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Ontario Cancer Facts

Poor self-reported mental health linked to greater chance of chronic disease risk factors

May 2020

Highlights

 

  • Adults in Ontario who reported having poor or fair mental health were more likely to report current smoking, being physically inactive, and eating vegetables and fruit less often than adults who reported good, very good or excellent mental health.
  • Youth in Ontario who reported having poor or fair mental health were more likely to report current smoking, underage drinking, and eating vegetables and fruit less often than youth who reported good, very good or excellent mental health.
  • Healthcare providers have the opportunity to improve overall health outcomes by promoting mental health and addressing chronic disease risk factors in people with poor or fair mental health.

In 2015/2016, adults in Ontario who reported having poor or fair mental health status had higher rates of current smoking, physical inactivity and low vegetable and fruit intake than adults who reported having good, very good or excellent mental health (See Figure 1).

A similar pattern could be seen in youth who reported poor or fair mental health. Their rates of current smoking, underage drinking, and low vegetable and fruit intake were higher than youth who reported good, very good or excellent mental health (See Figure 2). For example, 71.3% of youth with poor or fair mental health who engaged in underage drinking reported having at least 1 drink in the past 12 months, but only 28% of youth with good, very good or excellent mental health reported having at least 1 drink (Figure 2).

Adults and youth in Ontario who reported having poor or fair mental health were also more likely to have 2 or more chronic disease risk factors than those who reported having good, very good or excellent mental health.

Source: CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019.

Notes:
I––I represents 95% confidence intervals.
* = Significant difference by self-perceived mental health determined by Rao-Scott Chi-Square Test.
Current smoking (ages 20 and older) = people who are daily or occasional smokers. Excess alcohol consumption (ages 19 and older) = exceeding Canada’s Low-Risk Alcohol Drinking Guidelines, which recommend no more than 10 drinks a week for women, with no more than 2 drinks a day most days and no more than 15 drinks a week for men, with no more than 3 drinks a day most days. Physical inactivity (ages 18 and older) = respondents whose levels of physical activity do not meet the Canadian Physical Activity Guidelines, which recommend that adults ages 18 and older should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week in bouts of 10 minutes or more. Inadequate vegetable and fruit consumption (ages 20 and older) = respondents who reported eating vegetables (excluding potatoes) and fruit fewer than 5 times per day.

Source: CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019.

Notes:
I––I represents 95% confidence intervals.
* = Significant difference by self-perceived mental health determined by Rao-Scott Chi-Square Test.
Current smoking (ages 12 to 19) = people who are daily or occasional smokers. For 'Poor / Fair', interpret estimate with caution due to high sampling variability.
Underage drinking (ages 12 to 18) = at least 1 drink in the past 12 months.
Physical inactivity (ages 12 to 17) = respondents whose levels of physical activity do not meet the Canadian Physical Activity Guidelines, which recommend that youth ages 12 to 17 accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.
Inadequate vegetable and fruit consumption (ages 12 to 19) = respondents who reported eating vegetables (excluding potatoes) and fruit fewer than 5 times per day.

Percent of adults reporting selected chronic disease risk factors, by self-perceived mental health, Ontario, 2015/2016
Risk factor Good / Very good / Excellent 95% Lower Confidence Limit 95% Upper Confidence Limit Poor / Fair 95% Lower Confidence Limit 95% Upper Confidence Limit
Current smoking* 17.2 16.4 18.0 31.7 28.3 35.1
Excess alcohol consumption 21.1 20.2 22.0 18.5 15.7 21.4
Physical inactivity* 41.0 39.9 42.0 46.5 42.7 50.3
Inadequate vegetable and fruit consumption* 71.4 70.4 72.4 77.6 74.5 80.8

Source: CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019.

