Background:The COVID-19 pandemic has highlighted several issues among health care workers in Canada's long-term care and seniors' (LTCS) homes, including labour shortages, staff retention difficulties, overcrowding, and precarious working conditions. There is currently a lack of information on the health, well-being and working conditions of health care workers in LTCS homes - many of them immigrants - and a limited understanding of the relationship between them. This paper examines differences between immigrant and non-immigrant workers' health outcomes and precarious working conditions during the pandemic. Data and methods:The data were from the 2021 Survey on Health Care Workers' Experiences During the Pandemic, which collected information on LTCS home health care workers' (n=2,051) health, employment or work experiences, and working environment during the COVID-19 pandemic. Summary statistics and multivariable logistic regressions were conducted to examine the association between precarious work and workers' health (life stress, mental health and general health), stratified by immigrant status. Selected working characteristics were included in the regression models as covariates, namely occupation, number of locations worked, facility ownership status and number of years worked. Results:Immigrant health care workers were more likely than non-immigrant health care workers to experience precarious work in LTCS homes. Precarious work - characterized by income loss, reduced hours of work, and unpaid leave - was associated with stress and poor general health among immigrant and non-immigrant workers in the sector. Employment precarity was also associated with poor mental health for immigrant workers, but there was no association for non-immigrant workers. Interpretation:Employment precarity and the health and well-being of health care workers warrants further attention, in particular among immigrants employed in the LTCS residential care sector.

OBJECTIVE:To investigate prospective associations between type of child abuse (physical, sexual, both), timing (childhood, young adulthood, both), and welfare receipt into middle-age.METHODS:Database linkage study using the Quebec Longitudinal Study of Kindergarten Children cohort born in 1980 and government administrative databases (N = 3020). We assessed parental tax returns, family and personal background characteristics (1982-1987). At age 22 years, participants answered retrospective questionnaires on experienced childhood abuse (physical, sexual abuse < age 18 years) and intimate partner violence (IPV) (ages 18-22). Main outcome was years on social assistance, on the basis of participant tax returns (ages 23-37 years). Analysis included weights for population representativeness.RESULTS:Of 1690 participants (54.4% females) with available data, 22.4% reported childhood abuse only, 14.5% IPV only, and 18.5% both. Prevalence of childhood physical, sexual, and both was 20.4%, 12.2%, and 8.3%, respectively. Adjusting for socioeconomic background and individual characteristics, we found that childhood physical abuse alone and physical or sexual abuse combined were associated with a two-fold risk of welfare receipt, as compared to never-abused (adjusted incidence risk ratio 2.43, 95% confidence interval [CI], 1.65-3.58; and adjusted incidence risk ratio 2.04, 95% CI, 1.29-3.23, respectively). Repeated abuse (childhood abuse combined with adult IPV) had a three-fold risk (adjusted incidence ratio 3.59, 95% CI, 2.39-5.37).CONCLUSIONS:Abuse across several developmental periods (childhood and young adulthood) is associated with increased risks of long-term welfare receipt, independently of socioeconomic background. Results indicate a dose-response association. Early prevention and targeted identification are crucial to preventing economic adversity that may potentially lead to intergenerational poverty.

This study offers insights into lifetime earnings growth differences between individuals with and without childhood-onset disabilities (COD) defined as disabilities whose onset occurred before an individual's 16th birthday. We use a newly available database linking data from the 2017 Canadian Survey of Disability with individual income tax records covering a period of over 3 decades. We estimate the average earnings growth profiles of individuals with COD from the age when individuals generally enter the labor market to the age when most retire. The main finding of our study is that individuals with COD experience very little earnings growth when they are in their mid-30 and 40s while the earnings of those without COD grow steadily until they reach their late 40s and early 50s. The largest earnings growth differences between individuals with and without COD are observed for male university graduates.

Violence against children is a complex social, health, and legal issue in Canada associated with poor physical and mental health (PHAC, 2012; Burczyka, 2017). Eliminating violence against children is a target of multiple Sustainable Development Goals (SDGs) outlined by the United Nations General Assembly in the 2030 Agenda for Sustainable Development (United Nations, 2022). While the SDGs were developed to provide international indicators to assess the progress of signatory nations, insufficient data prevented an evaluation of Canada (UNICEF, n.d. a). Although national, population-based child maltreatment research was underdeveloped in Canada prior to 2012, Statistics Canada, the nation's statistical agency, has been collecting data since the 1960s. However, it may be difficult for researchers to navigate the range of data sources available to study child maltreatment in Canada because they span multiple topics. This paper provides an overview of national survey and administrative data sources capturing child maltreatment housed by Statistics Canada and other government departments. These data may inform future data collection on child maltreatment and assess Canada's progress on SDG indicators related to the protection of children from violence. The paper concludes with a discussion of the benefits of using survey and administrative data, a new methodology to study child maltreatment, gaps in child maltreatment research, and policy implications.

