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Devyn E. Hoopfer Department of Health Sciences, Carleton University HLTH 5402: Biological and Social Fundamentals of Health Dr. Renate Ysseldyk April 7, 2025  Artificial Intelligence Declaration This paper was written by the author. ChatGPT 4o was used for the purposes of idea generation, outlining, and/or language refinement. All content, arguments, and references have been independently evaluated by the author. The use of AI complies with the academic integrity policies of Carleton University and the HLTH 5402 instructor’s policy for this assignment. Position Statement I was previously employed by Correctional Services Canada. The stories I heard were nothing short of atrocities. These experiences profoundly changed the way I see the world. While this paper presents facts, figures, and statistics to build its case, it’s crucial to remember that behind every number is a human being shaped by circumstances. Each data point is a son or daughter that deserves dignity and respect. Perpetual Punishment: Incarceration As a Social Determinant of Health In Canada, approximately 38,570 people are held in federal, provincial or territorial custody (Statistics Canada, 2024), yet only 53.3% of them have been tried and sentenced (Public Safety Canada, 2023). For many incarcerated Canadians, a prison sentence marks the beginning of a vicious cycle fueled by stigma and systematic neglect. Indeed, of those sentenced, the average two-year recidivism rate was 23.4% (Stewart et al., 2019) with incarceration impacting nearly every facet of life, including accessibility to housing, income, and, as discussed in more detail in this blog, health. Social determinants of health (SDoH) are systemic social factors that drive differences in health across groups and are closely tied to structural inequities (Raphael et al., 2020). Incarceration is a profound but often overlooked SDoH. It disproportionately affects marginalized communities, worsening existing health disparities, and creating new ones. Incarceration is not just a legal issue or a moral failing, it reflects deeper societal failures, including those related to health equity and public health. Colonization & Incarceration The Canadian criminal justice system is deeply intertwined with the legacy of colonialism. Indigenous inmates account for 28% of the prison population, despite representing just 5% of the national population (Department of Justice, 2023). The forced relocation of indigenous communities to reserves, the repressive measures of the Indian Act, and the denial of treaty rights have contributed to socio-economic marginalization, setting the conditions for crime and victimization (Department of Justice, 2023). Additionally, the intergenerational trauma caused by residential schools and the foster care system has further disrupted family and community structures. Consequently, Indigenous people are more likely to suffer from poorer mental health and substance use disorders compared to non-Indigenous people (Cameron et al., 2021). Similarly, Black Canadians are overrepresented in correctional institutions due to racial profiling, socio-economic disadvantages, and systematic inequalities within the criminal justice system (Department of Justice, 2022). Intersecting Inequities There is significant overlap between risk factors associated with criminal behaviour and SDoH such as poverty, housing instability, racism, level of education, unemployment, and mental illness (Department of Justice, 2024). Most of the prison population report some history of family violence, family separation, physical or sexual abuse (Ulzen & Hamilton, 1998). Additionally, substance-use is also highly prevalent in this population compared to the general public (Kouyoumdjian et al., 2016). The intersection of these social determinants is often clustered in communities that are marginalized and under-resourced, where chronic stress and limited access to opportunity create vulnerability (Department of Justice, 2024). In such settings, individuals may adopt coping or survival strategies, such as substance use, petty theft, or informal economic activities, that are more likely to be criminalized than treated with social or health-based interventions. Rather than addressing the root causes of these behaviors, the criminal justice system often responds with punishment, reinforcing cycles of disadvantage. For instance, homelessness or mental illness may lead to minor legal infractions like loitering or public intoxication, resulting in arrest rather than connection with housing services or mental health care. These punitive responses reveal the structural inequities in how different populations are policed and punished. Recognizing the overlap between SDoH and incarceration is essential for shifting toward a public health approach that treats these behaviors as symptoms of systemic failure rather than individual moral weakness. Barriers to Services Behind Bars Once incarcerated, these individuals face further harm within the correctional system, particularly when in need of medical and/or mental health services. Adequate health care remains a persistent