Adverse birth outcomes in relation to maternal marital and cohabitation status in Canada.

Purpose: An increasing percentage of children are born to couples who cohabit but are not legally married. Using data from a nationally representative Canadian sample, we estimated associations of maternal marital and cohabitation status with stillbirth, infant mortality, preterm birth (PTB), and small- and large-for-gestational-age (SGA and LGA) birth.

Methods: The 2006 Canadian Birth-Census Cohort was created by linking birth registration data with the 2006 long-form census.

Positional accuracy of geocoding from residential postal codes versus full street addresses.

Background: Postal codes are often the only geographic identifier available for assigning contextual or environmental information to a study population. This analysis assesses the influence of three factors-delivery mode type (mode of postal delivery), representative point type (source of latitude-longitude coordinates), and community size-on the accuracy of postal code spatial assignment.

Data And Methods: PCCF+ (Postal Code Conversion File Plus) was used to assign delivery mode type, representative point type and community size to each individual in the 2011 Census of Canada.

Birth outcomes among First Nations, Inuit and Métis populations.

Background: First Nations, Inuit, and Métis are at higher risk of adverse birth outcomes than are non-Indigenous people. However, relatively little perinatal information is available at the national level for Indigenous people overall or for specific identity groups.

Data And Methods: This analysis describes and compares rates of preterm birth, small-for-gestational-age birth, large-for-gestational-age birth, stillbirth, and infant mortality (neonatal, postneonatal, and cause-specific) in a nationally representative sample of First Nations, Inuit, Métis, and non-Indigenous births.

Socioeconomic disparities in small-for-gestational-age birth and preterm birth.

Background: Maternal socioeconomic disadvantage has been associated with increased risk of small-for-gestational-age birth and preterm birth. Few studies, however, have considered maternal education and income simultaneously to better understand the mechanisms underlying perinatal health disparities. This analysis examines both maternal education and income and their association with the risk of small-for-gestational-age birth and preterm birth.

The 2006 Canadian Birth-Census Cohort.

Background: Evidence on socioeconomic and ethnocultural disparities in perinatal health in Canada tends to be limited to analyses by neighbourhood or for selected provinces. In 2010, the Canadian Institutes of Health Research awarded funding for a project on perinatal outcomes. This article describes the resulting 2006 Canadian Birth-Census Cohort Database.

Socio-economic inequalities in cause-specific mortality: a 16-year follow-up study.

Objectives: To examine socio-economic inequalities in cause-specific mortality by examining the independent effects of education, occupation and income in a population-based study of working-age Canadian adults.

Methods: This is a secondary analysis of data from the 1991-2006 Canadian Census mortality and cancer follow-up study (n=2.7 million persons).

Cause-specific mortality by income adequacy in Canada: A 16-year follow-up study.

Background: People with lower incomes tend to have less favourable health outcomes than do people with higher incomes. Because death registrations in Canada do not contain information about the income of the deceased, vital statistics cannot be used to examine mortality by income at the individual level. However, through record linkage, information on the individual or family income of people followed for mortality can be obtained.

Data resource profile: 1991 Canadian Census Cohort.

The 1991 Canadian Census Cohort is the largest population-based cohort in Canada (N=2,734,835). Prior to the creation of this Cohort, no national population-based Canadian cohort was available to examine mortality by socioeconomic indicators. The 1991 Canadian Census Cohort was created via the linkage of a sub-sample of respondents from the mandatory 1991 Canadian Census long-form to historical tax summary files, Canadian Mortality Database, Canadian Cancer Database, 1991 Health and Activity Limitation Survey and a sub-sample of the Longitudinal Worker File.

Neighbourhood income and neonatal, postneonatal and sudden infant death syndrome (SIDS) mortality in Canada, 1991-2005.

Background: Rates of infant mortality declined in Canada in the 1990s and 2000s, but the extent to which all socio-economic levels benefitted from this progress is unknown.

Objectives: This study investigated differences and time trends in neonatal, postneonatal and sudden infant death syndrome (SIDS) mortality across neighbourhood income quintiles among live births in Canada from 1991 through 2005.

Methods: The Canadian linked live birth and infant death file was used, excluding births from Ontario, Yukon, Northwest Territories and Nunavut.

Mortality following unemployment in Canada, 1991-2001.

Background: This study describes the association between unemployment and cause-specific mortality for a cohort of working-age Canadians.

Methods: We conducted a cohort study over an 11-year period among a broadly representative 15% sample of the non-institutionalized population of Canada aged 30-69 at cohort inception in 1991 (888,000 men and 711,600 women who were occupationally active). We used cox proportional hazard models, for six cause of death categories, two consecutive multi-year periods and four age groups, to estimate mortality hazard ratios comparing unemployed to employed men and women.

Cause-specific mortality by education in Canada: a 16-year follow-up study.

Background: People with lower levels of education tend to have higher rates of disease and death, compared with people who have higher levels of education. However, because death registrations in Canada do not contain information on the education of the deceased, unlinked vital statistics cannot be used to examine mortality differentials by education.

Methods: This study examines cause-specific mortality rates by education in a broadly representative sample of Canadians aged 25 or older.

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec.

Objectives: The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec.

Study Design And Methods: In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193), we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal) and by community type (predominantly First Nations, Inuit or non-Aboriginal).

Results: From 1991-1995 to 1996-2000, there was a trend of increasing rates of preterm birth for all 6 study groups.

Remaining life expectancy at age 25 and probability of survival to age 75, by socio-economic status and Aboriginal ancestry.

