Review of Key Findings
This section provides an overview of a selection of the key findings from each dimension examined in the child and youth health and well-being project. For more information, please see the dimensions within the Findings section of this online report.
Physical Health & Well-being
Generally, the physical health and well-being of children and youth in BC is stable or improving, which represents the establishment of lifelong habits that support long-term health in BC. However, across many of these indicators, geographic differences appear, revealing populations for which these healthy behaviours are a greater challenge.
Infant mortality has fallen over the last 30 years, and the percentage of low birth weight infants has been relatively stable over the last 25 years. The percentage of mothers who report smoking during pregnancy has decreased, but the percentage of women of reproductive age who report binge drinking has increased. There has been a substantial increase in the rate of mothers who exclusively breastfeed for the first six months, and BC is now a leader in Canada for this indicator. Unfortunately, rates varied substantially by geography, with almost half of mothers in Vancouver Coastal Health exclusively breastfeeding but less than one-third doing so in Northern Health.
Across the childhood years, the indicators show both positive and negative trends, and point to areas for improvement. The indicators among kindergarten students for gross and fine motor skills have been relatively stable over the eight years reported. The percentage of children in kindergarten with visible tooth decay decreased, reflecting improvement across BC; however, almost 15 per cent of children in BC continue to have visible tooth decay. Further, almost one-third of children are not up-to-date with their immunizations by age 7.
Children & Youth
Serious injury-related hospitalizations among BC children and youth have substantially declined over the 10 years reported; however, Northern Health and Interior Health have rates about one-third higher than the provincial average. Among youth in grades 7-12, most rated themselves as having good or excellent health. The percentage of youth who reported being at a healthy body weight has remained relatively stable, with approximately 25 per cent reporting a body weight outside of the healthy range. Males were less likely to report being at a healthy weight. The percentage of youth who reported eating vegetables and fruits is increasing, but in 2013, there were still 6 per cent who reported that they did not eat any fruits or vegetables the previous day. Further, only about 16 per cent of youth participated in at least 60 minutes of physical activity seven days per week, and male participation was 10 percentage points higher than females.
The percentage of youth who reported ever having smoked and who reported smoking daily decreased over the 10 years reported. Similarly, the percentage of youth who reported drinking alcohol decreased over this same time period, and there is a slight decrease in binge drinking during this same period. However, with 17 per cent of students across BC reporting binge drinking in the past 30 days, and as many as 28 per cent in some geographic areas, binge drinking is still an important issue among youth. Approximately one-quarter of youth surveyed reported having ever used marijuana, which indicates a decreasing trend. Teenage pregnancy is associated with a variety of poor physical health outcomes for both mother and baby.1 There has been a substantial decrease in teenage pregnancies over the 25 years reported. However, there is a fivefold difference between the health authorities, with Northern Health having the highest teenage birth rate.
For more information see: Physical Health & Well-being
Mental and Emotional Health and Well-being
From a mental health perspective, youth in BC have a positive view of themselves and their lives; however, it is evident that there are important differences between the sexes. For example, in comparison to female youth, a larger percentage of male youth reported that they usually feel good about themselves, that they have “good” or “excellent” mental health, and that they are satisfied with their lives. Specifically, while 80 per cent of BC youth reported that they feel good about themselves, this is a 5 per cent decline largely from fewer females reporting that they felt good about themselves. Female youth are also more likely to consider and/or attempt suicide than male youth, although male youth have a higher suicide mortality rate. Unfortunately, youth in some parts of the province, such as in Northern Health, are more likely to have considered or attempted suicide than their peers in other geographic areas.
For more information see: Mental & Emotional Health & Well-being
Social connections with one’s family, school, and community are known to be protective factors that foster healthy development, decision making, and behaviours.2,3,4,5 Many of the social relationship dimension indicators are encouraging. Youth in BC are reporting a higher level of family connectedness than they did 10 years ago and are reporting a higher level of school connectedness during this time. However, it is concerning that increasing numbers of youth—almost 20 per cent—are reporting that they do not have an adult inside or outside of their family that they can talk to about a serious problem. It is also disconcerting that only 40 per cent of youth in BC report that they have a sense of community connectedness.