challenge in Canada’s correctional facilities, with health care issues being among the most frequently reported inmate complaint (Office of the Correctional Investigator, 2023). Incarcerated individuals often face barriers to receiving timely and adequate care in prison (Canada et al., 2022), leading to poorer health outcomes than the general population (Kouyoumdjian et al., 2016). Mental health services are particularly inadequate. There is strict control of medications within prisons and jails, where institutional concerns over drug misuse or diversion often override medical necessity (Fazel et al., 2004). This is extremely problematic given the disproportionately high rates of mental illness among inmates (Fazel et al., 2016). Fazel et al (2004) found that a mere 18% of participants with diagnosed mental illness were prescribed appropriate medication. Shortages of mental health professionals have left many struggling with mental illness, who were already failed by outside community supports (Mental Health Commission of Canada, 2017). Those with mental illness may be written-up for being disruptive or aggressive, which could be caused by untreated mental health problems. Unfortunately, penalties may extend their sentences leaving them vulnerable longer. In many cases, individuals feel they have no escape other than to self-harm to receive medical attention or commit suicide, with much higher rates of both compared to the public (Kouyoumdjian et al., 2016). Chronic and communicable diseases are more common in prisons and are often poorly managed (Stewart et al., 2015). Delays in care from prolonged waiting times, inadequate staffing, and limited access to specialized services further burden an already strained and underfunded system (Kouyoumdjian et al., 2016). For those with pre-existing issues or emerging health conditions, poor nutrition, inadequate ventilation, and overcrowding can worsen their health and enable the spread of communicable diseases (National Research Council, 2013). Diseases such as tuberculosis thrive in such conditions, where it remains a persistent concern (Kouyoumdjian et al., 2016). COVID-19 further exposed these vulnerabilities, with incarcerated populations experiencing higher infection and hospitalization rates (Zygmunt et al., 2024). Additionally, the prevalence of HIV, Hepatitis C, and syphilis is significantly higher among incarcerated individuals (Kouyoumdjian et al., 2016). Despite the high prevalence of substance use (Correctional Service Canada, 2024) and associated health risks among incarcerated individuals, there is a notable lack of harm reduction programs within the provincial correctional system (Sander et al., 2019). Most facilities do not offer supervised consumption services, needle exchange programs, or tailored educational materials (Sander et al., 2019). This gap increases the risk of disease transmission through the sharing of needles, unprotected sex, and reusing tattoo needles. Taken together, these conditions reflect a broader failure to uphold the health and rights of incarcerated individuals who fall under the purview of the government. Addressing these systemic gaps is not only a matter of health care reform but also one of social justice and public accountability. The Lingering Impacts of Incarceration The health challenges of incarcerated individuals persist long after they are released. While there is no available Canadian data on post-release outcomes, international research consistently shows elevated mortality rates among the formerly incarcerated (Kinner et al., 2013), most often from preventable causes such as drug overdoses or chronic illnesses (Kinner et al., 2013). Additionally, many individuals experience traumatic events during their internment that contribute to long-term mental health problems such as post-traumatic stress disorder (Hammock et al., 2024). Furthermore, stigma and restrictions may prevent individuals from acquiring adequate social support. Released individuals are more likely to be underemployed, earn lower incomes, lack social support, and have difficulty securing stable housing (Babchishin et al., 2022). These factors all negatively impact health (Raphael et al., 2020) and increase recidivism (Augustine & Kushel, 2022) further perpetuating the cycle. The Need for Systemic Reform Health issues in the criminal justice system are deeply rooted in structural inequities. Incarceration undermines physical, mental, and social well-being, far past the initial sentence, impacting health long after their debt to society has been paid. Without systemic reform, the correctional system will continue to function as both a consequence and a driver of poor health, particularly for marginalized communities. True justice cannot be achieved until the health, well-being, and dignity of every Canadian is recognized, prioritized and addressed. Until then, vulnerable individuals will continue to bear the cost of our inaction. References
