environment health and alberta first nations children
TRANSCRIPT
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Environment Healthand Alberta First Nations Children
Child Health and the Environmentin Aboriginal Communities
Dr Wadieh Yacoub, MD MSc FRCPCMOH/Dir, Health Protection
First Nations and Inuit HealthHealth Canada
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ACKNOWLEDGMENTS
Alberta Health and Wellness – Larry Svenson
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OUTLINE
1. Introduction2. Key determinants of the health of children3. Model of risk exposure4. The various child environments and some of the health impacts
-intrauterine-home: physical and non-physical-outdoor
5. Summary6. Questions
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Introduction
Children are the future 2.3 billion (0-19) in the world (WHO)
Boundless potential Exposed to health risks from environmental hazards Over 40 % of the global burden of disease attributed
to environment falls on children below 5 years of age (who account for 10 % of the world population)
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The Numbers in the World (WHO)
Each year in the world , 3 million children under 5 die from environment‐related diseases
60% of acute respiratory infections are related to environmental conditions; they kill 2 million children
Diarrheal diseases claim 2 million every year; 80‐90% are related to environmental conditions such as contaminated water and inadequate sanitation
One million under 5 died of malaria in 1998; 90% are attributed to environmental factors
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Key Determinants of Health in Children
Families and relationships Nutrition Income Poverty Physical and social environment Risk behaviour Genetics Health service provision Social attitude and stigma
Adapted from Blair et al, 2004
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The Formula
Risk + risk + risk + social conditions + economic + conflict + poverty
Multiple Exposures Multiple Effects (MEME) model (WHO)
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Child Environment
Physical and social E:major impact on children’s life and health
Traffic, industrial emissions/respiratory illness Housing quality, dampness, poor heating,
overcrowding Lack of good public transport/lack of access to
leisures/adequate safe play space/more TV
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All-Children’s Environments
In the womb
In the home: physical; non-physical (social)
Outdoor: Head start, day care and school yard
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In the Womb
Tobacco smoke
Drugs
Alcohol
Home stress
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In the Home
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Age‐Specific Treated Prevalence for Influenza Seen in Physician Offices,First Nations and Non‐First Nations, Alberta, 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Trea
ted
Prev
alen
ce p
er 1
00
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
First NationsNon First Nations
13
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Age‐Specific Treated Prevalence for Pneumonia Seen in Physician Offices,First Nations and Non‐First Nations, Alberta, 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Trea
ted
Prev
alen
ce p
er 1
00
0
5
10
15
20
25
30
First NationsNon-First Nations
14
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Age‐Specific Influenza Rate Ratio (Physician Offices) –First Nations to Non‐First Nations, 1998 to 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Rat
e R
atio
0.5
1.0
1.5
2.0
2.5
3.0
15
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Age‐Specific Pneumonia Mortality Rate Ratio, First Nations to Non‐First Nations, Alberta, 2007
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Rat
e R
atio
0
5
10
15
20
25
30
16
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Age‐Specific Pneumonia Hospital Separation Rate Ratio,First Nations to Non‐First Nations, Alberta, 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Rat
e R
atio
0
4
8
12
16
20
17
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Age‐Specific Hospital Separation Rate per 100,000 Population for Pneumonia, Alberta, 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Sepa
ratio
n R
ate
per 1
00,0
00
0
1000
2000
3000
4000
5000
6000
7000
8000
First NationsNon-First Nations
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Age‐Specific Pneumonia Rate Ratio – First Nations to Non‐First Nations, 1998 to 2008
Age
< 1 1 - 4 5 - 910 - 1
415 - 1
920 - 2
425 - 2
930 - 3
435 - 3
940 - 4
445 - 4
950 - 5
455 - 5
960 - 6
465 - 6
970 - 7
475 - 7
980 - 8
485 - 8
9 90+
Rat
e R
atio
0
1
2
3
4
5
6
7
19
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Age‐Specific Percent of Patients Seen in Emergency Departments for Influenza, First Nations and Non‐First Nations, Alberta, 2008
Age
< 11 - 4 5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85 - 89 90+
Rat
e pe
r 100
0.0
0.2
0.4
0.6
0.8
1.0
First NationsNon First Nations
20
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In the Home
Non-physical (Social) E and its impact: Emotional stress (family break up and domestic violence) Emotional and behavioural problems Poor personal relationships and difficulty in dealing with
conflict Increased risk of child abuse Increased risk of violence in children Poverty
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Outdoors
Playground safety Water safety Transportation and pedestrian safety Infectious diseases Vaccine preventable diseases Chemical exposure
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Summary: Health Effects of the Environment
Poor air quality respiratory disease
Poor housing asthma, respiratory infections
No safe play areas injuries on streets, obesity, lack of exercise
TV obesity, delayed language development, violence
Social isolation fear of crime, lack of social support
School ethos impact on emotional wellbeing and behaviour
Source: Blair et al, 2004
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YOUR QUESTIONS, PLEASETHANK YOU FOR LISTENING