Air Pollution - Information Needs and the Knowledge, Attitudes and Behaviour of Canadians - Final Report

4.0 Determinants of Health

Canadians face a number of challenges to their health throughout their lives. In this survey we asked respondents to identify those factors that they thought had an impact on a person's health. Furthermore, we obtained their perceptions with respect to the factor that had the biggest impact on the health of Canadians.

4.1 Factors Influencing Health

Lifestyle choices and the environment are the most frequently cited factors that have an impact on a person's health.

When asked, top-of-mind, to identify factors that have an impact on a person's health, a clear majority of Canadians (63%) identify lifestyle choices such as diet and exercise. One-third (31%) spontaneously suggest that the environment has an impact on health. More than one in ten Canadians each mention stress (15%) or societal factors such as income and education levels (11%). Other factors identified include attitude/positive thinking (8%), hereditary or genetic factors (8%), occupation or occupational hazards (6%), accessible or reliable health care (5%), monitoring your health (5%), pollution (4%) and age (2%). Five percent of Canadians mention a variety of other factors.² Seven percent offer no response to this question.

Canadians with an annual household income between $50,000 and $70,000 (74%), Atlantic Canadians (73%), university graduates (70%) and those with an annual household income of more than $70,000 (68%) are the most likely to suggest that lifestyle choices have an impact on a person's health. In addition, men (66%) and anglophones (66%) are more likely than women (60%) and francophones (53%) to cite lifestyle choices.

Women (35%) are more likely than men (28%) to say that the environment has an impact on the health of Canadians. The most affluent Canadians (40%) are also more likely to spontaneously mention the environment. In general, those more concerned about the quality of air, those who feel that air pollution has more of an impact on the health of Canadians, and those who feel that air pollution in their community has become worse are more likely than others to identify the environment as a factor that can influence a person's health. Similarly, those with a respiratory illness are more likely to mention the environment as a factor that has an impact on a person's health.

It is interesting to note that those with a respiratory illness are also more likely to identify stress as a factor that has an impact on a person's health (20% vs. 14%). Residents of British Columbia (22%), those between 30 and 44 years of age (20%) and those with a college education (20%) are also more likely to identify stress as one of these factors.

Q.1 In your opinion, what factors have an impact on a person's health? Any other factors? (n=1,213
Multiple responses allowed

The most affluent and most educated Canadians are more likely than others to cite societal factors and hereditary or genetic factors as influences on a person's health.

In general, focus group participants identified similar factors that might impact health, with lifestyle, genetics and the environment being mentioned most often.

4.2 Relative Importance of Factors Influencing Health

Lifestyle choices are seen as having the biggest impact on a person's health.

We presented respondents with a list of four factors that can impact a person's health (the environment, lifestyle choices, hereditary or genetic factors and societal factors) and asked them which one has the biggest impact on health. Almost one-half of Canadians (48%) feel that lifestyle choices have the biggest impact. More than one in ten each believe societal impacts (15%) and hereditary or genetic factors (13%) have the biggest impact. While the environment is the second most frequently cited factor (31%) having an impact on a person's health, only 12 percent of Canadians suggest that the environment has the biggest impact on health of the various factors we examined in this question. Fewer Canadians suggest that a combination of these factors (5%) or all of them equally (5%) have the most influence on health.

Anglophones are more likely than francophones to suggest that lifestyle choices (51% vs. 40%) and hereditary factors (15% vs. 9%) have the biggest impact on a person's health. On the other hand, francophones (16%) place greater emphasis on the environment than do anglophones (10%). In addition, francophones are more likely than anglophones to suggest that a combination of these four factors (11% vs. 3%) has the most impact on health or that all of them have an equal impact (10% vs. 3%).

Q.2 Which of the following factors do you think has the biggest impact on a person's health ... the environment ... lifestyle choices (e.g. diet, exercise habits) ... hereditary or genetic factors ... societal factors such as income and education level? (n=1,213)

From a regional perspective, we find that Albertans (63%), residents of Manitoba and Saskatchewan (57%) and Atlantic Canadians (56%) are more inclined than other Canadians to believe that lifestyle choices have the biggest impact on a person's health. Residents of Ontario (18%) place relatively more importance on hereditary or genetic factors.

While Canadians between 16 and 29 years of age (55%) are more likely to say that lifestyle choices have the biggest impact on the health of Canadians, those 60 years of age or more (19%) are relatively more likely to see hereditary or genetic factors as having the most influence.

Better educated and more affluent Canadians and those who reside in communities with between 100,000 and one million people tend to place more importance on lifestyle choices. Those with a high school education or less and those with an annual household income of less than $30,000 are relatively more likely to suggest that the environment has the biggest impact on a person's health.

Canadians who feel that air pollution has a great deal of effect on the health of Canadians are more likely than those who feel that air pollution has little to no effect to suggest that the environment has the biggest influence on health (14% vs. 4%).

When we explored the relative importance of various factors in the focus group sessions, a number of interesting differences emerged in the three centres. Montreal participants tended to see lifestyle choices or stress as the most influential factor that impacts a person's health. Focus group participants in the Vancouver sessions tended to view genetics or the environment as the factor that has the biggest impact. Toronto participants argued that no one factor has the biggest impact, rather it is a combination of factors that influence a person's health. Most of the participants in the two Toronto sessions felt that either a combination of genetics and the environment or an even more encompassing combination of the environment, genetics and lifestyle choices has the biggest impact on the health of Canadians.

² These "other" factors include family and friends, government, media/TV, chemicals and war/terrorism.