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Oct 24 CAPHC National Symposium

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CAPHC National Symposium
Optimal Health Outcomes for Children and Youth: Are We Attending to the Biggest Challenges?

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Oct 24 CAPHC National Symposium

  1. 1. Child health and inequality Frank Elgar, PhD Associate Professor of Psychiatry Canada Research Chair in Social Inequalities in Child Health Institute for Health and Social Policy McGill University
  2. 2. What we know The odds that a child is healthy, happy, and doing well in school significantly improve as social class rises This graded social pattern is found in most cultures and areas of health Percentage of children with serious emotional or behavioral difficulties, by age group and family income Source: CDC, 2009 National Health Interview Survey
  3. 3. What we don’t know What happens to child health as we become more unequal? Income inequality and school bullying in 11-year-olds in 37 countries Source: Elgar FJ, Craig W, Morgan A, Vella-Zarb R (2009). Income inequality and school bullying: multilevel study of adolescents in 37 countries. Journal of Adolescent Health, 45(4),351-359.
  4. 4. Rethinking child poverty Calton, Glasgow Delhi, India
  5. 5. • National perspectives on health inequality point to the need to improve health services in the most vulnerable groups. • Global perspectives suggest that Canada could do more to tackle the structural determinants of child health that give rise to inequality in the first place. Raise and level the bar Attawapiskat, Ontario
  6. 6. + “The 42% Problem”: Practical Challenges in the Promotion of Child Wellbeing Charlotte Moore, MD, FRCPC, FAAP Medical Director, Canadian Paediatric Society Assistant Professor, Department of Paediatric Medicine, University of Toronto Staff Paediatrician, Division of Paediatric Medicine, The Hospital for Sick Children
  7. 7. EVIDENCE POLITICS POLICY OBJECTIVES
  8. 8. + Total Health Expenditure as % of GDP * Source: OECD Health Data 2012 0 2 4 6 8 10 12 14 16 18 20 1960 1970 1980 1990 2000 2010 United States Canada
  9. 9. + Total Public Sector Spending Province of Ontario *Source: Ministry of Finance Estimates Operating and Capital Expenses Health Education Social Services Justice Other
  10. 10. + “Health” / “Illness” Accounting S O C I A L H E A L T H $48B Public Confidence in Health Care System LOS/ Hospitalization for ASC/ Readmission Rates for AMI Rates of Flu Vaccination Median Wait Time for Priority Surgeries Investment in Home Care (Fragile Seniors) Scope of Practice for Allied Health Professions
  11. 11. + Case Study: Setting Priorities S O C I A L J U S T I C E H E A L T H $109,286 / 28 weeker 1 1. CIHI, Too Early, Too Small: A Profile of Small Babies Across Canada, 2009 2. Cohen, E. et al. Patterns and Costs of Health Care Costs of Children with Medical Complexity, (2012) Pediatrics 130;6. 3. CADTH Canadian Drug Expert Review Committee Final Recommendation – Asfotase Alfa, 2016. H E A L T H H E A L T H 36% 15,771 CMC2 H E A L T H $102 / mg Asfotase Alfa 3
  12. 12. + Case Study: “Stop FASD” S O C I A L J U S T I C E H E A L T H $3400 / family 1 1. Manitoba Health H E A L T H
  13. 13. + Case Study: “Stop FASD” E D U C A T I O N S O C I A L J U S T I C E H E A L T H $3400 / family 1 $ 4,596 / year 2 $ 4,075 / year 3 $46,000/year 5 if incarcerated 1. Manitoba Health 2. Stade et al (2009) 3. Stade et al (2009) 5. Fuchs et al (2009) $ 23,760/year 4 if in care 4. Fuchs et al (2008)

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