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The Canadian Index of Wellbeing (CIW) Survey was developed by CIW researchers at the University of Waterloo(1). It measures many different aspects of people's lives that contribute to overall quality of life. The CIW defines wellbeing as:
"the presence of the highest possible quality of life in its full breadth of expression, focused on but not necessarily exclusive to: good living standards, robust health, a sustainable envi-ronment, vital communities, an educated populace, balanced time-use, high levels of de-mocratic participation, and access to and par-ticipation in leisure and culture"(2).
In Spring 2013, the region of Kingston, Fronte-nac and Lennox & Addington (KFL&A), in part-nership with the Community Foundation for Kingston & Area (CFKA), KFL&A Public Health, and Kingston Community Health Centres was selected by the CIW to pilot the survey. The purpose of using the CIW survey in KFL&A was to:
1) to determine how KFL&A residents are doing in terms of this broader understanding of wellbeing,
2) uncover areas where wellbeing can be improved, and
3) obtain baseline measures that can be used to assess change in various aspects of wellbeing over time.
This report briefly highlights the survey methods, and presents CIW survey results pertinent to public health. Where available, equivalent indicators derived from Statistics Canada surveys are presented for comparison purposes. More detail on statistical methods and interpretation can be found in the Appendix.
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Of the 11 000 invited to participate, 1 515 completed the survey. This represents a response rate of 14%. Generally, to obtain high quality results, statistical organizations such as Statistics Canada aim for a response rate of 70% or higher.
Since very few people aged 18-24 years responded, these individuals have not been included in any analyses. Results reported here pertain to participants aged 25 years or older (Table 1). Compared to the 2011 Census, the CIW survey underrepresents people aged 25-44 years, and those living in the City of Kingston (versus surrounding counties), and overrepresents people who are not in the workforce, and who have a bachelor's university degree or higher. Additionally, almost 80% of respondents reported living in KFL&A for 10 years or more. The reader is therefore cautioned that careful interpretation and use of these results is required; the needs of underrepresented groups, particularly disadvantaged and younger age groups, are unlikely to be fully captured in this survey.
Other key characteristics of the sample:
- Sample was evenly split between male and female respondents;
- Most respondents reported English as their mother tongue. A small number reported French (3%, 2-4) or 'Other' (5%, 4-6);
- Over three quarters (77%, 75-79) reported having a partner;
- One fifth (18-22) reported living with a disability; and
- 16% (15-18) said they were not born in Canada.
Table 1. Socio-demographic characteristics of CIW Survey respondents, 2013 (N = 1,465)
| Characteristic | % (95% CI) |
|---|
| Age (years) |
| 25-44 |
13 (12-15) |
| 45-64 |
45 (42-47) |
| 65 or more |
42 (40-45) |
| Education |
| High school or less |
28 (25-30) |
| Post-secondary certificate |
12 (10-13) |
| College diploma |
26 (24-28) |
| Bachelor's degree |
22 (19-24) |
| Masters degree or higher |
13 (12-15) |
| Working status |
| Full time |
29 (27-32) |
| Part-time or non-standard |
14 (13-16) |
| Not working |
7 (6-9) |
| Retired |
49 (46-52) |
| Income |
| Less than $40 000 |
24 (21 -26) |
| $40 000 to $99 999 |
51 (48 - 53) |
| $100 000 or more |
25 (23 - 28) |
| Marital status |
| Single, never married |
7 (6 - 8) |
| Married or common-law |
73 (70 - 75) |
| Separated, divorced, or widowed |
20 (18 - 22) |
| Region of residence |
| City of Kingston |
48 (46 -51) |
| Lennox & Addington |
31 (29 - 34) |
| Frontenac |
20 (18 - 22) |
| Years living in KFL&A |
| Less than 10 |
23 (20 -25) |
| 10 to less than 20 |
20 (18 - 22) |
| 20 to less than 40 |
32 (29 - 34) |
| 40 or more |
26 (23 - 28) |
| Health status |
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The CIW contains three scale questions that assess different compo-nents of overall health. These are physical health, mental health, and life satisfaction. Survey respondents were asked to rate their general physical and mental health on a five-point scale labeled:
1 "poor", 2 "fair", 3 "good", 4 "very good", and 5 "excellent",
and to rate their general life satisfaction on a 5-point scale labeled:
1 "very dissatisfied", 2 "dissatisfied", 3 "neither satisfied nor dissatisfied," 4 "satisfied", and 5 "very satisfied."
