The fourth edition of the CICH Profile is a web-based resource that provides stakeholders across many disciplines access to and use of information on multiple inter-related aspects of children’s health. The modules of this document will be published online in stages and updated on an ongoing basis to ensure that current and reliable data is being used to tell the story of children’s health in Canada. This edition expands beyond the scope of the previous three to address emerging issues in children’s health – such as the health and well-being of immigrant and refugee children, children in the healthcare system, active living and health weights, and genetics and paediatric health.
The online Profile is a living battery of information capable of answering questions that have already been asked and spawning curiosity and new research. In addition to supplying information, the Profile is an educational resource and a vehicle for knowledge translation related to both child health and data collection and analysis.
To develop the online Profile, CICH has engaged in extensive consultations with experts in child health from across the country. This process was designed to ensure that all of the information (whether statistical or textual) will be accurate, reliable and useful. An interprofessional National Advisory Group has been formed to set the overall vision for the online Profile and to ensure that the content is timely, relevant, and comprehensive. They will review drafts of the modules, identify information gaps, and recommend the use of additional indicators, as well as assist with knowledge translation and dissemination. Multidisciplinary Expert Committees have been formed for the modules on Aboriginal children and youth, income inequity and the health and well-being of children and youth, mental health, children and youth with disabilities, genetics and paediatric health, healthy active living, the health and well-being of immigrant and refugee children and youth, the early years, environmental health and children and youth in the health care system. The role of the Expert Committees is to review current and identify additional indicators and data sources, to assist in the interpretation of data, to review drafts of chapters and to offer advice on matters requiring particular expertise.
Understanding this Profile
Health and well-being are measured both directly and indirectly through the use of indicators. The CICH Profile reports on a wide range of health indicators, drawing on reliable, validated data sources. These data are presented for children and youth up to 24 years when such data are available.
When choosing indicators it is important to ensure that they are meaningful and suit our intended purpose. Taking into account criteria used in a number of children’s indicator reports, we will use the following guidelines to select indicators for the Profile:
• Indicators can be quantitative (e.g., counts of low birth-weight babies in a given year) or qualitative data (e.g., categorization of how satisfied young people feel about their body size in a given year).
• Indicators can represent:
o determinants of children’s health and well-being, that is, what influences
health and well-being
o health outcomes, or how children and youth are doing.
• Indicators should be relevant – the indicators should be directly relevant to one or more of the issues pertaining to the determinants of children’s health and well-being or health outcomes.
• Indicators should be credible – the indicators and their underlying data should be unbiased and come from reliable sources.
• Indicators should be comparable – wherever possible indicators should be comparable across jurisdictions and over time.
• Indicators must be clearly presented and easy to understand.
• Indicators should be responsive – that is, sufficiently sensitive to signal positive changes in a timely fashion, and to provide early warning of problems wherever possible.
• Indicators must be feasible – the data should be available or if not, producing data should be technically and financially feasible, whether through new analyses of existing data, or new data collection (e.g., environmental monitoring, health surveillance).
• It is recognized that there may not be data available for all identified indicators. If not available, these indicators will be flagged, since one of the objectives of our work will be to help identify important information gaps.
Determinants of health
The CICH Profile examines several different factors that can influence the health and well-being of children and youth. Social, economic and political factors, psychological, genetic and biological factors, personal health practices, community resources and the physical environment all determine the health of children and youth (Federal, Provincial and Territorial Advisory Committee on Population Health, 1994). As such, these factors are described as “determinants of health.” A health determinants approach focuses on health at the population-level as opposed to the individual-level, and allows for the exploration of trends and variations within and across populations and time periods.
The Profile is organized around a child development perspective. It describes what children need from their social and physical environments at different ages to develop healthily.
Putting it all together
The Profile will be a repository of modules, each of which explore and examine a different area of children’s health, well-being and functioning. This online edition will not come together in the same manner as the printed editions; rather, each module will be researched, written and published as funding for its content is secured allowing the Profile to continually expand and evolve, and providing its user-base with the most current, informed and comprehensive material available.
Information from the CICH Profile comes from traditional sources such as census data, vital statistics (births and deaths), and hospitalization data. It also comes from population-based national and provincial surveys, and peer reviewed research findings.
When selecting data sources, the following guidelines apply:
• The data are population-based.
• The indicators are described either based on primary analysis of a population-based data source or from published sources (based on population-based data).
• The data are presented nationally and by all provinces/territories wherever possible.
• If data do not exist nationally and by all provinces/territories, but a subset of jurisdictions or a single province/territory/jurisdiction has population-based data, these data are used to describe the indicators to illustrate important issues. It is made clear what the source of the data is and what it represents.
• If data do not exist nationally and by all provinces/territories or from a subset of jurisdictions or a single province/territory, but research has been published in a peer reviewed journal to describe an important issue, this information
will be presented. It will be made clear what the source of the information is and what it represents.
• If data do not exist nationally and by all provinces/territories, from a subset of jurisdictions or a single province/territory, or from published/peer-reviewed research to describe an issue that is deemed important by the experts, this information will be presented as a gap in information.
• All results will be referenced/linked to their original source.
Presenting the Information
The Profile will be presented via an online web portal. The presentation of information, including charts and figures, will be standardized as much as possible to ensure that the presentation of the material is clear and comprehensible. Each module presented in the on-line Portal will have a consistent look and feel – however, there will be a number of templates developed and used to present the information to suit the specific data/indicators being presented. The user will have a variety of ways of capturing in the information – for example, it could be through downloading a full module or a presentation of a specific indicator, printing PDF versions, accessing ‘fact sheets’ on specific topics or linking to the data used to create a graphic. A number of knowledge translation strategies will be employed to reach the audience in a variety of ways. The intended audience for the profile is varied – professionals from many backgrounds – e.g., health, social services, social policy; educators; clinicians; policy/decision makers, to name a few.
The following guidelines will be followed when presenting charts and figures:
• Data used to create each chart is provided in the relevant chart.
• When the chart is presenting percentages or proportions, the vertical axis will be either 100%, 50% or 10%. This allows the reader to more easily compare charts.
• When the chart is presenting information by province and territory, the figure for Canada will be represented alongside the provinces and territories in another colour/format.)
• All of the information used to create a chart will be available, with a link to the corresponding spreadsheet of numbers.
• The sample size (n) will been included, as the number is often important to interpreting the chart.
• Notes from the original sources will be linked directly to the chart, along with any other required notes.
• All sources will be fully cited.