MLHU - Health Status Resource

Behavioural risk factors

Behavioural risk factors
Key Findings: 

Children and youth should achieve high levels of physical activity, low levels of sedentary behaviour, a healthy diet, and adequate sleep each day for optimal health.1 Vaccines also help children and youth build and strengthen their immune system, protecting them against diseases such as measles, polio, and tetanus. Ontario public health units have a mandate to ensure greater adoption of healthy living behaviours among school-aged children and youth.2 For Middlesex-London youth age 12–17 in 2015/16: less than 1 in 5 reported meeting physical activity guidelines, just over 1 in 4 reported consuming vegetables and fruits five or more times per day, and just over half reported meeting age-specific guidelines for sleep. Immunization coverage for certain diseases of public health significance was below the national target in 2017 among 7-year old and 12-year old students in Middlesex-London; indicating that further vaccination efforts are needed to ensure population-level protection against these diseases.

The Behavioural Risk Factors topic contains data for the overall Middlesex-London population on sleep, physical activity and sedentary behaviour, healthy eating, stress, and ultraviolet radiation exposure.

Immunization coverage Healthy eating
Physical activity Sleep

Immunization coverage

The Immunization topic contains data on childhood immunization coverage, adolescent immunization coverage, and school-based immunization coverage.

Interpretation

Infectious diseases can spread at school among children and youth who are not vaccinated.3 The Immunization of School Pupils Act (ISPA) requires that students attending primary or secondary schools in Ontario be immunized against certain diseases. Ontario public health units monitor the immunization coverage rates among students in their community. Having a high immunization coverage—a large proportion of the population vaccinated—is important to prevent and control vaccine-preventable diseases at schools and in the wider community.4

Among 7-year old students in Middlesex-London schools in the most recent school year, coverage for all diseases of public health significance was below the national target of 95%, which means that coverage in this age group was less than optimal to provide population-level protection. Up-to-date coverage for the hepatitis B, human papilloma virus (HPV) and meningococcal ACYW-135 vaccines among 12-year old students in Middlesex-London schools was below the national target of 90% in the 2018/19 school year. Immunization coverage among 17-year old students in Middlesex-London schools for measles, mumps, and rubella all exceeded the national target of 95% in the most recent school year. Ongoing vaccination efforts and monitoring of immunization coverage is needed to ensure that a high level of coverage is sustained.

Physical activity

The Physical Activity and Sedentary Behaviour section contains data for the overall Middlesex-London population on physical activity, hours of sedentary behaviour, and active transportation.

Less than one in five (17.7%) youth age 12–17 in Middlesex-London reported achieving at least 60 minutes of moderate to vigorous physical activity each day in the past week in 2015/16 (Figure 13.4.1). While the percent in Middlesex-London was lower compared to Ontario and the Peer Group, the difference was not statistically significant.

About 85% of the youth population age 12–17 reported using active transportation in the past week in 2015/16 (Figure 13.4.2). The percent in Middlesex-London was higher compared to Ontario and the Peer Group, but the difference was not statistically significant.

Among youth (age 12–17) in Middlesex-London, about one in five (19.4%) reported no use of active transportation in the past week (Figure 13.4.3). About half (48.7%) used a form of active transportation for up to four hours and 31.9% used active transportation four or more hours in the past week. There were no significant differences between the percentages in Middlesex-London, Ontario and the Peer Group.

Interpretation

Regular physical activity in children and youth helps to develop muscular strength, heart health, and bone density, and prevent chronic diseases later in life.5 For optimal health, it is recommended that children and youth (age 5–17) achieve at least 60 minutes of moderate to vigorous physical activity, and engage in no more than two hours of recreational screen time per day.1 According to a 2018 report by ParticipACTION, only 35% of Canadian children and youth age 5–17 achieved the recommended physical activity levels for their age group.6

Active transportation is any form of human-powered transportation, such as walking, cycling, running, skateboarding, rollerblading, or riding a scooter. It provides a means for children and youth to incorporate physical activity into their daily routines.

In the 2017 cycle of the Ontario Student Drug Use and Health Survey (OSDUHS), 23.0% of students reported more than 60 minutes of daily physical activity in the past week; the percent was significantly higher in males compared to females (29.5% vs. 16.2%, respectively). Sedentary behaviour, described as three or more hours of screen time daily, was reported by 64.2% of students.7

Healthy eating

The Healthy Eating section contains data for the overall Middlesex-London population.

Just over one-quarter (27.4%) of Middlesex-London youth age 12–17 reported consuming vegetables and fruits five or more times per day in 2015/16. Although the percent in Middlesex-London was higher than Ontario and the Peer Group, the difference was not statistically significant and needs to be interpreted with caution due to high variability (Figure 13.4.4).

For the Middlesex-London population age 12 and older, a significantly higher percent of females reported consuming fruits and vegetables five or more times per day compared to males (Figure 6.3.2).