All three of these measures varied significantly by age and income but not by region of residence (Table 2). Although the youngest age group reported significantly better physical health than those aged 65 years or more, they reported lower levels of mental health and life satisfaction. For all three measures, low income respondents reported that their physical or mental health was very good/excellent or that they were satisfied with life in general significantly less often than respondents with higher incomes.
Table 2. Physical, mental health status, and the satisfaction by age and income, CIW Survey, 2013
| Subgroup | Physical health
very good / excellent%
(95%CI) | Mental health
very good / excellent%
(95%CI) | Life satisfaction
satisfied /very satisfied%
(95%CI) |
|---|
| Total % |
45 (43 - 48) |
61 (58 - 63) |
82 (80 - 84) |
| Total n |
1,458 |
1,461 |
1,435 |
| Age (years) |
| 25-44 |
53 (46 - 60) |
50 (43 - 57) |
75 (69 - 81) |
| 45 -64 |
45 (41 - 49) |
58 (54 - 61) |
79 (76 - 82) |
| 65 or more |
43 (39 - 47) |
68 (64 - 71) |
88 (86 - 91) |
| Income |
| Less than $40,000 |
31 (26 - 36) |
51 (45 - 56) |
67 (62 - 73) |
| $40,000 to $99,999 |
45 (41 - 49) |
61 (57 - 64) |
85 (82 - 88) |
| $100,000 or more |
60 (55 - 65) |
71 (66 - 76) |
89 (86 - 93) |
Statistics Canada measures overall health status, mental health status, and life satisfaction in KFL&A using the Canadian Community Health Survey (CCHS). In 2011/12, the percentage of KFL&A respondents aged 25 years or older with very good or excellent overall health was similar to that for mental health (Figure 1). Nine in 10 residents are satisfied with their lives (Figure 1).
Figure 1. Overall health status, mental health status and life satisfaction of KFL&A respondents aged 25 years or older; CCHS 2011/12
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62% (57-67)
Overall health (very good / excellent)
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67% (62-72)
Mental health (very good / excellent)
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91% (88-93)
Life satisfaction (satisfied / very satisfied)
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| Lifestyle |
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Healthy behaviours can help to prevent disease and disability. The CIW asked questions relating to physical activity participation, use of physical activity facilities, and amount of sleep per day. Results to all of these health behaviour questions are reported in this section, along with compara-ble measures from Statistics Canada (when applicable). A measure related to food insecurity is also reported here.
| Physical activity |
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Participation in regular physical activity can have many health benefits including preventing chronic diseases like Type 2 diabetes and heart disease, reducing stress, and reducing frailty in old age. CIW respondents were asked if they participate in vigorous exercise in a typical month (e.g., aerobics, jogging, weight training). The percentage reporting participation varied significantly by age, income, and region (Figure 2). As age increases and income decreases, the percentage participating in vigorous exercise decreases. City of Kingston residents reported participating in vigorous exercise more often then those in Lennox & Addington and Frontenac. Of those reporting that they participate in vigorous exercise in a typical month, the median number of times reported was 10 (min of 1 to max of 52) in a typical month.
Based on the 2011/12 CCHS, only 30% (25-35) of KFL&A residents aged 25 years or older were considered active. Activity level ('active', 'moderately active', and 'inactive') in the CCHS is based on estimates of daily energy expenditure required for the physical activities that respondents report participating in during the previous 3 months. This is a very different measure than that used by the CIW.
Figure 2. Percentage participating in vigorous exercise in a typical month, by age, income and region; CIW Survey, 2013
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| Recreational facility-use |
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Respondents to the CIW survey were asked how frequently they used specific recreational facilities within the previous year ("never", "sometimes", "regularly", "quite often", "all of the time"). The percentage reporting regular use (regularly to all of the time) was highest for parks (Figure 3). The youngest age group (25-44 years) reported the most frequent use of each of the facilities specified in the survey. Overall, however, a relatively small proportion of survey respondents reported regular use of available recreational facilities.
In terms of income, the lowest income group (less than $40,000) reported regular use of multi-purpose rec centres, arenas, parks, sports fields and outdoor rinks significantly less often than the highest income group ($100,000). Regionally, City of Kingston residents reported regular use of parks most frequently, followed by Lennox & Addington, then Frontenac. City of Kingston residents also reported regular use of multi-purpose rec centres more often than Frontenac residents. Finally, Frontenac residents reported regular use of swimming pools less often than residents of the City of Kingston and Lennox & Addington.