Augustine, D., & Kushel, M. (2022). Community supervision, housing insecurity, & homelessness. The Annals of the American Academy of Political and Social Science, 701(1), 152–171. https://doi.org/10.1177/00027162221113983 Babchishin, K., Mularczyk, K., & Keown, L.-A. (2022). Economic outcomes of Canadian federal offenders. Public Safety Canada. https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/2021-r002/index-en.aspx?wbdisable=true Cameron, C., Khalifa, N., Bickle, A., Safdar, H., & Hassan, T. (2021). Psychiatry in the federal correctional system in Canada. BJPsych International, 18(2), 42–46. https://doi.org/10.1192/bji.2020.56 Canada, K., Barrenger, S., Bohrman, C., Banks, A., & Peketi, P. (2022). Multi-level barriers to prison mental health and physical health care for individuals with mental illnesses. Frontiers in Psychiatry, 13, 777124. https://doi.org/10.3389/fpsyt.2022.777124 Committee on Causes and Consequences of High Rates of Incarceration. (2013). Impact of incarceration on health. In National Research Council, Health and incarceration: A workshop summary. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK201966/ Correctional Service Canada. (2024). Findings from the 2022 National Health Survey: Harm reduction services, risk behaviours, institutional drug use, and infectious disease. https://www.canada.ca/en/correctional-service/corporate/library/research/glance/477.html Department of Justice. (2022). Overrepresentation of Black people in the Canadian criminal justice system. Government of Canada. https://www.justice.gc.ca/eng/rp-pr/jr/obpccjs-spnsjpc/index.html Department of Justice. (2023a). JustFacts: Recidivism in the criminal justice system. Government of Canada. https://www.justice.gc.ca/eng/rp-pr/jr/jf-pf/2020/aug01.html Department of Justice. (2023b). Overrepresentation of Indigenous people in the Canadian criminal justice system: Causes and responses. Government of Canada. https://www.justice.gc.ca/eng/rp-pr/jr/oip-cjs/e.html Department of Justice. (2024). Social determinants of justice. Government of Canada. https://www.justice.gc.ca/eng/cj-jp/cbjs-scjn/transformative-transformateur/p8.html Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: Prevalence, adverse outcomes, and interventions. The Lancet Psychiatry, 3(9), 871–881. https://doi.org/10.1016/S2215-0366(16)30142-0 Fazel, S., Hope, T., O'Donnell, I., & Jacoby, R. (2004). Unmet treatment needs of older prisoners: A primary care survey. Age and Ageing, 33(4), 396–398. https://doi.org/10.1093/ageing/afh113 Government of Canada, Statistics Canada. (2024). Average counts of adults in provincial and territorial correctional programs. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=3510015401 Hammock, J. A., López-Castro, T., & Fox, A. D. (2024). Prior incarceration, restrictive housing, and posttraumatic stress disorder symptoms in a community sample of persons who use drugs. Health & Justice, 12, 20. https://doi.org/10.1186/s40352-024-00276-7 Kinner, S. A., Forsyth, S., & Williams, G. (2013). Record linkage studies of ex-prisoner mortality. Addiction, 108(1), 38–49. https://doi.org/10.1111/add.12010 Kouyoumdjian, F., Schuler, A., Matheson, F. I., & Hwang, S. W. (2016). Health status of prisoners in Canada: Narrative review. Canadian Family Physician, 62(3), 215–222. Mental Health Commission of Canada. (2017). Mental health and the criminal justice system: “What we heard” evidence summary report. https://www.mentalhealthcommission.ca/wp-content/uploads/drupal/MHStrategy_Strategy_ENG.pdf National Research Council. (2013). Health and incarceration: A workshop summary. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK201966/ Office of the Correctional Investigator. (2023). Annual report 2022–2023. https://oci-bec.gc.ca/en/reports/annual Public Safety Canada. (2023). 2021 corrections and conditional release statistical overview. https://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/ccrso-2021/index-en.aspx#sec-a11 Raphael, D., Bryant, T., Mikkonen, J., & Raphael, A. (2020). Social determinants of health: The Canadian facts (2nd ed.). York University School of Health Policy and Management. Riep, A. (2019). The effects of culture and punishment philosophies on recidivism: Comparing prison systems in the United States and Scandinavia (Honors Thesis No. 700). Eastern Kentucky University. https://encompass.eku.edu/honors_theses/700 Sander, G., Shirley-Beavan, K., & Stone, S. (2019). The global state of harm reduction in prisons. Health & Justice. https://www.liebertpub.com/doi/10.1177/1078345820917356 Stewart, L. A., Nolan, A., Sapers, J., Power, J., Panaro, L., & Smith, J. (2015). Chronic health conditions reported by male inmates newly admitted to Canadian federal penitentiaries. CMAJ Open, 3(1), E97–E102. https://doi.org/10.9778/cmajo.20140025 Stewart, L., Wilton, G., Baglole, S., & Miller, R. (2019). A comprehensive study of recidivism rates among Canadian federal offenders: August 2019. Correctional Service Canada. https://www.canada.ca/en/correctional-service/corporate/library/research/report/426.html Ulzen, T. P., & Hamilton, H. (1998). The nature and characteristics of psychiatric comorbidity in incarcerated adolescents. Canadian Journal of Psychiatry, 43(1), 57–63. https://doi.org/10.1177/070674379804300106 Zygmunt, A., Warsame, K., Mather, R. G., McKinnon, L., Philipneri, A., Li, S., & Menon, S. (2024). COVID-19 in correctional facilities in Ontario, Canada: A retrospective epidemiological analysis from 15 January 2020 to 31 December 2022. International Journal of Prison Health, Advance online publication, 422–433. https://doi.org/10.1108/IJOPH-01-2024-0002
