Laura C Rosella
Biographic Data
| ID | 104683 |
|---|---|
| NAME | Laura C Rosella |
| GIVEN NAMES | Laura C |
| FAMILY NAME | Rosella |
| SIGNATURE | ROSELLA L C |
| AFFILIATIONS | University of Toronto |
| ORCID | 0000-0003-4867-869X |
| VERIFIED | Yes |
| TOTAL WORKS | 73 |
| TOTAL CITATIONS | 48 |
| AUTHOR COUNT | 73 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2010 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 5 |
Contextualizing community wellbeing among newcomer residents in the Greater Toronto Area
Newcomers experience unique social, economic, and institutional challenges that shape their wellbeing, yet community wellbeing frameworks have rarely been applied to understand settlement experiences. This qualitative study explores how newcomer residents conceptualize community wellbeing in the Greater Toronto Area, Canada, while extending an existing relational framework of community wellbeing. Four focus groups (n = 22) were conducted in partn…
Using Personas as a Tool for People-Centred Segmentation and Health Systems Planning in Ontario, Canada
Introduction: Health systems are increasingly using population segmentation for planning to organise populations into segments with similar health characteristics. However, given that these data-driven approaches rely on available data, they fail to encompass important social determinants of health, thereby making decision-making challenging. Segmentation is powerful, but little is known about how missing information could be incorporated to more…
Machine learning used to study risk factors for chronic diseases
OBJECTIVES: Machine learning (ML) has received significant attention for its potential to process and learn from vast amounts of data. Our aim was to perform a scoping review to identify studies that used ML to study risk factors for chronic diseases at a population level, notably those that incorporated methods to mitigate algorithmic bias. We focused on ML applications for the most common risk factors for chronic disease: tobacco use, alcohol u…
Designing measurement systems for contemporary public health priorities
Covid-19 in Rural Ontario Communities
Interventions should be specific to geographic communities as well as individual needs (e.g., additional financial and childcare support). Rural communities need to be considered as independent geographies rather than as one geography (i.e., urban vs. rural)
Robust Indicators of Residential Mobility Derived From Longitudinal Canadian Data to Examine Population Health Across the Life Course
Championing public health
Implementation and evaluation of a novel community-based urban mobile health clinic in Toronto, Ontario
We demonstrate that in a single-payer health system, MHCs alleviate major barriers to care access for marginalized populations. Learnings provide context to the most salient factors influencing clients' decisions to seek care at MHCs and can inform how these outreach models are designed
Will AI Improve Public Health? Setting the Standards for Meaningful Impact
Risk of premature mortality due to smoking, alcohol use, obesity and physical activity varies by income
These findings highlight the need for targeted strategies to reduce health inequities and more careful attention to how policies and interventions are distributed at the population level. This includes targeting and tailoring resources to those in lower income groups who disproportionately experience premature mortality risk to prevent further widening health inequities
The association between total social exposure and incident multimorbidity
These findings demonstrate the importance of considering the cumulative effects of multiple social determinants of health on multimorbidity
Using a causal decomposition approach to estimate the contribution of employment to differences in mental health profiles between men and women
This study provided an estimate of the contribution of employment to the observed differences in multidimensional mental health between men and women. This adds to the literature by including a broader range of mental health indicators than disorders alone, and by formalizing the causal framework used to study these relationships
Using community-based participatory research methods to build the foundation for an equitable integrated health data system within a Canadian urban context
Health inequalities amplified by the COVID-19 pandemic have disproportionately affected racialized and equity-deserving communities across Canada. In the Municipality of Peel, existing data, while limited, illustrates that individuals from racialized and equity-deserving communities continue to suffer, receive delayed care, and die prematurely. In response to these troubling statistics, grassroots community advocacy has called on health systems l…
The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians
Objective: Estimate the impact of 20 % flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages and 100 % juice by age, sex and socio-economic position. Design: We modelled the impact of price changes – for each tax structure – on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single-day 24-h dietary recalls fr…
HealthyPlan.City
Urban environmental factors such as air quality, heat islands, and access to greenspaces and community amenities impact public health. Some vulnerable populations such as low-income groups, children, older adults, new immigrants, and visible minorities live in areas with fewer beneficial conditions, and therefore, face greater health risks. Planning and advocating for equitable healthy urban environments requires systematic analysis of reliable s…
Modeling chronic disease risk across equity factors using a population-based prediction model
BACKGROUND: Predicting chronic disease incidence at a population level can help inform overall future chronic disease burden and opportunities for prevention. This study aimed to estimate the future burden of chronic disease in Ontario, Canada, using a population-level risk prediction algorithm and model interventions for equity-deserving groups who experience barriers to services and resources due to disadvantages and discrimination. METHODS: Th…
A national cohort study of community belonging and its influence on premature mortality
BACKGROUND: Community belonging, an important constituent of subjective well-being, is an important target for improving population health. Ageing involves transitioning across different social conditions thus, community belonging on health may vary across the life course. Using a nationally representative cohort, this study estimates the life stage-specific impact of community belonging on premature mortality. METHODS: Six cycles of the Canadian…
A new chapter in the Canadian Journal of Public Health
Centralization and integration of public health systems
Using healthcare encounter data to identify high-cost users among adults with a history of homelessness
People experiencing homelessness are often considered frequent healthcare users. Although their service use is not uniform, it can be difficult to identify the highest-cost users without access to comprehensive cost data. This study validated a set of algorithms that apply healthcare encounter data to identify high-cost users among adults with a history of homelessness. Administrative healthcare cost data were compared across common frequent user…
Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020
As the frequency of international travel increases, more individuals are at risk of travel-acquired infections (TAIs). In this ecological study of over 170,000 unique tests from Public Health Ontario’s laboratory, we reviewed all laboratory-reported cases of malaria, dengue, chikungunya, and enteric fever in Ontario, Canada between 2008–2020 to identify high-resolution geographical clusters for potential targeted pre-travel prevention. Smoothed s…
Clarifying rural‐urban disparities in alcohol‐related emergency department visits and hospitalizations in Ontario, Canada
PURPOSE: Rates of alcohol-related harm are higher in rural versus urban Canada. This study characterized the spatial distribution and regional determinants of alcohol-related emergency department (ED) visits and hospitalizations in Ontario to better understand this rural-urban disparity. METHODS: This was a cross-sectional spatial analysis of rates of alcohol-related ED visits and hospitalizations by Ministry of Health subregion (n = 76) in Ontar…
Bridging ethics and epidemiology
Health inequities are differences in health that are 'unjust'. Yet, despite competing ethical views about what counts as an 'unjust difference in health', theoretical insights from ethics have not been systematically integrated into epidemiological research. Using diabetes as an example, we explore the impact of adopting different ethical standards of health equity on population health outcomes. Specifically, we explore how the implementation of …
Experiences and Reported Outcomes of Patients and Caregivers Enrolled in an Integrated Care Program for Thoracic Surgery
Patients and caregivers generally reported this IC Program met their health care needs, which may help inform how future IC programs are designed
How patients define success for integrated care
Background: While many standardized surveys exist to measure patient experience, they are not designed to assess unique features of integrated care (IC) programs including transitions from hospital to community, satisfaction with homecare, or resources and supports provided post-discharge. The aim was to have patients lead efforts to develop a set of quality indicators for routine monitoring of patient experience in the University Health Network …
Predictive risk algorithms in a population setting
