Investments in Children’s Health Are community-based health services reaching those most at risk?...

Investments in Children’s HealthAre community-based health services

reaching those most at risk? A spatial analysis

International Society for Child Indicators Conference Presentation

Sub-theme: HealthPresenter: Lauranne Matheson

Co-author: Kara Hayne, Kate-Lynn DuplessisYork, EnglandJuly 28, 2011

Public Health Agency of Canada | Agence de la santé publique du Canada 2

Outline

• Program context and description• Methodologies• Initial Results• Future work


Program Context• Public Health Agency of Canada

– Centre for Health Promotion• Division of Childhood & Adolescence:

Aboriginal Head Start in Urban and Northern Communities (AHSUNC)• 4,800 children & families• 129 sites

Community Action Program for Children (CAPC)• 441 projects• 65,000 participants/month

Canada Prenatal Nutrition Program (CPNP)• 325 projects• 50,000 women each year

ConditionsOf Risk:-low income-young mothers-low education-isolation-recent immigrants-language


On the ground…


Project Description• Purpose:

– The purpose of this pilot project is to determine the location of at-risk populations in Canada, and to assess through spatial analysis, whether CAPC and CPNP projects are reaching these populations.

• Specific questions to answer:1. Where are at-risk priority populations located? 2. Are CAPC/CPNP projects located in close proximity to priority

populations?

• Uses:– Resulting map products to be exploratory in nature as GIS has

been largely underused up to this date. Initial results expected to create further discussion and fine tuning for future analysis and application


Collaborative Approach• Program Consultants located in regional offices across Canada:

– Gathered 100% of program delivery street addresses– Guided methodology selection– Feedback & support (Advisory Committee)

• Geomatics Expertise:– Data clean-up– Requirements gathering– Spatial Analysis– Cartography & Map output

• Management & National Office Evaluation Analysts:– Coordinating body bridging geomatics expertise and program consultants– Feedback & support to Geomatics Expertise (Advisory Committee)


Data Layer 1: INSPQ* Deprivation Index

Target Group

Material: 1) % with no high school degree; 2) ratio employment/population;3) average personal incomeSocial: 1) % living alone; 2) % of persons separated,

divorced or widowed; 3) % of single-parent families

*Institut national de santé publique du Québec


Data Layer 2: Children

Variable: Proportion of Adults 15 and over with at least 1 child under the age of 6 years, by Dissemination Area 2006

Target Group


Analysis Layer 1: Priority Areas1. Priority Target GroupsChildren

AND

Deprivation

ANDAND

1,263 Dissemination Areas across Canada

AND

Analysis Layer 3: Driving DistanceIncremental distance from each site using Road Network (1, 5, 10, 20km)

AND

Off-reserve*

Using INAC Criteria for On-reserve

Analysis Layer 2: Site Locations2,300 street addresses geocoded across Canada

* Health Canada’s First Nations & Inuit Health Branch provides sister programs for on-reserve populations


1km 22% (n=24)5km 68.8% (n=75)10km 72.5% (n=79)20km 72.5% (n=79)

109 Priority Areas

1km 26.3% (n=21)5km 70% (n=56)10km 82.5% (n=66)20km 87.5% (n=70)

80 Priority Areas

1km 34.1% (n=28)5km 67.1% (n=55)10km 68.3% (n=56)20km 68.3% (n=56)

82 Priority Areas

Alberta115 sites

Saskatchewan 27 sites

Manitoba14 sites

27.5% beyond 20km 31.7% beyond 20km 12.5% beyond 20km


Desktop mapping tool – ArcExplorer (ESRI)

Layers (on/off):- CAPC/CPNP sites- Priority Areas

(analysis results)- Incremental Driving

Distance from sites- Deprivation Index- Children- Aboriginals- Recent Immigrants- Visible Minorities


Considerations for Future Work

• Application to other programs:– Fetal Alcohol Spectrum Disorder, Aboriginal Head Start

• Additional data layers:– Public Transportation– United Way 211– Early Development Instrument– Community Services

• Retrospective Analysis– Trends, changes over time- both in deprivation and

participation.

More complete picture


Thank you!

Lauranne MathesonManager, PRPM

[email protected]

Public Health Agency of CanadaCentre for Health Promotion

Division of Childhood & AdolescencePlanning, Reporting and Performance Measurement

Kara Hayne

Strategic Research Analyst

[email protected]

Kate-Lynn Duplessis

Evaluation Analyst

[email protected]

Investments in Children’s Health Are community-based health services reaching those most at risk?...

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