A comparison of the prevalence of and modifiable risk factors for cognitive impairment among community-dwelling Canadian seniors over two decades, 1991–2009

Background The prevalence of cognitive impairment or dementia is of public health concern globally. Accurate estimates of this debilitating condition are needed for future public health policy planning. In this study, we estimate prevalence and modifiable risk factors for cognitive impairment by sex over approximately 16 years. Methods Canadian Study of Health and Aging (CSHA) baseline data conducted between 1991–1992 were used to measure the prevalence of cognitive impairment and dementia among adults aged 65+ years. The standard Modified Mini-Mental State Examination (3MS) was used for the screening test for cognitive impairment. We compared the CSHA data with Canadian Community Health Survey–Healthy Aging (CCHS-HA) conducted between 2008–2009. The CCHS-HA used a four-dimension cognitive module to screen for cognitive impairment. Only survey community-dwelling respondents were included in the final sample. After applying exclusion criteria, final samples of (N = 8504) respondents in the CSHA sample and (N = 7764) respondents for CCHS–HA sample were analyzed. To account for changes in the age structure of the Canadian population, prevalence estimates were calculated using age-sex standardization to the 2001 population census of Canada. Logistic regression analyses were used to examine predictors of cognitive impairment. A sex stratified analysis was used to examine risk factors for cognitive impairment in the survey samples. Results We found that prevalence of cognitive impairment among respondents in CSHA sample was 15.5% in 1991 while a prevalence of 10.8% was reported in the CCHS–HA sample in 2009, a 4.7% reduction [15.5% (CI = 14.8–16.3), CSHA vs 10.8% (CI = 10.1–11.5), CCHS–HA]. Men reported higher prevalence of cognitive impairment in CSHA study (16.0%) while women reported higher prevalence of cognitive impairment in CCHS–HA (11.6%). In the multivariable analyses, risk factors such as age, poor self-rated health, stroke, Parkinson’s disease, and hearing problems were common to both cohorts. Sex differences in risk factors were also noted. Conclusions This study provides suggestive evidence of a potential reduction in the occurrence of cognitive impairment among community-dwelling Canadian seniors despite the aging of the Canadian population. The moderating roles of improved prevention and treatment of vascular morbidity and improvements in the levels of education of the Canadian population are possible explanations for this decrease in the cognitive impairment.


Average Daily Alcohol Consumption 2 )
1 CCC_Q102=<11 The respondent's age when first diagnosed with diabetes.

80=<CCC_Q102
The respondent's age when first diagnosed with diabetes.
In processing, if a respondent answered CHP_01 = 2 (no), the variable CHP_02 is given the value of 0. The "not stated" category includes respondents who reported in CHP module not having been a patient overnight in a hospital, nursing home or convalescent home in the past 12 months and who reported in INJ having been admitted to a hospital for one night following the injury that occurred in the past 12 months. // Prior to 2009, CHPG02 was called HCUG01A and was calculated with questions from the Health care utilization (HCU) module. In 2009, the HCU module was split and all questions associated with the derived variable CHPG02 were moved into a new module called Contacts with Health Professionals (CHP)

Number of consultations -fam. doctor/gen. practitioner -(G) 2 )
CHPG04 CHP_04 This variable indicates the number of consultations with a family doctor/general practioner in the past 12 months.
For respondents aged less than 18, includes consultations with pediatricians. The most recent contact with the other medical doctor took place at the doctor's office.

CHP_10 = 2
The most recent contact with the other medical doctor took place at a hospital emergency room.

CHP_10 = 3
The most recent contact with the other medical doctor took place at a hospital outpatient clinic.

CHP_10 = 4
The most recent contact with the other medical doctor took place at a walk-in clinic.

CHP_10= 5
The most recent contact with the other medical doctor took place at an appointment clinic.

CHP_10 = 6
The most recent contact with the other medical doctor took place at a community health centre/CLSC. 7 CHP_10 = 7, 8, ou 11 The most recent contact with the other medical doctor took place at work/at school/other.

CHP_10 = 9
The most recent contact with the other medical doctor took place at home.

CHP_10 = 10
The most recent contact with the other medical doctor took place as a telephone consultation only.

Number of consultations -nurse -(G) 7 )
1 CHP_13 = 1 The most recent contact with a nurse took place at the doctor's office.

CHP_13 = 2
The most recent contact with a nurse took place at a hospital emergency room.

CHP_1= 3
The most recent contact with a nurse took place at a hospital outpatient clinic.

CHP_13 = 4
The most recent contact with a nurse took place at a walk-in clinic.

CHP_13 = 5
The most recent contact with a nurse took place at an appointment clinic.

CHP_13 = 6
The most recent contact with a nurse took place at a community health centre/CLSC. 7 CHP_13 = 7, 8, ou 11 The most recent contact with a nurse took place at work/at school/other.

CHP_13 = 9
The most recent contact with a nurse took place at home. 9 CHP_13 = 10 The most recent contact with a nurse took place as a telephone consultation only.

Number of consultations -dentist or orthodontist -(G) 9 )
CHPG15 CHP_15 This variable indicates the number of consultations with a dentist or orthodontist in the past 12 months. This variable indicates the number of respondent"s consultations, including over the phone, with medical doctor in the last 12 months.

Problem gambling (6 DVs)
This module assesses gambling activity and problems with gambling. The questionnaire and derived variables are based on the Canadian Problem Gambling Index (CPGI) but a number of modifications made both to the questionnaire and the calculation of the derived variables (described below) means that the results are not directly comparable to the CPGI.

