Abstract
Indicators of health are important to inform public health policies and identify health disparities among population sub-groups. However, to date most indicator-driven health reports: a) have focused primarily on illness, such as rates of mortality and common chronic conditions; b) have come from an adult health care perspective; or c) have not considered the influence of geographical location on health. The purpose of this project was to identify indicators of child health and well-being that would be most applicable to rural and northern regions of Canada. Indicator selection began with a detailed review of the academic and grey literature, followed by formal consultation with a small group of experts, then a series of consultations with an extended group of 12 experts using a Delphi-approach and an on-line survey. The result was the identification of 33 indicators of child health and well-being relevant to rural and northern regions of Canada. The approach used to identify these indicators is distinct from previous efforts, and their application may begin to ‘shed light’ on the health and well-being of this understudied and vulnerable segment of the Canadian population.
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Notes
Due to the demanding schedules and geographical dispersion of the expert panel, not all experts were in attendance.
References
Bollman, R. D., & Biggs, B. (1992). Rural and small town Canada: An overview. In R. D. Bollman (Ed.), Rural and small town Canada (pp. 1–43). Toronto: Thompson Education Publishing, Inc.
Boyce, W. (2004). Young people in Canada: their health and well-being. http://www.phac-aspc.gc.ca/dca-dea/publications/hbsc-2004/pdf/hbsc_report_2004_e.pdf. Accessed 7 April 2010.
Boydell, K. M., Pong, R., Volpe, T., Tilleczek, K., Wilson, E., & Lemieux, S. (2006). Family perspectives on pathways to mental health care for children and youth in rural communities. The Journal of Rural Health, 22(2), 182–188.
Canadian Child and Youth Health Coalition. (2008). Child and youth health indicator program. http://www.ccyhc.org/work_indicators.html. Accessed 3 August 2010.
Canadian Institute for Health Information. (2006). Health indicators. http://secure.cihi.ca/cihiweb/products/Indicators_2006_e.pdf. Accessed 5 April 2010.
Canadian Institute for Health Information. (2009). The Health Indicators Project: Report from the Third Consensus Conference on Health Indicators. http://ecomm.cihi.ca/ec/product.asp?dep_id=22&sku=HIPRFTCCHIEPDF. Accessed 7 April 2010
Canadian Institute of Child Health. (1989). The health of Canada’s children: A CICH profile. Ottawa: Canadian Institute of Child Health.
Canadian Institute of Child Health. (1994). The health of Canada’s children: A CICH profile (2nd ed.). Ottawa: Canadian Institute of Child Health.
Canadian Institute of Child Health. (2000). The health of Canada’s children: A CICH profile (3rd ed.). Ottawa: Canadian Institute of Child Health.
Chen, E., Martin, A. D., & Matthews, K. A. (2007). Trajectories of socioeconomic status across children’s lifetime predict health. Pediatrics, 120(2), E297–303.
DesMeules, M., Pong, R., Lagacé, C., Heng, D., Manuel, D., Pitblado, R., et al. (2006). How healthy are rural Canadians? An assessment of their health status and health determinants. http://www.phacaspc.gc.ca/publicat/rural06/pdf/ruralcanadians_2006_report_e.pdf. Accessed 7 April 2010.
Dooley, D., Fielding, J., & Levi, L. (1996). Health and unemployment. Annual Review of Public Health, 17, 449–465.
du Plessis, V., Beshiri, R., Bollman, R., & Clemenson, H. (2001). Definitions of rural. Rural and Small Town Canada Analysis Bulletin, 3(3)
Ermisch, J., Francesconi, M., & Pevalin, D. J. (2004). Parental partnership and joblessness in childhood and their influence on young people’s outcomes. Journal of the Royal Statistical Society, 167(1), 69–101.
European Union Community Health Monitoring Programme. (2002). child health indicators of life and development (Child): Report to the European Commission.
Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science & Medicine, 31(12), 1347–1363.
Federal, Provincial and Territorial Advisory Committee on Population Health. (1996). Report on the health of Canadians: Technical appendix. Prepared for the meeting of ministers of health, Toronto.
Fischer, R. G. (1978). The Delphi method: A description, review, and criticism. Journal of Academic Libranianship, 4, 64–70.
Hasson, F., Kenney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of Advanced Nursing, 32, 1008–1015.
Haselth, G., & Ryser, L. (2006). Trends in service delivery: examples from rural and small town Canada, 1998 to 2005. Journal of Rural and Community Development, 1, 69–90.
Health Canada. Healthy Canadians: A Federal Report on Comparable Health Indicators. (2004). http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/system-regime/2004-fed-comp-indicat/2004-fed-comp-indicat-eng.pdf. Accessed 7 April 2010.
Health Canada. Healthy Canadians: A Federal Report on Comparable Health Indicators. (2006). http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/2006-fed-comp-indicat/2006-fed-comp-indicat-eng.pdf. Accessed 7 April 2010.
