Canadian Community Health Survey - Annual Component (CCHS)

Detailed information for 2025

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).

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

Description

In 1991, the National Task Force on Health Information cited several 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. The survey is offered in both official languages. 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 with both consistent design and consistent population representation 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.

The CCHS has undergone two major redesigns. The first in 2015 reviewed the sampling methodology, adopted a new sample frame, modernized, and updated its health content, and reviewed the target population. The second in 2022, further reviewed and updated the content of the survey as well as transitioned it to an online electronic questionnaire (EQ) that was available for direct self-reporting by selected respondents. Consultations were held with federal, provincial, and territorial share partners, health region authorities and academics for both redesigns.

As a result of these redesigns and major changes to collection and sampling approaches as well as content updates, caution should be taken when comparing data from previous cycles to data released for the 2015 and 2021 and for data released 2022 and onwards.

Reference period: Varies according to the question (for example: "over the last 12 months", "over the last 6 months", "during the last week", etc.)

Collection period: January 2, 2025 to December 31, 2025

Subjects

• Diseases and health conditions
• Health
• Health care services
• Lifestyle and social conditions
• Mental health and well-being

Data sources and methodology

Target population

The 2025 CCHS covers the population 18 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 18 and over.

Instrument design

Each content component of the CCHS questionnaire is developed in collaboration with specialists from Statistics Canada, other federal and provincial departments and/or academic fields. Questions are designed to be answered directly by the respondent via an online electronic questionnaire (EQ). Statistics Canada interviewers will also interview respondents by phone or in person using the same questionnaire for follow up on non-responses. In designing the electronic questionnaire (EQ), questions flow logically according to conditions such as previous responses, non-responses, and specific demographic variables such as sex at birth and age. Additional specifications provide guidance on the type of answer required, the minimum and maximum values, and edits associated with the question. Help text is made available by clicking on an on-screen bubble or by being included with the question text.

CCHS content is comprised of groups of questions (referred to as modules), which focus on a particular theme of health. These modules may be included in multiple cycles of CCHS or may be asked only periodically. Examples of modules asked in most cycles are: general health, chronic conditions, smoking, and alcohol use. For the 2025 cycle, thematic content related to mental health, telework and parental experiences, among many others, has been included. In addition to the health component of the survey, questions about respondent characteristics such as labour market activities, income, and sociodemographics are included.

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 and correct any errors in the program flow and text before the start of the main survey.

Sampling

This is a sample survey with a stratified sample and cross-sectional design.

Frame
The CCHS uses two frames.

The regular CCHS sample is selected from the area frame of the Labour Force Survey.
An additional sample is also selected from the 2021 Census.

Sampling unit

Area frame:
A stratified multi-stage design is used. A small contiguous geographical area, called a cluster, is the sampling unit at the first stage. The sampling unit at the second stage is the dwelling and at the third stage, the sampling unit is the person. In Prince Edward Island, a two-stage design is used (selection of dwellings from a list, then selection of a person in the dwellings).

Census 2021:
A two-stage design is used. Dwellings are selected at the first stage while persons are selected at the second stage.

Stratification method
The area frame is stratified by health region (HR), except in two provinces. In Ontario, strata are intersections of HRs and Ontario Health Regions. In Alberta, strata are subdivisions of HRs named subzones.

The frame built using Census 2021 is stratified by province and employment equity group.

Sampling and sub-sampling

Area frame:
The sample has a multi-stage design. First, a sample of clusters was selected independently within each stratum. At the second stage, a systematic sample of dwellings was selected within each of the sampled clusters. 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.

Sufficient sample was allocated to each of the provinces and HRs so that the survey could produce estimates of good quality at the provincial level each year and at the HR level for a two-year cycle. For each of the three territories, the data from a two-year cycle is needed to produce estimates of good quality. In 2025, the size of the sample selected from the area frame is approximately 100,000 dwellings.

Census 2021:
In 2021, Statistics Canada created a new initiative called the 'Disaggregated Data Action Plan (DDAP)'. The DDAP aims to support more representative data collection methods, enhance statistics on diverse populations to allow for intersectional analyses, and support government and societal efforts to address known inequalities by bringing considerations of fairness and inclusion into decision-making. Disaggregated data based on the four employment equity groups should be provided for: Indigenous peoples (First Nations, Inuit, Métis), Gender (women, men, gender diverse people), Persons from racialized populations (various subcategories), Persons with disabilities. More information about the DDAP can be found at: www.statcan.gc.ca/en/trust/modernization/disaggregated-data.

In response to the DDAP initiative, the sample size for CCHS was increased by 51,000 units in 2021 and 56,500 for 2022. The goal of these sample increases was to increase the number of DDAP group respondents by increasing the number of overall respondents. Starting in 2023, the DDAP initiative was enhanced by the availability of data from Census 2021. Since then, an extra sample is selected from the respondents to the Census 2021 long-form (approximately 28,000 in 2025).

Census 2021 was again chosen as an additional frame for the CCHS 2025 as it is the best option to allow stratification by population characteristics. Census 2021 data was used to target households with members who identified on the Census 2021 as belonging to groups that are part of the DDAP initiative. An extra sample of 28,000 households was selected from Census 2021 long form data. These households were allocated equally across the four collection periods of 2025. This extra sample was selected at the province and equity group level.

Data sources

Data collection for this reference period: 2025-01-02 to 2025-12-31

Responding to this survey is voluntary.

Data is collected from survey respondents either through an electronic questionnaire (EQ) directly online or assisted by a Statistics Canada interviewer through CATI (computer assisted telephone interviewing) or CAPI (computer assisted personal interviewing). A letter is mailed to the selected dwelling, which contains a code that gives access to the online questionnaire. It also informs the householder about the survey and asks that a household member access the questionnaire online with the given access code to answer some preliminary questions including a listing of all people that reside in that dwelling. From this information, a household member aged 18 or older is then randomly selected to participate in the survey. An email containing a second access code is sent to the selected respondent so that they may answer their portion online.

A Statistics Canada interviewer may follow up by calling, emailing, texting, or visiting the respondent if a completed online questionnaire is not received within a certain period of time.

Proxy reporting (when a selected respondent is unable to answer for themselves) is allowed on CCHS, although certain questions may be skipped.

The questionnaire is available in both official languages and can be completed by interview in either English or French. To remove language as a barrier to conducting interviews, each of the Statistics Canada regional offices recruited interviewers with a wide range of language competencies. When necessary, cases were transferred to an interviewer with the language competency needed to complete an interview. The average time to complete the survey is 40 minutes.

The information collected during the 2025 CCHS will be linked to the personal tax records (T1, T1FF or T4) of respondents, and tax records of all household members. Household information (address, postal code, and telephone number), respondent's information (Provincial or Territorial heatlh insurance number, surname, name, date of birth/age, sex) and information on other members of the household (surname, name, age, sex, and relationship to respondent) are key variables for the linkage.

Respondents are notified of the planned linkage before and during the survey. Any respondents who object to the linkage of their data have their objections recorded, and no linkage to their tax data takes place. Income information obtained from income tax records will also be provided to federal, provincial, and territorial share partners only with respondent consent.

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