Canadian Health Survey on Children and Youth (CHSCY)

Detailed information for 2023

The Canadian Health Survey on Children and Youth explores issues that have an impact on the physical and mental health of children and youth, such as physical activity, the use of electronic devices, time spent in school and extracurricular activities, mental health, childhood experiences, suicidal thoughts, substance use and impact of the COVID-19 pandemic.

Additionally, the 2023 iteration of the Canadian Health Survey on Children and Youth follows respondents from the previous cycle (2019), assessing changes over time in health and well-being outcomes of Canadian children and youth.

Information from the survey will be used to develop appropriate programs and policies to better serve Canadian children and youth, as well as promote physical activity and good physical and mental health.

Data release - September 10, 2024

• Questionnaire(s) and reporting guide(s)
• Description
• Data sources and methodology
• Data accuracy

Description

The main objectives of the Canadian Health Survey on Children and Youth are to:

- provide current, detailed, and ongoing health-related information on Canadian children and youth;
- better understand the impact of the COVID-19 pandemic on their health and functioning;
- assess changes over time in their health and well-being;
- examine their levels of health following the first years of the COVID-19 pandemic;
- explore issues that have an impact on the physical and mental health of Canadian children and youth.

The data collected will be used by Statistics Canada, Health Canada and the Public Health Agency of Canada, provincial and territorial ministries of Health, as well as by other federal and provincial departments.

The survey was developed by Statistics Canada, the Public Health Agency of Canada, and a national research team led by McMaster's Offord Centre for Child Studies. McMaster's Offord Centre for Child Studies received funding from the Canadian Institutes of Health Research (CIHR) to directly support the longitudinal data collection and lead the initial longitudinal analyses.

The information collected from respondents will be used to monitor, plan, implement and evaluate programs to improve the health of Canadian children and youth. Researchers from various fields are also interested in the survey data and will use the information to conduct research into the various factors that affect the health and well-being of children and youth in Canada.

Subjects

• Children and youth
• Health
• Health and well-being (youth)
• Health care services
• Risk behaviours

Data sources and methodology

Target population

For producing annual estimates, the 2023 Canadian Health Survey on Children and Youth (CHSCY) covers the population aged 1 to 21 as of January 31, 2023, living in the ten provinces. Excluded from the survey's coverage are children and youth living on First Nation reserves and other Aboriginal settlements in the provinces, children and youth living in foster homes and the institutionalized population.

Follow-up with respondents to the 2019 CHSCY will also be done in order to produce longitudinal estimates measuring change in outcomes over time for the target population of that survey (children and youth aged 1-17 as of January 31, 2019).

Based on a study comparing the Canadian Child Benefit (CCB) file with the 2018 population estimates, the CCB covers 98% of the Canadian population aged 1 to 17 in all provinces.

Instrument design

The survey content was developed based on consultation across Canada with key experts and federal and provincial stakeholders. The goal of the consultation was to provide advice to Statistics Canada on what survey content would be relevant for programs and policies and to fill data gaps related to children and youth. The questionnaire was developed by Statistics Canada, in collaboration with McMaster's Offord Centre for Child Studies, the Public Health Agency of Canada and Health Canada.

Qualitative testing by Statistics Canada's Questionnaire Design Resource Centre, using face-to-face interviews and focus groups, was conducted in November 2021 and February 2022.

Sampling

This is a sample survey with a cross-sectional design and a longitudinal follow-up.

FRAME
The sampling frame for the Canadian Health Survey on Children and Youth is the Canada Child Benefit file.

SAMPLING UNIT
The sample for the 2023 CHSCY consists of two parts: a longitudinal sample and a cross-sectional sample.
The longitudinal sampling units are children and youth for whom responses to the 2019 CHSCY were collected. These children and youth are therefore aged 5 to 21 as of January 31, 2023. Data collected from longitudinal sampling units will support longitudinal estimation while only data collected from the subset of longitudinal sampling units who are 5 to 17 years of age as of January 31, 2023 will support cross-sectional estimates.
The cross-sectional sampling units are children and youth aged 1 to 17 years of age as of January 31, 2023.

STRATIFICATION METHOD
In terms of geography, the sample is primarily stratified by province. The one exception is in Ontario, where the geographic strata consist of the province's 34 health regions. The sample is further stratified into four age groups: children aged 1 to 4 years old (cross-sectional sample only), children aged 5 to 11 years old (all sampling units), youth aged 12 to 17 years old (all sampling units) and young adults aged 18 or older (longitudinal sample only).

SAMPLING
The longitudinal sample consists of all respondents to the 2019 survey, aside from all respondents originally stratified in the Territories in 2019, as well as a subset of respondents stratified in Ontario, and a small number of other exclusions.
The cross-sectional sample consists of a random sample of units selected from each geography and age group stratum. The number of longitudinal units in the strata for 5- to 17-year-olds is considered when determining the required cross-sectional stratum sample size.
The sample size for the survey is 175,000 raw units (41,932 longitudinal units and 133,068 cross-sectional units sent to collection).

Data sources

Data collection for this reference period: 2023-03-13 to 2024-03-31

Responding to this survey is voluntary.

Data are collected directly from survey respondents.

Data collection for this reference period takes place in two waves. Data collection for all longitudinal units and a random sample of cross-sectional records in each stratum takes place from March to June 2023. The remainder of the data collection for the cross-sectional sample takes place from September 2023 to March 2024.

Respondents are given an opportunity to complete the questionnaire online using an e-questionnaire. If an e-questionnaire is not completed in the first month of collection (March 2023 for wave 1 and September 2023 for wave 2), a Statistics Canada interviewer will call and ask the respondent to complete the questionnaire over the telephone.

