Monthly Archives: October 2017


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Click to download info sheet: Info-Sheet-Health-Promotion-and-Gender-Equity

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Introduction to Women’s Health Indicators

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Having a comprehensive picture of the health of a population is critical to guiding health research, policy and programs. Such a picture is created by collecting data on a range of health measures – health indicators – that can be pooled together and analyzed to describe, compare and monitor patterns of mortality (deaths), morbidity (illness, disease), wellness, and health-affecting factors (personal behaviours, resources such as housing and systemic influences such as the availability of care). To understand women’s health, this information must be available and should be analyzed by sex and by gender. Sex- and gender-based analysis (SGBA) is recognized internationally and by the Canadian government as a critical component of sound health planning. According to Government of Canada policy, SGBA is used “to ensure that the initiatives and activities of the Health Portfolio lead to sound science, ensure gender equality and are effective and efficient”.

To understand women’s health, this information must be available and should be analyzed by sex and by gender. Sex- and gender-based analysis (SGBA) is recognized internationally and by the Canadian government as a critical component of sound health planning. According to Government of Canada policy, SGBA is used “to ensure that the initiatives and activities of the Health Portfolio lead to sound science, ensure gender equality and are effective and efficient”.

Canadian Women’s Health Indicators: An Introduction, Environmental Scan, and Framework Examination has been developed to introduce the concepts and context of work done in the area of women’s health indicators in Canada. This introduction includes an overview of what is meant by women’s health indicators and the rationale behind their use. This material is followed by a brief introduction to indicator frameworks, which are explained more fully in the following pages.

Click to download document: Womenshealthindicators_review_final

Three Principles to Improve Outcomes for Children and Families


Core Principles of Development Can Help Us Redesign Policy and Practice

Recent advances in the science of brain development offer us an unprecedented opportunity to solve some of society’s most challenging problems, from widening disparities in school achievement and economic productivity to costly health problems across the lifespan. Understanding how the experiences children have starting at birth, even prenatally, affect lifelong outcomes—combined with new knowledge about the core capabilities adults need to thrive as parents and in the workplace—provides a strong foundation upon which policymakers and civic leaders can design a shared and more effective agenda.

The science of child development and the core capabilities of adults point to a set of “design principles” that policymakers and practitioners in many different sectors can use to improve outcomes for children and families. That is, to be maximally effective, policies and services should:

  1. Support responsive relationships for children and adults.
  2. Strengthen core life skills.
  3. Reduce sources of stress in the lives of children and families.

The three principles point to a set of key questions: What are policies, systems, or practices doing to address each principle? What could be done to address them better? What barriers prevent addressing them more effectively?

These three principles can guide decision-makers as they choose among policy alternatives, design new approaches, and shift existing practice in ways that will best support building healthy brains and bodies. They point to a set of key questions: What are current policies, systems, or practices doing to address each principle? What could be done to address them better? What barriers prevent addressing them more effectively?

Moreover, these design principles, grounded in science, can lead policymakers to think at all levels about the forces that could lead to better outcomes for children. At the individual level, policies can focus on skill-building for both kids and adults; at the human services level, they might focus on the critical place of relationships in promoting healthy development, supportive parenting, and economic productivity; and at the systemic or societal level, policies can emphasize reducing sources of stress that create lifelong challenges for children and make it extraordinarily difficult for adults to thrive as parents and breadwinners.

The Science Behind the Principles

Scientists have discovered that the experiences children have early in life—and the environments in which they have them—not only shape their brain architecture, but also affect whether, how, and when the developmental instructions carried in their genes are expressed. This is how the environment of relationships young children experience with adult caregivers, as well as early nutrition and the physical, chemical, and built environments, all get “under the skin” and influence lifelong learning, behavior, and both physical and mental health—for better or for worse. Starting at birth and continuing throughout life, our ability to thrive is affected by our ongoing relationships and experiences and the degree to which they are healthy, supportive, and responsive or not.

The biology of stress activation also explains why significant hardship or threat (e.g., from abuse, neglect, or extreme poverty) can lead to physiological and behavioral disruptions that can have lasting impact. Not all stress is bad—for example, children need to experience manageable amounts of stress in the presence of supportive adults to develop a healthy stress response system. But frequent or extreme experiences that cause excessive stress can be toxic to the architecture of children’s developing brains and can overload adults’ capacity to engage productively in work, families, and communities. Fortunately, most of us have powerful stress-protection shields in the form of supportive caregivers, families, and friends. Stable and responsive relationships in the earliest years of life help protect children from the potential harm that excessive stress can cause, and in adulthood they provide the buffering and hope that are necessary for resilience.

Experiencing significant adversity early in life can set up our body’s systems to be more susceptible to stress throughout life, with long-term negative consequences for physical and emotional health, educational achievement, economic success, social relationships, and overall well-being. For adults who have experienced a pile-up of adversity since childhood, the additional weight of current adversity, such as prolonged poverty, may overload their ability to provide the stable, responsive relationships children need and consistently meet the demands of the modern workplace. Therefore, these scientific findings are relevant to policy choices in a wide variety of areas—from traditional “children’s” areas such as pediatrics, early care and education, and child nutrition to “adult” domains such as income support, employment training, foster parent training, health care, and housing.

