Predictors of Child Health in Northern Ontario

CPHA Annual Conference

Halifax, Nova Scotia

June 4, 2008

Darshaka Malaviarachchi, Epidemiologist, SDHUDerek Wilkinson, Associate Professor, Laurentian University

Julie Vaillancourt, Health Promoter, SDHU

Outline

• Review of Northern Ontario Perinatal and Child Health Survey (NOPCHS) Consortium

• Literature review: Predictors of child health

• Results: Analyses of NOPCHS data

• Limitations

• Conclusions

The Consortium is coordinated by thePublic Health Research, Education and Development (PHRED) Program

Sudbury & District Health Unit

• Algoma Health Unit

• Muskoka-Parry Sound Health Unit

• North Bay & District Health Unit

• Northwestern Health Unit

• Porcupine Health Unit

• Sudbury & District Health Unit

• Thunder Bay District Health Unit

NOPCHS Consortium Partners

• Timiskaming Health Unit

• Northern Health Information Partnership

• Lakehead University

• Laurentian University

• Nipissing University

NOPCHS Consortium Partners

• Perinatal and Child Health Survey Strategies Initiative funded by Ontario Ministry of Health and Long-Term Careo Northern Health Units pooled funds in

2002 and 2003

• Louise Picard Public Health Research Grant

Funding

2002 Consortium Reports

• Northern Ontario Baseline Child Health Information: Analysis of Secondary Data

• Northern Ontario Perinatal & Child Health Survey Highlights Report: A First Look

2003 Focused Reports

Objective

• Comprehensive literature review to explore the predictors of child health

• Further explore predictors and outcomes using NOPCHS data

Literature Review

• PubMed 1996-2006

Outcome

Child health

Asthma

Injuries

BMI

Overweight

Obesity

Predictor

Breastfeeding

Smoking

Income or socioeconomic status

Partner or single/sole support parent

AND

OR

OR

OR

OR

OR

OR

OR

OR

Literature: Breastfeeding

• Asthma

• Overweight and obesity

• Confounderso SES, ageo Country of birtho Low birth weighto Prenatal classeso Partner status

Literature: Smoking

• Asthma

• Overweight and obesity

• Confounderso Ageo Ethnicityo Educationo Other smoker(s) in

household

Literature: Socioeconomic Status

• Child health

• Overweight and obesity

• Injuries

• Confounderso Maternal age, educationo Marital statuso Ethnicity

Literature: Partner Status

• Child health

• Injuries

• Asthma

• Confounderso SES, maternal deprivation

• Overweight/obesity

• General health status

• Injury

• Asthma

NOPCHS: Outcomes

• Sex

• Francophone status

• Breastfeeding

• Partner status

NOPCHS: Predictors

• Family income (LICO)

• Maternal education

• Prenatal class

• Smoking

NOPCHS: Overweight/Obesity

• Influenced by: o Not breastfeeding [OR = 1.30, 95% CI (1.02,1.67)]*o Other smoker(s) [OR = 1.40, 95% CI (1.09, 1.80)]

* remained significant after adjusting for potential confounders

• Influenced by: o Sex of child [OR = 1.36, 95% CI (1.02, 1.81)]*o Partner status [OR = 1.80, 95% CI (1.23, 2.65)]o LICO [OR = 1.72, 95% CI (1.19, 2.49)]o Education [OR = 1.42, 95% CI (1.07, 1.88)]o No prenatal class [OR = 1.82, 95% CI (1.33, 2.48)]*o Smoking

- Maternal [OR = 1.92, 95% CI (1.42, 2.59)]

- Other smoker(s) [OR = 2.30, 95% CI (1.72, 3.08)]*

NOPCHS: General Health Status

NOPCHS: Injury

• Influenced by: o Not breastfeeding [OR =1.38, 95% CI (1.07, 1.79)]o Partner status [OR = 1.96, 95% CI (1.44, 2.68)]*o Education [OR = 1.36, 95% CI (1.07, 1.71)]o Smoking

- Maternal [OR = 1.43, 95% CI (1.11, 1.85)]- Other smoker(s) [OR = 1.63, 95% CI (1.28, 2.09)]

NOPCHS: Asthma

• Influenced by: o Sex of child [OR = 1.53, 95% CI (1.25, 1.88)]*o Partner status [OR = 1.92, 95% CI (1.45, 2.53)]*o LICO [OR = 1.69, 95% CI (1.30, 2.19)]*o Education [OR = 1.30, 95% CI (1.06, 1.59)]o Smoking

- Maternal [OR = 1.39, 95% CI (1.11, 1.74)]

- Other smoker(s) [OR = 1.68, 95% CI (1.36, 2.09)]*

Limitations

• Mother-reported

• Phone Survey

• Non-response

Conclusions

• Literature vs. Northern Ontario

• Social determinants of health

• Continued need for focus on second-hand smoke

Thank you!

• Questions?

• NOPCHS Reports available at:o www.sdhu.com

• Contact Info:o Dar Malaviarachchi: malaviarachchid@sdhu.com

• Acknowledgements:– NOPCHS Consortium– Jacqueline Elliott, student researcher

This presentation was prepared by staff at the Sudbury & District Health Unit.

This resource may be reproduced, for educational purposes, on the condition that full credit is given to the Sudbury & District Health Unit.

This resource may not be reproduced or used for revenue generation purposes.

© Sudbury & District Health Unit, 2008