Abstract Purpose To examine household income trajectories of children with and without neurodisability over a period of 6 years. Method We used four cycles of the Canadian National Longitudinal Survey of Children and Youth, a longitudinal study of the development and well-being of Canadian children from birth into adulthood. Results While household income increased over time for both groups, families of children with neurodisability had consistently lower household income compared to families of children without neurodisability even after controlling for child and family socio-demographic characteristics. The presence of an interaction effect between parent work status and child with neurodisability at baseline indicated that among children whose parent(s) were not working at baseline, household incomes did not differ between children with and without neurodisability. Conclusions The association between child with neurodisability and lower household income may not hold for all types of parents’, working status is an important consideration. Implications for Rehabilitation Findings support the health selection hypothesis that health status shapes diverging economic conditions over time: children with a ND have lower household incomes than children without a ND child across all waves of the Canadian National Longitudinal Survey of Youth. Income gaps did not increase or decrease over time; rehabilitation services and policies must consider the lower average incomes associated with raising a child with a ND. Social assistance support likely plays a key role in closing the gap, especially for non-working families.

This study examines the differences in mental health experiences of workers in professional and non-professional roles, with a particular focus on the influence of gender. We examine: i) the perceived mental health of a subset of professional workers including accounting, academia, dentistry, medicine, nursing, and teaching, chosen because they represent different gender composition and sectors; and ii) work stress and work absences. Statistical analyses were applied to data from the Canadian Community Health Survey and a related Mental Health and Well-Being survey. Those in the selected professions reported better mental health, higher job satisfaction, and a lower prevalence of mental disorders, but higher self-perceived life and work stress compared to workers in non-professional roles. Workers in these professions reported higher job security and higher job control, but also higher psychological demands. Women in these professions showed significantly higher physical exertion and lower job authority and higher rates of work absences.

Affordability of child care is fundamental to parents’, in particular, women’s decision to work. However, information on the cost of care in Canada is limited. The purpose of the current study was to examine the feasibility of using linked survey and administrative data to compare and contrast parent-reported child care costs based on two different sources of data. The linked file brings together data from the 2011 General Social Survey (GSS) and the annual tax files (TIFF) for the corresponding year (2010). Descriptive analyses were conducted to examine the socio-demographic and employment characteristics of respondents who reported using child care, and child care costs were compared. In 2011, parents who reported currently paying for child care (GSS) spent almost $6700 per year ($7,500 for children age 5 and under). According to the tax files, individuals claimed just over $3900 per year ($4,700). Approximately one in four individuals who reported child care costs on the GSS did not report any amount on their tax file; about four in ten who claimed child care on the tax file did not report any cost on the survey. Multivariate analyses suggested that individuals with a lower education, lower income, with Indigenous identity, and who were self-employed were less likely to make a tax claim despite reporting child care expenses on the GSS. Further examination of child care costs by province and by type of care are necessary, as is research to determine the most accurate way to measure and report child care costs.

BACKGROUND:Spontaneous reporting of adverse drug reactions (ADRs) is an important source of information for post-marketing drug safety evaluation. Most countries have public access to reporting systems, but patients report only 3% of all ADRs. Little is known about factors affecting patient reporting. Our aim was to explore patients' experiences reporting ADRs and their views on the usability of the Canadian Vigilance reporting forms on MedEffect.METHODS:An interpretive description qualitative study was used. Adults in Canada, who experienced an ADR, were invited to participate through social media (Kijiji, Facebook, Twitter) and by associations (e.g., Patients Canada or Canadian Arthritis Society). Participants were interviewed in English and French using structured interview guides. Inductive content analysis was used.RESULTS:Fifteen interviews were conducted from October 2014 to May 2015. Two participants reported ADRs to MedEffect, and others to physicians and/or pharmacists. Motives for reporting were intolerable side effect impacting daily activities and encouragement from others to report (e.g., family, colleagues). Factors that interfered with reporting were physicians normalized or minimized the side effect, confusion on what to report, no feedback after report submission to MedEffect, and previous experience with side effects. MedEffect forms were described as comprehensive and important, but its usability was affected by the number of questions and complexity of some questions.CONCLUSIONS:Most participants were unaware of MedEffect and reported ADRs to physicians and pharmacists. Several barriers and motives affected patients' reporting of ADRs. MedEffect form could be simplified for use by patients.

