Congenital abnormalities in newborns of women with pregestational diabetes: A time-trend analysis, 1994 to 2009.

Background: The main objective of the current study is to examine the trend of congenital abnormalities among children born by women with and without diabetes, and to explore the impact of food fortification by folic acid on the rate of birth defects among these two groups of mothers.

Methods: All children born alive in Ontario, Canada, during 1994 to 2009 and their mothers were included in study. Diagnosis of pregestational diabetes among mothers was identified using Diabetes registry, and diagnosis of birth defects among children were identified using hospital records.

Food fortification and decline in the prevalence of neural tube defects: does public intervention reduce the socioeconomic gap in prevalence?

Objective: A significant decline in the prevalence of neural tube defects (NTD) through food fortification has been reported. Questions remain, however, about the effectiveness of this intervention in reducing the gap in prevalence across socioeconomic status (SES).

Study Design: Using health number and through record linkage, children born in Ontario hospitals between 1994 and 2009 were followed for the diagnosis of congenital anomalies.

Socioeconomic status and prevalence of congenital heart defects: does universal access to health care system eliminate the gap?

Background: A twofold increase in the prevalence of congenital heart defects (CHDs) has been reported since the early 1970s with higher rates among children from low socioeconomic status (SES). This increase and the observed SES gap are postulated to be reflective of higher ascertainment, especially increased use of ultrasound and echography. The purpose of this study was to examine if trends over time in the prevalence of CHD were the same for high and low SES groups.

Risk adjustment using administrative data-based and survey-derived methods for explaining physician utilization.

Objectives: The objective of this study was to evaluate an administrative data-based risk adjustment method for predicting physician utilization and the contribution of survey-derived indicators of health status. The results of this study will support the use of administrative data for planning, reimbursement, and assessing equity of physician utilization.

Methods: The Ontario portion of the 2000-2001 Canadian Community Health Survey was linked with administrative physician claims data from 2002-2003 and 2003-2004.

Universal health insurance and equity in primary care and specialist office visits: a population-based study.

Purpose: Universal coverage of physician services should serve to reduce socioeconomic disparities in care, but the degree to which a reduction occurs is unclear. We examined equity in use of physician services in Ontario, Canada, after controlling for health status using both self-reported and diagnosis-based measures.

Methods: Ontario respondents to the 2000-2001 Canadian Community Health Survey (CCHS) were linked with physician claim files in 2002-2003 and 2003-2004.

Social disadvantage, air pollution, and asthma physician visits in Toronto, Canada.

Background: Previous research demonstrates that ambient air pollution exacerbates asthma. Asthma morbidity also varies with socioeconomic position (SEP). Few studies have examined if ambient air pollution has a differential impact on income subgroups of the population.

Relationship between social inequalities and ambulatory care-sensitive hospitalizations persists for up to 9 years among children born in a major Canadian urban center.

Objective: Hospitalizations for ambulatory care-sensitive (ACS) conditions have been considered a marker for access to timely and effective primary care, but there are few pediatric studies. Our purpose was to examine socioeconomic disparities in ACS and non-ACS admissions among birth cohorts in a universal health insurance setting.

Methods: We examined ACS and all hospitalizations of children born from 1993 to 2000 in Toronto, Canada, by birth year, calendar year, and socioeconomic status (SES).

Inadequacy of cervical cancer screening among urban recent immigrants: a population-based study of physician and laboratory claims in Toronto, Canada.

Objective: In Canada, Pap smears are recommended from 18 to 69. Self-reported socioeconomic gradients in screening have been documented in North America but there have been few direct measures of Pap smear use among immigrants or socially disadvantaged groups. Our purpose was to investigate whether socioedemographic factors are related to cervical cancer screening in Toronto, Canada.

Determinants of survival in children with congenital abnormalities: a long-term population-based cohort study.

Background: Today more children with birth defects survive early childhood because of improved medical care; however, little information is available about patterns of long-term mortality and survival in this population. In particular, it is not clear whether other birth characteristics, apart from birth defects, have any role in their mortality.

Methods: Two large cohorts of children with and without birth defects were followed for up to 17 years.

Congenital abnormalities and childhood cancer.

Background: The examination of specific characteristics of neoplasms diagnosed in children have suggested that a significant proportion can be attributed to a genetic mutation or genetic predisposition. Although the study of a genetic predisposition to cancer in children remains in the early stages, congenital abnormalities could provide essential information for mapping predisposing lesions in children with cancer.

Methods: In the current study, 2 large cohorts of children with and without congenital abnormalities were followed for the occurrence of cancer and death up to 18 years.

Age- and sex-specific income gradients in alcohol-related hospitalization rates in an urban area.

Purpose: This study examines the effects of age and sex on the relationship between neighborhood income and alcohol-related hospitalization rates in a large urban area.

Methods: Adults in Toronto, Canada, who were hospitalized with an alcohol-related condition between 1995 and 1998 were identified using discharge diagnoses. Income quintiles were determined based on area of residence.

Neighbourhood recent immigration and hospitalization in Toronto, Canada.

Recent immigrants to Canada tend to initially settle in low-income urban core areas. The relationships among immigration, neighbourhood effects and health are poorly understood. This study explored the risk of hospitalization in high recent-immigration areas in Toronto compared to other Toronto neighbourhoods.

Socioeconomic misclassification in Ontario's Health Care Registry.

Background: Addresses in some provincial health care registries are not systematically updated. If individuals are attributed to the wrong location, this can lead to errors in health care planning and research. Our purpose was to investigate the accuracy of socioeconomic classification based on addresses in Ontario's provincial health care registry.