Suchergebnisse

Although a substantial body of work has demonstrated that housing tenure (home ownership vs. renting) is a determinant of health, much less work has focused on this relationship between children and adolescents. This is a significant omission as there is good reason to hypothesize that the effect of housing status on health may change with age. In particular, growing independence and reduced exposure to the residential environment may attenuate the association between housing tenure and health as children age. Using a large representative sample of adolescents, ages 12 to 19 years old, the hypothesis that age moderates the relationship between housing tenure and psychological well-being is tested. The findings, in general, support the hypothesis. Future directions for research are discussed.

"Canada has long been recognized as a leader in the field of psychiatric epidemiology, the study of the factors affecting mental health in populations. However, there has never been a book dedicated to the study of mental disorder at a population level in Canada. This collection of essays by leading scholars in the discipline uses data from the country's first national survey of mental disorder, the Canadian Community Health Survey of 2005, to fill that gap.

A birth order and sexual orientation relationship has been demonstrated
numerous times in men, but a related variable, parental age (i.e. age of parents when the
participant was born), has been less studied and has demonstrated contradictory results. In
this research, the relations among birth order, parental age and sexual orientation were examined
in a national probability sample of the US (Kessler, 1994; Kessler et al., 1994) and in a Canadian sample of homosexual and heterosexual men closely matched on demographic characteristics (Blanchard & Bogaert, 1996a). In both studies, an interaction between birth order and parental age was observed in men, such that there was positive association between number of older siblings and the likelihood of homosexuality, but this association weakened with increasing parental age. No significant effects were observed for women. The results are discussed in relation to recent theories of the birth order/sexual orientation relationship.

Background:Despite broad scientific consensus about the importance of the early years in the lifelong health and wellbeing of children, there is debate about whether and how healthcare professionals can optimise early child development through monitoring or screening. The evidence in support of a systematic population-level intervention is disputed, which is reflected in the diversity of approaches to developmental screening internationally.
Methods:Using a case-study design, and interpretive qualitative methods, we explored how Canadian experts in child health (n=39): a) rationalise why they do, or would, pursue population-level developmental screening; b) articulate the policy goals of such an intervention, and; c) justify the practice with reference to evidence.
Findings:Respondents identified three distinct framings, or policy agendas, for what developmental screening can and should seek to achieve, specifically: 1) as medical intervention, facilitating the early identification of health risk or disorder; 2) as social intervention, providing an opportunity for communication and connection with parents for all children; and 3) as political intervention, staking a claim for early child health on the broader political agenda.
Discussion and conclusions:Each agenda is justified by distinct types of evidence, posing a challenge to simplistic models of evidence-based policymaking, and demonstrating that evidence is not just an input, but a contested part of a dynamic and political policymaking process.

IntroductionSingle-parent families are becoming increasingly common around the world with a particularly steep rise in households headed by single fathers. Research suggests that single parenthood is associated with adverse outcomes, however, little is known about the health profile or risk of death of single fathers compared to other parents.
Objectives and ApproachWe aimed to examine mortality risk in single fathers compared to single mothers and partnered parents, which is the first head-to-head comparison of single and partnered parent groups. Our population consisted of 871 single fathers, 4590 single mothers, 16,341 partnered fathers and 18,688 partnered mothers. We combined cross-sectional samples derived from the Ontario component of Statistics Canada's Canadian Community Health Survey (2001 to 2012) linked to health administrative databases to identify medical conditions, health service use, all-cause mortality and cause of death. We investigated differences in mortality using Cox proportional hazards models adjusted for socio-demographic characteristics, lifestyle and clinical factors.
ResultsEach family group was followed up for a median of 11.10 years (IQR 7.36–13.54). Single fathers had a poor risk profile, particularly among lifestyle factors, such as low fruit and vegetable consumption and alcohol consumption. The mortality rate was three-fold higher for single fathers compared to single mothers and partnered fathers (5.81, 1.74 and 1.94, respectively). Even after adjustment, single fathers had a significantly higher risk of death compared to both single mothers (hazard ratio (HR): 2.49 (95% CI: 1.20 – 5.15, p=0.01)) and partnered fathers (HR: 2.06 (95% CI: 1.11 – 3.83, p=0.02). Small sample sizes precluded us from identifying the leading cause of death for single fathers.
Conclusion/ImplicationsWe found that single fathers had the least favorable risk factor profile and greatest risk of mortality, which may be mitigated by physician intervention. Our study highlights that through cross-sectoral data linkages we can further advance our knowledge of social factors and their profound effects on health.

IntroductionOf the 15-18% of children and youth in Canada with a mental health disorder, some receive specialized mental health (MH) services and need additional treatment as young adults. Lack of a shared database across child and adult sectors has prevented examining predictors of future MH health service use.
Objectives and ApproachWe examined predictors of mental health service utilization in adulthood, and compared a sample of youth who received specialized MH treatment and age-, sex-, and region- matched controls. Patient-level administrative data from five MH agencies funded by the Ministry of Children and Youth Services (MCYS) in Ontario, with population health sector datasets held at the Institute for Clinical Evaluative Sciences (ICES). We expanded previous definitions of coding a MH visit by including codes specific to long-lasting childhood MH diagnoses (e.g., Attention Deficit-Hyperactivity Disorder).
ResultsOur match rate for linking the MCYS treated youth with their population health data was 77%. Youth who received MH treatment (N= 2957) were twice as likely as matched controls (N= 8891) to have a MH visit in the medical system in adulthood (i.e., after age 18). The most common diagnostic codes for the first visit were anxiety, depressive disorders, and ADHD. The median survival time (when 50% had a visit) from age 18 to first MH visit was 3.3 years. In adjusted Cox regressions, significant predictors of having an adult MH visit included service use history in both medical and MH systems during childhood and adolescence (e.g., ongoing pattern of children's MH service use).
Conclusion/ImplicationsThis study represents the first longitudinal, case-control cohort study in Canada to examine MH service utilization in the medical sector by youth treated for MH problems. The linkage of information from multiple datasets allowed for a broader understanding of MH service utilization across sectors of care, specific to children and youth.