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about the canadian community health survey (CCHS)

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  • For each data source, information about data collection and analytical methods, limitations, the citation and additional resources can be found on the Data Sources and Methods page.

The CCHS is a national cross-sectional survey aimed at providing health information at the regional and provincial levels. This survey collects information related to health status, health care utilization and health determinants for the Canadian population. About 130,000 Canadians age 12 years and older are surveyed per survey cycle, with one resident per household being asked to complete the survey.

DATA SOURCE

Original Source: Statistics Canada
Cite as: Canadian Community Health Survey Share File, 2000/2001, 2003, 2005, 2007/2008, 2009/2010, 2011/2012, 2013/2014. Statistics Canada. Ontario Ministry of Health and Long-Term Care.

METHODS

About the CCHS

  • The CCHS is a sample survey with a cross-sectional design. Three methods (sampling frames) are used to generate survey participants, an area frame, a list frame and random digit dialing. The area frame consists of a selection of dwellings drawn from Statistics Canada's Labour Force Survey sampling frame. The list frame consists of a list of telephone numbers from the Canada Phone Directory. Lastly, in four health regions, the sample is supplemented with random digit dialing.
  • This type of survey draws a sample from the population of interest (in this case, the population of Canada age 12 and older), and collects responses from people in the sample. By applying population weights, measures such as percentages and totals (referred to as population estimate in the tables on this website) are therefore estimates of the total population.
  • Prior to 2007, data were collected every two years on an annual period. Data presented for 2000/2001, 2003 and 2005 reflect this data collection method. Starting in 2007, major changes were made to the survey design in order to improve its effectiveness and flexibility through data collection on an ongoing basis. As a result, data collection now occurs every year, but a 'cycle' is now considered to be a 2-year period (i.e., 2007/2008, 2009/2010, 2011/2012, 2013/2014).

Data Collection Methods

  • The target population of the CCHS is all Canadian residents age 12 years and older. Excluded are individuals living on First Nation reserves and settlements, institutional residents, full-time members of the Canadian Forces, and residents of certain remote regions.
  • Data collection for the CCHS is done over the telephone or in person, by either computer assisted personal or computer assisted telephone interviewing techniques.
  • The interview lasts approximately 45 minutes: 30 minutes of common content to be asked of all participants, 10 minutes of optional content determined by each province from a predefined list of questionnaire modules, and 5 minutes of socio-economic and demographic content.
  • The CCHS Share File consists of all the respondents who agreed to share their data with the provincial ministries and health regions. The Health Analytics Branch of the Ministry of Health and Long-Term Care (MOHLTC) receives the Share File from Statistics Canada and distributes the Ontario portion of the Share File to public health units that agree to the privacy conditions for access.
  • Statistics Canada also maintains the CCHS Master File, which contains all the responses. The CCHS data tables on Peel Public Health's Health Status Data website are based on the Share File, and therefore may not always match with Statistics Canada's analysis products based on the Master File.
  • Additional details about the CCHS including instrument design, sampling and other measurement concepts can be found on the Statistics Canada website.

Release Guidelines

  • To assess whether data are releasable, all CCHS data presented have been analyzed using the SPSS complex samples module.
  • Coefficients of Variation (CV) are generated through this process and are applied to the Statistics Canada release guidelines as follows:
    • CV between 0 and 16.5: Releasable
    • CV between 16.6 and 33.3: Use with caution. In this scenario, the letter 'a' is presented within the data table, with a footnote stating 'Use estimate with caution'
    • CV greater than 33.3: Not releasable. In this scenario, the acronym 'NR' is presented in the data table, with a footnote stating 'Not releasable due to small numbers'
  • Additionally, release guidelines indicate that there should be at least 10 observations in the numerator and 20 observations in the denominator to release the data.

Analytical Methods

  • Estimates of the percentage and population for each category of interest are presented within the data tables.
  • 95% confidence intervals are also presented in the data tables. The confidence interval presents a lower and upper range of values, which contains the true value of the percentage for the whole population 95% of the time, or 19 times out of 20.
  • When the 95% confidence interval of one percentage does not overlap with that of another percentage, the difference between the percentages is considered statistically significant (i.e., very unlikely to be due to chance). Throughout the key messages, the terms "significantly higher" or "significantly lower" are used to describe data that are significantly higher or lower based on the 95% confidence intervals that do not overlap with one another.
  • 'Not stated' responses are excluded from the calculation of percentages. Usually, 'not stated' responses occur when the randomly selected member of the household is unable to respond to the survey, and a 'proxy' member of the household responds on their behalf.
  • Generally, if a survey participant answered 'don't know', or 'refused' to respond to the question, these responses were not included in the calculation of the percentages in the table. A note below the table will indicate that this process was followed.
  • In some cases, when there were a sizable number of respondents who did not answer the question (5% or greater of total respondents), then 'don't know' and 'refused' were included in the calculation of the percentages. A note below the table will indicate the percentages of 'don't know' and 'refused' responses. This may be presented as a range to cover multiple years of data.
  • In some cases, 'don't know' is a valid response to the question. For example, for the question, "When did you have your last seasonal flu shot?" some respondents may not know when they had their last shot.

