Our Research

The EMERGE Lab engages in highly collaborative and interdisciplinary research to better understand how various social and economic determinant impact our individual and collective health. Our work involves rigorous epidemiological methods and is conducted through a social and health equity lens.

Public Health Services and Adolescent Mental and Sexual Health During COVID-19 
Funded by: Canadian Institutes of Health Research (CIHR)

Before the COVID-19 pandemic, adolescent mental and sexual health conditions have been a concern to both public health and school administrators. High prevalence of depression and anxiety as well as increasing rates of chlamydia and gonorrhea have raised alarm. Public health restrictions, such as school closures, social distancing, and stay at home orders may exacerbate these mental and sexual health issues among adolescents since it may disrupt this important stage of their development. The goal of this study is to:

  • Estimate the extent to which interruptions to public health services during the COVID-19 pandemic has impacted mental and sexual health in adolescents in Ontario; and

  • Determine whether disruptions disproportionately affect youth across different gender and racial groups

To answer these important research questions, we will use three unique datasets to assess the associations between the availability of public health services (Ontario Public Health Information Database (OPHID)), and mental health (the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study) and sexual health (reportable disease data - Integrated Public Health Information System (iPHIS)) outcomes in adolescents during the COVID-19 pandemic.

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Photo credit: Prostooleh 

Inequities in COVID-19 Outcomes: The Mitigating Role of Public Health 
Funded by: Canadian Institutes of Health Research (CIHR)

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Photo credit: Freepik 

The COVID-19 pandemic has had a disproportionate impact on a number of socio-demographic groups, potentially leading to widening health inequities, and thus raising public health concern. For example, racial and ethnic minorities, and people from lower socioeconomic (SES) backgrounds have experienced higher rates of COVID-19 incidence, hospitalization, and mortality, and lower vaccination rates.

 

This study uses unique datasets, including the Ontario Public Health Information Database (OPHID), developed by our team, to assess the association between public health funding, programming, and services, and COVID-19 outcomes in Ontario, Canada. The overall goal of this study is to:

  • Estimate the extent to which public health services during the pandemic has lowered the risk for COVID-19 infection, hospitalization, mortality, and being unvaccinated; and

  • Determine if people from racial/ethnic and lower SES status backgrounds are more likely to benefit from public health services, thereby shrinking health disparities

Public Health Role on Risk for Deaths of Despair During the COVID-19 Pandemic
Funded by: Canadian Institutes of Health Research (CIHR)

The COVID-19 pandemic has had many spillover adverse effects on population health. Preliminary research indicates an increase in suicide attempts, drug poisonings and heavy alcohol consumption in Canada during the pandemic. This increased morbidity and mortality disproportionately impacts some socio-demographic groups, and thus has the potential to widening existing health inequities. Racial and ethnic minorities, people from lower socioeconomic (SES) backgrounds, and adolescents are at greater risk for suicide and drug and alcohol-related harm.

To assess the association between PHU-funding, programming, and services, and suicide, drug and alcohol poisoning in Ontario, Canada during the pandemic, this study will draw from unique datasets, such as the Ontario Public Health Information Database (OPHID), developed by our team, and the wealth of linked administrative data in the Ontario Health Data Platform (OHDP). The overall goal of this study is to:

  • Evaluate whether public health funding and services targeting suicide and drug and alcohol-related harm provided by local public health units (PHUs) in Ontario during the pandemic were associated with lower risk for suicide attempts, drug and alcohol poisoning and deaths attributed to these conditions; and

  • Determine if people from racial/ethnic, lower SES status backgrounds, and adolescents are more likely to experience the negative impacts of limited public health services during the pandemic.

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Photo credit: Moritz320 

Income Inequality and Maternal and Child Mental Health in Calgary
Funded by: M.S.I. Foundation

Image by Ivan Aleksic

Mental illness presents a substantial economic and public health burden in Canada, with 1 in 5 Canadian experiencing a mental illness  throughout their lifetime. Income inequality, which has been rising both domestically and globally over the past decades, is suspected to be associated with adverse mental health outcomes, such as anxiety and depression.

