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Muhajarine N, Adeyinka DA, Pisolkar V, Ahmed MS, Kallio N, Coomaran V, McIntosh T, Novik N, Jeffery B. Equity Analysis of Repeated Cross-Sectional Survey Data on Mental Health Outcomes in Saskatchewan, Canada during COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph192113808. [PMID: 36360688 PMCID: PMC9655244 DOI: 10.3390/ijerph192113808] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/12/2022] [Accepted: 10/16/2022] [Indexed: 06/07/2023]
Abstract
This paper aims to understand the impact of COVID-19 on three mental health outcomes-anxiety, depression, and mental health service use. Specifically, whether the associations between social and economic variables and these outcomes are exacerbated or buffered among equity-seeking groups in Saskatchewan. We analyzed secondary datasets of Saskatchewan adults from population-based national surveys conducted by Mental Health Research Canada (MHRC) on three occasions: cycle 2 (August 2020), cycle 5 (February 2021), and cycle 7 (June 2021). We examined temporal changes in the prevalence of anxiety, depression, and service utilization. Using the responses from 577 respondents in cycle 5 dataset (as it coincides with the peak of 2nd wave), we performed multinomial logistic regression. The policy implications of the findings were explored empirically through a World Café approach with 30 service providers, service users and policy makers in the province. The prevalence of anxiety and depression remained steady but high. Mental health services were not accessed by many who need it. Participants reporting moderate or severe anxiety were more likely to be 30-49 years old, women, and immigrants who earned less than $20,000 annually. Immigrants with either college or technical education presented with a lesser risk of severe anxiety. Factors associated with moderate or severe depression were younger age (<50 years), low household income, as well as immigrants with lower levels of education. Racialized groups had a lower risk of severe depression if they were under 30 years. Students and retirees also had a lower risk of severe depression. Canadian-born residents were more likely to require mental health supports but were not accessing them, compared to immigrants. Our analysis suggests mental health outcomes and service utilization remain a problem in Saskatchewan, especially among equity-seeking groups. This study should help drive mental health service redesign towards a client-centred, integrated, and equity-driven system in Saskatchewan.
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Affiliation(s)
- Nazeem Muhajarine
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Daniel A. Adeyinka
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Vaidehi Pisolkar
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Md Sabbir Ahmed
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Natalie Kallio
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Vithusha Coomaran
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Rd, Saskatoon, SK S7N 5E5, Canada
| | - Tom McIntosh
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Department of Politics and International Studies, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Nuelle Novik
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Faculty of Social Work, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
| | - Bonnie Jeffery
- Saskatchewan Population Health and Evaluation Research Unit (SPHERU), University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Faculty of Social Work, University of Regina, 3737 Wascana Parkway, Regina, SK S4S 0A2, Canada
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Rizvi A, Lawson DO, Young T, Dewidar O, Nicholls S, Akl EA, Little J, Magwood O, Shamseer L, Ghogomu E, Jull JE, Rader T, Bhutta Z, Chamberlain C, Ellingwood H, Greer-Smith R, Hardy BJ, Harwood M, Kennedy M, Kredo T, Loder E, Mahande MJJ, Mbuagbaw L, Nkangu M, Okwen PM, Ramke J, Tufte J, Tugwell P, Wang X, Wiysonge CS, Welch VA. Guidance relevant to the reporting of health equity in observational research: a scoping review protocol. BMJ Open 2022; 12:e056875. [PMID: 35589369 PMCID: PMC9121499 DOI: 10.1136/bmjopen-2021-056875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Health inequities are defined as unfair and avoidable differences in health between groups within a population. Most health research is conducted through observational studies, which are able to offer real-world insights about etiology, healthcare policy/programme effectiveness and the impacts of socioeconomic factors. However, most published reports of observational studies do not address how their findings relate to health equity. Our team seeks to develop equity-relevant reporting guidance as an extension of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. This scoping review will inform the development of candidate items for the STROBE-Equity extension. We will operationalise equity-seeking populations using the PROGRESS-Plus framework of sociodemographic factors. As part of a parallel stream of the STROBE-Equity project, the relevance of candidate guideline items to Indigenous research will be led by Indigenous coinvestigators on the team. METHODS AND ANALYSIS We will follow the Joanna Briggs Institute method for conducting scoping reviews. We will evaluate the extent to which the identified guidance supports or refutes our preliminary candidate items for reporting equity in observational studies. These candidate items were developed based on items from equity-reporting guidelines for randomised trials and systematic reviews, developed by members of this team. We will consult with our knowledge users, patients/public partners and Indigenous research steering committee to invite suggestions for relevant guidance documents and interpretation of findings. If the identified guidance suggests the need for additional candidate items, they will be developed through inductive thematic analysis. ETHICS AND DISSEMINATION We will follow a principled approach that promotes ethical codevelopment with our community partners, based on principles of cultural safety, authentic partnerships, addressing colonial structures in knowledge production and the shared ownership, interpretation, and dissemination of research. All products of this research will be published as open access.
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Affiliation(s)
- Anita Rizvi
- School of Psychology, University of Ottawa Faculty of Social Sciences, Ottawa, Ontario, Canada
| | - Daeria O Lawson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Taryn Young
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Omar Dewidar
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Stuart Nicholls
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elie A Akl
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Olivia Magwood
- CT Lamont Primary Care Research Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences University of Ottawa, Ottawa, Ontario, Canada
| | - Larissa Shamseer
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | | | - Tamara Rader
- Freelance health research librarian, (no affiliation), Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Centre for Global Child Health, SickKids Center for Global Child Health, Toronto, Ontario, Canada
- Institute for Global Health & Development, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Western Australia, Australia
| | - Holly Ellingwood
- Department of Psychology, Department of Law, Carleton University, Ottawa, Ontario, Canada
| | - Regina Greer-Smith
- Healthcare Research Associates, LLC/Strategically Targeting Appropriate Researchers (S.T.A.R.) Initiative, Apple Valley, California, USA
| | - Billie-Jo Hardy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Matire Harwood
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Michelle Kennedy
- College of Health Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Tamara Kredo
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Elizabeth Loder
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Johnson J Mahande
- Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Miriam Nkangu
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Jacqueline Ramke
- London School of Hygiene & Tropical Medicine, London, UK
- School of Optometry and Vision Science, The University of Auckland, Auckland, Auckland, New Zealand
| | | | - Peter Tugwell
- University of Ottawa Department of Medicine, Ottawa, Ontario, Canada
| | - Xiaoqin Wang
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Charles Shey Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Vivian A Welch
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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