Date: September 2024
Program manager: Director, Centre for Population Health Data
Director General, Health Statistics Branch
Original Supplement to the Generic Privacy Impact Assessment:
Reference to Personal Information Bank (PIB):
As with the original supplement for the CHSCY 2023, personal information collected through the voluntary CHSCY 2024 to 2027 continues to be described in Statistics Canada's "Health Surveys" PIB, (Bank number: StatCan PPU 806) which is published on the Statistics Canada website for Information about Programs and Information Holdings.
Description of changes to the statistical activity:
Under the authority of the Statistics ActFootnote1, Statistics Canada conducted the voluntary 2023 Canadian Health Survey on Children and Youth (CHSCY), in partnership with the Public Health Agency of Canada (PHAC) and a team of researchers, headed by McMaster University, a survey for which a Supplement to Statistics Canada's Generic Privacy Impact Assessment related to the Canadian Health Survey on Children and Youth (CHSCY) was created. CHSCY is a voluntary survey that has been conducted occasionally since 2019 and will be conducted annually from 2024 to 2027.
Under the authority of the Statistics Act, a new annual voluntary CHSCY program funded by the Federal government will be conducted from 2024 to 2027 with the main objective being to report on Shared Health Priority (SHP) indicators at the provincial and territorial levels. This is the result of the announcement by Federal, Provincial and Territorial governments to work towards improving health care for Canadians in four SHP areas:
- Expanding access to family health services, including in rural and remote areas
- Supporting our health workers and reducing backlogs
- Improving access to quality mental health and substance use services
- Modernizing the health care system with standardized health data and digital tools.
The announcement acknowledged that strong data and common indicators are essential for measuring and sharing progress with Canadians. The Canadian Institute for Health Information (CIHI) was asked to work collaboratively with provinces and territories, Health Canada, and data partners including Statistics Canada and other relevant organizations in a Shared Health Priorities Advisory Council to develop and report on the annual progress of the SHP indicators.
Statistics Canada will contribute to this initiative by monitoring several SHP indicators over time, such as those that relate to the access to a regular health care provider and perceived need for care. To inform about access to health care for children and youth, Statistics Canada will leverage CHSCY. By using CHSCY, Statistics Canada can gather essential data on determinants of health and outcomes. This effort will not only provide insights into the current state of health care but also guide future policies to enhance the well-being of younger populations in Canada.
Key differences between the original supplement detailing CHSCY 2023 and the follow-up annual program include:
- Changes to the Survey Content:
- Introduction of five new modules, including:
- The Regular Health Care Provider module to monitor SHP indicators related to access to a regular health care provider,
- The Perceived Need for Care module to monitor the SHP indicators related to access to integrated youth services for mental health and to monitor the number of Canadians who have unmet care needs,
- The Substance Use module to monitor the use of tobacco products, cannabis and alcohol among youth aged 12 to 17 years old,
- The Oral Health module to address a data gap in the territories,
- The Sexual Orientation module to replace the Sexual Attraction module;
- Modifications to some of the existing content.
- Removal of some content.
- Introduction of five new modules, including:
- Changes to the Collection Strategy:
- The removal of the longitudinal sample.
- The collection strategy will also be expanded to include the territories, with SHP indicators being reported at both the provincial and territorial levels.
- The sample size is being reduced.
Reason for addendum:
While Statistics Canada's Generic Privacy Impact Assessment (PIA) addresses most of the privacy and security risks related to statistical activities conducted by Statistics Canada, and the Supplement for the Privacy Impact Assessment for the Canadian Health Survey on Children and Youth 2023 addresses those more specific to CHSCY, this addendum details and assesses the changes in the survey content, methodology, and respondent communication strategy.
Necessity and Proportionality
The changes to the collection and use of personal information for the Canadian Health Survey on Children and Youth (CHSCY) can be justified against Statistics Canada's Necessity and Proportionality Framework:
1. Necessity:
1.1 Changes to Survey Content
The new annual CHSCY 2024 to 2027 will continue to gather comprehensive data on the health status of children and youth that will help shape policies and initiatives that support the well-being of children and youth aged 1 to 17 years old in Canada.
The program primarily reuses content from CHSCY 2023, but the questionnaire length is significantly shorter. Several 2023 modules were removed and new ones were introduced to track the new SHP indicators, align with Statistics Canada's Canadian Community Health Survey (CCHS) and address the most important data priorities and data gaps identified through a series of consultations with experts and stakeholders, including the Public Health Agency of Canada (PHAC) and Health Canada (HC).
The removal of modules resulted in a more concise survey that now takes approximately 35 minutes to complete, compared to 45 minutes for CHSCY 2023. Many of the CHSCY 2023 modules assessed the impacts of the COVID-19 pandemic, but the focus has now shifted to prioritize content that addresses the SHP indicators, and that aligns with key health indicators and data priorities identified through the consultations. Most of the new modules were directly taken or adapted from other surveys that have been conducted by Statistics Canada.
