Academic journal article Canadian Journal of Public Health

The Virtual Classroom

Academic journal article Canadian Journal of Public Health

The Virtual Classroom

Article excerpt

A Summary of Child Health Indicators

Objective: To provide an overview of child health indicators and health care utilization patterns in Manitoba by comparing child health outcomes for different income groups: a) children from two different community areas of Winnipeg (Fort Garry and Point Douglas), and b) adolescents from two different parts of Manitoba (the North, and Winnipeg).

Methods: Various child health indicators derived from population-based administrative data and national surveys are reported in the articles within this supplement. Childhood morbidity and mortality, health care utilization patterns, pharmaceutical use, and regional demographic information discussed in the research articles in this supplement are summarized here using comparisons of outcomes in "virtual classrooms" of 100 children. Results: Large gradients were observed in the comparison of the virtual classrooms of

100 high school students, including the following numbers of adolescents: females on birth control pills (Winnipeg 11, North 18); injury hospitalization annually (Winnipeg 1; North 4). Gradients are observed for some child outcomes of the virtual classroom of 100, but not for others. Examples include the following numbers of children: preterm at birth (FG 7, PD 7); breastfed at birth (FG 90, PID 66); hospitalized for lower respiratory tract infection in first year (FG 3, PD 8); parents having no high school (FG 11; PD 41).

Conclusion: Throughout Manitoba, child and adolescent health indicators and determinants of health show gradients by income as well as by geographical regions.

Greenwood,1 a health statistician, once made the comment that "health statistics represent people with the tears wiped off." Health statistics can, at times, distance a reader from the reality of the grassroots situation unless the data are translated into tangible word-pictures. This summary article attempts to translate the child health statistics from the various papers in the supplement into vivid wordpictures through the use of a "virtual classroom" image. One comparison focuses on differentials in adolescent health - a virtual high school of 100 students from northern Manitoba compared to the same age group in Winnipeg. The second virtual classroom comparison matches cohorts of children residing in two areas of Winnipeg - the community area with the most healthy population (Fort Garry) versus that with the least healthy population (Point Douglas). As well, our focus throughout this supplement has included two other concepts, or themes, that highlight child health differences income level and the healthiness of the community in which the children reside. Not surprisingly, some recurring patterns emerge from many of the papers as to their effects.

The effect of income level on child health

For the majority of the indicators studied, we found that the higher the neighbourhood income level, the better the outcomes for the children. It was not just the case that those children living in poverty had poor health and the rest of the children were indistinguishable. With every increase in neighbourhood income level, there tends to be an increase in favourable outcomes. For example, at the perinatal stage, the lower the income level the greater is the likelihood that the infant will: be born at a low birthweight (which has multiple potential problems associated with it),2 be readmitted to hospital,2 be hospitalized for lower respiratory tract infections,3 and die in the first year of life.4 Even in terms of perinatal preventive health measures, the lower the income the less is the likelihood that the infant will be breastfed.2

As children grow and develop, the impact of income continues to be felt. The lower the income level, the greater the likelihood the child will be hospitalized for any reason,5 or be hospitalized or die from injury.6 In relationship to their health needs, the good news is that children from lower income groups are more likely to visit a physician (urban children), but the downside is that they are less likely to have a usual provider for care and less likely to see a specialist. …

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