Concept: Family Size / Number of Children
Last Updated: 2023-04-03
First, the cohort of children or mothers for which family size will be calculated must be identified (e.g., children aged 0-19 on April 1, 2001). This method is a two-step process: mother and baby records must first be matched together and then the number of children born to that mother can be calculated.
a) Matching Mother and Baby Records
Determining the number of children born to a mother requires matching the baby's birth records to the mother's records. In this step of the analyses, duplicate baby Personal Health Identification Numbers (encrypted PHINs; a unique numeric identifier assigned by Manitoba Health to every person registered for health insurance in Manitoba) were removed.
Note: the mothers' files were not limited by date of admission to ensure that mothers admitted a longer period before the baby was born would be included in analyses.
b) Calculating the Number of Children
A mother/baby linkage file and the Manitoba Health Insurance Registry Data can be used to calculate the number of children. Mother/baby records going back to 1970 can be checked. Children's ages may vary widely (e.g., children born as early as 1951 and as late as the most recent update). The Manitoba Health Insurance Registry data begins with families as of 1970 (and will thus include children born in 1951 and later). The number of children born to each mother were counted, excluding children who:
- were born when the mother was less than 12 years of age (assumed to be an error)
- did not have a valid numeric encrypted PHIN (assuming these children probably did not survive birth).
When analyzing the birth records, some children may be linked to more than one mother's family. A suggested solution is to first use the birth mother of the child in the analyses. If no birth mother can be found on the baby's record, the female parent indicated on the baby's record from the Registry can be used.
When attempting to inform population projections, it may make sense to count all of the children born (and then delete those who have died) to mothers in a given area whether or not they are still children. Looking at the current number of children under 19 will only give planners a sense of potential differences across SES groups.
Method 2: Counting the Number of Children With the Same Registration Number (REGNO) at the Same Date(s)
This method simply involves counting the number of children who have the same REGNO number on their Manitoba Health file at the same date.
a) Description of REGNO Families
Most 18-year-olds are classified as a family head because children are issued their own REGNO at age 18. For some analyses, 18-year-olds still classified as children can be counted as children. The family head can change over time within an ongoing registration "family".
Prior to April 1992, dependent children automatically received their own registration number (as a family head) on the first day of the first calendar month following their 19th birthday. Since April 1992, dependent children automatically receive their own registration number (as a family head) on the first day of the first calendar month following their 18th birthday. The new registration card is mailed to the most recent known address of the parent/guardian/family head of their previous registration. Thus, the only contact required between Manitoba Health and the two REGNO families is the delivery of the new cards.
The year 1992 was selected because that was when Manitoba Health originally set out the specifics for the Drug Program Information Network (DPIN); which is based on PHINs even though the original deductible was based on family head age (i.e., via REGNO)]. The change was also made because 18 years is the age of majority in Manitoba, not 19 years of age.
If the card (and the new version of the original registration card to the family head) is returned, Manitoba Health will investigate and try to locate either or both family heads. If they cannot be found, both registrations can be cancelled. Persons taking up residence elsewhere in Canada and registering there will be reported by that province and coverage will be transferred to the new jurisdiction on the first day of the third calendar month following the date of the move (this shows up as a cancellation in Manitoba).
In rare cases, dependent children (natural or step) may become dependent adults under the original registration and thus keep the original REGNO.
A parent may notify Manitoba Health of a previously unreported death or other ineligibility of the dependent child. Manitoba Health may then decide to rescind the "new" registration of the dependent child before it takes effect.
In the event of a cancellation of the most recent family head, REGNOs can be reassigned two or more years after the cancellation.
b) Exclusions and Exceptions
All persons under the age of 18 are children but are not necessarily dependents in a REGNO. Anyone, including children, may request a private health registration card (and REGNO) and, therefore, would appear as a separate family head. As a result, children aged 18 or less who are classified as the family head, spouse or common-law spouse of the family head were excluded from analyses. Most of these children are the sole members of a REGNO family or are aged 16-18 and actually the parents in a family.