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Francophone and Anglophone perinatal health: temporal and regional inequalities in a Canadian setting, 1981–2008

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

We evaluated temporal and regional inequalities in adverse birth outcomes between Anglophones and Francophones of a Canadian province.

Methods

Odds ratios and rate differences in preterm birth (PTB, <37 gestational weeks) and small-for-gestational-age (SGA) birth were computed for Anglophones relative to Francophones for singleton live births in Québec from 1981 to 2008 (N = 2,292,237), adjusting for maternal characteristics. Trends over time and residential region were evaluated.

Results

Rates of PTB and SGA birth overall were lower for Anglophones relative to Francophones, but temporal and regional trends varied by outcome. Although PTB rates increased over time, inequalities between Francophones and Anglophones were relatively stable. In contrast, inequalities in SGA birth narrowed over time as Francophone rates declined more than Anglophones. Inequalities in SGA birth favored Anglophones overall, but the gap gradually reversed in Montréal (the largest metropolitan center) to currently favor Francophones.

Conclusions

PTB and SGA birth rates favored Anglophones over Francophones. The linguistic gap was generally stable over time for PTB, but narrowed or reversed for SGA birth. Language may be used to capture inequalities in perinatal health in countries where different linguistic groups predominate.

Résumé

Objectif

Nous avons évalué les tendances temporelles et régionales de la santé périnatale d’une province canadienne entre anglophones et francophones.

Méthodes

Les rapports de cotes et les différences de taux pour la prématurité et le retard de croissance intra-utérin (RCI) entre anglophones et francophones ont été calculés par période et par région pour 2,292,237 naissances simples au Québec de 1981 à 2008.

Résultats

Les taux de prématurité et de RCI étaient plus faibles pour les anglophones comparativement aux francophones, par contre les tendances temporelles et régionales variaient. Les taux de prématurité augmentaient dans le temps, mais les inégalités linguistiques sont restés stables. Les inégalités linguistiques pour le RCI se sont rétrécies dans le temps à cause d’une réduction plus rapide des taux francophones. Les taux de RCI favorisaient néanmoins globalement les anglophones, à l’exception de Montréal où les inégalités se sont inversées.

Conclusions

Les issues de naissance étaient généralement plus favorables chez les Anglophones. Les inégalités linguistiques étaient stables pour la prématurité et se sont réduites ou inversées pour le RCI. L’appartenance linguistique pourrait être utilisée pour identifier les inégalités de santé périnatale dans d’autres pays.

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Acknowledgments

The authors acknowledge with appreciation funding provided by the McGill Training and Retention of Health Professionals Project Research Development Program for Québec Institutions. The authors thank Normand Trempe for comments on the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics statement

Research ethics approval was waived by the institutional review board of the University of Montréal Hospital Centre. This study conformed to the 2010 Tri-Council Policy Statement for ethical conduct of research involving humans in Canada.

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Correspondence to Nathalie Auger.

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Auger, N., Park, A.L. & Harper, S. Francophone and Anglophone perinatal health: temporal and regional inequalities in a Canadian setting, 1981–2008. Int J Public Health 57, 925–934 (2012). https://doi.org/10.1007/s00038-012-0372-y

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  • DOI: https://doi.org/10.1007/s00038-012-0372-y

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