Previously, little information has been available about life expectancy and the probability of survival by socio-economic status or for Aboriginal groups. However, data from the 1991 to 2001 Canadian census mortality follow-up study made it possible to construct life tables for the non-institutional population aged 25 or older by a range of census variables. Those life tables have now been updated to include deaths through to the end of 2006.

Breast cancer incidence and neighbourhood income.

Background: In developed countries, women of higher socioeconomic status often have higher breast cancer incidence rates, compared with women of lower socioeconomic status.

Data And Methods: Data were extracted from the Canadian Cancer Registry for the 229,955 cases of adult female invasive breast cancer diagnosed from 1992 through 2004. Postal code at diagnosis was used to determine neighbourhood income quintile.

Potential years of life lost at ages 25 to 74 among Métis and non-Status Indians, 1991 to 2001.

Background: Aboriginal peoples experience a disproportionate burden of disease, compared with other Canadians. However, relatively little information is available about mortality among Métis and non-Status Indians.

Methods: This study calculates potential years of life lost before age 75 (PYLL) for people aged 25 to 74 by all-cause and cause-specific mortality, and examines the effect of socio-economic factors on premature mortality.

Potential years of life lost at ages 25 to 74 among Status Indians, 1991 to 2001.

Background: Compared with other Canadians, First Nations peoples experience a disproportionate burden of illness and disease. Potential years of life lost (PYLL) before age 75 highlights the impact of youthful or early deaths.

Data And Methods: The 1991 to 2001 Canadian census mortality follow-up study tracked a 15% sample of adults aged 25 or older over more than a decade.

Avoidable mortality for causes amenable to medical care, by occupation in Canada, 1991-2001.

Objective: To describe the incidence of avoidable mortality for causes amenable to medical care among occupation groups in Canada.

Method: A cohort study over an 11-year period among a representative 15% sample of the non-institutionalized population of Canada aged 30-69 at cohort inception. Age-standardized mortality rates for causes amenable to medical care and all other causes of death were calculated for occupationally-active men and women in five categories of skill level and 80 specific occupational groups as well as for persons not occupationally active.

Association of macrosomia with perinatal and postneonatal mortality among First Nations people in Quebec.

Background: High prevalence of infant macrosomia (up to 36%, the highest in the world) has been reported in some First Nations communities in the Canadian province of Quebec and the eastern area of the province of Ontario. We aimed to assess whether infant macrosomia was associated with elevated risks of perinatal and postneonatal mortality among First Nations people in Quebec.

Methods: We calculated risk ratios (RRs) of perinatal and postneonatal mortality by birthweight for gestational age, comparing births to First Nations women (n = 5193) versus women whose mother tongue is French (n = 653 424, the majority reference group) in Quebec 1991-2000.

Birth outcomes and infant mortality among First Nations Inuit, and non-Indigenous women by northern versus southern residence, Quebec.

Background: In circumpolar countries such as Canada, northern regions represent a unique geographical entity climatically, socioeconomically and environmentally. There is a lack of comparative data on birth outcomes among Indigenous and non-Indigenous subpopulations within northern regions and compared with southern regions.

Methods: A cohort study of all births by maternal mother tongue to residents of northern (2616 First Nations (North American Indians), 2388 Inuit and 5006 non-Indigenous) and southern (2563 First Nations, 810,643 non-Indigenous) Quebec, 1991-2000.

Birth outcomes and infant mortality by the degree of rural isolation among first nations and non-first nations in Manitoba, Canada.

Context: It is unknown whether rural isolation may affect birth outcomes and infant mortality differentially for Indigenous versus non-Indigenous populations. We assessed birth outcomes and infant mortality by the degree of rural isolation among First Nations (North American Indians) and non-First Nations populations in Manitoba, Canada, a setting with universal health insurance.

Methods: A geocoding-based birth cohort study of 25,143 First Nations and 125,729 non-First Nations live births to Manitoban residents, 1991-2000.

Income disparities in health-adjusted life expectancy for Canadian adults, 1991 to 2001.

Background: Health-adjusted life expectancy is a summary measure of population health that combines mortality and morbidity data into a single index. This article profiles differences in health-adjusted life expectancy across income categories for a representative sample of the Canadian population.

Data And Methods: Mortality data were obtained from the 1991-2001 Canadian census mortality follow-up study, which linked a 15% sample of the 1991 adult non-institutional population with 11 years of death records from the Canadian Mortality Data Base.

Mortality of Métis and registered Indian adults in Canada: an 11-year follow-up study.

Background: Little information has been published about the mortality of the Métis people of Canada. This study describes mortality patterns among Métis and Registered Indian adults, compared with the non-Aboriginal population.

Data Source And Methods: The 1991 to 2001 Canadian census mortality followup study tracked mortality among a 15% sample of respondents aged 25 or older, including 11,800 Métis, 56,700 Registered Indians and 2,624,300 non-Aboriginal adults, all of whom were enumerated by the 1991 census long-form questionnaire.

Birth outcomes in the Inuit-inhabited areas of Canada.

Background: Information on health disparities between Aboriginal and non-Aboriginal populations is essential for developing public health programs aimed at reducing such disparities. The lack of data on disparities in birth outcomes between Inuit and non-Inuit populations in Canada prompted us to compare birth outcomes in Inuit-inhabited areas with those in the rest of the country and in other rural and northern areas of Canada.

Methods: We conducted a cohort study of all births in Canada during 1990-2000 using linked vital data.