Notes Condition(s) Description Value
Temporary Reformat

CPGT13
(CPG_13-1) (CPG_13 = 1, 2, 3, 4) Rescale the variables so that the range is from 0 to 3 instead of 1 to 4 Gambling Activity -Gambler vs. Non-gambler  1 )   CPGFGAM   CPG_01A, CPG_01B, CPG_01C, CPG_01D, CPG_01E, CPG_01F, CPG_01G, CPG_01H, CPG_01I, CPG_01J, CPG_01K,  CPG_01L,CPG_01M This variable categorizes respondents as gamblers or non-gamblers. A non-gambler is defined as someone who has not engaged at all in the past year in any type of the gambling activities listed. A gambler is defined as someone who has engaged in at least one type of gambling activity in the past year.
A modification from the CPGI is that if respondents volunteered in CPGB_02 that "I am not a gambler", they were not asked the severity questions despite having reported gambling activity in the past 12 months. These respondents are assigned a code of 95 for this variable. In addition, respondents who reported participating in each gambling activity from CPGB_01B to CPGB_01M at most 1 to 5 times each during the past year were not asked questions on problem gambling. Finally, gambling activities were regrouped in the questionnaire into fewer categories than used in the original CPGI. Modifications made to the original instrument were approved by Dr. Wynne. Non-gamblers have been excluded from the population. Higher scores indicate more problems associated with gambling. A modification from the CPGI is that if respondents volunteered in CPG_02 that "I am not a gambler", they were not asked the severity questions despite having reported gambling activity in the past 12 months. These respondents are assigned a code of 95. In addition, respondents who reported participating in each gambling activity from CPG_01 to CPG_01M at most 1 to 5 times each during the past year were not asked questions on problem gambling. Finally, gambling activities were regrouped in the questionnaire into fewer categories than used in the original CPGI. Modifications made to the original instrument were approved by Dr. Wynne. Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01C
0 CPG_01C = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01C <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01D
0 CPG_01D = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01D <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPG_01E = 8
Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01E <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01F
0 CPG_01F = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.

Value Notes Condition(s) Description
Specifications 1 (1<= CPG_01F <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01G
0 CPG_01G = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01G <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01H
0 CPG_01H = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01I
0 CPG_01I = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01I <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01J
0 CPG_01J = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01J <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.

CPGT01K
0 CPG_01K = 8 Temporarily recode 8 to 0 so that "never" does not count in sum of different types of gambling activity participated in.
1 (1<= CPG_01K <=7) Temporarily recode 1 to 7 to 1 so that each activity can be counted as a different type of gambling activity participated in.
Respondents who did not gamble enough or did not indicate problems with gambling were excluded from the population. Higher scores indicate greater interference. This variable indicates the interference that gambling had on daily activities and responsibilities in the past 12 months. This is a threshold that indicates whether gambling interferes significantly with the person"s normal routine, occupational (academic) functioning, or social activities or relationships.
Respondents who did not gamble enough or did not indicate problems with gambling were excluded from the population.

DHHGLE5 PERSONID, DHH_AGE
This variable indicates the number of people living within the household whose age is less than 6 years old.
The variable DHHDLE5 is derived by sorting the household roster dataset by SAMPLEID and PERSONID and by counting the number of PERSONIDs that have a DHH_AGE value of 5 and under within each SAMPLEID. DHHGLE5 is a regrouping of DHHDLE5. This variable indicates the number of people living within the household whose age is less than 12 years old.
The variable DHHDL12 is derived by sorting the household roster dataset by SAMPLEID and PERSONID and by counting the number of PERSONIDs that have a DHH_AGE value less than 12 within each SAMPLEID. DHHGL12 is a regrouping of DHHDL12.

Living/Family Arrangement of Selected Respondent -Grouped 6 )
DHHGLVG DHH_REL of selected respondent, DHHDHSZ, DHHDLVG This variable identifies the family relationships between the selected respondent and the rest of the household.
The necessary data are collected using a set of relationship codes that define a link between each pair of persons in a household. DHHGLVG is a regrouping of DHHDLVG.

Distress (3 DVs)
Both the K10 and K6 scale questions were developed from a pool of 612 questions drawn from existing distress and depression screening scales (Kessler RC, et al, 2002). After eliminating redundant and unclear questions, the remaining questions in the pool were organized to retain items consistent with 15 domains represented in the DSM-III-R diagnoses of major depression and generalized anxiety disorder plus the positive affect domain. These items were eventually reduced to those found in the K6 and K10 through processes involving ratings by an expert advisory panel, and analyses using item response theory of two subsequent pilot surveys. The final K10 and K6 scale questions were generated from the analysis of the telephone pilot survey using factor-analysis (Kessler RC. et al. 2002; http://www.hcp.med.harvard.edu/ncs/k6_scales.php) The effectiveness of the K6 and K10 measurement scales of non-specific psychological distress were subsequently tested in the Australian National Survey of Mental Health and Well-Being against the criteria for the DSM-IV disorders and both scales performed well (Furukawa TA et al. 2003.) DSM refers to the Diagnostic and Statistical Manual of Mental Disorders used by the American Psychiatric Association. It is an internationally recognized classification of mental disorders with several versions.