This study described perceptions of bullying as a school characteristic and associations with school, academic, and health characteristics among a representative sample of First Nations high school students living off reserve in Canada using data from the 2012 Aboriginal Peoples Survey. Almost 4 in 10 of First Nations youth living off reserve perceived bullying as a problem at their schools. A perceived climate of bullying co-occurred with other negative school climate characteristics such as racism, violence, and the presence of alcohol and drugs. First Nations youth living off reserve who perceived bullying as a problem at school reported higher psychological distress and a higher prevalence of suicidal ideation, even after controlling for the effects of youth sex, age, and household income. These findings highlight the need to focus on school characteristics as perceived by youth to improve school climate and youth health.

OBJECTIVES: To test associations between onset of formal child care (in infancy or as a toddler), high school graduation, and employment earnings from ages 18 to 35 years. METHODS: A 30-year prospective cohort follow-up study, with linkage to government administrative databases (N =3020). Exposure included formal child care, if any, by accredited caregivers in centers or residential settings at ages 6 months and 1, 1.5, 2, 3, and 4 years. A propensity score analysis was conducted to control for social selection bias. RESULTS: Of 2905 participants with data on child care use, 59.4% of male participants and 78.5% of female participants completed high school by age 22 to 23. Mean income at last follow-up (n = 2860) was $47 000 (Canadian dollars) (SD = 37 700) and $32 500 (SD = 26 800), respectively. Using group-based trajectory modeling, we identified 3 groups: formal child care onset in infancy (∼6 months), formal child care onset as a toddler (after 2.5 years), and never exposed. After propensity score weighting, boys with child care started in infancy had greater odds of graduating than those never exposed (odds ratio [OR] 1.39; 95% confidence interval [CI]: 1.18–1.63; P < .001). Boys attending child care had reduced odds of low income as young adults (infant onset: OR 0.60 [95% CI: 0.46–0.84; P < .001]; toddler onset: OR 0.63 [95% CI: 0.45–0.82; P < .001]). Girls’ graduation rates and incomes revealed no significant association with child care attendance. CONCLUSIONS: For boys, formal child care was associated with higher high school completion rates and reduced risk of adult poverty. Benefits for boys may therefore extend beyond school readiness, academic performance, and parental workforce participation.

While typesetting the article the word “physician” has been inadvertently deleted.

BACKGROUND:While the physical health implications of the COVID-19 pandemic are regularly publicly available, the mental health toll on Canadians is unknown. This article examines the self-perceived mental health of Canadians during the COVID-19 pandemic and explores associations with various concerns after accounting for socioeconomic and health factors.DATA:The cross-sectional Canadian Perspectives Survey Series 1 collected information related to COVID-19 in late March and early April 2020 concerning labour market participation, behaviours, and health for the Canadian population 15 years and older living in the 10 provinces.METHODS:Socioeconomic and health characteristics of respondents as well as concerns about the impact of COVID-19 were examined to determine differences in experiencing excellent or very good compared to good, fair or poor perceived mental health.RESULTS:Just over half of Canadians aged 15 and older (54%) reported excellent or very good mental health during the COVID-19 pandemic. Several concerns were also associated with mental health. Notably, after considering the effects of socioeconomic and health characteristics, women, youth, individuals with a physical health condition and those who were very or extremely concerned with family stress from confinement were less likely to report excellent or very good mental health.DISCUSSION:These findings point to particular risks for lower perceived mental health during the COVID-19 pandemic. Results highlight various concerns of Canadians which may be associated with mental health, in particular, family stress in the home.

The importance of learning an Aboriginal language has been documented, yet associations with positive educational outcomes are inconclusive. Previous research in the area has been limited by small sample studies, lack of comparison groups, and the omission of the consideration of socio-demographic factors and cultural activity participation. This study uses the Canadian population-based Aboriginal Peoples Survey 2006 to examine the relationship between speaking an Aboriginal language, learning it in school, and educational outcomes for First Nations children living off reserve. Compared to children who did not speak an Aboriginal language, children who spoke an Aboriginal language and had school teachers help them learn the language at school were more likely to be rated as doing very well at school and had higher parent ratings of the importance of a post-secondary education, with no difference in the likelihood of being the appropriate age for grade, even after controlling for socio-demographic factors and participation in other cultural activities. These results suggest that learning an Aboriginal language in school is associated with positive outcomes for children who speak an Aboriginal language. Future research on this topic is needed including longitudinal studies and inclusion of direct measures of educational outcomes.

