Document is current

Article History

Accepted: 10 December 2025

First Online: 10 January 2026

Declarations

:

: All the authors declare that they have no conflicts of interest that are directly relevant to the content of this article.

: Pursuant to Article 2.2 of the Tri-Council Policy Statement on Ethical Conduct for Research Involving Humans ( ), Statistics Canada’s NPHS data are considered information that is publicly available through a mechanism set out by legislation or regulation that is protected by law, and therefore their use for research purposes does not require research ethics board review, as long as there is no linkage to other datasets. Participation in the NPHS was voluntary, with agreements in place to protect the confidentiality of respondents’ information.

: The datasets analyzed for this study are available through the Research Data Centers (RDC) Program at Statistics Canada ( ).

: Stephanie Prince: conceptualization, methodology, formal analysis and investigation, writing—original draft preparation, supervision. Tyler Thomas: methodology, formal analysis and investigation, writing—review and editing. Aviroop Biswas: conceptualization, methodology, writing—review and editing. All authors read and approved the final version.