Notes Condition(s) Description Value
Temporary Reformat

Depression (4 DVs)
The depression module used in CCHS is based on a long form of the Composite International Diagnostic Interview (CIDI) scale, which was developed in the late 1980s/early 1990s. This scale was never fully validated by the CIDI research team and its psychometric properties are therefore not well understood. Statistics Canada is currently exploring strategies to complete such a validation. At this time, Statistics Canada recommends that analysis of data from this module be restricted to examination of depression as a correlate of other health behaviours and characteristics. For now, use of the data as an indicator for the probability of depression or to calculate simple population prevalence is discouraged.  For DPS_08A, answers are rescaled so 1 = respondent gained or lost more than 4 kg (9 lbs.) and 0 if less or did not lose/gain weight This variable assesses the depression level of respondents who felt depressed or lost interest in things for 2 weeks or more last year. These include normal periods of sadness (for example, after the death of a loved one), as well as "serious" depression.

Notes
The items used to measure depression are based on the work of Kessler and Mroczek (from University of Michigan). They selected a subset of items from the Composite International Diagnostic Interview (CIDI) that measure major depressive episodes (MDE). The CIDI is a structure diagnostic instrument that was designed to produce diagnoses according to the definitions and the criteria of both DSM-lll-R and the Diagnostic Criteria for the Research of the ICD-10. The short-form of MDE used in the CCHS was developed to operationalize Criteria A through C of the DSM-III-R diagnosis of MDE. The diagnostic hierarchy rules defined in the Criterion D (not superimposed on schizophrenia, schizophrenia form disorder, delusional disorders, or psychotic disorders NOS) were ignored.
Higher scores indicate higher level of depression.  DPSDPP DPSDSF This variable calculates from the score obtained on the depression scale, the probability (expressed as a proportion) that the respondent would have been diagnosed as having experienced a major depressive episode in the past 12 months, if they had completed the Long-Form Composite International Diagnostic Interview (CIDI).
A probability of caseness of 0 was assigned to respondents who denied the stem questions. This variable indicates the specific month when the respondent last felt depressed in the last year.
The following respondents have been excluded from the population: 1) respondents who did not show any required signs of depression; or 2) respondents who have been depressed for more than 51 weeks in the past year This variable indicates whether the respondent always fastens his/her seatbelt when he/she is a front seat or back seat passenger in a car, truck or van.
Those who are never a front-seat and never a rear-set passenger in a car, truck or van are excluded from the population. This variable is derived by temporarily creating EDUDR04 for each member of the household (all PERSONID within SAMPLEID). The highest value is then obtained by comparing values of EDUDR04 for all members within the household. If any PERSONID has EDUDR04 of NS (not stated) then NS is returned. If all of EDUDR04 are NA (not applicable) then NA is returned. NS At least one required question was not answered (don"t know, refusal, not stated)

Derived Variable Specifications
Exposure to second-hand smoke (1 DV)

ETSG11 ETS_11
This variable groups the number of people who smoke inside the home.  This variable indicates whether the respondent chooses or avoids certain types of foods because of one or more of the following health concerns: body weight, heart disease, cancer, and osteoporosis.
All (Min: 0; Max: 10) Sum of all temporary variables for adults to be used in determining the level of household food insecurity Total will range from 0 to 10.
All (Min: 0; Max: 8) Sum of all temporary variables for children to be used in determining the level of household food insecurity Total will range from 0 to 8.

FSCT020
0 (FSC_020 = 3) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_020 in (1, 2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT030 0 (FSC_030 = 3) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above. 1 (FSC_030 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT040 0 (FSC_040 = 3) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above. 1 (FSC_040 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT050 0 (FSC_050 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_050 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.

Derived Variable Specifications
FSCT060 0 (FSC_060 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above. 1 (FSC_060 in (1, 2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT070 0 (FSC_070 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_070 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT080 0 (FSC_080 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 ( FSC_080 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT081 0 (FSC_081 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_081 in (1, 2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT090 0 (FSC_090 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_090 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT100 0 (FSC_100 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_100 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT110 0 (FSC_110 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_110 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.

November 2011
Canadian Community Health Survey Derived Variable Specifications 0 (FSC_120 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_120 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.

FSCT121
0 (FSC_121 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_121 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT130 0 (FSC_130 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_130 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT140 0 (FSC_140 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_140 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.

FSCT141
0 (FSC_141 in (3,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above. 1 (FSC_141 in (1,2)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT150 0 (FSC_150 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_150 = 1) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
FSCT160 0 (FSC_160 in (2,6)) and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.
1 (FSC_160 = 1)and DOFSC = 1 Set the value to 0 if respondent did not provide an "affirmative" response to food security questions. Set the value to 1, if respondent did provide an "affirmative" response. See note above.