The new modules added to the CHSCY 2024-2027 are:
| New module | Source of module | Targeted respondents | Reason(s) for addition |
|---|---|---|---|
| Regular Health Care Provider | This module was built based on recommendations from the Shared Health Priorities Advisory Council. This module will also be used in the Canadian Community Health Survey (CCHS) 2025. | Parent or legal guardian of children and youth aged 1 to 17 years old. | This module measures the following SHP indicators:
Monitoring access to regular health care providers helps identify gaps in the health system, ensuring that everyone can receive timely and consistent care. For example, if data shows that a significant number of people in a certain area don't have regular access to a health care provider, targeted interventions can be implemented to address this issue, ultimately improving overall health outcomes. This data is crucial for informed decision-making and resource allocation. |
| Perceived Need for Care | This module was adapted from the Mental Health and Access to Care Survey (MHACS)Footnote2. | Parent or legal guardian of children and youth aged 1 to 14 years old and to youth aged 15 to 17 years old. | To monitor the SHP indicators related to access to integrated youth services for mental health and to monitor the number of Canadians who have unmet mental health care needs. Tracking access to youth mental health services and unmet mental health needs helps identify where support is lacking. For example, if data shows many young people can't access mental health services, targeted programs can be developed to address this gap. |
| Substance Use | This new module was built using existing content from the CHSCY 2023 (Smoking, Tobacco Alternatives, Alcohol Consumption, and Cannabis Consumption). These modules were shortened and regrouped into this new module. | Youth aged 12 to 17 years old. | To monitor the use of tobacco products, cannabis and alcohol among youth aged 12 to 17 years old. Gathering data on youth use of tobacco, cannabis and alcohol in Canada is crucial for several reasons. These substances pose significant health risks, especially for young people. Monitoring usage helps identity trends and potential health crises early. Accurate data informs policymakers, enabling them to create effective prevention and intervention programs tailored to youth needs. For example, if data shows a rise in cannabis use among youth, schools and communities can implement specific programs to address this issue, promoting healthier lifestyles and reducing long-term health impacts. |
| Oral Health | This module is from the Canadian Oral Health Survey (COHS)Footnote3. | Parent or legal guardian of children and youth aged 1 to 17 years old. This module will only be asked in the territories. | To address a data gap as the Canadian Oral Health Survey (COHS) is not collected in the territories. This module includes questions about oral health status and oral health care. It will provide information about the oral health status of Canadian children and youth living in the territories, including their ability to pay and challenges finding oral health services to meet their care needs. |
| Sexual OrientationFootnote4 | The module is part of Statistics Canada's harmonized content that is repeated across many surveys. | Youth aged 15 to 17 years old. | To replace the Sexual Attraction module. The decision to use the Sexual Orientation module over the Sexual Attraction module is rooted in historical consistency, harmonization, and time efficiency; the Sexual Orientation module's previous use in similar surveys such as the CCHS supports trend analysis between different surveys. Additionally, the Sexual Orientation module's shorter completion time aligns with the survey's time constraints. |
Modifications were also made to some existing modules from the CHSCY 2023. Substantial updates include:
| Modified module | Modification being made | Reason(s) for modification |
|---|---|---|
| Household Composition | No longer asks for the names of siblings living elsewhere. | This information is no longer required. This also helps to reduce the length of the survey, thereby minimizing any additional unnecessary response burden on the respondents. |
| Long-term Conditions | Now includes additional questions on post-traumatic stress disorder, chronic pain, obsessive-compulsive disorder, oppositional defiant disorder, and substance use disorder. | These health conditions are important to monitor considering they are related with mental health, a rising challenge in children's health. These conditions were incorporated to enhance alignment with the content included in the Canadian Community Health Survey (CCHS). This helps with cross-survey comparisons. |
| Information on survey data sharing conditions | The data sharing consent request, for youth aged 15 to 17 years, was clarified, "to share the information about you that you and your parent or legal guardian provided as part of this survey". | Wording in the data sharing consent request was clarified to reflect that information about the youth provided by their parent or legal guardian would not be shared without the consent of the youth. |
| Data sharing consent request question | The data sharing consent request no longer includes Health Canada or the PHAC. | The PHAC and Health Canada will no longer have share files for the CHSCY. Instead, select employees of these organizations will have direct secure access to the microdata files as deemed employeesFootnote5 of Statistics Canada. The data files will remain in Statistics Canada's possession and not be transferred into the possession of those departments, further protecting the confidentiality of respondents through reduced disclosure. |
Some content that is no longer necessary, such as modules related to childcare, organized sports and clubs, eating behaviours, sleep, and neighbourhood safety, was removed.
While some of the content will remain the same through the survey cycles, other content adjustments are anticipated for the upcoming annual CHSCY cycles (2025, 2026 and 2027). Every year, new modules — primarily from CHSCY 2023 and other Statistics Canada surveys — will be incorporated, while others will be removed or modified. The final content for each cycle will be confirmed through a content consultation process with experts and key stakeholders, ensuring the program's continued relevance. All changes to future cycles will be assessed for privacy risks or considerations and new addendums for the Supplement for the Privacy Impact Assessment for the Canadian Health Survey on Children and Youth 2023 will be developed and published as required, ensuring transparency.