 

This study uses data from the All Our Families (AOF) longitudinal cohort to investigate the association between neighbourhood-level income inequality and mental health over time among mothers and their young children in Calgary, Alberta. The three primary objectives of this study are:

  • Identifying the relationships between income inequality and maternal and child mental health  outcomes over time;

  • Forecasting and analyzing the impacts that interventions intended to lower income inequality (e.g., minimum wage increase) have on disparities in mental health outcomes using agent-based modelling techniques ; and

  • Investigating potential mechanisms through which income inequality affects mental health 

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Income Inequality within Schools and Mental Health among Canada’s Youth

Funded By: Women and Children’s Health Research Institute (WCHRI)

 

Previous research has demonstrated that income inequality within a given environment is a risk factor for adverse mental health outcomes, especially among women and girls. Despite the rising levels of global, national, and local income inequality, relatively little work has been done investigating the relationship between income inequality and mental health within the school environment. The gap is especially pertinent when considering adolescent health, as they spend the majority of their waking hours within schools.

 

This studies explores the relationships and mechanisms of school-level income inequality with depression and anxiety among adolescents. Data from the nine-year Cohort on Obesity, Marijuana use, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study provides a rich sample of over 65,000 students attending 120 secondary schools in Alberta, Ontario, Quebec, and British Columbia. The specific goals of this study include:

  • Examining the association of school-level income inequality with depression and anxiety among adolescents over time and determining if this association differs across boys and girls;

  • Identifying the mechanisms involved in which income inequality leads to adverse mental health outcomes among teens; and

  • Investigating the effect of interventions that potentially change the income inequality within schools on mental health outcomes

The Impact of Austerity on Health: Identifying What Gets Cut and Who Gets Hit the Hardest
Funded by: Canadian Institutes of Health Research (CIHR)

Business Meeting

Public health aims to promote community health and well-being through a wide range of policies, programs, and initiatives. Unfortunately, governments tend to divest in public health during times of austerity. This divestment could result in disastrous consequences for population health and health disparities. However, the evidence on the health impacts of public health spending is limited. 

The current study aims to address this gap by considering the current climate of austerity in Ontario. The overall goal of this study is to establish an open access data system and measures for tracking public health expenditures, governance, and delivery over time in Ontario and to determine the potential for examining the relationship between public health financing and population and health inequities. Specific aims include:

  • Establishing an open access exposure measurement dataset to systematically record public health expenditures and program delivery in Ontario at the Public Health Unit-level;

  • Qualitatively exploring the impact of public health divestment on the delivery of public health services at the Public Health Unit-level ; and

  • Examining the impacts of public health divestments in Ontario on population health outcomes, such as smoking behaviour, and health equity

Inequality and Risk for Deaths of Despair

Funded by: CIHR- Institute of Human Development, Child and Youth Health

Life expectancy is a key indicator of the health of a population, as is reflective of a nation’s social and economic conditions. Despite previous increases in life expectancy among high income countries during the 20th and 21st centuries, recent trends indicate declining life expectancy in many of these countries. Researches have linked these trends to an increase in rates of Deaths of Despair, defined as deaths attributed to suicide, cirrhosis of the liver (due to excessive alcohol consumption), and fatal opioid-related overdoses. Preliminary evidence points to increasing societal inequality as a cause.

This study aims to determine if social economic indicators or inequality, such as income inequality and labour force participation, act as risk factors for Deaths of Despair among Canadians. Data for this study comes from large administrative population based datasets linked to patient data (mortality records, Emergency Department visits). We hope that our results will contribute to decision making and practice at the local, provincial, and national level, and can inform policy to reduce the risk of in Deaths of Despair in Canada.

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Want to learn more about our ongoing and past research projects? Please contact us at emerge@ualberta.ca