Child abuse and child neglect can have lasting and harmful outcomes, including physical and mental health problems, reduced educational attainment and employment prospects, homelessness, and greater involvement in criminal activity.6,7,8,9,10 Children and youth living in Northern Health, the health authority with the highest rate of abuse and neglect, were three times more likely to be abused or neglected than those living in Vancouver Coastal Health. It is also disturbing that sexual abuse rates among youth have not meaningfully improved in the last 10 years; this is particularly important for females, who were more than three times as likely as males to have experienced sexual abuse.
More than 10 percent of youth in BC reported experiencing discrimination on the basis of race, ethnicity, or skin colour. More males than females experienced this, but the percentage of males experiencing discrimination decreased over the 10 years while the percentage of females experiencing discrimination remained relatively stable. Conversely, there has been an overall increase in youth experiencing discrimination based on sexual orientation over the same time period, with the largest increase seen among females. In addition, there are obvious geographic differences for both types of discrimination. An alarming 50 per cent of youth report being bullied, and this has increased slightly over the past 10 years, although cyberbullying has decreased over the past five years.
For more information see: Social Relationships
Economic & Material Well-being
Economic disadvantages, such as low household income, inadequate housing conditions, and parental unemployment, adversely influence the health and well-being of children and youth.11,12 Among Canadian provinces, BC has the second highest percentage of children and youth under age 18 living in low-income households. The percentage of families with at least one unemployed parent decreased until the economic downturn of 2008, when it increased until 2010, only to decrease again but not reach the lower levels of unemployment seen between 2006 and 2008. The percentage of the urban population in BC with unmet core housing need increased dramatically between 2008 and 2011, and at a much faster rate than the national average, resulting in BC having the highest unmet housing need among the Canadian provinces by a substantial margin.
Unmet food needs arise when families cannot afford to purchase foods that constitute a healthy diet and so are closely associated with low-income households.13 In BC over the past five years, the percentage of youth reporting that they go to bed hungry due to insufficient food in their house has decreased; however, over 7 per cent still reported this most severe form of food insecurity, and more than 10 per cent of youth in both the Northwest and Northeast Health Service Delivery Areas (HSDAs) reported that they go to bed hungry.
In BC, youth unemployment, meaning youth who are not in school, training, or employment,14 is 10 per cent and sits in the mid-range among Canadian provinces. Again, there is substantial geographic variation for this indicator, with the highest percentage of unemployed youth being reported in Northern BC.
For more information see: Economic & Material Well-being
Cognitive development, such as the ability to read and communicate, is important for academic success and critical thinking and decision-making later in life. Over the past 10 years in BC there has been a decrease in the percentage of kindergarten children who require additional support and care in their language and cognitive development, while the percentage of children requiring similar support for their communication skills and general knowledge has remained relatively stable. While this indicates that children are arriving at school more prepared from a literacy and numeracy perspective than in the past, there are geographic differences across the province.
Another area of consideration is a child’s ability to interact positively with others and establish relationships. The social and emotional skills developed in the early years are foundational to lifelong positive mental health and functioning.15 An increasing percentage of kindergarten children require additional support and care in the areas of social competence and emotional maturity.
Evidence suggests that academic performance is strongly linked to better health in later life.16 While most of the indicators for academic performance have stayed steady over the years, high school completion across BC has increased. However, there are clear geographic differences in educational achievement between health authorities, and the pattern of which health authorities had the best and worst results was consistent across several measures: Foundation Skills Assessment – Reading (grades 4 and 7); Foundation Skills Assessment – Numeracy (grades 4 and 7); grade 10 English Provincial Examinations; and grade 10 Math Provincial Examinations. For these indicators, among the health authorities, the results found in schools within Vancouver Coastal Health were substantially better than schools within Northern Health. The percentage of students who graduated from high school is highest in Fraser Health, followed by Vancouver Coastal Health by a very small margin, with Northern Health having the lowest percentage of students who graduated from high school.