Derived Variable Specifications
Household Food Security Status -Modified version 1 ) FSCDHFS2   FSC_020, FSC_030, FSC_040, FSC_050, FSC_060, FSC_070, FSC_080, FSC_081, FSC_090, FSC_100, FSC_110,  FSC_120, FSC_121, FSC_130, FSC_140, FSC_141, FSC_150, FSC_160 This variable is based on a set of 18 questions and describes the food security situation of the household in the previous 12 months. It captures three kinds of situations: 1-Food secure: No, or one, indication of difficulty with income-related food access. 2-Moderately food insecure: Indication of compromise in quality and/or quantity of food consumed. 3-Severely food insecure: Indication of reduced food intake and disrupted eating patterns.
This variable is adopted from the Health Canada model of food security status.
When using the person weight (WTS_M), this variable reflects the number of people living the household with food insecurity. When using the household weight (WTS_MHH), this variable reflects the number of households with food insecurity.
Households with children are defined as households with individuals who are either aged 15 or less (DHHDYKD=1), or aged 16 or 17 (DHHDOKD=1) and who are the child, grandchild, child-in-law, niece or nephew of another household member.
In order to determine household food security status, responses to each question are first coded as either "affirmative" or "negative". Some of this coding is obvious because the only response options are "yes" or "no". For questions with less obvious response categories, the procedure for coding is as follows: response categories such as "Often true", "Sometimes true", "Almost every month", "Some months but not every month" are coded as "affirmative" (i.e. coded equal to 1). Response categories such as "Never true", "Only 1 or 2 months" are coded as "negative" (i.e. coded equal to 0).
In 2009, an error in the model was corrected. Please see the Canadian Community Health Survey Errata for more information.
http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/insecurit/status-situation-eng.php  This variable is adopted from the Health Canada model of food security status.
This variable does not necessarily reflect the experience of all adult members in the household. When using the person weights (WTS_M), this variable reflects the number of people living in households with food insecurity among the adult members of the household. When using the household weights (WTS_MHH), this variable reflects the number of households with food insecurity among the adult members of the household.
In order to determine household food security status, responses to each question are first coded as either "affirmative" or "negative". Some of this coding is obvious because the only response options are "yes" or "no". For questions with less obvious response categories, the procedure for coding is as follows: response categories such as "Often true", "Sometimes true", "Almost every month", "Some months but not every month" are coded as "affirmative" (i.e. coded equal to 1). Response categories such as "Never true", "Only 1 or 2 months" are coded as "negative" (i.e. coded equal to 0).  This variable is adopted from the Health Canada model of food security status.
This variable is only defined for households with individuals who are either aged 15 or less (DHHDYKD=1), or aged 16 or 17 (DHHDOKD=1) and who are the child, grandchild, child-in-law, niece or nephew of another household member. This variable does not necessarily reflect the experience of all child members in the household. When using the person weights (WTS_M), this variable reflects the number of people living in households with food insecurity among the child members of the household. When using the household weights (WTS_MHH), this variable reflects the number of households with food insecurity among the child members of the household.
In order to determine household food security status, responses to each question are first coded as either "affirmative" or "negative". Some of this coding is obvious because the only response options are "yes" or "no". For questions with less obvious response categories, the procedure for coding is as follows: response categories such as "Often true", "Sometimes true", "Almost every month", "Some months but not every month" are coded as "affirmative" (i.e. coded equal to 1). Response categories such as "Never true", "Only 1 or 2 months" are coded as "negative" (i.e. coded equal to 0). Respondents are asked to report in "servings" rather than "times" so that all different fruits or vegetables eaten at the same meal are counted. Servings should not be interpreted as referring to a specific quantity.
In this question, the CCHS measures the number of servings, not the amount consumed.

Province of residence of respondent -(G) 1 )
GEOGPRV GEO_PRV This is the respondent's province of residence.

Health region -Grouped 2 )
GEODPMF GEODHR4 This variable is a 5-digit number that identifies the sub-provincial health areas. It is based on the 4-digit health regions specified by the Provincial Ministries of Health. This reconstruction is as follows: -positions 1-2 (first two positions of GEODHR4); -position 3 (value of "9"); -positions 4-5 (3rd, 4th position of GEODHR4).
The variable GEODHR4 is the health region based on GEODPC (postal code) and is derived using the information available on the survey frame at the time of sampling and the geographic information provided by the respondent. GEODHR4 and GEODPC are not included in the Public Use Microdata File.

Health Authority -British Columbia 3 )
GEODBCHA GEODPC This variable is a 4-digit number that identifies the 5 Health Authorities for British Columbia. It is equal to 9996 (for not applicable) anywhere else. This variable is derived using the information available on the survey frame at the time of sampling and the geographic information provided by the respondent. As of 2009, this variable is based on the dissemination areas from the 2006 Census.

Variable name:
Based on: Description:

Health utilities index (8 DVs)
The Health Utilties Index (HUI) is a multi-attribute health status classification system for measuring generic health status and health-related quality of life. The version used by CCHS has been adapted from the HUI Mark 3 (HUI3) for NPHS. The questions are slighlty different than the original HUI3 developed at McMaster University. This instrument allows the calculation of a generic health status index based on attributes found in two different CCHS modules -the Health utilities index (HUI) and Health utilities index -Pain and discomfort (HUP). For more information see " Feeny  (HUI_01 = 2 and HUI_02 = 2 and HUI_03 = 1 and HUI_04 = 1 and HUI_05 = 6) or (HUI_01 = 2 and HUI_02 = 2 and HUI_03 = 1 and HUI_04 = 2 and HUI_05 = 1) Problems seeing close -not corrected 5 HUI_01 = 2 and HUI_02 = 2 and HUI_03 = 1 and HUI_04 = 2 and HUI_05 = 2 or HUI_01 = 2 and HUI_02 = 2 and HUI_03 = 2 and HUI_04 = 6 and HUI_05 = 6 Problem seeing close and distance -not corrected, or no sight at all