Health Canada. Healthy Canadians: A Federal Report on Comparable Health Indicators. (2008). http://www.hc-sc.gc.ca/hcs-sss/alt_formats/hpb-dgps/pdf/pubs/system-regime/2008-fed-comp-indicat/index-eng.pdf. Accessed 7 April 2010.
Hertzman, C. (1999). The biological embedding of early experience and its effects on health in adulthood. Annals of the New York Academy of Sciences, 896(1), 85–95.
Jacobs, B., et al. (2000). Canadian acute respiratory illness and flu scale (CARIFS): development of a valid measure for childhood respiratory infections. Journal of Clinical Epidemiology, 53(8), 793–799.
King, A. J. C., Boyce, W. F., & King, M. A. (1999). Trends in the health of Canadian youth. http://www.phac-aspc.gc.ca/dca-dea/7–18yrs-ans/trends-eng.php. Accessed 7 April 2010.
Kirby, M., & LeBreton, M. (2002). The health of Canadians—the federal role. Volume six: Recommendations for reform. http://www.parl.gc.ca/37/2/parlbus/commbus/senate/Com-e/soci-e/rep-e/repoct02vol6-e.htm. Accessed 7 April 2010.
Mahon, N. E., Yarcheski, A., & Yarcheski, T. J. (2004). Social support and positive health practices in early adolescents: a text of mediating variables. Clinical Nursing Research, 13, 126–236.
McKenna, H. P. (1994). The Delphi technique: a worthwhile approach for nursing?. Journal of Advanced Nursing, 19, 1221–1225.
Ng, E., Wilkins, R., Pole, J., & Adams, O. (1999). How far to the nearest physician. Rural and Small Town Analysis Bulletin, 1(5), 1–7.
Pitblado, R. J. (2005). So, what do we mean by “rural”, “remote”, and “northern”? The Canadian Journal of Nursing Research, 37, 163–168.
Pong, R. W., & Pitblado, J. R. (2005). Geographic distribution of physicians in Canada: Beyond how many and where. http://secure.cihi.ca/cihiweb/products/Geographic_Distribution_of_Physicians_FINAL_e.pdf. Accessed 7 April 2010.
Rennie, D. C., Lawson, J. A., Cockcroft, D. W., Senthilselvan, A., & McDuffie, H. H. (2004). Differences in respiratory symptoms and pulmonary function in children in 2 Saskatchewan communities. Annals of Allergy, Asthma & Immunology, 92(1), 52–59.
Romanow, R. J. (2002). Building on values: The future of health care in Canada. http://publications.gc.ca/pub?id=237274&sl=0. Accessed 7 April 2010.
Starfield, B. (2002). Forward to supplement on children’s health. Canadian Journal of Public Health, 93, S7.
Tepper, J. D., Schultz, S. E., Rothwell, D. M., & Chan, B. (2006). Physician services in rural and Northern Ontario. http://www.ices.on.ca/file/Physician_Services_in_Rural_and_Northern_Ontario.pdf. Accessed 7 April 2010.
To, T., et al. (2006). The burden of asthma in Ontario in ICES investigative reports. http://www.ices.on.ca/file/Burden_of_Asthma_Aug-07.pdf. Accessed 7 April 2010.
World Health Organization. (1946). Definition of health. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.
World Health Organization. (1982). Health Behaviour in School-Aged Children (HBSC) Project, A World Health Organization collaborative cross-national study, jointly funded by WHO and 42 participating countries.
World Health Organization. (2004) Young people’s health in context. Health Behaviour in School-Aged Children (HBSC) Study: International report from the 2001/2002 survey. Health policy for children and adolescents. In C. Currie, et al. (Eds.) Vol. 4. 2004: Geneva.
Young, N. L., Yoshida, K. K., Williams, J. I., Bombardier, C., & Wright, J. G. (1995). The role of children in reporting their physical disability. Archives of Physical Medicine and Rehabilitation, 76(10), 913–918.
Zylke, J. W., & DeAngelis, C. D. (2007). Pediatric chronic diseases—stealing childhood. Journal of the American Medical Association, 29(24), 2765–2766.
Acknowledgements
Dr. Young is supported by a Canada Research Chair from the Canadian Institutes for Health Research. The project was financially supported by a Louise Picard Public Health Research Grant and by the Northern Ontario Heritage Fund Corporation; Youth Internship Program.
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Gauthier, A.P., Young, N.L., Snelling, S.J. et al. Looking Beyond the Bright Lights: Identifying Canadian Indicators of Health for Children in Rural and Northern Regions. Child Ind Res 4, 169–183 (2011). https://doi.org/10.1007/s12187-010-9085-z
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DOI: https://doi.org/10.1007/s12187-010-9085-z