Study shows Canada's obesity epidemic is growing

Canada’s obesity epidemic is more acute than previously thought, says a study based on the biggest sample of body mass index (BMI) measurements ever reported in this country. According to the study, the trend places a strain of $7 billion in direct and indirect costs annually on the Canadian health-care system.

The study looks at the prevalence of obesity in Canada using a relatively new source of data — electronic medical records (EMR). It was led by Tyler Williamson, a Cumming School of Medicine researcher, and student Alanna Rigobon and co-authored by colleagues from Queen’s University. 

Experts believe EMRs are a predominantly untapped resource with the potential for big implications on how public health surveillance is conducted, says Williamson, a member of the O’Brien Institute for Public Health and the Alberta Children’s Hospital Research Institute (ACHRI). The data from this study indicates higher obesity prevalence rates than previously reported.

Obesity comes with other health problems that impact public health

According to data gathered by the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), an EMR-based information system, obesity in Canadian adults nearly doubled from 2003 to 2012, increasing from 17.9 per cent to 30.8 per cent; a sharper curve than anticipated by the Canadian Health Measures Survey developed by Statistics Canada.

Canadians living with obesity face an increased risk of health problems while also being subject to a number of biases and stigmas. 

“The majority of adults in Canada have a body weight (or BMI) that puts them in the overweight or obese category,” says Ian Janssen, PhD, professor at Queen’s University, Canada Research Chair in Physical Activity and Obesity, and study co-author. “Excess weight is associated with a host of health problems such as heart disease, stroke, diabetes, arthritis, and certain cancers and treating the health problems of obesity costs billions of dollars a years, having a tremendous impact on public health in Canada.”

Digitized patient data offers timely and larger sample of population 

Information on the prevalence of obesity is critical for understanding risk factors and evaluating current prevention practices. Using digitized patient data has the potential to improve care and cut costs by tracking population health risk factors, says Williamson, assistant professor with the department of community health sciences and primary investigator on the study.

Currently health-related data on obesity in Canada comes from self-reported survey information or from objective measurements of BMI for small samples of the population. Janssen says there are limitations to this data including the high cost of collection which limits it to a smaller sample size. 

Electronic medical records are, by nature, more timely and span a larger swath of the Canadian population, adds Williamson.

“Primary care electronic medical records — routinely collected data in a family physicians office — has enormous potential for all sorts of public health surveillance, and obesity is just one example of that,” says Williamson.  

“EMR data is the next health-care data iceberg,” he says. “We’re beginning to see its potential, but there’s so much below the surface that isn’t being used. We’re measuring heights and weights, we’re measuring blood pressures and lab results and I’m sure there are dozens of other uses that haven’t been thought of yet.”

Potential to track other population health risk factors like smoking and drinking

The majority of Canadians have a family doctor, and CPCSSN is becoming increasingly populated from those primary care practices.

Williamson says he hopes to eventually see EMR data being used to track other population health risk factors that aren’t being recorded right now, such as smoking and alcohol consumption. He believes once family physicians recognize the impact tracking these factors can have on public health, more and more will start to do it, creating an unprecedented database full of valuable information.

"Adult Obesity Prevalence in Primary Care Users: An Exploration Using Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Data"

Funding for the study came from the Public Health Agency of Canada, ACHRI, from community donations through the Alberta Children’s Hospital Foundation, and the College of Family Physicians of Canada.

 

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