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Article History

Received: 5 February 2026

Accepted: 7 August 2026

First Online: 15 August 2026

Ethics

Competing interests: The authors declare no competing interests.

Ethics approval and consent to participate: This study is based on secondary analysis of data from the Canadian Community Health Survey (CCHS), a nationally representative dataset collected and administered by Statistics Canada. All participants in the original survey provided informed consent prior to data collection, in accordance with Statistics Canada’s ethical guidelines and procedures. Because the present study involved analysis of fully anonymized, publicly available data, additional ethics approval and consent to participate were not required. The CCHS was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki and complied with relevant institutional and national standards governing research involving human participants.