Interpretation

Eating healthy food is vital for the normal growth and development of children and youth. Canada’s Food Guide recommends that vegetables and fruits make up the largest proportion of the foods we eat, roughly half of the plate in a meal.8 For Canadian youth age 12–17, 30.5% of females and 27.7% of males reported consuming fruits and vegetables five or more times per day in 2016.9

Sleep

The Sleep section contains data for the overall Middlesex-London population on rates of individuals meeting sleep guidelines and those reporting difficulty sleeping.

Over half (55.8%) of Middlesex-London youth (age 12–17) reported meeting the age-specific guidelines for sleep (Figure 13.4.5).

Interpretation

Sleep is very important to the health of children and youth since it allows the mind and body to rest and recover.10 The recommended amount of sleep for children and youth varies by age group. For children age 5–13, 9 to 11 hours of uninterrupted sleep per night is recommended, with consistent bed and wake-up times. For youth age 14–17, 8 to 10 hours of uninterrupted sleep per night is recommended, also with consistent bed and wake-up times.1

Ontario Public Health Standard: 

Ontario Public Health Standards: Requirements for Programs, Services, and Accountability
Population Health Assessment and Surveillance Protocol, 2018
School Health Guideline, 2018

References:

1. Canadian Society for Exercise Physiology. Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep [Internet]. Ottawa, ON: Canadian Society for Exercise Physiology, 2016 [cited 2019 Jul 25]. Available from: https://csepguidelines.ca/wp-content/themes/csep2017/pdf/Canadian24HourM...

2. Ministry of Health and Long-Term Care. Ontario Public Health Standards: Requirements for Programs, Services, and Accountability [Internet]. Toronto, ON: Queen's Printer for Ontario, 2018 [cited 2019 Jul 30]. Available from: http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/d...

3. Ministry of Health and Long-Term Care. Vaccines for Children at School [Internet]. Toronto, ON: Queen's Printer for Ontario; 2015 [cited 2019 July 16]. Available from: https://www.ontario.ca/page/vaccines-children-school

4. Ontario Agency for Health Protection and Promotion (Public Health Ontario). Immunization Coverage Report for School Pupils in Ontario: 2016–17 School Year [Internet]. Toronto, ON: Queen's Printer for Ontario, 2018 2019 Jul 16 [cited 2019 Jul 16]. Available from: https://www.publichealthontario.ca/-/media/documents/immunization-covera...

5. Public Health Agency of Canada. Physical Activity and Your Health [Internet]. Ottawa, ON: Government of Canada; 2018 [cited 2019 Jul 25]. Available from: https://www.canada.ca/en/public-health/services/being-active/physical-ac...

6. ParticipACTION. The Brain + Body Equation: Canadian Kids Need Active Bodies to Build Their Best Brains. The 2018 Participaction Report Card on Physical Activity for Children and Youth [Internet]. Toronto, ON: ParticipACTION, 2018 [cited 2019 Jul 25]. Available from: https://participaction.cdn.prismic.io/participaction%2F38570bed-b325-4fc...

7. Boak A, Hamilton HA, Adlaf EM, Henderson JL, Mann RE. The Mental Health and Well-Being of Ontario Students, 1991–2017: Detailed Findings from the Ontario Student Drug Use and Health Survey (OSDUHS) (CAMH Research Document Series No. 47) [Internet]. Toronto, ON: Centre for Addiction and Mental Health, 2018 [cited 2019 Jul 18]. Available from: https://www.camh.ca/-/media/files/pdf---osduhs/mental-health-and-well-be...

8. Health Canada. Canada's Food Guide: Eat Vegetables and Fruits [Internet]. Ottawa, ON: Government of Canada; 2019 [cited 2019 Jul 26]. Available from: https://food-guide.canada.ca/en/healthy-eating-recommendations/make-it-a...

9. Statistics Canada. Health Fact Sheets: Fruit and Vegetable Consumption, 2016 [Internet]. Ottawa, ON: Government of Canada; 2017 [cited 2019 Jul 26]. Available from: https://www150.statcan.gc.ca/n1/pub/82-625-x/2017001/article/54860-eng.htm

10. SickKids staff. Sleep: Benefits and Recommended Amounts [Internet]. Toronto, ON: The Hospital for Sick Children; 2016 [cited 2019 Aug 2]. Available from: https://www.aboutkidshealth.ca/Article?contentid=645&language=English

Last modified on: November 7, 2019

Jargon Explained: 

Sedentary behaviour
Time spent in the last seven days doing sedentary activities such as using a computer (including playing computer games), using the Internet, playing video games and watching television or videos. For all activities, the time spent at school or work is excluded. Time spent reading is not included.

Active transportation
Includes all time spent traveling in active ways in the 7 days prior to the survey interview. Active transportation is any form of human-powered transportation, such as walking, cycling, running, skateboarding, rollerblading, or riding a scooter.