Background: Caregivers of children with health problems (CHPs; usually mothers) experience more physical and psychological health problems than those of children without health problems (non-CHPs). Primarily cross-sectional and survey-driven, this literature has not yet explored whether these health differences existed before the birth of the CHPs, or are exacerbated postbirth. Methods: Using linked administrative health data on all mother-child dyads for children born in the year 2000 in British Columbia, Canada, we examined maternal health before, during, and after the birth of CHPs, and compared it between mothers of CHPs and non-CHPs with piecewise growth curve modeling. Results: Compared with mothers of non-CHPs, mothers of CHPs had more physician visits (8.09 vs. 11.07), more medication types (1.81 vs. 2.60), and were more likely to be diagnosed with selected health conditions (30.9% vs. 42.5%) 4 years before the birth of the child. Over the 7-year postbirth period, the health of the 2 groups of mothers further diverged: while mothers of CHPs showed increases on physician visits and types of medication, mothers of non-CHPs did not experience any changes in physician visits and had less steep increases for types of medication. Conclusions: Health issues associated with having a child with a health problem may begin well before the birth of the child, but also appear to be exacerbated postbirth. The health challenges of caregivers of CHPs may be multifactorial, involving both preexisting conditions and the stresses associated with caring for a child with health problems.

Background: Using linked administrative health data, this study compared the health and healthcare service utilization between mothers of children with and without neurodevelopmental disabilities (NDD), before, during, and after the birth of a child. Methods: The population (N = 25,388) was based on a cohort of children born in 2000 and who were, along with their mothers, continuously registered with the British Columbia's universal health insurance program between 2000 and 2007. Results: Compared to mothers of children without NDD, mothers of children with NDD were more likely to have chronic conditions and higher service utilization before child birth. Mothers of children with NDD showed a smaller increase in physician visits in the year before birth but a greater increase in different prescription drugs in the year after birth. There was no further divergence (or convergence) in health and service utilization between the groups in the 7-year period post-birth. Conclusions: Differences in health and healthcare service utilization between mothers of children with and without NDD existed before the birth of the child and did not diverge in the 7 years post-birth. Replication of these findings is warranted as well as follow-up analyses examining longer term outcomes for mothers beyond 7 years post-birth.

Introduction Caregivers of children with health problems experience poorer health than the caregivers of healthy children. To date, population-based studies on this issue have primarily used survey data. Objectives We demonstrate that administrative health data may be used to study these issues, and explore how non-categorical indicators of child health in administrative data can enable population-level study of caregiver health. Methods Dyads from Population Data British Columbia (BC) databases, encompassing nearly all mothers in BC with children aged 6-10 years in 2006, were grouped using a non-categorical definition based on diagnoses and service use. Regression models examined whether four maternal health outcomes varied according to indicators of child health. Results 162,847 mother-child dyads were grouped according to the following indicators: Child High Service Use (18%) vs. Not (82%), Diagnosis of Major and/or Chronic Condition (12%) vs. Not (88%), and Both High Service Use and Diagnosis (5%) vs. Neither (75%). For all maternal health and service use outcomes (number of physician visits, chronic condition, mood or anxiety disorder, hospitalization), differences were demonstrated by child health indicators. Conclusions Mothers of children with health problems had poorer health themselves, as indicated by administrative data groupings. This work not only demonstrates the research potential of using routinely collected health administrative data to study caregiver and child health, but also the importance of addressing maternal health when treating children with health problems. Keywords Population data, linked data, case-mix, children with special health care needs

Using data from the 2012 Aboriginal Peoples Survey (APS), this study investigated associations between smoking and a number of school, peer, and family characteristics among off-reserve First Nations (n = 2,308), Métis (n = 2,058), and Inuit (n = 655) high school students aged 12 to 21 years. Logistic regressions revealed important group differences in Indigenous youths' correlates of smoking. Characteristics that were negatively associated with smoking included attending a school with a positive environment or having peers with high educational aspirations among First Nations students; participating in school-based club extra-curricular activities or living in a smoke-free home among Métis; and living in higher-income families among Inuit. A consistent risk factor for smoking among all Indigenous students was having close friends who engaged in risk behaviours.

Contrary to a large and growing literature on center-based childcare workers, we know little about the work and health experiences of those providing childcare services in their homes. This study examines the job content, context, and requirements of regulated Home-Based Childcare workers in Canada. It is based on the qualitative analysis of eleven individual semistructured interviews. These workers perform business administration tasks and more housekeeping and domestic work than those in the center-based childcare, which affect their health and well-being. In addition, they reported factors related to the context and the content of their job such as the high physical and mental efforts, the absence of contact with other adults during working hours, the lack of external help, the exposure to noise and bad odors, the interference of work with personal and family life, the precarious remuneration, and the lack of benefits as potential factors that may affect their health.

This study investigated whether associations between Indigenous language knowledge and educational outcomes might be changing for cohorts of language speakers over time. Using Census and National Household Survey data, educational attainment for First Nations people aged 20 to 34 was examined at four time points (1996, 2001, 2006, and 2011), separately for those able versus unable to speak an Indigenous language and separately for those living on and off reserve. Findings point to improvements in levels of education for Indigenous language speakers among First Nations people living on and off reserve. Findings should be interpreted with caution as differences in educational attainment may reflect differences between language speakers and non-speakers that go beyond the ability to speak an Indigenous language.