Figure 3. Regular use of recreational facilities in KFL&A in the previous year, by age; CIW Survey, 2013
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| Sleep |
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Sleep is as critical to health as diet and physical activity. It may play an important part in determining cognitive processing and the regulation of metabolism and emotions. CIW survey respondents were asked how many hours of sleep they get per day, including night-time sleep and naps. Results are shown in Figure 4. A higher percentage of respondents aged 65 years or more reported getting at least 8 hours of sleep per day than younger age groups. Regardless of age differences, a sizable percentage of the sample are not getting at least 8 hours of sleep per day. There were no differences by income or region.
Figure 4. Percentage reporting 8 hours of sleep or more per day; CIW Survey, 2013 (n = 1,452)
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| Food insecurity |
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Food insecurity refers to the financial inability to acquire and consume enough good quality food to maintain optimal health. Studies have shown food insecurity to be related to a number of health problems such as developmental problems in children, and depression among adults. Other health and behavioural correlates include obesity, cardiovascular disease risk factors, and delaying health care. The CIW included a question related to food insecurity. This question asks respondents how often in the previous year they ate less because there was not enough food or money for food. This is not the same measure of food insecurity that is used in national and provincial surveys.
In terms of the percentage who reported having to eat less at least once in the previous year, there were significant differences by age and income (Table 3). A much higher percentage of respondents aged 25-44 years and those with incomes less than $40,000 reported having to eat less at least once in the previous year, compared to older age groups and higher income groups, respectively. In fact, when comparing to respondents 65 years or more, those aged 25-44 years are at a 17-fold (9-34) increased odds of eating less at least once in the previous year. For those with incomes less than $40,000, the odds of eating less is 24 times (10-54) higher than for those with incomes of $100,000 or more.
In the CCHS, food insecurity is measured using an 18-item validated survey. According to 2011/12 data for KFL&A, 9% (6-13) of respondents aged 25 years or older were moderately or severely food insecure.
Table 3. Percentage who ate less because there was not enough food or money for food at least once in the previous year; CIW Survey, 2013
| Subgroup | % (95% CI) |
|---|
| Total % |
8 (6-9) |
| Total n |
1,377 |
| Age (years) |
| 25-44 |
22 (16-28) |
| 45 -64 |
8 (6-10) |
| 65 or more |
3 (2-4) |
| Income |
| Less than $40,000 |
22 (17-26) |
| $40,000 to $99,999 |
5 (4-7) |
| $100,000 or more |
2 (1-4) |
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| Time use |
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People need to feel that they have the time to engage in activities conducive to health and wellbeing. The CIW asked respondents to indi-cate the time they feel they have to engage in a number of different activities along a 10-point scale from 'not at all enough time' to 'almost always enough time'. For the specific activities named in Figure 5, the percentage of respondents indicating 'almost always enough time' varied significantly by age. Fewer respondents 25-44 years of age reported having enough time compared to older ages. As age increases, having enough time for activities appears to increase. Younger age groups may represent a target for services and environmental supports that increase their time to engage in healthy activities. No differences in time use were seen between income levels or regions.
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| Social capital |
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Social capital refers to the level of social connectedness within communities and the associated norms of trust and reciprocity. Low social capital has been shown to relate to a number of health problems including delayed child development, child and adolescent behaviour problems, stress and isolation, violent crime, obesity, and higher death rates. A number of questions relating to social capital were included in the CIW survey. Those discussed in this document include feelings about community and whether respondents reported being a member of or participating in organizations or groups serving the community within the previous 12 months.
The distribution of responses for perceptions of neighbourhood safety at night significantly differed by income level, but not age or region. Figure 6 suggests that as income increases, scores for safety concentrate at the safer end of the scale.
The distribution of responses for sense of belonging to the community significantly differed by age and income, but not by region (Figure 7 and 8). Figure 7 suggests that the distribution of responses does not differ between 25-44 and 45-64 years of age, but that responses for those 65 years of older may cluster at the strong end of the scale - indicating a stronger sense of belonging. Finally, Figure 8 suggests that there is no difference between the middle and high income groups, but that responses for the low income group may cluster at scores slightly below those of the two higher income groups - this may indicate that the low income group has a slightly weaker sense of belonging than the higher income groups.
In the 2011/12 CCHS, 72% (66 - 77) of KFL&A respondents aged 25 years or older indicated a 'somewhat strong' to 'very strong' sense of community belonging.