BACKGROUND: The widespread use of risk algorithms in clinical medicine is testimony to how they have helped transform clinical decision-making. Risk algorithms have a similar but underdeveloped potential to support decision-making for population health. OBJECTIVE: To describe the role of predictive risk algorithms in a population setting. METHODS: First, predictive risk algorithms and how clinicians use them are described. Second, the population …
A population-based risk algorithm for the development of diabetes
BACKGROUND: National estimates of the upcoming diabetes epidemic are needed to understand the distribution of diabetes risk in the population and to inform health policy. OBJECTIVE: To create and validate a population-based risk prediction tool for incident diabetes using commonly collected national survey data. METHODS: With the use of a cohort design that links baseline risk factors to a validated population-based diabetes registry, a model (Di…
Socioeconomic gradients in all-cause, premature and avoidable mortality among immigrants and long-term residents using linked death records in Ontario, Canada
BACKGROUND: Immigrants have been shown to possess a health advantage, yet are also more likely to reside in arduous economic conditions. Little is known about if and how the socioeconomic gradient for all-cause, premature and avoidable mortality differs according to immigration status. METHODS: Using several linked population-based vital and demographic databases from Ontario, we examined a cohort of all deaths in the province between 2002 and 20…
Pandemic H1N1 in Canada and the use of evidence in developing public health policies - A policy analysis
The Social Determinants of Health and Pandemic H1N1 2009 Influenza Severity
Objectives. We explored the effects of social determinants of health on pandemic H1N1 2009 influenza severity and the role of clinical risk factors in mediating such associations. Methods. We used multivariate logistic regression with generalized estimating equations to examine the associations between individual- and ecological-level social determinants of health and hospitalization for pandemic H1N1 2009 illness in a case-control study in Ontar…
Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians
Social inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted
Neighbourhood walkability and the incidence of diabetes
BACKGROUND: People living in highly walkable neighbourhoods tend to be more physically active and less likely to be obese. Whether walkable urban design reduces the future risk of diabetes is less clear. METHODS: We used inverse probability of treatment weighting to compare 10-year diabetes incidence between residents living in high-walkability and low-walkability neighbourhoods within five urban regions in Ontario, Canada. Adults (aged 30-85 yea…
The role of ethnicity in predicting diabetes risk at the population level
Although from the individual risk perspective, incorporating information on ethnicity is important, when predicting new cases of diabetes at the population level and accounting for other risk factors, detailed ethnic information did not improve the discrimination and accuracy of the model or identify significantly more diabetes cases in the population
A new chapter in the Canadian Journal of Public Health
Promise and peril
Our study highlighted that stakeholder priorities and a limited understanding about public health systems influenced how reforms were implemented. Our findings support calls for modernized and inclusive governance, stable public health funding, and investment in the public health workforce, which may help inform future reforms
The Economic and Long-Term Health Consequences of Canadian Covid-19 Lockdowns
To prevent exponential spread of COVID-19, many governments restricted economic activity through lockdowns. We model these restrictions as shocks to productivity by sector and trace total equilibrium effects across the economy using techniques from production network economics. We combine this economic model with an epidemiological model of income shocks to long-term health. On both long-run health and economic grounds, it is better to keep upstr…
Rising burden of multimorbidity and related socio-demographic factors
Characterising risk of homicide in a population-based cohort
BACKGROUND: Homicide is an extreme expression of violence that has attracted less attention from public health researchers and policy makers interested in prevention. The purpose of this study was to examine the socioeconomic gradient of homicide and to determine whether risk differs by immigration status. METHODS: We conducted a population-based cohort study using linked vital statistics, census and population data sets that included all deaths …
Association between the regional variation in premature mortality and immigration in Ontario, Canada
The findings demonstrate that health region differences in premature mortality in Ontario are in part explained by individual-level effects associated with the health advantage of immigrants, as well as contextual area-level effects that are associated with regional differences in the immigrant population. These factors should be considered in addition to health system factors when looking at health region variation in premature deaths
