INTRODUCTION

Researchers at the Manitoba Centre for Health Policy (MCHP) have consistently found, as have researchers in many other countries, a socioeconomic gradient in health. On average, people who are the poorest and least educated are more at risk of poor health and functioning than people who are less poor and more educated, who in turn are likely to be more at risk of poor health than the wealthiest and highest educated.

This socioeconomic gradient in health is also found for one of our most vulnerable groups ~ children. As family incomes decline, the risk of poor developmental outcomes for children rise - in the areas of health, learning, achievement and socialization.(1) Children who live in environments characterized by low income, low education level and high unemployment have higher morbidity and mortality rates than children who do not live in these types of environments.(1-6) Children who reside in disadvantaged environments are also at higher risk for problems with psychosocial development, emotional well being, behaviour and academic performance.(1;7-9) Furthermore, delays in early language development have been linked to literacy and social behavior problems in adulthood, which have significant implications in adult labour market participation.(4;10)

Research regarding the determinants and importance of child health reinforces what many Canadians already know. First, the families and communities in which children grow influence their health and functioning.(11) Unfortunately, the social factors and public policies that prevent children from experiencing poor outcomes are not well understood.(12;13) Second, a child’s early experiences play an important role in laying the foundations for later development. That is, child health is one determinant of good adult health.(14-19) Unfortunately, the societal benefits of reducing inequities in child health have not been clearly described or quantified so that policy-makers understand the importance of addressing these issues.

To optimally invest in children and the long-term health of our society, it is imperative that we understand the relationship between socioeconomic and environmental circumstances and the health and functioning of children in Canada. Understanding these relationships is essential to identify the public policies that contribute to reducing inequities.(10;14;20) The goal of our CPHI-funded research program is to evaluate the relative contribution of individual factors, family circumstances and community characteristics to health and educational inequalities, as well as identify the factors that may protect children from socioeconomic risk.

This first report provides descriptive, population-based analyses of the health and educational outcomes of Manitoba children, at the level of health regions and sub-regions. We also explored the relationship between health/educational outcomes and family circumstances and community characteristics.