Hearing Problems (Function Code) -Grouped 2 )
HUIGHER HUI_06, HUI_07, HUI_07A, HUI_08, HUI_09 This variable classifies the respondents based on their hearing state. NS At least one required question was not answered (don"t know, refusal, not stated) 1 HUI_06 = 1 and HUI_07 = 6 and HUI_07A = 6 and HUI_08 = 6 and HUI_09 = 6 No hearing problems 2 HUI_06 = 2 and HUI_07 = 1 and HUI_07A = 6 and HUI_08 = 1 and HUI_09 = 6 or (HUI_06 = 2 and HUI_07 = 1 and HUI_07A = 6 and HUI_08 = 2 and HUI_09 = 1) or (HUI_06 = 2 and HUI_07 = 1 and HUI_07A =6 and HUI_08 = 2 and HUI_09 = 2) Problem hearing in group -corrected Or Problem hearing in group and individual -corrected   This derived variable is a Health Utilties Index which provides a description of an individual"s overall functional health, based on eight attributes: vision, hearing, speech, ambulation (ability to get around), dexterity (use of hands and fingers), emotion (feelings), cognition (memory and thinking) and pain. The version of the index used in CCHS is adapted from the HUI Mark 3 (HUI3). The index is designed to produce both an overall health utility score and eight individual attribute scores. Analysts can use either a single-attribute utility scale or look at the complete health state (levels on all eight attributes) on the overall utility scale to produce a measure of an individual's perceived health related quality of life (HRQL).
The index is appropriate for use to describe and monitor the health of general populations, and has been extensively validated for use in cross-sectional and longitudinal population health studies.
The 8 single-attribute utility scores measure functional capacity within a single attribute, and range from 1.00 (normal) to 0.00 (most disabled). In combination, these scores are used to produce a multi-attribute utility index producing a score ranging from 1.00 (perfect health), through 0.00 (health status equal to death) to -0.36 (health status worse than death).
HUI3 question content resides in the public domain, and is not subject to copyright restrictions. The HUI3 algorithm is the property of Health Utilities Inc. and is protected by copyright. Statistics Canada is authorized, when requested, to share this algorithm with users who wish to replicate results or analyses conducted by Statistics Canada. The use of the algorithm for other purposes, or the sharing of it with others, is prohibited. Pain health status refers to the degree of pain that is usually felt by a person. This concept also considers whether this pain prevents him or her from performing certain activities. This variable is one of the 8 attributes used to calculate the Health Utility Index (HUIDHSI).
Reference: Reference: For more information on the Health Utilities Index and more details on each category please see http://www.statcan.gc.ca/subjects-sujets/standard-norme/otherclass-subject-autreclass-sujet-eng.htm.  This variable classifies children aged 12 to 17 (except female respondents aged 15 to 17 who were pregnant or did not answer the pregnancy question) as "obese", "overweight" or "neither obese nor overweight" according to the age-and-sexspecific BMI cut-off points as defined by Cole et al. The Cole cut-off points are based on pooled international data (Brazil, Great Britain, Hong Kong, Netherlands, Singapore, and United States) for BMI and linked to the widely internationally accepted adult BMI cut-off points of 25 (overweight) and 30 (obese).
Respondents who do not fall within the categories of "Obese" or "Overweight" (as defined by Cole et al.) have been classified by CCHS as "neither obese nor overweight".
This variable excludes respondents who are 18 years old or over (216 months).

Illicit drug use (9 DVs)
This module assesses use of various illicit drugs and drug interference. The questions for drug use are based on Canada's Alcohol and Other Drugs Survey (1994). Interference in daily activities and responsibilities is assessed. This variable assesses the interference that drug use had on daily activities and responsibilities in the past 12 months. It is a mean of the 5 items.

Cannabis Drug Use -Lifetime (Including "One Time
Respondents who did not use drugs frequently enough or did not indicate problems with drug use were excluded from the population. This variable assesses the interference that drug use had on daily activities and responsibilities in the past 12 months. This is a classification that indicates whether drug use interferes significantly with the person"s normal routine, occupational (academic) functioning, or social activities or relationships.
Respondents who did not use drugs frequently enough or did not indicate problems with drug use where excluded from the population. Drug use did not interfere significantly with normal routine, occupation (academic) functioning or social activities or relationships in the past 12 months This derived variable is a ratio between the total income of the respondent's household and the low income cut-off corresponding to the number of persons in the household and the size of the community. The low income cut-off is the threshold at which a family would typically spend a larger portion of its income than the average family on the necessities of food, shelter and clothing.
This derived variable is produced in three separate steps. A summary of those steps is provided below.
Step 1: Low income cut-offs for each family and community size were obtained for the 2007 reference year from the Survey of Labour and Income Dynamics (SLID). In the case of CCHS, the income questions refer to the past 12 months. Although the survey data were collected in 2008, at the time the data was to be processed, 2007 was the most recent year for which low income cut-offs could be provided.
A low income cut-off was linked to all respondents (INCTLIC). This cut-off corresponded to the size of the respondent's household (DHHDHSZ) and the size of the community in which the respondent lives (GEODPSZ). Therefore, respondents were assigned one of the 35 possible combinations that exist (7 household size groups times 5 community size groups). For instance, the INCTLIC variable of a respondent living in a household size of 3 people and in an urban community with a population of 47,000 people would be 28,379. Step 2a: Household income is obtained using INC_5 questions for a specific amount and INCDHH (INC_5A to INC_5C) for an amount in an interval.

Ref.: Low income cut-offs (INCTLIC) were taken from
If a specific amount is obtained at question INC_5, that amount is used as household income. If only one interval is reported for INC_5A to INC_5C, a random value within each interval is derived from INCDHH for household income for all intervals but the highest one (see next step).
Step 2b: For the highest household income interval ($100 000 or more), for each province, the median value from the Survey of Labour and Income Dynamics (SLID) for the same interval will be used as the household income. Data from SLID 2007 were used as they were the most recent available at the time CCHS data were processed.
Median provincial household income in 2007 from the SLID for the "100 000 $ or more" category are as follows: Step 3: Individual ratios of household income to the low income cut-off are calculated for each household within each household and community size using the DHHDHSZ household size variable and the GEODPSZ community size variable. Ratios are calculated by dividing household income (INCTINC) by the corresponding low income cut-off (INCTLIC).

INCDRCA INCDADR
This derived variable is a distribution of respondents in deciles (ten categories including approximately the same percentage of residents for each province) based on their value for INCDADR, ie. the adjusted ratio of their total household income to the low income cut-off corresponding to their household and community size. It provides, for each respondent, a relative measure of their household income to the household incomes of all other respondents.
Deciles are generated using weighted data. Adjusted ratios are presented in increasing order, from smallest to largest, for all 10 provinces irrespective of household and community size. Derived variables are calculated only for valid responses (not stated, refusal and don't know are excluded). Boundaries are determined in order to derive deciles from the total weighted number of cases for which derived variables are calculated. The Territories are excluded from this derived variable.

INCDRPR INCDADR, GEO_PRV
This derived variable is a distribution of residents of each province in deciles (ten categories including approximately the same percentage of residents for each province) based on their value for INCDADR, ie. the adjusted ratio of their total household income to the low income cut-off corresponding to their household and community size. It provides, for each respondent, a relative measure of their household income to the household incomes of all other respondents in the same province. The Territories are excluded from this derived variable.
Deciles are generated using weighted data. Adjusted ratios are presented in increasing order, from smallest to largest, for each of the 10 provinces irrespective of household and community size. Derived variables are calculated only for valid responses (not stated, refusal, etc. are excluded). Boundaries are determined in order to derive deciles from the total weighted number of cases for which derived variables are calculated.
The INCDRPR values are based on a distribution of adjusted ratios for the residents of each of the 10 provinces. This variable should therefore be used in conjunction with the variable for the province of residence (GEO_PRV).

INCDRRS INCDADR, GEO_DHR4
This derived variable is a distribution of residents of each health region in deciles (ten categories including approximately the same percentage of residents for each province) based on their value for INCDADR, ie. the adjusted ratio of their total household income to the low income cut-off corresponding to their household and community size. It provides, for each respondent, a relative measure of their household income to the household incomes of all other respondents in the same health region. The Territories are excluded from this derived variable.
Deciles are generated using weighted data. Adjusted ratios are presented in increasing order, from smallest to largest, for each of the 117 health regions irrespective of household and community size. Derived variables are calculated only for valid responses (not stated, refusal, etc. are excluded). Boundaries are determined in order to derive deciles from the total weighted number of cases for which derived variables are calculated.
The INCDRRS values are based on a distribution of adjusted ratios for the residents of each of the 122 health regions. This variable should therefore be used in conjunction with the variable for the health region province of residence (GEO_DHR4). INJ_14C in (7,8,9) or INJ_14L in (7,8,9) or INJ_14F in (7,8,9) NS At least one required question was not answered (don"t know, refusal, not stated) INJ_14M in ( 7,8,9) or INJ_14N in ( 7,8,9) or INJ_14K in (7,8,9) NS At least one required question was not answered (don"t know, refusal, not stated) Respondents who did not suffer any injuries in the past 12 months before the interview have been excluded from the population.

Total usual hours worked -current jobs -Grouped 2 )
LBSGHPW LBSDHPW This variable indicates the total number of hours the respondent worked per week.
Respondents aged less than 15 or more than 75 years old or who did not work in the week prior to the interview have been excluded from the population.

Full-time/part-time working status (for total usual hours) 3 )
LBSDPFT LBSDHPW This variable indicates if the respondent works full-time or part-time.
Respondents aged less than 15 or more than 75 years old or who did not work in the week prior to the interview have been excluded from the population.

Value Notes Condition(s) Description
Specifications 6 LBSDOCG = 96 Respondent did not work at a job or business in the past year or age was out of range 9 LBSDOCG = 95, 99 Respondent refused, did not know, or did not state their occupation or their occupation was uncodable 1 LBSDOCG = "01", "03", "04", "05", "06" Occupations relating to Management, Natural and Applied Sciences , Health, Social Sciences, Education, Religion, Art, Culture and Recreation 2 LBSDOCG = "02" Occupations relating to Business, Finance, Administration 3 LBSDOCG = "07" Occupations relating to Sales and Service 4 LBSDOCG = "08" Occupations relating to Trades, Transport and Equipment Operator This variable measures sense of mastery, that is, the extent to which individuals believe that their life-chances are under their control.

MEX_03, MEX_06, MEX_07
This variable indicates whether the respondent exclusively breastfed her last baby for at least 6 months.
Health Canada recommends exclusive breastfeeding for a period of up to 6 months. This variable indicates the number of mothers who followed this recommendation. Respondents who had not given birth in the past 5 years or who were less than 15 years old or more than 55 years old are excluded from the population. Since the variable is used to measure only the final duration of exclusive breastfeeding, mothers who still breastfed and who had not yet added any other liquid or solid foods to the baby"s feeds are also excluded.

MXS_03
This variable groups the number of cigarettes the respondent smoked during her last pregnancy.

