Examining the association between public health unit spending and adolescent substance use
Background: Based on the socio-ecological model of health, socioeconomic policy is an important determinant of population health. Spending decisions by public health units (PHU) have been shown to be associated with population health outcomes. Some studies have found greater PHU spending to be assoc...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024169150 |
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| author | Urvi Rai Karen A. Patte Brendan T. Smith Ambikaipakan Senthilselvan Elaine Hyshka Scott T. Leatherdale Roman Pabayo |
| author_facet | Urvi Rai Karen A. Patte Brendan T. Smith Ambikaipakan Senthilselvan Elaine Hyshka Scott T. Leatherdale Roman Pabayo |
| author_sort | Urvi Rai |
| collection | DOAJ |
| description | Background: Based on the socio-ecological model of health, socioeconomic policy is an important determinant of population health. Spending decisions by public health units (PHU) have been shown to be associated with population health outcomes. Some studies have found greater PHU spending to be associated with improved population health, while others report mixed findings, warranting further research. The objective of this study was to investigate the association between per capita PHU spending and self-reported substance use among Canadian adolescents. Methods: Cross-sectional, multilevel modelling was conducted using student data from the 7th wave (2018/19) of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study, as well as spending data from the audited financial statements of Ontario's PHUs. The sample included 29,056 students in grades 9–12 attending 61 secondary schools in 15 PHUs across Ontario. Substance use was measured as the self-reported use of alcohol, cannabis, cigarettes and e-cigarettes, at least once per month on average. Results: Approximately 50 % of the study sample was female and the majority identified as being White. Per capita spending ranged from $54.07 to $224.95, with a median spending amount of $89.62. The highest quartile of PHU spending was significantly associated with higher alcohol use (adjusted odds ratio (AOR): 1.41, 95 % CI: 1.04, 1.91), binge drinking (AOR: 1.71, 95 % CI: 1.18, 2.48), and cigarette use (AOR: 2.19, 95 % CI: 1.23, 3.91) in adolescents, while the second highest quartile was associated with lower e-cigarette use (AOR: 0.74, 95 % CI: 0.56, 0.98), relative to the lowest quartile. Conclusion: Public health spending is associated with adolescent substance use. The present study reports mixed results, warranting further prospective research to explore the directions and mechanisms of the associations found. |
| format | Article |
| id | doaj-art-436b6b585354481da626c3834aac806f |
| institution | Kabale University |
| issn | 2405-8440 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj-art-436b6b585354481da626c3834aac806f2025-01-17T04:49:51ZengElsevierHeliyon2405-84402025-01-01111e40884Examining the association between public health unit spending and adolescent substance useUrvi Rai0Karen A. Patte1Brendan T. Smith2Ambikaipakan Senthilselvan3Elaine Hyshka4Scott T. Leatherdale5Roman Pabayo6School of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada; Corresponding author. School of Public Health, 3-300 Edmonton Clinic Health Academy, University of Alberta, 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, L2S 3A1, St. Catharines, Ontario, CanadaHealth Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, 661 University Avenue, Suite 1701, M5G 1M1, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, 25 King's College Circle, M5S 1A1, Toronto, Ontario, CanadaSchool of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, CanadaSchool of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, CanadaSchool of Public Health Sciences, University of Waterloo, 200 University Ave W, N2L 3G1, Waterloo, Ontario, CanadaSchool of Public Health, University of Alberta, 11405 87 Ave NW, Edmonton, Alberta, T6G 1C9, CanadaBackground: Based on the socio-ecological model of health, socioeconomic policy is an important determinant of population health. Spending decisions by public health units (PHU) have been shown to be associated with population health outcomes. Some studies have found greater PHU spending to be associated with improved population health, while others report mixed findings, warranting further research. The objective of this study was to investigate the association between per capita PHU spending and self-reported substance use among Canadian adolescents. Methods: Cross-sectional, multilevel modelling was conducted using student data from the 7th wave (2018/19) of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study, as well as spending data from the audited financial statements of Ontario's PHUs. The sample included 29,056 students in grades 9–12 attending 61 secondary schools in 15 PHUs across Ontario. Substance use was measured as the self-reported use of alcohol, cannabis, cigarettes and e-cigarettes, at least once per month on average. Results: Approximately 50 % of the study sample was female and the majority identified as being White. Per capita spending ranged from $54.07 to $224.95, with a median spending amount of $89.62. The highest quartile of PHU spending was significantly associated with higher alcohol use (adjusted odds ratio (AOR): 1.41, 95 % CI: 1.04, 1.91), binge drinking (AOR: 1.71, 95 % CI: 1.18, 2.48), and cigarette use (AOR: 2.19, 95 % CI: 1.23, 3.91) in adolescents, while the second highest quartile was associated with lower e-cigarette use (AOR: 0.74, 95 % CI: 0.56, 0.98), relative to the lowest quartile. Conclusion: Public health spending is associated with adolescent substance use. The present study reports mixed results, warranting further prospective research to explore the directions and mechanisms of the associations found.http://www.sciencedirect.com/science/article/pii/S2405844024169150Adolescent healthPublic health spendingPublic health unitsAlcoholCannabisTobacco |
| spellingShingle | Urvi Rai Karen A. Patte Brendan T. Smith Ambikaipakan Senthilselvan Elaine Hyshka Scott T. Leatherdale Roman Pabayo Examining the association between public health unit spending and adolescent substance use Heliyon Adolescent health Public health spending Public health units Alcohol Cannabis Tobacco |
| title | Examining the association between public health unit spending and adolescent substance use |
| title_full | Examining the association between public health unit spending and adolescent substance use |
| title_fullStr | Examining the association between public health unit spending and adolescent substance use |
| title_full_unstemmed | Examining the association between public health unit spending and adolescent substance use |
| title_short | Examining the association between public health unit spending and adolescent substance use |
| title_sort | examining the association between public health unit spending and adolescent substance use |
| topic | Adolescent health Public health spending Public health units Alcohol Cannabis Tobacco |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024169150 |
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