Notes: I––I represents 95% confidence intervals.
* = Significant difference by self-perceived mental health determined by Rao-Scott Chi-Square Test.
Current smoking (ages 20 and older) = people who are daily or occasional smokers. Excess alcohol consumption (ages 19 and older) = exceeding Canada’s Low-Risk Alcohol Drinking Guidelines, which recommend no more than 10 drinks a week for women, with no more than 2 drinks a day most days and no more than 15 drinks a week for men, with no more than 3 drinks a day most days. Physical inactivity (ages 18 and older) = respondents whose levels of physical activity do not meet the Canadian Physical Activity Guidelines, which recommend that adults ages 18 and older should accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week in bouts of 10 minutes or more. Inadequate vegetable and fruit consumption (ages 20 and older) = respondents who reported eating vegetables (excluding potatoes) and fruit fewer than 5 times per day.

Percent of youth reporting selected chronic disease risk factors, by self-perceived mental health, Ontario, 2015/2016
Risk factor Good / Very good / Excellent 95% Lower Confidence Limit 95% Upper Confidence Limit Poor / Fair 95% Lower Confidence Limit 95% Upper Confidence Limit
Current smoking* 5.6 4.2 7.0 16.1C 9.2 23.0
Underage drinking* 28.0 25.5 30.4 71.3 61.9 80.7
Physical inactivity 72.1 69.2 75.0 81.3 72.2 90.3
Inadequate vegetable and fruit consumption* 75.7 73.2 78.2 89.8 85.3 94.4

Source: CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019.

Notes:
I––I represents 95% confidence intervals.
* = Significant difference by self-perceived mental health determined by Rao-Scott Chi-Square Test.
Current smoking (ages 12 to 19) = people who are daily or occasional smokers. For 'Poor / Fair', interpret estimate with caution due to high sampling variability.
Underage drinking (ages 12 to 18) = at least 1 drink in the past 12 months.
Physical inactivity (ages 12 to 17) = respondents whose levels of physical activity do not meet the Canadian Physical Activity Guidelines, which recommend that youth ages 12 to 17 accumulate at least 60 minutes of moderate- to vigorous-intensity physical activity daily.
Inadequate vegetable and fruit consumption (ages 12 to 19) = respondents who reported eating vegetables (excluding potatoes) and fruit fewer than 5 times per day.

Opportunity to improve health outcomes

Being aware of these patterns gives healthcare providers the opportunity to promote mental health and to identify and address chronic disease risk factors among people who report having poor or fair mental health status, and improve the overall health outcomes of their patients. Researchers and health professionals around the world are working on addressing mental health, including illnesses related to substance use, to improve health outcomes related to chronic diseases. Poor mental health may also have a direct relationship with poorer chronic disease outcomes; however, this connection is not examined in this Cancer Fact.

Streamlining Ontario’s mental health and addictions sector

Ontario is one jurisdiction working to address mental health through Ontario Health’s recently established Mental Health and Addictions Centre of Excellence. This new centre will serve as a foundation for the province to build a comprehensive and connected mental health and addictions system.

The Mental Health and Addictions Centre of Excellence will play a critical role in helping to standardize and organize the mental health and addictions sector by providing the tools, data, performance indicators and common infrastructure to disseminate evidence and set service expectations. These initiatives will support the implementation of the new mental health and addictions roadmap, and the province's cross-government approach to meaningfully improving the care and services provided to people in Ontario.

For more information about the burden of chronic diseases and the prevalence of chronic disease risk factors in Ontario, please read The Burden of Chronic Diseases in Ontario – Key Estimates to Support Efforts in Prevention.

For questions about this Cancer Fact or for more information about chronic disease risk factors, please contact populationhealth@cancercare.on.ca.

References

  1. CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019. Available from https://www.ccohealth.ca/en/chronic-disease-prevention/report-burden-chronic-diseases.
  2. CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019. Supplementary Tables S34 and S36. Available from https://www.ccohealth.ca/en/chronic-disease-prevention/report-burden-chronic-diseases.
  3. World Health Organization. Noncommunicable diseases country profiles 2018. Geneva: World Health Organization; 2018.