To download the full document please click: HCDC_3PrinciplesPolicyPractice

Article Review: Protective Factors for Child Development

Protective factors for child development at age 2 in the presence of poor maternal mental health: Results from the All Our Babies (AOB) pregnancy cohort 

Authors: Sheila McDonald, Heather Kehler, and Suzanne Tough                                  Journal: BMJ Open

What is this study about? This study looked at what combination of factors were most protective of developmental delay at age two among children exposed to poor maternal health.

Who are the participants? The study team recruited a cohort of 3000 pregnant women. Two years later, 1596 mother-child dyads completed questionnaires. Of these 1596 pairs, 305 mothers (27%) were determined to be high risk for having poor mental health. The results we describe below are based on information from these 305 mother-child pairs from the Calgary area.

Why is this study important? The authors explain that maternal depression…

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Fetal Alcohol Spectrum Disorder: A Significant Global Problem

fetal-acohol-spectrum-disorder-minA study of the global prevalence of fetal alcohol spectrum disorder (FASD) estimates that it affects as many as 8 out of 10,000 children, highlighting the need to improve public education about the potential harm of drinking alcohol during pregnancy.

Drinking alcohol during pregnancy may harm the developing fetus. A wide range of resulting health problems have been observed including defects of the heart, kidneys or bones, problems with brain development, low IQ, and hyperactivity. This group of conditions is known as fetal alcohol spectrum disorder (FASD). Affected children may have mild to severe health problems. However, it is not possible to predict the severity from the amount or timing of their mother’s alcohol consumption. There is no safe amount or safe time of alcohol consumption for a pregnant woman.

It is important to know the prevalence of a condition in order to look at patterns of occurrence.  This helps to direct the focus of resources for prevention and treatment. Researchers in Toronto have completed a comprehensive analysis of the available data on FASD to estimate its global prevalence in children and young people. They recently published their findings in JAMA Pediatrics.

The research team reviewed the medical literature to identify high-quality studies that reported the prevalence of FASD among children and youth in the general population. A total of 24 studies including 1,416 children and youth (0-16 years) were included in the analysis.

They found that the global prevalence of FASD among children and youth in the general population was estimated to be around eight affected children per 1000 people. The WHO European Region had the highest prevalence, approximately 20 per 1000 people, and the WHO Eastern Mediterranean Region had the lowest, approximately 0.1 per 1000 people. At a country level, South Africa had the highest prevalence of FASD (111 per 1000 population), followed by Croatia (55.3 per 1000 population), and Ireland (47 per 1000 population).

Using selected studies, the team also looked at the prevalence of FASD amongst special populations, compared to the general population. They estimated that FASD was 15.6-24.6 times higher in Aboriginal populations, 5.2-67.7 times higher among children in care, 30.3 times higher in a correctional population, 23.7 times higher in a population with low socioeconomic status and 18.5 times higher among a population in psychiatric care.

The estimates of the global prevalence of FASD show that it is a significant health problem. It has an impact on large numbers of children and youth and a high cost of health services. Fetal alcohol spectrum disorder is a largely preventable condition. The researchers suggest there is a need for wider public education about the potential harm of drinking during pregnancy. They also suggest a screening system to identify problem drinking before and during pregnancy. These strategies could be widely implemented at relatively little cost.

Written by Julie McShane, Medical Writer


Lange S, Probst C, Gmel G, et al. Global prevalence of fetal alcohol spectrum disorder among children and youth. A systematic review and meta-analysis. JAMA Pediatrics, published online August 21, 2017. Doi:10.1001/jamapediatrics.2017.1919.

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Your developing baby: Building the brain is like building a house

Your baby’s growth and development is guided by the brain. Brain development begins during pregnancy and continues into the adult years. In the developing embryo, neurons start to form by 6 weeks of pregnancy. By 16 weeks of pregnancy, 250,000 neurons are being created every minute.

Building the brain is like building a house:

In a house…

  • The structure is built starting on the ground.
  • The base or foundation is set, the walls are built and the electrical system is wired—all in an exact order.
  • The electrical wiring allows all parts of the house to work together.
  • A strong foundation supports everything that is built on top of it.

In the brain…

  • The brain’s basic structure forms during pregnancy.
  • The ‘wiring’ of the brain starts as the brain’s neurons begin to connect with each other.
  • Connections in the brain continue to develop through an ongoing process until the early adult years.
  • These connections are how the brain communicates. Communication happens between neurons in the brain, and between the brain and the rest of the nervous system.
  • Early brain development lays the foundation for future learning, behaviour and health.

Your newborn’s brain is like a house that has just been built. The walls and doors are up but the wiring isn’t all in place. There are still a lot of changes to come.

Caring for yourself during pregnancy is important because it supports your child’s brain development, which affects all parts of your child’s growth and development.

The quickly developing brain is very sensitive to harmful environments such as too much stress, certain illnesses and being exposed to harmful chemicals.

This site suggests ways to create healthy environments to help your baby’s developing brain during pregnancy. More information on helping to build your child’s brain through the early years.

  • When stress becomes too much

    Everyone has some amount of stress. But some things cause so much stress it can be harmful to your health, and your baby’s developing brain and overall health. If you are going through something stressful that isn’t going away or for which you have no support, it’s important to get help. Talk to your health care provider or call Health Link toll-free in Alberta at 8-1-1.

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