Demographic variables:
The CCHS data tables show estimates of the percentage and population, as well as the 95% confidence intervals for each health question of interest. Responses to the health question are grouped by the following demographic variables:

Income Level:
Question: Thinking about the total income for all household members, from which of the following sources did your household receive any income in the past 12 months?

Wages and salaries
Income from self-employment
Dividends and interest (e.g., on bonds, savings)
Employment insurance
Worker's compensation
Benefits from Canada or Quebec Pension Plan
Job related retirement pensions, superannuation and annuities
RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
Old Age Security and Guaranteed Income Supplement
Provincial or municipal social assistance or welfare
Child Tax Benefit
Child support
Alimony
Other (e.g., rental income, scholarships)
None
Don't know, Refused

Income categories:
The income categories shown in the CCHS tables are determined based on a combination of the number of people in the household, and the total household income:

Household Income Level
shown in CCHS tables

Number of people
in the household
Total household income
Low-middle 1 or more
3-4 people
5+ people
Less than $15,000
$15,000 to $19,999
$15,000 to $29,999
Middle 1-2 people
3-4 people
5+ people
$15,000 to $29,999
$20,000 to $39,999
$30,000 to $59,999
Upper-middle 1-2 people
3-4 people
5+ people
$30,000 to $59,999
$40,000 to $79,999
$60,000 to $79,999
Highest 1-2 people
3 or more
More than $60,000
More than $80,000

NOTE: Beginning in 2011, missing values for the income variable due to either respondent refusal or respondent's lack of knowledge of household income were imputed. Imputation is a statistical technique that can assign a value when responses are missing.

Education Level:
Question: A series of questions are asked to determine the highest level of education of respondents aged 14 years and older.

Education categories:
Less than high school-Did not graduate from high school
High school graduate-No post-secondary education
Some Post-Secondary-Received some college or university education
Post-secondary graduate-Completed post-secondary degree/diploma

Immigrant status:
Question: Were you born a Canadian citizen? In what year did you first come to Canada to live?

Immigrant Status categories:

Recent Immigrant-person who immigrated to Canada within the last 10 years of the CCHS interview

Long-term immigrant-person who immigrated to Canada 11 or more years prior to the CCHS interview

Non-immigrant (born in Canada)

Ethnicity:
Question: Two questions are asked to determine the respondent's ethnicity.

Are you an Aboriginal person, that is, First nations, Métis or Inuk(Inuit)? First Nations includes Status and Non-Status Indians.

If no, you may belong to one or more racial or cultural groups on the following list:

Are you?
White?
South Asian (e.g., East Indian, Pakistani, Sri Lankan etc.)?
Chinese?
Black?
Filipino?
Latin American?
Arab?
Southeast Asian (e.g., Vietnamese, Cambodian, Malaysian, Laotian, etc.)?
West Asian (e.g., Iranian, Afghan, etc.)?
Korean?
Japanese?
Other - Specify
Don't know, Refused

Ethnicity categories:

Ethnicity shown in CCHS tables Responses to Ethnicity questions
during CCHS interview
White White
Black Black
East/Southeast Asian Korean
Filipino
Japanese
Chinese
Southeast Asian
West Asian/Arab Arab
West Asian
South Asian South Asian
Latin American Latin American
Aboriginal Aboriginal
Other Other racial or cultural origin
Multiple racial/cultural origins

LIMITATIONS

  • Depending upon the question, self-reported data may be subject to a number of survey biases, including social desirability bias (when asked questions of a sensitive nature, respondents may give an answer that they believe to be socially acceptable), response bias (differences between those who respond to the survey and those who don't) or recall bias (being unable to recall the information to accurately answer the question)
  • Errors may occur from proxy reporting (when another member of the household completes the survey for the randomly selected household member).
  • Individuals and/or households without a telephone would be excluded from the sampling frame.
  • Some analyses are limited by sample size.
  • Modules change from one cycle to another. Question response categories may also change. Both of these can make comparisons of data by year difficult.

REFERENCES AND RESOURCES

  1. Beland Y. Canadian Community Health Survey – Methodological Overview. Health Reports 2002;13(3):9-14.
  2. Canadian Community Health Survey - Annual Component (CCHS) Detailed Information for 2014 [Internet].Ottawa (ON): Statistics Canada; [updated 2015 Apr 20; cited 2016 Oct 27]
    http://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&Id=164081

Last updated: April 11, 2017



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