Estimating the impact of various menu labeling formats on parents’ demand for fast-food kids’ meals for their children
The effectiveness and efficiency of diabetes screening in Ontario, Canada
Diabetes screening was high in this population-based cohort of Ontarians. Screening efficiency varied considerably in the population. Undiagnosed diabetes continues to be prevalent and remains concentrated in the highest risk groups for diabetes, especially among men
Assessing secondary attack rates among household contacts at the beginning of the influenza A (H1N1) pandemic in Ontario, Canada, April-June 2009
Secondary attack rates for pandemic influenza A (H1N1) were comparable to seasonal influenza estimates suggesting similarities in transmission. High secondary attack rates in children provide additional support for increased susceptibility to infection
Estimating background rates of Guillain-Barré Syndrome in Ontario in order to respond to safety concerns during pandemic H1N1/09 immunization campaign
Our analyses do not suggest an increased number of GBS cases due to the vaccine. Awareness of expected rates of GBS is crucial when assessing adverse events following influenza immunization. Furthermore, since individuals with influenza infection are also at risk of developing GBS, they must be considered in such analyses, particularly if the vaccine campaign and disease are occurring concurrently
A population-based risk algorithm for the development of diabetes
BACKGROUND: National estimates of the upcoming diabetes epidemic are needed to understand the distribution of diabetes risk in the population and to inform health policy. OBJECTIVE: To create and validate a population-based risk prediction tool for incident diabetes using commonly collected national survey data. METHODS: With the use of a cohort design that links baseline risk factors to a validated population-based diabetes registry, a model (Di…
The potential effect of temporary immunity as a result of bias associated with healthy users and social determinants on observations of influenza vaccine effectiveness; could unmeasured confounding ex…
We found that unmeasured healthy user effects and social determinants could result in an apparent association between seasonal influenza vaccine and pandemic influenza infection by virtue of being related to temporary immunity. Adjustment for social determinants of health and the healthy user effects are required in order to improve the quality of observational studies of influenza vaccine effectiveness
Evaluating risk factors for endemic human Salmonella Enteritidis infections with different phage types in Ontario, Canada using multinomial logistic regression and a case-case study approach
Our study findings offer interesting hypotheses about the role of phage type-specific risk factors. Multinomial logistic regression analysis and the case-case study approach are novel methodologies to evaluate associations among SE infections with different PTs and various risk factors
The use of syndromic surveillance for decision-making during the H1N1 pandemic
Syndromic surveillance had limited use in decision-making during the 2009 H1N1 pandemic in Ontario. This study provides insights into the reasons why this occurred. Despite this, syndromic data were valued for providing situational awareness and confidence to support public communications and recommendations. Developing an understanding of how syndromic data are utilized during public health events provides valuable evidence to support future inv…
The role of ethnicity in predicting diabetes risk at the population level
Although from the individual risk perspective, incorporating information on ethnicity is important, when predicting new cases of diabetes at the population level and accounting for other risk factors, detailed ethnic information did not improve the discrimination and accuracy of the model or identify significantly more diabetes cases in the population
Predictive risk algorithms in a population setting
BACKGROUND: The widespread use of risk algorithms in clinical medicine is testimony to how they have helped transform clinical decision-making. Risk algorithms have a similar but underdeveloped potential to support decision-making for population health. OBJECTIVE: To describe the role of predictive risk algorithms in a population setting. METHODS: First, predictive risk algorithms and how clinicians use them are described. Second, the population …
The Social Determinants of Health and Pandemic H1N1 2009 Influenza Severity
Objectives. We explored the effects of social determinants of health on pandemic H1N1 2009 influenza severity and the role of clinical risk factors in mediating such associations. Methods. We used multivariate logistic regression with generalized estimating equations to examine the associations between individual- and ecological-level social determinants of health and hospitalization for pandemic H1N1 2009 illness in a case-control study in Ontar…
Assessing the Relative Timeliness of Ontario’s Syndromic Surveillance Systems for Early Detection of the 2009 Influenza H1N1 Pandemic Waves
Pandemic H1N1 in Canada and the use of evidence in developing public health policies - A policy analysis
Ethnic disparities in acquiring 2009 pandemic H1N1 influenza
pH1N1 cases were more likely to come from certain ethnic groups compared to test-negative controls. Insights into whether these disparities arise due to social or biological factors are needed in order to understand what approaches can be taken to reduce the burden of a future influenza pandemic
The influence of socioeconomic status on future risk for developing Type 2 diabetes in the Canadian population between 2011 and 2022
This study characterized socio-contextual predictors for future diabetes risk, showing sex-specific effects. Diabetes prevention must consider factors beyond individual-level behavioral lifestyle change and actively take steps to mitigate the adverse impacts of socio-contextual factors
Association of Neighborhood Walkability With Change in Overweight, Obesity, and Diabetes
IMPORTANCE: Rates of obesity and diabetes have increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. OBJECTIVE: To examine whether walkable urban neighborhoods are associated with a slower increase in overweight, obesity, and diabetes than less walkable ones. DESIGN, SETTING, AND PARTICIPANTS: Time-series analysis (2001-2012) using annual provincial health care (N ≈ …
Estimating the impact of various menu labeling formats on parents’ demand for fast-food kids’ meals for their children
What predictors matter
Trajectories of objectively measured sedentary time among secondary students in Manitoba, Canada in the context of a province-wide physical education policy
A population-based study of homicide deaths in Ontario, Canada using linked death records
Homicides are an important cause of death among young males, and populations living in disadvantaged neighbourhoods. Our findings raise concerns about the burden of homicides in the Canadian population and the importance of addressing social determinants to address these premature deaths
Evaluation of the ability of standardized supports to improve public health response to syndromic surveillance for respiratory diseases in Canada
This study raises questions about the effectiveness of using standardized protocols to improve the performance of syndromic surveillance in a decentralized public health system. Despite efforts to create standardized protocols and engage public health agencies in the process, no significant differences in the effective use of syndromic alerts were observed beyond year 1. It also raises questions about the minimum capacity of the agency and minimu…
Socioeconomic gradients in all-cause, premature and avoidable mortality among immigrants and long-term residents using linked death records in Ontario, Canada
BACKGROUND: Immigrants have been shown to possess a health advantage, yet are also more likely to reside in arduous economic conditions. Little is known about if and how the socioeconomic gradient for all-cause, premature and avoidable mortality differs according to immigration status. METHODS: Using several linked population-based vital and demographic databases from Ontario, we examined a cohort of all deaths in the province between 2002 and 20…
Diabetes risk reduction in primary care
Evaluating the Process and Outcomes of a Knowledge Translation Approach to Supporting Use of the Diabetes Population Risk Tool (DPoRT) in Public Health Practice
To support the use of the Diabetes Population Risk Tool (DPoRT) in public health settings, a knowledge brokering (KB) team used and evaluated the Population Health Planning Knowledge-to-Action model. Participants (n = 24) were from four health-related organizations. Data sources included document reviews, surveys, focus groups, interviews, and observational notes. Site-specific data were analyzed and then triangulated across sites using an evalua…
Predicting High Health Care Resource Utilization in a Single-payer Public Health Care System
BACKGROUND: A large proportion of health care spending is incurred by a small proportion of the population. Population-based health planning tools that consider both the clinical and upstream determinants of high resource users (HRU) of the health system are lacking. OBJECTIVE: To develop and validate the High Resource User Population Risk Tool (HRUPoRT), a predictive model of adults that will become the top 5% of health care users over a 5-year …
Limitations of administrative data to identify measles cases in Ontario, Canada
Medicine (66 works) · Environmental health (49 works) · Population (34 works) · Demography (31 works) · Public health (29 works) · Gerontology (27 works) · Internal Medicine (22 works) · Nursing (22 works) · Demography (21 works) · Health disparities and outcomes (21 works)