MXS_06
This variable groups the number of cigarettes the respondent smoked while while breastfeeding her last baby. This variable indicates whether the respondent"s oral health status impacts on social functioning as measured by avoiding conversation or contact with others, or by avoiding laughing or smiling. This variable is a measure of the average daily energy expended during leisure time activities by the respondent in the past three months.
Energy Expenditure (EE) is calculated using the frequency and duration per session of the physical activity as well as the MET value of the activity. The MET is a value of metabolic energy cost expressed as a multiple of the resting metabolic rate. For example, an activity of 4 METS requires four times the amount of energy as compared to when the body is at rest. EE (Energy Expenditure for each activity) = (N X D X METvalue) / 365 Where: N = the number of times a respondent engaged in an activity over a 12 month period D = the average duration in hours of the activity MET value = the energy cost of the activity expressed as kilocalories expended per kilogram of body weight per hour of activity (kcal/kg per hour)/365 (to convert yearly data into daily data) MET values tend to be expressed in three intensity levels (i.e. low, medium, high). The CCHS questions did not ask the respondent to specify the intensity level of their activities. Therefore the MET values adopted correspond to the low intensity value of each activity. This approach is adopted from the Canadian Fitness and Lifestyle Research Institute because individuals tend to overestimate the intensity, frequency and duration of their activities. OTHER (X)* 4 * Jogging (MET value 7) and running (MET value 12) fall under one category. Therefore, the MET value for the combined activity is the average of their MET values (9.5). Since it is difficult to assign a MET value to the category "Other Activities", the MET value used is the average of the listed activities except for the average value of jogging and running. Here, the average value of jogging and running is replaced by the value for jogging only. Some activities have MET values lower than the average, however, this approach is consistent with other studies, such as the Campbell"s Survey and the Ontario Health Survey (OHS).
* Times were assigned an average duration value for the calculation, as with NPHS: (13 minutes or .2167 hour, 23 minutes or .3833 hour, 45 minutes or .75 hour, 60 minutes or 1 hour) Beginning in CCHS cycle 2.1, the list of activities (PAC_1n) changed slightly from previous CCHS cycles: The activity "Soccer" was asked explicitly in Cycle 2.1. For Cycle 1.1, this activity was part of the "Other" activities.  This variable measures the total number of times per month that respondents took part in leisure time physical activity(ies) lasting more than 15 minutes.

Variable name:
Based on:

Derived Variable Specifications
The survey questions refer to "the past three months". This variable calculates a one-month average by dividing the total reported frequency by three.   This variable indicates whether the respondent participated in any transportation or leisure time physical activities in the three months prior to the interview.
In 2010, the programming of the response categories for this derived variable were changed. Respondents who provided a mix of valid answer and non response to PAC_1V, PAC_7, or PAC_8 have been coded to category 1 or 2 in PACFLTI. Previously, if they provided a non response to either PAC_1V, PAC_7, or PAC_8 they were coded as non response in PACFLTI.  Never (RAC_2A = DK, R, NS) or (RAC_2B1 = DK, R, NS) or (RAC_2B2 = DK, R, NS) or (RAC_2C = DK, R, NS) NS At least one required question was not answered (don"t know, refusal, not stated)

Participation and Activity Limitation 3 )
RACDPAL RAC_1, RAC_2A, RAC_2B1, RAC_2B2, RAC_2C This variable classifies respondents according to the frequency with which they experience activity limitations imposed on them by a condition(s) or by long-term physical and/or mental health problems that has lasted or is expected to last 6 months or more.
This variable is the same as RACDIMP with the exception that RAC_1 is used in the calculation. This variable is a modification of the Participation and Activity Limitation Survey (PALS) derived variables. Whereas PALS treats non-response (DK, R) as a negative response (set to "Never"), CCHS treats them as non-response and the derived variable is set to notstated. This variable estimates the total number of hours the respondent spent in a typical week in the past three months in sedentary activities including using a computer (including playing computer games), using the Internet, playing video games (e.g. Nintendo, PlayStation) (for respondents aged 25 or less), watching television or videos and reading. For all activities, the time spent at school or work is excluded. This variable estimates the total number of hours the respondent spent in a typical week in the past three months in sedentary activities including using a computer (including playing computer games), using the Internet, playing video games (e.g. Nintendo, PlayStation)(for respondents aged less than 25), and watching television or videos. For all activities, the time spent at school or work is excluded. Time spent in reading is not included.

Smoking -Stages of change (1 DV)
The stages of change model defines five stages of change in the process of smoking cessation: 1) Precontemplation -The person has no intention of changing behaviour in the foreseeable future (for example, quitting smoking).
2) Contemplation -The person is aware of the problem and is seriously thinking about changing the behaviour but has not yet made a commitment to take action or is not confident of being able to sustain the behavioural change (that is, seriously thinking of quitting in the next 30 days but did not try to quit for at least 24 hours in the past 12 months, or seriously thinking of quitting smoking in the next 6 months but not in the next 30 days).
3) Preparation -The person is seriously planning to take action in the next month and is confident of success (that is, seriously thinking of quitting smoking in the next 30 days and has already stopped smoking at least once during the past 12 months). 4) Action -The person has successfully modified the behaviour within the past 6 months (that is, has quit smoking less than six months ago). 5) Maintenance -The person has maintained the behaviour change for at least six months (that is, has quit smoking at least six months ago). This variable assesses the level of self-esteem (positive feeling) an individual has.

