Investments in Children’s Health Are community-based health services reaching those most at risk? A spatial analysis International Society for Child Indicators Conference Presentation Sub-theme: Health Presenter: Lauranne Matheson Co-author: Kara Hayne, Kate-Lynn Duplessis York, England July 28, 2011

Public Health Agency of Canada | Agence de la santé publique du Canada1 Outline Program context and description Methodologies Initial Results Future work

Public Health Agency of Canada | Agence de la santé publique du Canada2 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 Conditions Of Risk: -low income -young mothers -low education -isolation -recent immigrants -language

Public Health Agency of Canada | Agence de la santé publique du Canada3 On the ground…

Public Health Agency of Canada | Agence de la santé publique du Canada4 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

Public Health Agency of Canada | Agence de la santé publique du Canada5 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)

Public Health Agency of Canada | Agence de la santé publique du Canada6 Data Layer 1: INSPQ* Deprivation Index Target Group Material: 1)% with no high school degree; 2)ratio employment/population; 3)average personal income Social: 1)% living alone; 2)% of persons separated, divorced or widowed; 3)% of single-parent families *Institut national de santé publique du Québec

Public Health Agency of Canada | Agence de la santé publique du Canada7 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

Public Health Agency of Canada | Agence de la santé publique du Canada8 Analysis Layer 1: Priority Areas 1. Priority Target Groups Children AND Deprivation AND 1,263 Dissemination Areas across Canada AND Analysis Layer 3: Driving Distance Incremental distance from each site using Road Network (1, 5, 10, 20km) AND Off-reserve* Using INAC Criteria for On-reserve Analysis Layer 2: Site Locations 2,300 street addresses geocoded across Canada * Health Canada’s First Nations & Inuit Health Branch provides sister programs for on-reserve populations

Public Health Agency of Canada | Agence de la santé publique du Canada9

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Public Health Agency of Canada | Agence de la santé publique du Canada11 Alberta 115 sites Saskatchewan 27 sites Manitoba 14 sites 27.5% beyond 20km31.7% beyond 20km12.5% beyond 20km

Public Health Agency of Canada | Agence de la santé publique du Canada12 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

Public Health Agency of Canada | Agence de la santé publique du Canada13 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

Public Health Agency of Canada | Agence de la santé publique du Canada14 Thank you! Lauranne Matheson Manager, PRPM Public Health Agency of Canada Centre for Health Promotion Division of Childhood & Adolescence Planning, Reporting and Performance Measurement Kara Hayne Strategic Research Analyst Kate-Lynn Duplessis Evaluation Analyst