Canadian Community Health Survey - Annual Component (CCHS)
The central objective of the Canadian Community Health Survey (CCHS) is to gather health-related data at the sub-provincial levels of geography (health region or combined health regions).
Detailed information for 2015
Data release - planned for June 2016
In 1991, the National Task Force on Health Information cited a number of issues and problems with the health information system. To respond to these issues, the Canadian Institute for Health Information (CIHI), Statistics Canada and Health Canada joined forces to create a Health Information Roadmap. From this mandate, the Canadian Community Health Survey (CCHS) was conceived.
The CCHS is a cross-sectional survey that collects information related to health status, health care utilization and health determinants for the Canadian population. It relies upon a large sample of respondents and is designed to provide reliable estimates at the health region level every 2 years.
The CCHS has the following objectives:
- Support health surveillance programs by providing health data at the national, provincial and intra-provincial levels;
- Provide a single data source for health research on small populations and rare characteristics;
- Timely release of information easily accessible to a diverse community of users;
- Create a flexible survey instrument that includes a rapid response option to address emerging issues related to the health of the population.
The CCHS produces an annual microdata file and a file combining two years of data. The CCHS collection years can also be combined by users to examine populations or rare characteristics.
The primary use of the CCHS data is for health surveillance and population health research. Federal and provincial departments of health and human resources, social service agencies, and other types of government agencies use the information collected from respondents to monitor, plan, implement and evaluate programs to improve the health of Canadians. Researchers from various fields use the information to conduct research to improve health. Non-profit health organizations and the media use the CCHS results to raise awareness about health, an issue of concern to all Canadians.
The survey began collecting data in 2001 and was repeated every two years until 2005. Starting in 2007, data for the Canadian Community Health Survey (CCHS) were collected annually instead of every two years. While a sample of approximately 130,000 respondents were interviewed during the reference periods of 2001, 2003 and 2005, the sample size was changed to 65,000 respondents each year starting in 2007.
In 2012, CCHS began work on a major redesign project that was completed and implemented for the 2015 cycle. The objectives of the redesign were to review the sampling methodology, adopt a new sample frame, modernize the content and review the target population. Consultations were held with federal, provincial and territorial share partners, health region authorities and academics.
As a result of the redesign, the 2015 CCHS has a new collection strategy, is drawing the sample from two different frames and has undergone major content revisions. With all these factors taken together, caution should be taken when comparing data from previous cycles to data released for the 2015 cycle onwards.
- Diseases and health conditions
- Health care services
- Lifestyle and social conditions
- Mental health and well-being
- Prevention and detection of disease
Data sources and methodology
The CCHS covers the population 12 years of age and over living in the ten provinces and the three territories. Excluded from the survey's coverage are: persons living on reserves and other Aboriginal settlements in the provinces; full-time members of the Canadian Forces; the institutionalized population and persons living in the Quebec health regions of Région du Nunavik and Région des Terres-Cries-de-la-Baie-James. Altogether, these exclusions represent less than 3% of the Canadian population aged 12 and over.
In the north, the frame for the CCHS covers 92% of the targeted population in the Yukon, 96% in the Northwest Territories and 92% in Nunavut. In Nunavut, starting in 2013, the coverage was expanded to represent 92% of the targeted population. Before 2013, the coverage was 71% since the survey covered only the 10 largest communities.
Each component of the CCHS questionnaire is developed in collaboration with specialists from Statistics Canada, other federal and provincial departments and/or academic fields. The CCHS questions are designed for computer-assisted interviewing (CAI), meaning that, as the questions were developed, the associated logical flow into and out of the questions was programmed. This includes specifying the type of answer required, the minimum and maximum values, on-line edits associated with the question and what to do in case of item non-response.
The CCHS has three content components: the common content (core and theme), the optional content and the rapid response content. The common content is collected from all survey respondents. Some modules are collected every year and remain relatively unchanged over several years. Other common modules are collected for one or two years and rotate every two or four years. The optional content fulfils the unique data needs of each province or territory and may vary from year to year. The rapid response component is offered to organizations interested in national estimates on an emerging or specific issue related to the population's health. Provincial estimates may also be yielded from a rapid response however they may be of limited quality. The rapid response content may be included in the survey in each collection period, that is, in every three month period. The data will be released about six months after the collection period via an announcement in The Daily.
New modules and revisions to existing CCHS content are tested using different methods. Qualitative tests using individual cognitive interviews or, more rarely, focus groups are used to ensure that questions and concepts are appropriately worded.
The computer application for data collection is extensively tested in-house each time changes are made. The objective of these tests is to identify any errors in the program flow and text before the start of the main survey.
This is a sample survey with a cross-sectional design.
To provide reliable estimates at the health region (HR) level, a sample of 130,000 respondents is required on a two years basis: 120,000 respondents to cover the population aged 18 and over and 10,000 respondents to cover the population aged 12 to 17 years.
Starting in 2015, a new multi-stage sample allocation strategy is used to give relatively fair sample distribution to the HRs and the provinces. For each age group (18 and over, 12 to 17), the sample is first allocated among the provinces using a power allocation of 0.75 according to the size of their respective population. Each province's sample is then allocated among its HRs using a power allocation of 0.35 according to the size of the population in each HR.
Starting in 2015, the CCHS sample is selected using two different frames: an Area frame and the Canadian Child Tax Benefit (CCTB) frame. Using the Area frame, a sample of dwellings is selected to target the population aged 18 and over. During collection, all members of the dwelling are listed and a person aged 18 years or over is automatically selected using various selection probabilities based on age and household composition. The CCTB frame is used to sample persons aged 12 to 17 years. One child is then pre-selected to complete the survey.
The area frame is mainly designed to serve the Labour Force Survey (LFS). Thus, the sampling plan of the LFS must be considered in selecting the CCHS dwelling sample. The LFS plan is a complex two stage stratified design in which each stratum is formed of clusters. The LFS first selects clusters using a sampling method with a probability proportional to size (PPS), and then the final sample is chosen using a systematic sampling of dwellings in the cluster. For CCHS, LFS clusters are grouped in each HR. Then, a sample of clusters and systematic dwellings are selected in each HR. The process maximises the overlap between the clusters selected by both surveys and ensure that the same dwelling is selected only once.
For the CCTB frame, a HR is assigned to each child in the target population based on the address. The CCTB frame is then stratified by HR. A simple random sample (SRS) of children aged 12 to 17 is selected within each HR.
The size of the sample is enlarged during the selection process to account for non responses and units outside the coverage (for example, vacant dwellings, institutions, children not eligible due to age or death, etc.).
Responding to this survey is voluntary.
Data are collected directly from survey respondents.
A small proportion of the data is collected from proxy respondents because of physical or mental incapacity from the selected respondent.
The CCHS questionnaire is administered using computer-assisted interviewing (CAI). All sample selected from the CCTB frame (respondent aged 12-17) and the sample selected from the Area frame (18+) with at least one telephone number (including cellular phone numbers) will be interviewed using the Computer Assisted Telephone Interviewing (CATI) method. The sample selected from the area frame without a telephone number will be interviewed using the Computer Assisted Personal Interviewing (CAPI) method. Some cases from the area frame may be transferred to CAPI if the selected dwelling is not reached using the phone number from the Area frame.
View the Questionnaire(s) and reporting guide(s) .
Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act. Various confidentiality rules are applied to all data that are released or published to prevent the publication or disclosure of any information deemed confidential. If necessary, data are suppressed to prevent direct or residual disclosure of identifiable data.
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