to report being overweight and obese than those living in suburban or rural areas.

There are income and gender differences in healthy weights

There is a relationship between income and health. Analysis in the report shows that adults in the highest income households are less likely to be inactive, compared to adults in the lowest, lower-middle, middle and upper-middle income households. High-income adults are also more likely to report consuming fruit and vegetables five or more times a day.

There are also gender differences within income groups. For example, Canadian men in lower-middle income households were less likely to be obese than men in the highest income households. In contrast, women in middle and upper-middle income households had higher obesity rates than women in the highest income households. The obesity rate for women in the highest income group was not significantly different from the rates for women in the lowest and lower-middle income groups.

Where we live, learn, work and play are potential settings to promote healthy weights

The report also looks at the policy options for promoting healthy weights. For example, systematic reviews of the latest research show that worksite interventions that combine diet and physical activity initiatives can be effective in helping employees control overweight or obesity.

In 2003, the Canadian Fitness and Lifestyle Research Institute conducted a survey of Canadian workplaces with 20 or more employees to assess the proportion of these workplaces with strategies to increase employees’ physical activity. The study found that 3% and 16% of workplaces had formal extended lunch-hour and flex-hour policies, respectively, and 30% and 38% of workplaces had informal extended lunch-hour or flex-hour policies, respectively. While 17% of workplaces had in-house facilities for physical activity, 42% offered employee subsidies for fitness programs.

“Creating effective policy interventions is challenging because the factors that influence obesity are so complex,” says Elizabeth Gyorfi-Dyke, Director of the Canadian Population Health Initiative at the Canadian Institute for Health Information. “This report offers insights into factors to consider when looking at policy options. What’s exciting is that we are starting to see what works—including in areas outside of traditional health policy.”

Canadians’ views on obesity

In 2005, CIHI’s Canadian Population Health Initiative commissioned the public opinion research firm POLLARA to survey a nationally representative sample of 1,816 adult Canadians to look at Canadians’ views on health and healthy weights. More than half of those polled (56%) think reducing obesity is very important to the overall health of Canadians, and nearly three-quarters (73%) view reducing obesity as a personal responsibility.

The survey also asked Canadians about their views on a variety of potential initiatives to promote healthy weights, some of which have more supporting evidence than others. The majority of those polled strongly support future initiatives that would ensure people have access to reasonably priced foods (78%) and that would require fast food companies to provide nutritional information about each product they sell (68%). Over half (57%) strongly support offering incentives to employers who provide fitness facilities or programs to their workers. Thirty-nine percent (39%) of Canadians polled believe that encouraging the development of communities where cars are not always needed to get around is very important to the health of the people in their community. Nearly one-quarter (24%) strongly support charging more tax for less healthy food choices.

Other interesting findings

Other highlights from Improving the Health of Canadians: Promoting Healthy Weights include:

• Many youth are trying to lose weight. A quarter (25%) of normal weight youth, 44% of overweight youth and 56% of obese youth reported trying to lose weight, according to analyses from the 2001 National Longitudinal Survey of Children and Youth (NLSCY).
• A number of provinces have introduced policies for schools. For example, New Brunswick has adopted a comprehensive policy on food and nutrition to provide students in public schools with healthy food and beverage choices. British Columbia has also introduced guidelines for food and beverages to eliminate the sale of junk food in schools. Ontario and Alberta have introduced policies regarding minimum physical activity requirements in schools.

Background information

• Past research has linked obesity with a number of major preventable chronic diseases, including cardiovascular disease, hypertension, type 2 diabetes, arthritis and some types of cancer.
• Statistics Canada data indicate that obesity among adults has increased from 14% in 1978–1979 to 23% in 2004.
• There are differences between provinces in measured obesity among adults. Results from Statistics Canada’s 2004 Canadian Community Health Survey (CCHS) show that adult men in Newfoundland and Labrador (33%) and Manitoba (30%) were more likely to be obese, relative to the Canadian average (23%). Among women, obesity rates are higher in Newfoundland and Labrador (35%), Nova Scotia (30%) and Saskatchewan (33%) than the national average of 23%.
• Among children (2 to 17 years), the CCHS results show that the overweight/obesity rate in 2004 was significantly higher than the Canadian average (26%) in Newfoundland and Labrador (36%), New Brunswick (34%), Nova Scotia (32%) and Manitoba (31%)—and significantly lower in Quebec (23%) and Alberta (22%).

The Canadian Population Health Initiative (CPHI)

The Canadian Population Health Initiative is part of the Canadian Institute for Health Information (CIHI). CPHI’s mission is to foster a better understanding of the factors that affect the health of individuals and communities and to contribute to the development of policies that reduce inequities and improve the health and well-being of Canadians. Improving the Health of Young Canadians, released in October 2005, is the first report in the 2005–2006 Improving the Health of Canadians Report Series. A report on urban health will be released in fall 2006.

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

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