Smoking Stages of Change (Current and Former
Scores on the index are based on a subset of items from the self-esteem Rosenberg scale (1969). The six items have been factored into one dimension in the factor analysis done by Pearlin and Schooler (1978

Health status (SF-36) (10 DVs)
The 36-item short form (SF-36) of the Medical Outcomes Study questionnaire was designed as a generic indicator of health status for use in population surveys and evaluative studies of health policy. The SF-36 was developed by John E. Ware Jr., Institute for the Improvement of Medical Care and Health, New England Medical Center Hospitals. The items in the SF-36 were drawn from the original 245-item Medical Outcomes Study (MOS). The SF-36 includes multi-item scales to measure the following three major health attributes and eight health concepts: Functional Status -Physical Functioning -Social Functioning -Role Limitations attributed to Physical Problems -Role Limitations attributed to Emotional Problems Well-Being -Mental Health -Energy (vitality) -Bodily Pain Overall Evaluation of Health -General Health Perception A scale is calculated for each of the eight health concepts. All scales are scored so that a high score is consistent with a positive health status. For example, a "functioning" scale is scored so that a higher score reflects increased function.
In order to facilitate comparisons across the SF-36 scales, the raw scores for each scale are linearly transformed to a 0-to-100 scale using the formula: Transformed scale = [(Actual score -Lowest possible score) / Possible score range] X 100 The transformed score reflects a relative position of the respondent on a continuum of lowest to highest possible scale scores.
Two summary measures of physical and mental health are also constructed from the eight scales. This variable measures the level of social functioning of the respondent relative to the general population.

Notes Condition(s) Description Value
A high score reflects increased social functioning. This variable measures the role limitations due to physical health problems for the respondent relative to the general population.
A high score reflects increased physical function (ie., less limitation). This variable indicates the type of smoker the respondent is, based on his/her smoking habits.
This variable includes lifetime cigarette consumption.

Reference:
In 2010, the programming of the response categories for this derived variable was changed. Respondents who stated that they were non-smokers, did not smoke more than 100 cigarettes, but have smoked a whole cigarette (SMK_202=3, SMK_05D=5, SMK_01A=2, and SMK_01B=1) were being classified as not stated (SMKDSTY=99) and should have been classified former occasional smokers (at least 1 whole cigarette, non-smoker now)(SMKDSTY=5). Programming was adjusted to ensure that the category was being assigned correctly to all cases. Current smokers and respondents who have never smoked a whole cigarette and respondents who did not smoked a total of 100 cigarettes or more lifetime were excluded from the population. The Medical Outcomes Study (MOS) Social Support Survey provides indicators of four categories of Social Support. An initial pool of 50 items was reduced to 19 functional support items that were hypothesized to cover five dimensions: -Emotional support -the expression of positive affect, empathetic understanding, and the encouragement of expressions of feelings.
-Informational support -the offering of advice, information, guidance or feedback.
-Tangible support -the provision of material aid or behavioural assistance. -Positive social interaction -the availability of other persons to do fun things with you.
-Affection -involving expressions of love and affection.

Notes Condition(s) Description Value
Temporary Reformat

Derived Variable Specifications
Waiting times (9 DVs)

WTM_07A, WTM_07B
This variable indicates the number of days that passed between the moment the respondent and his or her doctor decided that the respondent should see a medical specialist and when the actual visit with the specialist took place.
For this variable, the number of waiting days has only been considered for respondents 15 years and older who consulted a medical specialist due to a new health related problem during the past 12 months. This variable indicates the number of days that passed between the moment the respondent and his or her doctor decided the respondent should see a specialist and when the interview took place.
For this variable, the number of waiting days has only been considered for respondents 15 years and older who were referred to a specialist due to a new health related problem during the past 12 months, but who did not see the specialist with whom they had an appointment. This variable indicates the number of days, in the respondent"s view, he or she can wait to see a medical specialist and still find it acceptable.
The number of acceptable waiting days has only been considered for respondents 15 years and older who were referred to a medical specialist due to a new health related problem during the past 12 months, whether or not they saw the specialist at the time of the interview.

WTM_21A, WTM_21B
This variable indicates the number of days that passed between the moment the respondent and his or her doctor decided the respondent should receive non-emergency surgery and when the surgery actually took place.
For this variable, the number of waiting days was only considered for respondents 15 years and older who received nonemergency surgery during the past 12 months. This variable indicates the number of days that passed between the moment the respondent and his or her doctor decided the respondent should receive a magnetic resonance imaging test (MRI), a Computed Tomography exam (CT-SCAN) or a nonemergency angiography (heart test) and when the test was actually received.
For this variable, the number of waiting days was only considered for respondents of 15 years and older who received a MRI or a CT-SCAN exam, or a non-emergency heart test during the past 12 months. For this variable, the number of waiting days was only considered for respondents 15 years and older who were referred to receive a MRI or a CT-SCAN exam, or a non-emergency heart test during the past 12 months, but who had not received the test at the time of the interview. This variable indicates the number of days, in the respondent"s view, he or she can wait to receive a magnetic resonance imaging test (MRI), a Computed Tomography exam (CT-SCAN) or a non-emergency angiography (heart test) and still find it acceptable.
The number of acceptable waiting days was only considered for respondents 15 years and older who were referred to pass a MRI or a CT-SCAN exam, or a non-emergency heart test during the past 12 months, whether the respondent received the test or not at the time of the interview.