View the Questionnaire(s) and reporting guide(s).

Error detection

Some editing of the data is performed at the time of the interview within the electronic questionnaire. The questionnaire has built-in checks for some out-of-range or extreme values that prompt respondents and interviewers to verify the recorded answer. Flow errors are controlled in the application through programmed skip patterns. For example, questions that do not apply to the respondent are not asked.

Imputation

Concepts related to total household income were not asked of respondents for this cycle of CHSCY. These income concepts were instead appended to the file from administrative sources for respondents who did not object to this process and for whom the process was possible. For the other respondents, total household income and some related variables were imputed using donor imputation. The imputation was done by geography (DA, postal code or Census subdivision), household size group, expected income group, and age group of the selected child or youth. Income was imputed for just under 3% of respondents on the master file.

Estimation

For estimates produced from survey data to be applicable to the covered population, and not just the sample itself, users must incorporate the survey weights in their calculations. A survey weight is given to each respondent included in the final sample. This weight corresponds to the number of persons in the entire population that are represented by the respondent.

As described in the sampling section, the 2023 CHSCY uses the Canada Child Benefit as a frame for its sample selection. For cross-sectional sample units selected from this frame, initial weights are calculated for each sampled child. For the longitudinal sample units, their final survey weights from 2019 serve as their initial weights for the 2023 survey. In order to produce final cross-sectional survey weights, these initial weights undergo several adjustments, including a reweighting to account for the fact that longitudinal and cross-sectional sample units were selected from overlapping frames, an adjustment for non-response and a calibration to align with known population totals. A subset of these adjustments is applied to the initial weights of longitudinal units alone to produce final weights suitable for longitudinal analysis.

In 2023, an additional set of survey weights (for both the longitudinal and cross-sectional data sets) was produced that accounts for partial submissions for sampled 12-17 year-old youth where the parent or legal guardian completed their portion of the questionnaire but the youth did not.

The sample design used for this survey was not self-weighting. That is to say, the sampling weights are not identical for all individuals in the sample. When producing simple estimates, including the production of ordinary statistical tables, users must apply the proper sampling weight.

The steps for weighting are described in the CHSCY User Guide.

Initial bootstrap weights are created through resampling the original sample. Adjustment steps similar to those applied to the survey weights are then applied sequentially to the initial bootstrap weights to compute the final bootstrap weights.

Estimates of the number of people with a certain characteristic are obtained from the data file by summing the final weights of all records possessing the characteristic of interest. Proportions and ratios are obtained by summing the final weights of records having the characteristic of the numerator and the denominator, and then dividing the first estimate by the second.

Estimates involving any data point reported by a 12-17 year-old youth should use the survey and bootstrap weights that do not account for the partial 12-17 year-old submissions. All other estimates should use the survey and bootstrap weights that do account for the partial submissions, as they are based on a larger data set and are therefore more precise.

Disclosure control

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.

Revisions and seasonal adjustment

This methodology type does not apply to this statistical program.

Data accuracy

As the data are based on a sample of persons, they are subject to sampling error. That is, estimates based on a sample will vary from sample to sample, and typically they will be different from the results that would have been obtained from a complete census. Precise estimates of the sampling variability of survey estimates can be produced with the bootstrap method using bootstrap weights that have been created for this survey.

NON-SAMPLING ERROR:
Common sources of these errors are imperfect coverage and non-response.

Coverage errors (or imperfect coverage) arise when there are differences between the target population and the surveyed population. People without telephones and mailable addresses were not collected as we had no way to contact them. To the extent that the excluded population differs from the rest of the target population, the results may be biased.

Non-response could occur at two points in this survey. For all sampled units, the parent or legal guardian could have chosen to not participate. For those who did participate (and, for 12-14 year-olds, consented to the participation of their children), it is possible that their children chose to not participate. Two sets of survey weights were developed to allow for the use of partial 12-17 year-old submissions, and both of these sets of weights were adjusted to account for patterns of non-response.

Other types of non-sampling errors can include response errors and processing errors.

NON-RESPONSE BIAS:
The main method used to reduce nonresponse bias involved a series of adjustments to the survey weights to account for nonresponse as much as possible. Information was extracted from administrative sources and used to model and adjust nonresponse.

COVERAGE ERROR:
The frame for the cross-sectional sample was the Canada Child Benefit (CCB) File while the frame for the longitudinal sample consisted of respondents to the 2019 CHSCY. All respondents in the ten provinces were interviewed by telephone or completed an electronic questionnaire without interviewer assistance. People with neither a mailing address nor an associated telephone number were not collected, as they could not be contacted by any of the survey collection modes. Also, in cases where multiple children were selected from a single dwelling, a subsampling step was added to select only one of these children for collection to reduce response burden. The weights of units sent to collection were adjusted to account for these withheld units.

OTHER NON-SAMPLING ERRORS:
Throughout the collection process, control and monitoring measures were put in place and corrective action was taken to minimize non-sampling errors. These measures included response rate evaluation, reported and non-reported data evaluation, improved collection tools for interviewers, follow-up with non-respondents and others.

Once processing steps are completed, data validation steps are undertaken. Validation programs are run in order to compare estimates for the health indicators taken from the common content with the 2019 CHSCY as well as the 2022 Canadian Community Health Survey estimates. Estimates from the 2023 CHSCY were compared internally using both the weights produced using only complete records and those produced while accounting for the partial 12-17 year-old records. These validations are performed by province, age and sex. Significant differences are examined further to find any anomalies in data.