For more information see: Cognitive Development
- H. Krueger & Associates. Child and youth health and well-being indicators project: appendix F – physical health and well-being evidence review [prepared for the Office of the Provincial Health Officer and the Canadian Institute for Health Information]. Ottawa, ON: Canadian Institute for Health Information; 2011.
- Saewyc E, Tonkin R. Surveying adolescents: focusing on positive development. Paediatr Child Health. 2008 Jan;13(1):43-7.
- Shonkoff J, Phillips D. From neurons to neighborhoods - the science of early childhood development. Washington, DC: National Academy Press; 2000.
- Resnick MD, Bearman PS, Blum RW, Bauman KE, Harris KM, Jones J, et al. Protecting adolescents from harm--findings from the National Longitudinal Study of Adolescent Health. JAMA. 1997 Sep 10;278(10):823-32.
- Federal, Provincial and Territorial Advisory Committee on Population Health. Toward a healthy future. Second report on the health of Canadians. Charlottetown, PE: Federal, Provincial and Territorial Advisory Committee on Population Health; 1999.
- Walsh CA, Jamieson E, MacMillan H, Boyle M. Child abuse and chronic pain in a community survey of women. J Interpers Violence. 2007 Dec;22(12):1536-54.
- Boden JM, Horwood LJ, Fergusson DM. Exposure to childhood sexual and physical abuse and subsequent educational achievement outcomes. Child Abuse Negl. 2007 Oct;31(10):1101-14.
- Gilbert R, Spatz Widon C, Browne K, Fergusson D, Webb E, Janson S. Burden and consequences of child maltreatment in high-income countries. Lancet. 2009 Jan 3;373(9657):68–81.
- Lamont A. Effects of child abuse and neglect for children and adolescents. National Child Protection Clearinghouse Resource Sheet. Melbourne: Australian Institute of Family Studies; 2010 Apr.
- Wilson C. The emergence of trauma-informed child welfare systems. CW360˚: Trauma-informed Child Welfare Practice. 2013 Winter:12-13.
- Children's Hospital of Eastern Ontario. Reducing poor health outcomes for children and youth: recommendations for the Ontario Poverty Reduction Strategy. Ottawa, ON: Children’s Hospital of Eastern Ontario; 2008 Apr [cited 2016 Mar 31]. Available from: http://www.cheo.on.ca/uploads/AboutUs/Files/poverty_submission_e.pdf.
- H. Krueger & Associates. Child and youth health and well-being indicators project: appendix I—economic and material well-being evidence review [prepared for the Office of the Provincial Health Officer and the Canadian Institute for Health Information]. Ottawa, ON: Canadian Institute for Health Information; 2011 [cited 2016 Apr 7].
- Wilde, P. Food security policy in developed countries. In: Lusk JL, Roosen J, Shogren JF, editors. The Oxford handbook of the economics of food consumption and policy. Oxford: Oxford University Press; 2012 [cited 2016 Apr 7]. Available from: http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199569441.001….
- Marshall, K. Youth neither enrolled nor employed. Perspectives on Labour and Income. 2012 Summer;24(2). Available from: http://www.statcan.gc.ca/pub/75-001-x/2012002/article/11675-eng.pdf.
- Hawkins JD, Kosterman R, Catalano RF, Hill KG, Abbott RD. Promoting positive adult functioning through social development intervention in childhood: long-term effects from the Seattle Social Development Project. Arch Pediatr Adolesc Med. 2005 Jan;159(1):25-31.
- Dewalt DA, Berkman ND, Sheridan S, Lohr KN, Pignone MP. Literacy and health outcomes: a systematic review of the literature. J Gen Intern Med. 2004 Dec;19(12):1228-39.