It is generally surmised that community stressors have an incubating effect for a variety of diagnoses on maternal and child health. This is of public health significance, as children of mothers facing long-term distress were found to have a 60% higher risk for asthma diagnosis at age 7 in Manitoba, Canada. Our objective was to determine the association of community stressors with childhood asthma prevalence in Winnipeg, Canada from participants who completed the Study of Asthma, Genes and the Environment (SAGE) survey administered in 2002-2003 to a birth cohort from 1995. Measures of community socioeconomic makeup and community disorder with rank ordinalized by quintile at the census tract level were obtained from the 1996 Canada Census. Crime data (annual incidence per 10,000 persons) by neighbourhood profile for 2001 was provided by the Winnipeg Police Service. Dichotomous caregiver report of child asthma along with other indicators from the geocoded SAGE survey allowed linkage to 23 neighbourhood profiles. Multilevel logistic regression analyses were performed to estimate the effect of community stressors on childhood asthma prevalence for birth and non-birth home children (N = 1472) and children resident of birth homes at age 7 or 8 (N = 698). After adjusting for individual risk factors, children resident of birth homes in a high thefts over $5,000 neighbourhood profile were twice as likely (Adjusted OR, 2.05; 95% CI, 1.11-3.81) to have report of asthma compared to children in a lower thefts over $5,000 profile, with community thefts over $5,000 explaining over half of the observed neighbourhood variation in asthma.
Cites: Ann Behav Med. 2001 Summer;23(3):177-8511495218
For future research of predictors of AIS, it would be advantageous to identify a general population in which the development of AIS is greatly increased when compared to the normal population. The probability of predicting future development of AIS among younger relatives of current patients based on the probability of AIS incidence was assessed from the research literature. Although there is considerable literature relating to familial relationships of the probability of developing AIS or having AIS, the probability is relatively low in most cases. Even with the best of predicted probabilities, the identification of patients with a high probability of developing AIS remained low. The identification of people among the general population who have a high probability of developing AIS based on the probabilities expressed in the literature is not possible.
We report a prevalence study of multiple sclerosis (MS) in the town of Westlock and surrounding county of Westlock, in Alberta, Canada. The prevalence rate for clinically definite MS on January 1, 1991, was 200/100,000. The average annual incidence rates for patients living in the area at onset were 1.91/100,000 for 1950-1959, 2.85/100,000 for 1960-1969, 3.82/100,000 for 1970-1979, and 7.26/100,000 for 1980-1989. Forty-eight percent of the patients were relapsing-remitting. Sixty percent were still walking without assistance. The female-to-male ratio was 1.4:1. Mean current age was 47, age at onset 30, and duration of illness 18 years. The majority of patients (40%) experienced multiple symptom onset. Forty percent were of single ethnic origin (primarily British); the remainder were predominantly north European combinations. Twenty-four percent of patients reported another MS relative, six first-degree and one second-degree relative.
Reports of a high prevalence rate for multiple sclerosis in Southern Alberta led to an epidemiologic study of this disease in the Crowsnest Pass and Cardston regions. In Cardston, the prevalence rate for multiple sclerosis was 88 per 100,000. In the Crowsnest Pass, the prevalence rate was 217 per 100,000. Previous epidemiologic studies of the prevalence rate of multiple sclerosis in Western Canada have shown rates between 93 and 111 per 100,000. Two prevalence studies of multiple sclerosis in Barrhead County, Alberta and Westlock County, Alberta show prevalence rates of 196 and 201 per 100,000. The prevalence rate in the Crowsnest Pass is comparable to the prevalence in Barrhead County and Westlock County, Alberta. However, there is no statistically significant difference between prevalence rates in the Cardston and Crowsnest Pass regions and our overall feeling is that the results of studies of small populations should be interpreted with caution.
Pediatric tuberculosis (TB) is important medically and indicative of a public health problem. An understanding of the epidemiology and case characteristics of pediatric TB, in a province that accepts large numbers of immigrants, can inform TB elimination strategy.
All cases of pediatric TB notified in Alberta between 1990 and 2004 were identified in the TB Registry. Individual diagnostic criteria were reviewed and case patients were related to a population grid derived from Statistics Canada censuses and population estimates of Status Indians from the Department of Indian and Northern Affairs, Canada. Incidence rates were determined by ethnic group and gender. Clinical/mycobacteriologic case characteristics were compared by ethnic group and birth country.
Among 124 notified cases, 95 (96 episodes) met strict diagnostic criteria: 45 Status Indians, 30 Canadian-born 'other' and 21 foreign-born. Incidence rates were much higher in Status Indians and the foreign-born compared to the Canadian-born 'other'; 10.7, 5.4, and 0.4 per 100,000 person-years, respectively. Among Canadian-born 'other' cases, 12 were Métis and 11 were Canadian-born children of foreign-born parents. Compared to foreign-born cases, Canadian-born cases were more likely to have a source case in Alberta, to be detected through contact tracing, to have primary pulmonary TB, and to have a rural address.
Pediatric TB in Alberta is mainly the result of ongoing transmission in Aboriginal peoples and immigration to Canada of persons with latent TB infection. The elimination of pediatric TB will require interruption of transmission in Aboriginal peoples and prevention of disease in immigrants.
This paper reports on expectations for and community members' experience in the development of community indicators in a healthy communities initiative (HCI) in Alberta, Canada. The HCI process involved community visioning, the creation of action plans to further the vision by addressing key health priorities and/or community capacity building activities and the development of indicators to monitor and report on progress towards goals. Nineteen semi-structured interviews were conducted with community participants to discuss definitions of success in the HCI and participant experience in developing indicators. Three themes emerged: the formal indicators lacked relevance to community members; the community did not own the HCI indicators and participants instead drew upon measures of success which were largely experiential in nature. The study provides a critically reflective, candid account of on-the-ground work with communities. The findings reveal limitations in the process of developing community indicators in this HCI, which we attribute in part to skills and discontinuities on the staffing side of the health authority and in part to failure to recognize and fully appreciate 'different ways of knowing' between communities and agencies.