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Population & Public Health Surveillance

The Population & Public Health Surveillance Program, currently within BCCDC’s Data & Analytic Services, collects, analyzes, and shares data about health status and chronic diseases as well as about protective and risk factors among British Columbians.
Our activities

The Population and Public Health (PPH) Surveillance program engages in the collection, analysis, interpretation, and dissemination of data about demography, socio-economic status, health status, and chronic diseases, as well as their protective and risk factors, among British Columbians.

We work closely with the Ministry of Health, PHSA-wide programs, the BC Observatory for Population and Public Health, regional health authorities, community partners and universities, enhancing provincial surveillance capacity through collaboration and partnership.

Community and school health data

PPH Surveillance works closely with partners at the Ministry of Health, regional health authorities, and community organizations to create standardized data, tools, and resources that support community health across the province. We support our partners from health, education, other sectors, and communities to use these tools and resources in informing their local-level planning and decision-making.

BC Community Health Data Website
The BC Community Health Data website contains a collection of data tools to support health care planning, policies and programs that are responsive to a community's needs. These include community health profiles, health database, BC Community Health Atlas, and archived profiles.

Community Health Data Website: Driven by the Local Needs in British Columbia

Rasali D, Fong D. (2019).

PPH Surveillance undertook a project to support the integration of data into the community health planning process in British Columbia. Details of this project were published in the Evidence-Informed Decision Making (EIDM) Casebook (Issue 3) by the National Collaborating Centre for Methods and Tools. 

BC Index of Multiple Deprivation (BCIMD)
We previously developed social and material deprivation indexes for BC based on Pampalon index methodology using CensusPlus 2011 data. In 2021, we developed the British Columbia Index of Multiple Deprivation (BCIMD) using Statistics Canada's Canadian Index of Multiple Deprivation (CIMD) methodology based on Census 2016 data. 

British Columbia's Index of Multiple Deprivation for Community Health Service Areas

Relova S, Joffres Y, Rasali D, Zhang LR, McKee G, Janjua N. (February 2022).

The British Columbia Index of Multiple Deprivation (BCIMD) provides area-based measures of multiple deprivation to examine social inequities across 218 Community Health Service Areas (CHSAs) in British Columbia. The Index comprises four dimensions: residential instability, economic dependency, ethno-cultural composition and situational vulnerability.

Health promotion evaluation
Evaluation is an integral component of health promotion for ensuring effective program implementation at the community level. PPH Surveillance has been involved in coordinating and providing leadership in evaluation of various provincial healthy living programs, such as Healthy Communities and Healthy Schools in BC.

Sexual Orientation and Gender Identity (SOGI) in Schools: Project Summary

Population and Public Health, BC Centre for Disease Control. (December 2019).

In the fall of 2017, the Population and Public Health Program, on behalf of the provincial Healthy Schools BC Working Group, commissioned an academic team to complete a study of the pilot year of the SOGI 1 2 3 program. This report summarizes the study and its findings. 

Healthy Schools BC Evaluation

Provincial Health Services Authority, Population and Public Health Program. (September 2017).

This report presents an evaluation that was conducted for the provincial Healthy Schools initiative in BC. The initiative supports schools and their health partners in implementing the Comprehensive School Health (CSH) approach and is a partnership between the ministries of Health and Education, the Directorate of Agencies for School Health BC (DASH), health authorities, and education partners. 

Healthy Families BC Communities Evaluation

Provincial Health Services Authority, Population and Public Health Program. (September 2017). 

This report presents an evaluation that was conducted for the Healthy Communities initiative in BC. The initiative involves fostering successes and building stronger relationships between the health sector and local governments to effectively implement healthy community actions. The initiative is a partnership between the Ministry of Health, Provincial Health Services Authority (PHSA), regional health authorities, BC Healthy Communities (BCHC) Society, the Union of BC Municipalities (UBCM), and other key stakeholders.


Chronic disease surveillance

Comorbidities and Multimorbidities
This project seeks to collect, analyze, and present distribution patterns and other relevant descriptive statistics on comorbidities and multimorbidities affecting BC residents to help inform health care strategies.

  • Diabetes comorbidities: PPH Surveillance conducts analyses of diabetes and its comorbidities to inform strategies for the prevention and management of diabetes disease in BC, and periodically provides surveillance information at the Type 2 Diabetes Network in BC.

