title: Linking the Canadian Community Health Survey and the Canadian Mortality Database: An enhanced data source for the study of mortality.
abstract: BACKGROUND
  This study summarizes the linkage of the Canadian Community Health Survey (CCHS) and the Canadian Mortality Database (CMDB), which was performed to examine relationships between social determinants, health behaviours and mortality in the household population.
  
  
  METHODS
  The 2000/2001-to-2011 Canadian Community Health Surveys were linked to the 2000-to-2011 CMDB using probabilistic methods based on common identifiers (names, date of birth, postal code and sex) for eligible respondents (85%; n = 614,774). Mortality records from January 1, 2000 through December 31, 2011 for people aged 12 or older were eligible for linkage (n = 2.774 million). The linkage was enhanced with information from the Historical Tax Summary File. Quality assessment consisted of internal and external validation. Cox survival analysis (age-adjusted) was conducted to estimate hazard ratios (HRs) associated with selected health behaviours.
  
  
  RESULTS
  Overall, 5.3% of eligible CCHS respondents linked to a mortality record; false positive and false negative rates were 0.04% and 2.43%, respectively. Linkage rates were higher among males (5.8%) and people aged 75 or older (20.2%), reflecting known mortality risks. Survival analyses confirmed elevated mortality risk associated with heavy (HR 2.36, CI 1.84, 2.89) and light smoking (HR 1.91, CI 1.52, 2.33), compared with not smoking; underweight and obesity, compared with normal and overweight; low fruit and vegetable consumption; and lack of physical activity.
  
  
  CONCLUSIONS
  Linking health behaviour information from the CCHS to mortality data from the CMDB allows for a greater understanding of modifiable determinants of mortality.
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Claudia
authors.initials: C
authors.lastname: Sanmartin
authors.affiliation: Health Statistics Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Yves
authors.initials: Y
authors.lastname: Decady
authors.affiliation: Special Surveys Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Richard
authors.initials: R
authors.lastname: Trudeau
authors.affiliation: Household Survey Methods Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Abel
authors.initials: A
authors.lastname: Dasylva
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Michael
authors.initials: M
authors.lastname: Tjepkema
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Philippe
authors.initials: P
authors.lastname: Finès
authors.affiliation: Health Canada, Ottawa, Ontario.
authors.forename: Rick
authors.initials: R
authors.lastname: Burnett
authors.affiliation: McGill University, Montreal, Quebec.
authors.forename: Nancy
authors.initials: N
authors.lastname: Ross
authors.affiliation: Health Analysis Division, Statistics Canada, and the Ottawa Hospital Research Institute, Ottawa, Ontario.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Manuel
keywords: Data linkage; health survey; mortality; risk factors