In the CIW, respondents were also asked if they had ever felt uncomfortable or out of place in their community because of their race, ethnicity, or culture, on a 7-point scale from 'never' to 'all of the time.' The percentage reporting having ever felt uncomfortable (score of 2 to 7) significantly differed by age and region (Table 4). The youngest age group (25-44 years) reported this feeling more often than the oldest (65 years or more), and City of Kingston residents reported this more often than residents of Lennox & Addington. Overall, however, the percentage in the sample reporting this feeling of discomfort in the community was relatively low.
A small percentage of CIW respondents reported that they were a member of or participated in at least one group or organization serving the community (e.g., school group, neighbourhood, civic or community association, service club or fraternal organization, or a public interest group) in the previous 12 months (Figure 9). Respondents in the lowest income group reported this significantly less often than the higher income groups.
Most respondents reported knowing at least one neighbour well enough to ask for a favour (Figure 10). This was found to significantly differ by age, income and region. Those 25-44 years of age or in the lowest income group reported knowing at least one neighbour less often than older age groups and higher income groups, respectively. Finally, residents of Frontenac reported knowing at least one neighbour more frequently than residents of the City of Kingston or Lennox & Addington.
Figure 6. Perceptions of neighbourhood safety at night, rated on a 7-pt scale 1 (very unsafe) to 7 (very safe), by income; CIW Survey, 2013
Figure 7. Sense of belonging to the community rated on a 7-pt scale 1 (weak) to 7 (strong), by age; CIW Survey, 2013
Figure 8. Sense of belonging to the community rated on a 7-pt scale 1 (weak) to 7 (strong), by income; CIW Survey, 2013
Table 4. Percentage reporting having ever felt uncomfortable or out of place in the community because of race, ethnicity, or culture; CIW Survey, 2013
| Subgroup | % (95% CI) |
|---|
| Total % |
10 (8-11) |
| Total n |
1,455 |
| Age (years) |
| 25-44 |
15 (10-20) |
| 45 -64 |
11 (8-13) |
| 65 or more |
7 (5-9) |
| Region |
| City of Kingston |
12 (10-14) |
| Lennox & Addington |
8 (5-10) |
| Frontenac |
8 (5-11) |
Figure 9. Percentage of respondents reporting involve-ment during previous year in a group or organization serving the community, by income; CIW Survey, 2013 (n = 1,317)
Figure 10. Percentage of respondents indicating they know at least one neighbour well enough to ask for a favour; CIW Survey, 2013
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| Perceptions of natural resources |
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Clean air and water, and a vibrant natural environment are essential for health and wellbeing. The CIW asked respondents to indicate their level of agreement with statements about their environment. The results for three of these agreement questions are presented here: "the air quality in my community is very good", "the quality of the natural environment in my town/city is very high", and "the water quality in my community is very good." The percentage of those who agreed with these three statements varied significantly by income (Table 5), where the lowest income group agreed less often with the three statements than the higher income groups. A higher percentage of respondents in Lennox & Addington (75%, 71-79) and Frontenac (82%, 78-86) agreed that the air quality is good than those in the City of Kingston (66%, 63-70). Finally, those aged 65 years or more (77%, 74-81) agreed that water quality is very good more often than those aged 25-44 years (67%, 61-74) and those aged 45-64 years (72%, 69-76). Overall, there appears to be room to improve in terms of perceptions of the quality of KFL&A's natural resources.
Table 5. Respondents' perceptions of air quality, quality of natural environment, and water quality in their town/city; CIW Survey, 2013
| Subgroup | Air quality is very good
(agree to very strongly agree)
% (95%CI) | Quality of natural environment is very high
(agree to very strongly agree)
% (95%CI) | Water quality is very good
(agree to very strongly agree)
% (95%CI) |
|---|
| Total % |
72 (70-74) |
73 (71 -75) |
74 (72 - 76) |
| Total n |
1,447 |
1,450 |
1,447 |
| Income |
| Less than $40,000 |
65 (59-70) |
65 (60 -70) |
66 (61 - 71) |
| $40,000 to $99,999 |
74 (71 -77) |
75 (72 - 78) |
77 (74 - 80) |
| $100,000 or more |
75 (70-80) |
79 (75 - 83) |
75 (71 - 80) |
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When interpreting box plots, the top part of each box indicates the 75th per-centile of response values and the bottom of each box indicates the 25th percentile. The median is a horizontal bar that often appears in the middle of the box, but sometimes can be equal to the 25th or 75th percentile. The 'whiskers', bars that extend out from the boxes, capture below the 25th percentile and above the 75th percentile. Outliers are omitted from the box plots.