  • Chronic disease multimorbidities: Multimorbidity is the co-occurrence of two or more disease conditions. The combined burden of multimorbidity and the health care resources required to manage it may be much greater than the sum of single diseases. The purpose of this study is to investigate the general distribution patterns and the extent of occurrences of multi-morbidities in various BC populations.

Looking at the Big Picture: Population Health & Diabetes Prevention in the Current Context of COVID-19 (Presentation at the Type 2 Diabetes Dialogue 2020)

Rasali, DP. (November 2020).

PPH Surveillance presented at, and participated in, a dialogue session hosted by the BC Patient Safety and Quality Council and the Institute for Health System Transformation and Sustainability. 

Measuring Multimorbidity to Support Chronic Disease Management and Prevention

Rasali DP, Li C, Rose C. (May 2020).

PPH Surveillance introduced an indicator measuring multimorbidity prevalence in individuals living with two or more chronic conditions from a list of 16 chronic diseases listed in chronic disease registries. The indicator is intended for use in health surveillance on a periodic basis to support management and prevention of chronic diseases in BC. 


Risk factors and burden of diseases 

PPH Surveillance conducts surveillance and applied research on chronic disease risk factors to assess their burden on chronic diseases across BC populations. We also network with public health professionals across Canada actively in this area.

The Economic Burden of Risk Factors in British Columbia, 2015: Excess Weight, Tobacco Smoking, Alcohol Use, Physical Inactivity and Low Fruit and Vegetable Consumption

Krueger H Rasali D, Fong D. (April 2018).

The report estimates the current provincial and regional prevalence rates as well as the direct health-care costs and indirect costs associated with each risk factor.

Regional variations in the economic burden attributable to excess weight, physical inactivity and tobacco smoking across British Columbia

Krueger H, Koot JM, Rasali DP, Gustin SE, Pennock M. (April 2016).

Prevalence rates of excess weight, tobacco smoking and physical inactivity vary substantially by geographical region within British Columbia (B.C.). The purpose of this study is to determine the potential reduction in economic burden in B.C. if all regions in the province achieved prevalence rates of these three risk factors equivalent to those of the region with the lowest rates.


Health equity indicators 

Various aspects of the health of the population are reported using health indicators, including health equity indicators. Health indicators are quantifiable measures for describing health status, determinants of health, and health system performance. 

  • Priority Health Equity Indicators reporting: We led and facilitated the development of a suite of priority health equity indicators that will support stakeholders’ efforts in improving, monitoring, and measuring equity work in BC. 

  • COVID-19 SES Analysis Working Group: We coordinate the COVID-19 Socioeconomic Status (SES) Analysis Working Group which provides support of the BCCDC’s work investigating the relationship between socioeconomic status and COVID-19. 

Priority Health Equity Indicators for British Columbia: Preventable and Treatable Premature Mortality

Rasali, D., Kao, D., Fong, D, Qiyam, L. (November 2019).

This report presents the rates of preventable and treatable premature mortality for the province and covers the data for the period from 2009 to 2013. These indicators provide a way to measure the extent of inequities in the province and show patterns of inequalities within geographic, demographic and socio-economic stratifiers.

Correlations of COVID-19 incidence with neighborhood demographic factors in BC

Rasali DP, Li C, Mak S, Rose C, Janjua N, Patrick D. (September 2021).

This study aims to assess the relationship of the proportions of neighborhood demographic factors with COVID-19 incidence in the Lower Mainland of British Columbia (BC).

Area-Based Disparities in Breast Cancer Screening Participation in British Columbia

Zhang LR, Rasali DP, Woods R, Sam J, Kan L. (September 2020).

A collaboration of the Provincial Health Services Authority's (PHSA's) programs, the BCCDC's Population and Public Health, and BC Cancer examined the 30-month breast cancer screening participation rate of BC women aged 50 to 69 years using data from the BC Cancer Breast Screening Mammography.

Area-Based Socioeconomic Disparities in Mortality due to Unintentional Injury and Youth Suicide in British Columbia, 2009–2013

Zandy M, Zhang LR, Kao D, Rajabali F, Turcotte K, Zheng A, Oakey M, Smolina K, Pike I, Rasali DP. (February 2019).

The association between health outcomes and socioeconomic status (SES) has been widely documented, and mortality due to unintentional injuries continues to rank among the leading causes of death among British Columbians. This paper quantified the SES-related disparities in the mortality burden of three British Columbia's provincial injury prevention priority areas: falls among seniors, transport injury, and youth suicide.

Indicators of Health Equity for BC: Disparities in Morbidity and Mortality

Rasali DP, Fong D. (June 2019).

