Concept: Child Health Indicators (2012)

Introduction

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:


• Physical and Emotional Health
  
• Safety and Security
  
• Successful Learning, and
  
• Social Engagement and Responsibility

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.

Methods

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.

Physical and Emotional Health Indicators

• Child Mortality - see Child Mortality / Child Mortality Rate
  
• Causes of Child Mortality - see Causes of Child Mortality
  
• Hospital Utilization - see Hospital Utilization
  
• Causes of Hospitalization - see Causes of Hospitalization
  
• Physician Visits - see Ambulatory Visits - Physician
  
• Asthma - see Asthma
  
• Diabetes - see Diabetes / Diabetes Mellitus
  
• Sexually Transmitted Infections (STIs) - see Sexually Transmitted Infections (STIs)
  
  • Chlamydia - see Chlamydia
    
  • Gonorrhea - see Gonorrhea
    
  • Syphilis - see Syphilis
    
  • Hepatitis B - see Hepatitis B
    
  • HIV - see Human Immunodeficiency Virus (HIV)
• Children Living with a Mother with Mood and/or Anxiety Disorders - see Children Living with a Mother with Mood and/or Anxiety Disorders
  
• Child Mood and Anxiety Disorders - see Child Mood and Anxiety Disorders
  
• Attention-Deficit Hyperactivity Disorder (ADHD) - see Attention Deficit Disorder (ADD) / Attention-Deficit Hyperactivity Disorder (ADHD)
  
• FASD - see Fetal Alcohol Spectrum Disorder (FASD)
  
• Suicide - see Suicide
  
  LINKS:
  
  • How Are Manitoba's Children Doing? Deliverable - Chapter 3: Physical and Emotional Health
    
  • How Are Manitoba's Children Doing? Data Extras - Chapter 03: Physical and Emotional Health Data Extras

Safety and Security Indicators

• Injury Hospitalizations - see Injury Hospitalizations
  
• Causes of Injury Hospitalization - see External Cause of Injury Codes
  
• Intentional Versus Unintentional Injury Hospitalizations - see External Cause of Injury Codes and Injury Categories concept - section from the 2012 Deliverable describing the intent of injury.
  
• Children in Care - see Children in Care (CIC) / Ever in Care
  
• Children in a Family Receiving Services from Child and Family Services - see Children in a Family Receiving Services from Child and Family Services (CFS)
  
  LINKS:
  
  • How Are Manitoba's Children Doing? Deliverable - Chapter 4: Safety and Security
    
  • How Are Manitoba's Children Doing? Data Extras - Chapter 04: Safety and Security Data Extras

Successful Learning Indicators

• Special Education Funding - see Level II and III Funding
  
• Grade Repetition - see Grade Repetition
  
• Grade 3/4 Assessments - see Grade 3/4 Assessments
  
  • Grade 3 Assessment in Reading - see Grade 3/4 Assessments
    
  • Cohort Approach to Grade 3 Assessment in Reading - the cohort approach looks at all children born in a specific year (in this research, 2001), including those who wrote the assessment, have fallen behind, and for whom assessments are unavailable. Students without assessments were included in the category "not meeting expectations" - see the section Cohort Approach to Grade 3 Assessment in Reading in the 2012 report.
    
  • Grade 3 Assessment in Numeracy - see Grade 3/4 Assessments
    
  • Cohort Approach to Grade 3 Assessment in Numeracy - the cohort approach looks at all children born in a specific year (in this research, 2001), including those who wrote the assessment, have fallen behind, and for whom assessments are unavailable. Students without assessments were included in the category "not meeting expectations" - see the section Cohort Approach to Grade 3 Assessment in Numeracy in the 2012 report.
• Grade 7 Assessment in Mathematics - see Grade 7 Assessment in Mathematics
  
  • Cohort Grade 7 Assessment in Mathematics - the cohort approach looks at all children born in a specific year (in this research, 1997), including those who wrote the assessment, have fallen behind, and for whom assessments are unavailable. Students without assessments were included in the category "not meeting expectations" - see the section Cohort Approach to Grade 7 Assessment in Mathematics in the 2012 report.
• Grade 8 Assessment in Reading and Writing - see Grade 8 Assessment in Reading and Writing
  
  • Cohort Approach to Grade 8 Assessment in Reading and Writing - the cohort approach looks at all children born in a specific year (in this research, 1996), including those who wrote the assessment, have fallen behind, and for whom assessments are unavailable. Students without assessments were included in the category "not meeting expectations" - see the section Cohort Approach to Grade 8 Assessment in Reading and Writing in the 2012 report.
• Grade 12 Standards Tests - these are provincial exams that grade 12 students are required to write.
  
  • Grade 12 Language Arts Standards Tests - see Grade 12 Standards Tests / Achievement Tests
    
  • Grade 12 Mathematics Standards Tests - see Grade 12 Standards Tests / Achievement Tests
• High School Completion - see High School Completion / Graduation
  
• Modeling of Successful Learning from Kindergarten to Grade 3 - in this section they looked at the relationship between level of Early Development Instrument (EDI) vulnerability (whether a child was vulnerable on none, one, two, three, four or all five EDI domains) and grade 3 vulnerability (measured by being assessed as "needs ongoing help").
  
  • Factors Associated with Outcomes - they used a statistical technique called structural equation modeling (SEM) to describe the complex inter-relationships between factors.
    
  • For more information, see the section Modeling of Successful Learning from Kindergarten to Grade 3 in the report.
  
  LINKS:
  
  • How Are Manitoba's Children Doing? Deliverable - Chapter 5: Successful Learning
    
  • How Are Manitoba's Children Doing? Data Extras - Chapter 05: Successful Learning Data Extras

Social Engagement and Responsibility Indicators

• Grade 7 Assessment of Student Engagement - see Grade 7 Assessment of Student Engagement
  
  • Cohort Approach to Grade 7 Assessment of Student Engagement - the cohort approach looks at all children born in a specific year (in this research, 1997), including those who wrote the assessment, have fallen behind, and for whom assessments are unavailable. Students without assessments were not included in the categories "established" or "developing" - see the section Cohort Approach to Grade 7 Assessment of Student Engagement in the 2012 report
• Teen Pregnancy - see Teenage Pregnancy
  
• Teen Births - see Teen Births
  
• Youths on Income Assistance - the prevalence of youths aged 18 to 19 years who have received at least one month of income assistance over the course of a year - see the section titled Youths on Income Assistance in the 2012 report.
  
  LINKS:
  
  • How Are Manitoba's Children Doing? Deliverable - Chapter 6: Social Engagement and Responsibility
    
  • How Are Manitoba's Children Doing? Data Extras - Chapter 06: Social Engagement and Responsibility Data Extras

Summary and Recommendations:

For more information on the summary and recommendations from this research, please read Chapter 7: Summary and Recommendations found in the 2012 MCHP Deliverable.