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Alissa Vaziri Department of Health Sciences Carleton University HLTH 5402: Biological and Social Fundamentals of Health Presented to Dr. Renate Ysseldyk March 31, 2025 Introduction: The Disappearance of Public Health Data Imagine waking up one day to see that thousands of public health datasets have simply disappeared. Vital information that advances scientific discoveries, tracks diseases, and develops treatments that are necessary to protect public health are all gone. This is the unfortunate reality that the United States is currently facing in the wake of President Donald Trump’s administration. “The shifting landscape in the United States has caused confusion, anger, uncertainty, and anxiety among members of our community,” stated the American Association for the Advancement of Science at its annual conference in Boston on Thursday, February 13, less than a month into the current Trump administration (Oza, 2025). In recent news, thousands of web pages have been removed on the US Centers for Disease and Control and Prevention (CDC) website. Dr. Angela Rasmussen, a virologist at the University of Saskatchewan recently reported her concerns to CBC News stating she never thought “that the CDC would actually start deleting some of these crucial public health data sets” and that public health data is “really important for everybody's health — not just in the U.S. but around the world” (Canadian Broadcasting Corporation [CBC], 2025). This means that the loss of American public health data does not just affect the United States healthcare, it also affects Canada’s healthcare advancements, since Canada heavily relies on American health research to inform policies, strengthen healthcare interventions, and gain a better understanding of current diseases and infections. The United States has been a global health leader for a long time with investments in global health initiatives to combat Malaria, Ebola, HIV/AIDS to name a few (Fuster et al., 2017). The “America First” initiative that President Trump proposes fails to understand that global health research is not a charity, it is an investment in improving the health and quality of life for people in the United States, as well as the entire world (Fuster et al., 2017). Health research and health data are essential in the containment of infectious, genetic, and lifestyle diseases, in which health research requires appropriate funding and allocated resources to make progress in diagnosis and treatment for patients (Shrivastava, Shrivastava, & Ramasamy, 2017). Additionally, it is important that health data from ethnic and racial minorities are routinely collected and become standard medical practice to avoid rendering these groups as “invisible” in health research (Heyrana et al., 2023). Limiting research on vulnerable groups leads to generalization, exacerbates health inequities, and hinders the development of targeted interventions (Heyrana et al., 2023).  Figure 1. Protests against the Trump-Musk cuts to research funding. Credits:afscme.org How Research and Data Address Social and Biological Factors So how does health research and health data shape biological factors and address the social determinants of health? Research has shown that collecting social determinants of health data such as socioeconomic status can help predict health outcomes and create evidence-based interventions to target issues like malnutrition, neurocognitive development problems, and infant mortality (Kachmar et al., 2019). Not only does collection of health data impact biological health but researching variables like socioeconomic status can also help inform policy decisions to tackle systemic barriers in healthcare (Kachmar et al., 2019). Another example is that social determinants of health data can help implement new support programs for patients such as housing assistance, which research has shown to reduce depression and anxiety (Bambra et al., 2010; Feldman, Davlyatov, & Hall, 2020). So what happens when life-saving public health data is suddenly erased, as is rapidly happening in the United States? Efforts made to address the social determinants of health and health disparities will be severely hindered, which can have devastating health and social consequences for vulnerable populations, especially since marginalized populations tend to have the most missing health data (Rose et al., 2023; Weiss & Waller, 2022). Funding Cuts to Health Research Unfortunately, the current cuts to American research are not new. Back in 2017, the Trump administration proposed a $5.8 billion cut to the National Institutes of Health (NIH), which Congress ultimately rejected (Cancer Discovery 2017; Katz & Wright, 2017). Experts warned that such cuts could have severely hindered efforts to develop immunotherapies and other life-saving treatments, potentially impacting patient outcomes (Cancer Discovery, 2017; Katz & Wright, 2017). Additionally, cuts made to lower drug prices in 2017 did not take drug research and patient access into account, with access to care being a social determinant of health (Dabbous et al., 2019).  Figure 2. Protestors holding signs to keep funding the NIH. Credits: The Hill What Can be Done About Missing Health Research and Data for Canada? Fortunately, in Canada, we have one of the highest life expectancies in the world according to the Canadian Institutes of Health Research (CIHR), in which advancements to improve quality of life were achieved through strong investments in health research (Canadian Institutes of Health Research, 2023). However, this success is not guaranteed, and with recent challenges in the United States, Canada could also be at risk. Given that there is potential for disruptions to health research and loss of data due to the cuts, scientists and researchers must be innovative by creating frameworks and investing in Canadian research to advance public health efforts here in Canada. To put the idea of frameworks into perspective, a case study in India was done to help locals implement preventative health strategies to combat cervical cancer but were met with missing epidemiological data like HPV, sexual behaviour, and cervical cancer incidence which hindered the research progress (Man et al., 2023). So this prompted the researchers to develop a framework called “Footprinting” which uses the epidemiological data from other similar geographical zones in India and make educated evidence-based estimates for the missing local data (Man et al., 2023). Frameworks like this can help researchers in Canada overcome missing data by using data from similar populations, ensuring that evidence-based public health research can still be conducted despite data losses. Additionally, Canada must increase health research funding and avoid the cuts to public health workforce, especially in light of the current challenges in the United States (Hoffman et al., 2019; Weil, 2016). As of July 2025, The Canadian Medical Association Journal (CMAJ) proposes that “we can improve our own systems” by implementing better wastewater surveillance and electronic medical records for increased infectious disease monitoring and strengthening overall public health of the population (CBC, 2025; Charlebois & Pawa, 2025). The work that is done in health research extends beyond any political election cycle and is useful for tackling systematic health injustices (Hoffman et al., 2019). Investing in evidence-based clinical practices, hiring more staff per capita, and addressing current systematic inefficiencies will help strengthen Canada’s healthcare during this time of limited data and research (Guyon & Perreault, 2016; Weil, 2016). It is time for Canada to innovate, invest, and commit to evidence-based public health research because when the data disappears, lives are put at risk. Declaration: The outline for creating this blog used the ChatGPT AI tool with permission for the HLTH 5402 course. The actual blog was written fully by the author without AI use. References
Bambra, C., Gibson, M., Sowden, A., Wright, K., Whitehead, M., & Petticrew, M. (2010). Tackling the wider social determinants of health and health inequalities: Evidence from systematic reviews. Journal of Epidemiology and Community Health, 64(4), 284–291. https://doi.org/10.1136/jech.2008.082743 Canadian Broadcasting Corporation. (2025, February 17). Canada concerned as U.S. deletes medical and environmental data under Trump administration. CBC News. https://www.cbc.ca/news/politics/canada-us-medical-environmental-data-1.7457627 Canadian Broadcasting Corporation. (2025, July 5). How Canada could boost disease surveillance to make up for U.S. health cuts. CBC News. https://www.cbc.ca/news/health/cmaj-editorial-canada-us-cuts-surveillance-1.7577992 Canadian Institutes of Health Research. (2023, November 24). What is health research? Government of Canada. https://www.cihr-irsc.gc.ca/e/53146.html Cancer Discovery. (2017, April 30). Budget cuts would harm research and patients. Cancer Discovery, 7(5), OF5. https://doi.org/10.1158/2159-8290.CD-NB2017-041 Charlebois, S., & Pawa, J. (2025, July 2). Tackling communicable disease surveillance and misinformation in Canada [Editorial]. Canadian Medical Association Journal, 197(24), E694–E695. https://doi.org/10.1503/cmaj.250916 Dabbous, M., François, C., Chachoua, L., & Toumi, M. (2019). President Trump's prescription to reduce drug prices: From the campaign trail to American Patients First. Journal of Market Access & Health Policy, 7(1), 1579597. https://doi.org/10.1080/20016689.2019.1579597 Feldman, S. S., Davlyatov, G., & Hall, A. G. (2020). Toward understanding the value of missing social determinants of health data in care transition planning. Applied Clinical Informatics, 11(4), 556–563. https://doi.org/10.1055/s-0040-1715650 Fuster, V., Frazer, J., Snair, M., Vedanthan, R., & Dzau, V. (2017). The future role of the United States in global health: Emphasis on cardiovascular disease. Journal of the American College of Cardiology, 70(25), 3140–3156. https://doi.org/10.1016/j.jacc.2017.11.009 