Presentation at the BCCDC Grand Rounds.


Food security surveillance

PPH Surveillance provides data analytic support to the Food Security program of the BCCDC's Population and Public Health. 

  • Food security indicators: In 2016, we supported the Population and Public Health program with the identification of food security indicators to measure and monitor variations and trends in food security across the province using national, provincial, regional and local level data. The indicators are intended to inform policy and practice by demonstrating the current state of food security/household food insecurity in B.C., reflecting the impact of food security initiatives and highlighting where gaps exist and further work is needed to improve food security. The indicators can also contribute to program planning, internal performance management and evaluation.

  • Food costing: Food costing involves estimating the average monthly cost of a nutritionally adequate, balanced diet in BC based on the National Nutritious Basket (NNFB) to assess food affordability and provide insight into the effects of household food insecurity on individuals and families. This activity is conducted on a bi-annual basis.

Reports on Food Security Indicators, Food Costing and other food security surveillance projects can be found on the Food Security Program page.

 
 

Societal consequences of COVID-19

The PPH Surveillance team has coordinated and contributed to analysis to the BCCDC's project, Examining the Societal Consequences of the COVID-19 Response

Assessing the impact of COVID-19 physical distancing measures on the mental health of British Columbians using crowdsourcing data

Zhang LR, Ye X, Rasali DP. (October 2021).

The introduction of public health measures in March 2020 in response to the COVID-19 pandemic brought about unprecedented changes. We assessed self-reported change in mental health as an impact of physical distancing in British Columbia (BC).

The unintended consequences of the COVID-19 pandemic response on maternal and infant health outcomes, British Columbia, Canada

Luke S, Rasali DP, Der K, Ye X, Saffari N. (October 2021).

In March 2020, British Columbia adopted a province-wide pandemic response to the novel

coronavirus disease (COVID-19) that encouraged social distancing and reduced access to services including health care. This study assessed whether these measures resulted in unintended consequences to maternal and infant health.


Academic research collaborations

PPH Surveillance conducts or participates in research regularly on emerging issues of population and public health research in collaboration with academic institutions, mainly the University of British Columbia (UBC), the University of Northern British Columbia (UNBC) and the University of the Fraser Valley (UFV).

  • Collaborative research on the link between antibiotics and asthma in early life with UBC: The population-level analysis of decreasing asthma incidence in children (1-4 years) was conducted as part of a large multi-institutional collaborative study that led to establishing the link between antibiotic prescribing and asthma incidence among children.

  • Health Promotion Complex Systems Approach Mapping: A research project currently underway in collaboration with UBC, funded by Canadian Institutes for Health Research (CIHR), Michael Smith Foundation for Health Research (MSFHR) and BCCDC under the Health Systems Impact Fellowship (HSIF) Program. Population health physical activity will be the focus in this research aimed at identifying leverage points for strengthening coordinated intersectoral action for health promotion in British Columbia (ongoing).

  • Move the North: A research collaboration with the UNBC and the UBC focussing on the development of community-partnered research and scoping of physical activity in rural, remote and Northern communities (successfully completed)

  • Monitoring and Evaluation of Health in the Northern Resource Development: A tripartite research collaboration among PHSA, UNBC and Northern Health on monitoring health and the social determinants of health related to resource extraction and development across Northern BC (successfully completed).

  • Collaborating in CIHR funded research "Effects of COVID-19 on South Asian Mothers and Families in British Columbia" with the UFV (ongoing).

Establishing a link between antibiotics and asthma in early life

Lishman H, Sbihi H, Al Mamun A, Rasali DP, Rempel E, Smith N, Turvey S, Patrick D. (March 2021).

A discussion of the current work in BC linking antibiotic use in early infancy with the risk of childhood asthma, what the next steps are for this work, and what role clinicians from diverse specialties can play in combating the asthma and allergy epidemic.

Decreasing antibiotic use, the gut microbiota, and asthma incidence in children: evidence from population-based and prospective cohort studies

Patrick D, Sbihi H, Dai D, Al Mamun A, Rasali DP, Rose C, Marra F, Boutin R, Petersen C, Stiemsma L, Winsor G, Brinkman F, Kozyrskyj A, Azad M, Becker A, Mandhane P, Moraes T, Sears M, Subbarao P, Finlay B, Turvey S. (March 2020).

