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Name
Obesity
Short/Other Names

Percentage of Adults Considered Obese, Self-Reported

Description
This indicator measures the percentage of adults who are considered to be obese, based on self-reported height and weight.
Interpretation
High results are undesirable.
HSP Framework Dimension

Social Determinants of Health: Biological, material, psychosocial and behavioural factors

Areas of Need

Not applicable

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region

Indicator Results

Accessing Indicator Results on Your Health System: In Depth

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<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
Name
Obesity
Short/Other Names

Percentage of Adults Considered Obese, Self-Reported


<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>
Description
This indicator measures the percentage of adults who are considered to be obese, based on self-reported height and weight.
Calculation: Description

Population age 18 and older considered obese divided by the total population age 18 and older

Population estimates are based on weighted survey responses to reflect the total population.

Calculation: Geographic Assignment

Place of residence

Calculation: Type of Measurement

Percentage or proportion

Calculation: Adjustment Applied

None

Calculation: Method of Adjustment

Not applicable

Denominator

Description:
Population age 18 and older (based on weighted survey responses)
Exclusions:
1. Pregnant females and persons less than 3 feet (0.914 metres) tall or greater than 6 feet 11 inches (2.108 metres) tall

2. Non-response categories (refusal, don’t know and not stated) are excluded as of 2009.

Numerator

Description:
Population age 18 and older with body mass index (BMI) greater than or equal to 30.00 kg/m2, based on self-reported height and weight (based on weighted survey responses)

BMI is calculated by dividing the respondent's body weight (in kilograms) by his or her height (in metres) squared.

According to World Health Organization (WHO) and Health Canada guidelines, the index for body weight classification is as follows:

– Less than 18.50: underweight

– 18.50 to 24.99: normal weight

– 25.00 to 29.99: overweight

– 30.00 to 34.99: obese, class I

– 35.00 to 39.99: obese, class II

– 40.00 or greater: obese, class III


<div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
Rationale

The prevalence of obesity has been increasing in Canada, and obesity is a risk factor for chronic diseases and cancer. Factors associated with obesity include dietary behaviours, physical inactivity and characteristics of the environment such as access to active modes of transportation and healthy foods.

Interpretation

High results are undesirable.

HSP Framework Dimension

Social Determinants of Health: Biological, material, psychosocial and behavioural factors

Areas of Need

Not applicable

Targets/Benchmarks

Not applicable

References

Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. British Medical Journal. 2000;320(7244):1240-1243.

Health Canada. Canadian Guidelines for Body Weight Classification in Adults—Quick Reference Tool for Professionals. Ottawa, ON: Her Majesty the Queen in Right of Canada; 2003. http://www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/guide-ld-adult/cg_quick_ref-ldc_rapide_ref-eng.php. Accessed September 13, 2016.

Statistics Canada. Canadian Community Health Survey - Annual Component (CCHS). http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&lang=en&db=imdb&adm=8&dis=2&SDDS=3226. Updated November 27, 2012. Accessed September 13, 2016.

St-Pierre M, Béland Y. Mode effects in the Canadian Community Health Survey: A Comparison of CAPI and CATI. 2004 Proceedings of the American Statistical Association Meeting . 2004. Toronto, ON, American Statistical Association.


<div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
Data Sources

CCHS, Statistics Canada

Available Data Years

Type of Year:
Calendar
First Available Year:
2003
Last Available Year:
2014

Geographic Coverage

All provinces/territories

Reporting Level/Disaggregation

National, Province/Territory, Region


<div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
Update Frequency

Every year

Indicator Results

Web Tool:
Your Health System: In Depth
URL:
Accessing Indicator Results on Your Health System: In Depth

Updates

Not applicable


<div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
Caveats and Limitations

Respondents with higher BMIs may be more likely to be in the non-response categories and therefore to be excluded from indicator calculation as of 2009.

Regional-level results for Nova Scotia are not available. In 2014, the Health Authorities Act passed by the Nova Scotia legislature consolidated the 10 district health authorities into 2 (1 provincial health authority with 4 management zones, and the IWK Health Centre). Canadian Community Health Survey (CCHS) data was not available for the new health authority boundaries.

The data year reflects the CCHS survey cycle. Prior to 2007, data for the CCHS was collected every 2 years, involving a sample of 130,000 respondents. In 2007, the survey transitioned to a yearly collection cycle, involving a sample of 65,000 respondents.

Some values have data quality flags that indicate "use with caution" or "suppressed" due to high coefficients of variation: health regions with small populations and results disaggregated by age group or sex within small regions.

The 2-year combined data has higher precision (less variability) than annual estimates. Users should refer to the annual CANSIM Table 105-0501 as the source for 2014 yearly CCHS estimates, as well as to obtain data from previous years. However, where data quality flags indicate suppression (F) or higher variability (E), the 2-year CANSIM Table 105-0502 should be used. Self-reported data is subject to bias, particularly for weight from women respondents and height from men respondents.

The CCHS covers the population age 12 and older living in the 10 provinces and 3 territories. Excluded from the survey's coverage are

– Persons living on reserves and other Aboriginal settlements in the provinces

– Full-time members of the Canadian Forces

– The population of institutionalized persons

– Persons living in 2 Quebec health regions: Nunavik Health Region and Terres-Cries-de-la-Baie-James Health Region

Altogether, these exclusions represent less than 3% of the target population.

In the North, the frame for the CCHS covers 92% of the target population in Yukon, 96% in the Northwest Territories and 92% in Nunavut. Before 2013, coverage in Nunavut was 71%.

Trending Issues

A definition change was implemented in 2004 to conform with WHO and Health Canada guidelines for body weight classification. The index is calculated for the population age 18 and older, excluding pregnant females and persons less than 3 feet (0.914 metres) tall or greater than 6 feet 11 inches (2.108 metres) tall.

Comments

Self-reported height and weight generally underestimate BMI. Statistics Canada conducts the Canadian Health Measures Survey (CHMS), which started in 2007, where physical measurements of height and weight are recorded. Estimates of overweight and obesity are available at the national level only.

Youth overweight and obesity are also reported by Statistics Canada. BMI for youths is different from that for adults, as youths are still maturing. This indicator classifies children age 12 to 17 (except female respondents age 15 to 17 who were pregnant or did not answer the pregnancy question) as "obese" or "overweight" according to the age- and sex-specific BMI cut-off points as defined by Cole et al. (2000). The Cole cut-off points have been applied to the CCHS since 2005 and are based on pooled international data (Brazil, Great Britain, Hong Kong, the Netherlands, Singapore and the United States) for BMI and linked to the internationally accepted adult BMI cut-off points of 25 (overweight) and 30 (obese). For more information, visit http://www.statcan.gc.ca/pub/82-221-x/2012002/tblstructure/1hs/1hc/hc1ybm-eng.htm.

An age-standardized estimate is also reported for the provinces/territories (using the direct method, standard Canadian population 1996) in CANSIM Table 105-0503.

Indicator results are also available on

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