Guyon, A., & Perreault, R. (2016). Public health systems under attack in Canada: Evidence on public health system performance challenges arbitrary reform. Canadian Journal of Public Health, 107, e326–e329. https://doi.org/10.17269/CJPH.107.5273 Heyrana, K. J., Kaneshiro, B., Soon, R., Nguyen, B. T., & Natavio, M. F. (2023). Data equity for Asian American and Native Hawaiian and other Pacific Islander people in reproductive health research. Obstetrics and Gynecology, 142(4), 787–794. https://doi.org/10.1097/AOG.0000000000005340 Hoffman, S. J., Creatore, M. I., Klassen, A., et al. (2019). Building the political case for investing in public health and public health research. Canadian Journal of Public Health, 110(3), 270–274. https://doi.org/10.17269/s41997-019-00214-3 Kachmar, A. G., Connolly, C. A., Wolf, S., & Curley, M. A. Q. (2019). Socioeconomic status in pediatric health research: A scoping review. The Journal of Pediatrics, 213, 163–170. https://doi.org/10.1016/j.jpeds.2019.06.005 Katz, I. T., & Wright, A. A. (2017). Scientific drought, golden eggs, and global leadership – Why Trump's NIH funding cuts would be a disaster. The New England Journal of Medicine, 376(18), 1701–1704. https://doi.org/10.1056/NEJMp1703734 Man, I., Georges, D., Bonjour, M., & Baussano, I. (2023). Approximating missing epidemiological data for cervical cancer through footprinting: A case study in India. eLife, 12, e81752. https://doi.org/10.7554/eLife.81752 Oza, A. (2025, February 17). At premier science gathering, “anger, uncertainty, and anxiety” about the future of research under Trump. STAT. https://www.statnews.com/2025/02/17/aaas-meeting-science-research-trump/ Rose, C., Barber, R., Preiksaitis, C., Kim, I., Mishra, N., Kayser, K., Brown, I., & Gisondi, M. (2023). A conference (Missingness in Action) to address missingness in data and AI in health care: Qualitative thematic analysis. Journal of Medical Internet Research, 25, e49314. https://doi.org/10.2196/49314 Shrivastava, S., Shrivastava, P., & Ramasamy, J. (2017). Reinforcing the need to invest in health-related research and development activities. MAMC Journal of Medical Sciences, 3(2), 108. https://doi.org/10.4103/mamcjms.mamcjms_13_17 Weil, T. P. (2016). What can the Canadians and Americans learn from each other’s health care systems? The International Journal of Health Planning and Management, 31(3), 349–370. https://doi.org/10.1002/hpm.2374 Weiss, P. S., & Waller, L. A. (2022). The impact of nonrandom missingness in surveillance data for population-level summaries: Simulation study. JMIR Public Health and Surveillance, 8(9), e37887. https://doi.org/10.2196/37887 Healthy Aging: Benefits of Physical Activity in Populations with Vascular Cognitive Impairments4/1/2025  W.R. Bud Jardine (88y 33d) sets the record for the oldest person (male) to perform a headstand (Guiness World Record, 2023). By Santina Temi and Klara Doelle In many countries worldwide, the combination of improved living conditions and advanced medical intervention has greatly increased human life expectancy. The world’s older adult population is increasing, and this is expected to continue. By 2050, a 22% increase in the population above the age of 60 is projected (WHO, 2024). This means an increased need for research on topics concerning this population. During the typical aging process, the skeletal muscle composition may weaken or atrophy, muscle metabolism is impaired, and there is often a decrease in muscle strength and mobility. Additionally, total brain volume decreases, often accompanied by a decline in global cognition, as well as specific domains such as memory and executive functions. The combined result is a reduced ability to perform a variety of physical and cognitive tasks compared with our younger selves. It is well known that physical activity has many benefits for the general population at any age. Specific to the aging population, exercise has been shown to be beneficial for mental, emotional, and physical wellbeing and to reduce risk factors for neurodegenerative diseases. An excellent example of healthy aging is my (Klara’s) grandfather, Bud Jardine. Over the years, more than one doctor told him he is “at least 10-12 years younger than his age”. At 88 years and 33 days old, Bud set the Guinness World Record for the oldest person to hold a headstand for more than 15 seconds. For Bud, exercise has always been an important aspect of healthy living, becoming even more so with age. At almost 90 years old now, he continues to maintain aerobic fitness through walking, or as he refers to it, marching. Three times per week he sets out for a 45-minute brisk walk. Bud complements his aerobic exercise with some strength training and a long-standing practice of tai chi, yoga, and meditation. His commitment to exercise in old age is a practice he calls “aging backwards” and lends credibility to the notion that regular exercise enables a good quality of cognitive and physical health for longer throughout one’s life. With increases in lifespan, dementia is an emerging issue for older adults. The most common form of dementia is Alzheimer disease, but a second, lesser known, form of dementia is vascular cognitive impairment. In vascular cognitive impairment, blood vessels that supply the brain are compromised. The most common cause of vascular cognitive impairment is cerebral small vessel disease, and it is estimated that by the age of 65, it has developed in 80% of the population (Bolandzadeh et al., 2015). Two sets of studies by Dr. Liu-Ambrose and colleagues have investigated the role of exercise in older adults living with cerebral small vessel disease, namely aerobic exercise and resistance training. Both studies included male and female participants who were diagnosed with mild vascular cognitive impairment due to cerebral small vessel disease.  