Childhood asthma incidence is decreasing in some parts of Europe and North America. Antibiotic use in infancy has been associated with increased asthma risk. In the present study, we tested the hypothesis that decreases in asthma incidence are linked to reduced antibiotic prescribing and mediated by changes in the gut bacterial community.

Implementation of Physical Activity Interventions in Rural, Remote, and Northern Communities: A Scoping Review

Pelletier CA, Pousette A, Ward K, Keahey R, Fox G, Allison S, Rasali DP, Faulkner G. (2020).

Understanding how the unique sociocultural and environmental factors in rural, remote, and northern communities contribute to implementation of physical activity interventions can help guide health promotion policy and practice. A scoping review was conducted to map literature describing the implementation of physical activity interventions in rural, remote, and/or northern communities.

Move the north: evaluation of a regional stakeholder engagement initiative to support the development of a community-partnered physical activity research agenda

Pelletier C, Pousette A, Fox G, Keahey R, Ward K, Faulkner G, Rasali DP, Allison S. (2019).

Although it is generally accepted that engaging with members of the public contributes to more actionable and relevant research, there are a limited number of reported evaluations of community engagement initiatives. For researchers and community members alike, it is important to understand and evaluate engagement initiatives to support participatory research methods, particularly when working with underserved or hard to reach populations.

Towards more robust and locally meaningful indicators for monitoring the social determinants of health related to resource development across Northern BC

Buse CG, Cornish K, Parkes MW, Harder H, Fumerton R, Rasali DP, Li C, Oke B, Loewen D, Aalhus M. (2018).

The purpose of this report is to provide clarity on identifying and selecting health and social determinants of health indicators related to resource extraction and development. It is a This report is the product of a collaboration between researchers at the University of Northern British Columbia, and staff from both Northern Health and the Provincial Health Services Authority.











Archived reports & resources
Health-adjusted life expectancy (HALE)

Infographic resource for health professionals that introduces health-adjusted life expectancy (HALE) as a population health measure. Explores life expectancy and HALE for British Columbians with and without hypertension and diabetes. Released: December 2015

The economic benefits of risk factor reduction in British Columbia: Excess weight, physical inactivity & tobacco smoking

Estimates the current and project future health-care costs and indirect productivity losses associated with each of three chronic disease risk factors: excess weight (obesity and overweight), physical inactivity and tobacco smoking. Released: July 2015

Life expectancy ranking of Canadians among the populations in selected OECD countries and its disparities among British Columbians

Zhang LR, Rasali D. Arch Public Health. 2015 Apr 3;73(1):17. doi: 10.1186/s13690-015-0065-0. eCollection 2015.PMID: 25922668

Student Health in BC: Provincial & regional highlights

This report presents provincial and HSDA-level student health data for seven priority areas: healthy eating, physical activity, tobacco use, healthy weight, mental health, learning to stay healthy at school and school connectedness. Released: December 2014

British Columbia Healthy Eating Population Health Survey, 2013

Provincial findings of a survey assessing healthy eating knowledge and behaviours among adult British Columbians. Released: October 2014

Status report on the British Columbia Paediatric Diabetes Program

Evidence review on the status of health care for children and youth with diabetes and other complex chronic diseases. Released: October 2010

Health assessment of school-aged children (HASAC)

Feasibility study to provide participating schools with data to assess students' health and assist in planning healthy school activities. Released: March 2010

Summary report on health for B.C. from regional, longitudinal & gender perspectives

Describes health behaviours, health conditions, and well-being among British Columbians at the health service delivery area, health region, and provincial levels. Released: March 2010

Local-level data on income & poverty for BC from 2006 Census

Key graphs and figures related to income and poverty at the local level in B.C. according to 2006 Census data. Released: October 2008

Population & public health indicators for BC

Comprehensive list of relevant indicators for monitoring and reporting on population health in B.C. Released: October 2008

Women's health: Evidence reviews

Evidence reviews summarize women's health issues in B.C. to facilitate action. Released: October 2008

Heart health

Respiratory disease

Type 2 diabetes

Identifying determinants for hospitalization based on healthcare utilization records

Explores patterns in healthcare use in Richmond, B.C. Released: June 2008

Life expectancy as a measure of population health: Comparing BC with other Olympic & Paralympic Winter Games host jurisdictions

Assessment of life expectancy in B.C. as compared to other developed countries that have hosted Winter Games. Released: April 2007

British Columbia Health & Wellness Survey

Results of a survey to measure health behaviours among people in 26 communities across all five regional health authorities in B.C. Released: January 2007

Pre-2007 reports


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