# Presentation: 394216

## The Joint Canada/U.S. Survey of 		Health (JCUSH)

**Catherine Simile, PhD, U. S. Project Officer**
**Division of Health Interview Statistics**
**National Center for Health Statistics**

**Notes:**
Main purpose of talk today is to encourage you to use the data
Briefly talk about purpose, background and content
Give you some idea of findings and analysis underway
Give you details about accessing the data

## Background

- Collaborative project undertaken by  Statistics Canada (STC) and NCHS
- Additional funders include The Robert Wood Johnson Foundation and the Canadian Institutes for Health Research
- One-time telephone survey
- Sample of 3505 Canadians and 5,183  U. S. residents

**Notes:**

National sample representing the ten Canadian provinces, all 50 United States, and the District of Columbia. 

## Background, cont’d

- Data collected from November 2002-March 2003
- One adult 18 years of age and older living in private dwellings
- Stratified for age and sex

**Notes:**
Ages 18-44; 45-64; 65+

## Survey Purpose

- To develop, implement, and document a collaboration between national statistical offices
- To enhance comparability between the two countries’ ongoing national surveys
- To produce highly comparable data on the Canadian and American populations

**Notes:**
Most questions were taken from each country’s ongoing national health interview surveys—US NHIS and Canadian CCHS

## Survey Content

- Health status
- Limitation of activities
- Asthma, arthritis, heart disease, diabetes, and depression
- Contact with mental health professionals
- Smoking
- Height and weight

## Survey Content, cont’d

- Health care utilization
- Use of prescription medications
- Pap smear test and mammography
- Dental visits
- Insurance, including single service plans
- Patient satisfaction
- Physical activities

## Data Files

- Microdata files released June 2, 2004 on both websites
- Microdata files accompanied by
- Analytic highlights report
- User’s Guide
- Questionnaires in English, French, and Spanish

## Possible Analytic Uses

- Questions taken from ongoing surveys:  NHIS and CCHS
- Comparisons between JCUSH and NHIS
- Comparisons between JCUSH and CCHS
- Direct comparisons between US and Canada using JCUSH

- 		YANK
- 			GIRLS ARE
- 					FATTER!!!!

**Notes:**
Headline from the June 3 Winnipeg Sun and Edmunton Sun

You’ll get Canadian press coverage if you use the data

## Findings

- Overall, most Canadians (88%) and U.S. residents (85%) reported they were in good or better health
- US slightly higher rate of unmet needs (13% v. 11%)
- Reasons different:  waiting time most often reported in Canada, cost in U.S.

- Data source: The Joint Canada/U.S. Survey of Health  2002-2003

- Preliminary Data

## 	Findings, cont’d

- Rate of obesity higher in US (21% v. 15%)
- Primarily because of differences between U.S and Canadian women (21% v. 13%); no significant differences between men
- Canada had a slightly higher percentage of current daily smokers compared with   U. S. (19% v. 17%).

- Data source: The Joint Canada/U.S. Survey of Health 2002-2003

- Preliminary Data

## Percent with regular medical doctor, Canada and United States, 2002/03

- Data source: The Joint Canada/U.S. Survey of Health 2002-2003

- Preliminary Data

**Notes:**

The highlights report on the web details many more comparisons between the two countries.

I want to show you 2 graphs  to illustrate some useful features of the data set.  

The health care systems are different, expecially vis-à-vis insurance.  We—and you—can make comparisons on any number of variables between the insured U.S. population and the entire Canadian population

Turn to this slide.  On this graph
	the x-access, reading from left to right:  Canada, US-All, US insured, US uninsured
	y-access is percent with regular medical doctor

Significant differences between 
	Canada and all use (83.4% vs. 82.4), 
	US insured and uninsured (85.6 vs. 61.4)
	Canada, US uninsured (83.4 vs. 61.4)
	but that disappears when insurance is taken into account (Canada 83.4 vs. US insured 85.6)

## Percent Obese by Income Quintile, Canada and United States, 2002/03

- Data source: The Joint Canada/U.S. Survey of Health 2002-2003

- Preliminary Data

**Notes:**
Regarding income comparisons the file contains

Household income—for Canadians in Canadian dollars and for U.S. in U.S dollars

Personal income

The median exchange rate for the data collection period

2 Quintile measurements;  one quintile only; one adjusted for household size

	This graph
		x axis—5 income quintiles, left to right—lowest to highest
		y axis, percent obese

In every quintile, US more likely to be obese

				Can		US
1st (Lowest)			17.62		27.29	
2nd				16.55		23.38	
3rd				16.18		19.41	
4th				14.35		19.54	
5th (Highest)		12.72		14.84	

The spread is wider between the highest and lowest quintile in US than in Canada:	Difference of Q1 and Q5	 (Canada) 4.61		US 9.60	
As in this graph, you can make direct comparisons between the two countries vis a vis access to income

## Access to Data and Reports

- NCHS website at **www.cdc.gov/nchs/nhis.htm**_ _
- Statistics Canada website at **www.statcan.ca**

**Notes:**
Again I want to encourage you use the JCUSH data

You can find that information at either website.  

Brochures are also available
And a list of key highlights from the release report