1.2 Changes to the Collection Strategy
The removal of the longitudinal component means that respondents aged 18 to 22 will no longer be part of the survey. Additionally, the new annual CHSCY program will feature a single collection period, in contrast to the 2023 cycle which included two separate waves of data collection.
The new CHSCY program will also expand to include the territories, providing a more comprehensive demographic coverage. This expansion is essential because SHP indicators are expected to be reported at the provincial and territorial levels.
The annual CHSCY sample will continue to be selected from the Canadian Child Benefit (CCB) file but will consist of 63,000 children and youth rather than 175,000 used for CHSCY 2023. This number which is reduced mainly due to the removal of the longitudinal component, ensures a sufficient number of respondents for the findings to provide a representative portrait of the population of each Canadian province and territory for those aged 1 to 17 years old. This includes 60,000 children and youth in the provinces and an additional 3,000 in the territories. The sampling method remains consistent with CHSCY 2023, with no further changes implemented.
2. Effectiveness - Working assumptions
2.1. Changes to Survey Content
New and modified questions taken from existing Statistics Canada surveys were selected in coordination with PHAC and Health Canada due to their proven effectiveness in collecting the necessary information on those surveys. As with other Statistics Canada surveys, this content, along with any original content, has also been reviewed and tested through cognitive interviews by the Questionnaire Design Resource Centre at Statistics Canada to ensure the questions are effective at obtaining the required information from respondents.
2.2 Changes to the Collection Strategy
The sample frame will be implemented in accordance with Statistics Canada's established and effective processes and methodologies. These changes ensure that the results are representative of the population and that there are sufficient respondents.
3. Proportionality:
3.1. Changes to Survey Content
The response burden on Canadians will be reduced by making the questionnaire more concise. As with CHSCY 2023, all new and modified content to be collected is considered proportional to the potential invasion of privacy and has been deemed required to provide results that will inform policy makers to create and update programs and policies that support the well-being of children and youth.
A limited number of Health Canada and PHAC employees will be deemed Statistics Canada employees and will be provided access to the data within Statistics Canada's secure statistical infrastructure in order to analyze the data, thus eliminating the need to obtain consent to share the information with these organizations and eliminating any potential risks associated with the transfer of the information to those organizations.
All other Information regarding proportionality from the original Supplement for the Privacy Impact Assessment for the Canadian Health Survey on Children and Youth 2023 will continue to apply to the CHSCY annual program covering children aged 1 to 17 years.
3.2 Changes to the Collection Strategy
The removal of the longitudinal component of the collection strategy limits the number of times respondents are asked to provide their sensitive personal information and reduces the overall amount of information collected.
The additional inclusion of the territories in the collection strategy will help inform policy makers to create and update programs and policies to better serve these populations.
The reduction in sample size reduces the number of individuals from whom personal information is collected, reducing the overall invasion of privacy.
4. Alternatives:
4.1. Changes to Survey Content
Research was conducted on existing administrative data and other surveys on the health of children and youth and although these other sources of data were considered, none would provide all the information required to fulfill one of the survey's primary objectives to monitor SHP indicators over time, including those that relate to mental health, substance use, long-term conditions, and access to a regular health care provider and perceived need for mental health care.
4.2 Changes to the Collection Strategy
Alternatives to the expansion of the survey to the territories have been considered, but there are no similar surveys conducted by Statistics Canada, nor any viable administrative data sources that contain relevant quality information capable of monitoring SHP indicators in the territories as well as in the provinces.
Mitigation factors:
All the mitigation factors from the original Supplement for the Privacy Impact Assessment for the Canadian Health Survey on Children and Youth 2023 remain unchanged, however, the references to 18-22 year-olds and to the sharing of analytical datasets with PHAC and Health Canada do not apply to this new annual survey, as the longitudinal element has been removed and a limited number of PHAC and Health Canada employees will access the data as deemed employees within Statistics Canada's secure infrastructure.
Conclusion:
This assessment concludes that, with the existing Statistics Canada safeguards including those listed in the original SPIA, any remaining risks are such that Statistics Canada is prepared to accept and manage the risk.
Formal approval:
This Supplementary Privacy Impact Assessment has been reviewed and recommended for approval by Statistics Canada's Chief Privacy Officer, Director General for Modern Statistical Methods and Data Science OR Chief Security Officer, and Assistant Chief Statistician for Social, Health and Labour Statistics.
Electronic signature
Pierre Desrochers
Chief Privacy Officer
Date: September 23, 2024
Electronic signature
Wesley Yung
Director General
Modern Statistical Methods and Data Science
Date: September 24, 2024
Electronic signature
Josée Bégin
Assistant Chief Statistician
Social, Health and Labour Statistics
Date: September 25, 2024
The Chief Statistician of Canada has the authority for section 10 of the Privacy Act for Statistics Canada, and is responsible for the Agency's operations, including the program area mentioned in this Supplementary Privacy Impact Assessment.
This Privacy Impact Assessment has been approved by the Chief Statistician of Canada.
André Loranger
Chief Statistician of Canada
Date: