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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
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