Publications

High-income countries like Canada report some of the worlds’ highest life-satisfaction levels, yet less is known about how life satisfaction varies by race and immigration status. This study investigates the factors that influence subjective well-being among 8,063 adults from the Canadian Alliance of Healthy Hearts and Minds study recruited between 2014 and 2018, including a subset of 2,142 immigrants. Measures of demographic, socioeconomic, health, healthcare access, and self-reported ethnicity were investigated in relation to self-reported life satisfaction as measured by the validated Cantril ladder score in which people were classified as suffering [1–4], struggling [5–6], or thriving [7–10]. Among 8,063 adults, approximately half were women, 18.6% were racialized, and 26.6% were immigrants. The mean life satisfaction score was 7.2 (1.4), with 71% classified as thriving. However racialized immigrants reported significantly lower life satisfaction than Canadian born non-racialized participants [6.6 (1.6) vs 7.2 (1.4); P < 0.001, and a lower proportion were classified as thriving [57% vs 73%]. In the overall sample, multivariable linear regression showed higher life satisfaction was associated with older age, male sex, having trusted neighbours, and having a language-concordant family doctor. Lower life satisfaction was associated with social disadvantage, being female, having poorer cardiovascular health, being unable to afford prescription medications, seeking care in an emergency department, and being racialized. Amongst the subset of immigrants, the life satisfaction associated factors were directionally consistent and racialized immigrants reported lower life satisfaction due to discrimination based on skin colour. Although Canada has amongst the highest life-satisfaction scores globally, the average masks persistent inequities as racialized people (especially racialized immigrants) have lower life satisfaction than non-racialized people. The findings highlight actionable levers—language-concordant primary care attachment, affordable medications, neighbourhood trust, and improved cardiometabolic health—that can be targeted to close the observed well-being gap.

Visceral fat, a type of fat stored in the abdomen, and buildup of fat within the liver are known to increase type 2 diabetes, high blood pressure, and heart disease risk. This study aims to see how these types of fat affect artery health. We studied 6760 Canadian adults to examine how visceral and liver fat relate to the buildup of fatty plaque deposits in arteries, and 26,547 adults from the United Kingdom to see how these fats affect artery thickness. Combined results confirm that narrowed arteries and plaque buildup are strongly related to visceral fat, and to a lesser extent liver fat. These results suggest that lowering visceral fat may prevent or slow the progression of atherosclerosis.

Epidemiologic evidence relating macronutrient intake and changes in the brain and cognition are limited. We assessed the associations of macronutrient consumption, including carbohydrate, protein, total fat, saturated fatty acids, monounsaturated fatty acids, and polyunsaturated fatty acids, with vascular brain injury and cognitive scores.

It is unclear whether variation in covert cerebrovascular disease prevalence is attributable to ethnic differences or to other factors. We aimed to examine the associations of country of residence with covert vascular brain injury (VBI) and cognitive dysfunction among Chinese adults residing in Canada and China.

This paper investigates the association between air pollution exposure, and early markers of carotid atherosclerosis within the Canadian Alliance for Healthy Hearts and Minds Cohort Study. Utilizing MRI to measure carotid vessel volume (CWV), the findings showed no direct association for PM₂.₅, but higher NO₂ was linked to reduced CWV and elevated O₃ to increased CWV. These findings suggest a complex relationship between air pollution and cardiovascular health warranting further research, to uncover underlying mechanisms.

In this cross-sectional analysis of 9189 adults between 30 and 75 years of age who were free of cardiovascular disease from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the Prospective Urban Rural Epidemiological–Mind (PURE-MIND) cohort studies, higher body fat percentage and visceral adipose tissue were associated with more cardiovascular risk factors, vascular brain injuries, and lower cognitive scores.

In the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.

To determine whether cognitive reserve attenuates the association of vascular brain injury with cognition.