Using Canadian administrative health data to measure the health of caregivers of children with and without health problems: A demonstration of feasibility.

Introduction Caregivers of children with health problems experience poorer health than the caregivers of healthy children. To date, population-based studies on this issue have primarily used survey data. Objectives We demonstrate that administrative health data may be used to study these issues, and explore how non-categorical indicators of child health in administrative data can enable population-level study of caregiver health. Methods Dyads from Population Data British Columbia (BC) databases, encompassing nearly all mothers in BC with children aged 6-10 years in 2006, were grouped using a non-categorical definition based on diagnoses and service use. Regression models examined whether four maternal health outcomes varied according to indicators of child health. Results 162,847 mother-child dyads were grouped according to the following indicators: Child High Service Use (18%) vs. Not (82%), Diagnosis of Major and/or Chronic Condition (12%) vs. Not (88%), and Both High Service Use and Diagnosis (5%) vs. Neither (75%). For all maternal health and service use outcomes (number of physician visits, chronic condition, mood or anxiety disorder, hospitalization), differences were demonstrated by child health indicators. Conclusions Mothers of children with health problems had poorer health themselves, as indicated by administrative data groupings. This work not only demonstrates the research potential of using routinely collected health administrative data to study caregiver and child health, but also the importance of addressing maternal health when treating children with health problems. Keywords Population data, linked data, case-mix, children with special health care need

The Physical and Mental Health of Off-Reserve First Nations Children of Teen Mothers

The teen birth rate for First Nations women is higher than the teen birth rate for non-Aboriginal women. While associations between physical and behavioural outcomes have been examined in non-Aboriginal children with teen mothers, fewer studies have focused on First Nations children of teen mothers. This study uses data from the 2006 Aboriginal Children’s Survey to compare physical and mental health outcomes of 2- to 5-year-old off-reserve First Nations children of teenage and older mothers. There were few differences in physical health outcomes between off-reserve First Nations children of teen mothers and older mothers with the exception of dental health. However, for all of the mental health outcomes examined, child prosocial behaviours, emotional symptoms, inattention-hyperactivity, and conduct problems, scores were poorer for off-reserve First Nations children of teen mothers. Although the differences in prosocial and emotional problems were attributable to socio-economic factors, differences in child inattention-hyperactivity and conduct problems were not. Future research would help our understanding of the differences in outcomes between off-reserve First Nations children of teen and older mothers

Do Factors Other than SES Explain Differences in Child Outcomes Between Children of Teenage and Older Mothers for Off-Reserve First Nations Children?

This study used data from the Aboriginal Children’s Survey (ACS) to explore differences in behavioural outcomes for First Nations children born to teen and older mothers living off-reserve in Canada. Of particular interest was an examination of socio-economic and contextual influences, and their contributions to differences in child outcomes. Findings from this study demonstrate that off-reserve First Nations children born to teen mothers (aged 12 - 19 years when they started childbearing) had poorer behavioural outcomes compared to off-reserve First Nations children born to older mothers (aged 25 and over when they started childbearing). These differences were found for emotional symptoms, inattention and hyperactivity, and conduct disorder scores, but not for prosocial behaviours. Contextual factors differed for children born to teen mothers as compared to older mothers, but parenting behaviors and the number of people involved in raising the child was similar for both groups. While differences in the behaviour of children born to teen mothers are often attributed to poorer socio-economic conditions, this study demonstrates that other contextual factors (e.g., breastfeeding, social support, screen time, residential mobility) may be as important as socio-economic factors in their contribution to the behavioural outcomes of children of teen mothers

Indigenous Language Knowledge and Educational Attainment Among First Nations People: Trends Over Time

This study investigated whether associations between Indigenous language knowledge and educational outcomes might be changing for cohorts of language speakers over time. Using Census and National Household Survey data, educational attainment for First Nations people aged 20 to 34 was examined at four time points (1996, 2001, 2006, and 2011), separately for those able versus unable to speak an Indigenous language and separately for those living on and off reserve. Findings point to improvements in levels of education for Indigenous language speakers among First Nations people living on and off reserve. Findings should be interpreted with caution as differences in educational attainment may reflect differences between language speakers and non-speakers that go beyond the ability to speak an Indigenous language