In their studies on the effects of aerobic exercise (Liu-Ambrose et al., 2016; Hsu et al. 2018), participants (average age 74, sample size=71) were randomized into two groups. One group received an aerobic training program (progressive walking, up to 65-70% HRR, 60 min/class) three times per week, while the other group received a monthly educational cooking class (60 min/class); both lasted 6 months. The cooking class was used as a control for the effects of social interaction. At the end of the study period, individuals in the aerobic training group showed a significant improvement in general cognitive functions, especially memory, compared to the group in the educational cooking class.  In the studies on resistance training (Liu-Ambrose et al., 2021; Liu-Ambrose et al. 2024), participants (age 55 or over, sample size= 91) underwent either a progressive resistance training program or balance and tone classes twice a week, for 6 months. The training program consisted of Keiser circuit exercises and free weights: 2 sets of 10-12 reps. The balance and tone program involved stretches, Kegal and balance exercises in addition to functional movements, such as sit-to-stand. The balance and tone training group acted as a control and did not receive any progression in external loading. At the end of the training, older adults in the progressive resistance training group had a significant improvement in global cognition compared to the balance and tone group.
In both studies, when comparing results based on biological sex, females were found to have benefitted more from both aerobic and resistance training than males. Aerobic exercise particularly improved performance on measures of cognitive flexibility in females (Barha et al., 2017). Similarly, resistance training slowed the progression of white matter lesions in females with cerebral small vessel disease (Liu-Ambrose et al., 2024). The reason for such sex differences is unclear, but perhaps females benefitted more from these interventions because, according to some studies, resistance training increases insulin-like growth factor 1 (IGF-1) levels mainly in females and this, in turn, seems to be associated with lower white matter hyperdensities (Jiang et al., 2020; Cao et al., 2023). The take home message from these studies is that both aerobic and resistance training are beneficial for individuals (especially biological females) over the age of 65. Aerobic exercise seems to improve memory and executive functions (Liu Ambrose et al, 2016; Hsu et al. 2018), whereas resistance training improves global cognition in people with vascular cognitive impairment (Liu-Ambrose et al., 2012; Bolandzadeh et al., 2015). Overall, exercise can delay disease progression and the onset of dementia, while also improving quality of life in older adults. A shift towards more active lifestyles for older populations may allow current and future generations to live longer and healthier lives. This blog is a part of a series exploring how physical activity builds resilience against stress-related brain changes and mental health disorders. References:
By Katherine Griffiths & Shannon Smith The conversation surrounding mental health has gained significant traction in research and the media in recent years. With approximately 10-20% of children and adolescents diagnosed with mental disorders (World Health Organization, 2024), and an assumed association between sedentary screen time and poorer psychological wellbeing (Mougharbel & Goldfield, 2020), the need for effective interventions that address these concerns has never been clearer. Dr. Katie Gunnell is an associate professor in the Department of Psychology at Carleton University who is investigating the relationship between screen time, physical activity, and mental health in adolescents and young adults. She received her Bachelor of Kinesiology and Master’s in Applied Health Sciences from Brock University followed by her PhD at the University of British Columbia. She then began working as a Junior Researcher and Scientist with the Healthy Active Living and Obesity Research Group at CHEO Research Institute. Dr. Gunnell now conducts research in the area of exercise and health psychology at Carleton University. Dr. Gunnell’s research addresses some growing concerns in today’s society. Recent trends show increasing rates of mental illnesses such as anxiety and depression among young people (Wiens et al., 2020). Further, declines in overall well-being have been exacerbated by the COVID-19 pandemic and lifestyle changes (e.g., increased sedentary behaviours and screen time, and decreased physical activity) (Gabet et al., 2023). Blame is often placed on screen time: headlines about the negative impacts of social media and other forms of device use on mental health are ever-present in the media. Despite this, the relationship between screen time and mental health outcomes is not cut-and-dry. The impact of screen time on mental health is highly debated and inconsistent (Gunnell et al., 2016b). Dr. Gunnell is particularly interested in the role that quality, as opposed to quantity, of screen time plays in this relationship. This avenue of research is particularly promising given the constant evolution of technology and variations in types of screen use. Currently, most research in the field focuses on the quantity of screen time, which may not tell the whole story. There is a concerning trend towards decreasing physical activity and increasing screen time (Gallant et al., 2020), two lifestyle variables linked to adverse health outcomes in youth. Canadian 24-hour movement guidelines have been established, which suggest healthy goals for physical activity and screen time for children and adolescents. This guideline suggests 1 hour of moderate-to-vigorous intensity physical activity, and less than 2 hours of screen time per day (Tremblay et al., 2016). However, in a longitudinal study of Canadian children, only 5% met all three guidelines at any point over an 8-year period (Gallant et al., 2020). Physical activity is one lifestyle variable which has a well-known and consistent correlation with better brain health and well-being (Gunnell et al., 2019). Since the pandemic in Canada, overall sedentary activity has increased. By spending more time behind a screen, we inherently spend less time being physically active. While the quantity of screen time may be influential, physical activity likely mediates the relationship between screen time and mental health. Physical activity is an important behavioural target that can be modified to enhance well-being. To understand how to better optimize the benefits of physical activity, we are required to delve into the three fundamental psychological needs within the Self-Determination Theory (Deci & Ryan, 2002): competence, autonomy, and relatedness. The satisfaction of these needs is thought to directly predict psychological well-being and behavioural outcomes and, in turn, play a significant role in how young people engage with physical activity (Deci & Ryan, 2000; Gunnell et al., 2016a). The feeling of competence arises when individuals believe they can successfully tackle tasks, such as mastering a new sport or achieving fitness goals. Activities that are optimally challenging—neither too easy nor overwhelmingly difficult—are most beneficial, as success in these activities fosters self-efficacy and improved mental health. Autonomy refers to the sense of control and choice over one’s actions. Involvement in physical activities that youth genuinely choose for themselves, rather than those imposed by parents or institutions, enhances their motivation and engagement. Finally, relatedness encompasses the need to feel connected to others who you feel are important. Social interactions during physical activities create a sense of belonging and support, whether through team sports, group exercises, or simply playing with friends. A longitudinal study in New Brunswick, part of the Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) project followed 842 participants aged 10 to 11, tracking their measures of psychological need satisfaction and moderate-to-vigorous physical activity every four months for three years. The findings of this study revealed that those who experienced higher satisfaction of their psychological needs engaged in more physical exercise, leading to better health-related quality of life (Gunnell et al., 2016a). Therefore, as we seek to address the mental health crisis among young people, promoting physical activity that fulfills these three needs can be a vital strategy. Increasing outdoor time not only boosts physical activity but also enhances mental well-being (Bélanger et al., 2019). Additionally, incorporating active transportation, like walking or biking, supports independent mobility and exploration and significantly reduces mental distress in children (Larouche et al., 2024). Families also play an essential role in this by modelling active lifestyles and prioritizing outdoor activities together. Engaging in physical activities as a family can help to strengthen bonds and fulfill the need for relatedness. Ultimately, prioritizing physical activity and addressing these fundamental psychological needs can have a significant impact on improving mental health outcomes for young people in today’s challenging environment.  Source: Canadian Society for Exercise Physiology, Canadian 24-Hour Movement Guidelines for the Children and Youth (5-17 years) This blog is a part of a series exploring how physical activity builds resilience against stress-related brain changes and mental health disorders. References:
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