Max Rady College of Medicine

Concept: Child Health Indicators (2012)

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Concept Description

Last Updated: 2019-04-15


    This concept contains a list of the child health indicators used in the MCHP Deliverable How are Manitoba's Children Doing? (2012). The list of indicators are divided into four different sections, including:

    Each indicator has a hyperlink that links to the glossary definition in the MCHP Concept Dictionary, that contains additional hyperlinks to detailed, methodological information about the indicator in the MCHP Concept Dictionary. Two additional hyperlinks at the end of each section contain links to the corresponding section in the Deliverable, and to the Data Extras (e.g.: additional graphs) related to the section.

    NOTE: This concept is related to two other Child Health Indicator concepts contained in the MCHP Concept Dictionary. This concept represents the indicators that were used in the 2012 Deliverable mentioned above. The other two Child Health Indicator-related concepts are:

    • Child Health Status Indicators (2001) based on the information in the MCHP Deliverable Assessing the Health of Children in Manitoba: A Population-Based Study (2001), and
    • Child Health Indicators (2008) based on the information in the MCHP Deliverable Manitoba Child Health Atlas Update (2008).

      These two concept list some of the same indicators used in the 2012 Deliverable, but are organized differently than the current information.


    The following is a summary of the methods used in this report:

    • the analyses in this report include virtually all children 0 to 19 years of age living in Manitoba.
    • the information is based on where children live, not where they received services or attended school.
    • wherever possible, indicators were examined over a 10-year period, from 2000/01 through 2009/10. Presenting information on the indicators over several years allows us to study changes in the indicator over time.
    • information is also presented according to different age groups, highlighting variations in outcomes depending on developmental stage.
    • indicators are presented according to geographic regions as well as socioeconomic groupings.
    • information at the RHA and Winnipeg Community Area levels, as well as at the RHA District and Winnipeg Neighbourhood Cluster levels, is available for most indicators in the On-line Data Extras section for this report.
    • information for all indicators is also displayed according to area-level income quintiles, in order to highlight the association between socioeconomic status and child health and development.
    • using income quintiles, the degree of inequity or disparity is examined for each indicator. Lorenz curves were created to display inequities (Martens et al., 2010a).
    • Longitudinal analyses, following the same cohort of children over different stages of development, are conducted to explore why some of the outcomes occur by examining relationships between factors (such as age and sex) and the outcome. We used statistical modeling in this report to predict children’s outcomes in Kindergarten (using the Early Development Instrument or EDI) and in Grade 3 (using reading and numeracy assessments).

    How Rates Were Generated

    • To compare and estimate rates, the count of events for each indicator was modeled using a statistical technique called a generalized linear model (GLM), which is suitable for non-normally distributed data such as counts (e.g., number of physician visits). Various distributions were used for different indicators depending on which provided the best fit of the data, including Poisson distribution (for very rare events, such as death) and negative binomial distribution for relatively rare but highly variable events, such as children in care. Most models included the covariates of age and sex to "adjust" for differences in underlying regional, or income quintile, age and sex distributions.
    • in order to obtain regional and income quintile rates for the analyses, relative risks were estimated for each region or income quintile.
    • most of the indicators in this report are given as age- and sex-adjusted rates through the statistical modeling described above. This rate adjustment allows for a fair comparison among areas or income quintiles that have different age and sex distributions. Adjusted rates show what the rate would be if each area’s population had the same age and sex composition as the overall Manitoba population for that time period.
    • for indicators where models could not be fitted, adjusted rates could not be computed, so crude (unadjusted) rates are reported instead.
    • Statistical testing indicates how much confidence to put in the results. If a difference is "statistically significant", then the difference is large enough that we are confident it is not just due to chance or random fluctuation.
    • Lorenz curves and Gini coefficients are used in this report to indicate inequities in the indicators. A Gini coefficient has a value between 0 and 1; zero indicates no inequity and 1 indicates maximum inequity. The Gini coefficient represents the fraction of the area between the Lorenz curve and the line of equity. Confidence intervals (CI) of the Gini coefficients were derived using bootstrapping techniques.

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Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada