Health at birth a risk factor for children's vulnerability

The health of a child at birth can be strongly linked to school readiness, according to a recent report released by the Manitoba Centre for Health Policy (MCHP).

The researchers at the University of Manitoba-based centre looked at data from the first province-wide administration of the Early Development Instrument (EDI).

The EDI measures the vulnerability of kindergarten children, assessing them to see if they are vulnerable in any of five domains or areas: physical health and well-being; social competence; emotional maturity; language and cognitive development; and communications skills and general knowledge.

EDI has been used extensively across the country and internationally, including here in Saskatchewan. Nazeem Muhajarine has been involved with EDI analysis since 2000 with the Understanding the Early Years projects. EDI data is now collected on kindergarten children across the province by the Ministry of Education, in partnership with school boards.

One of the findings in the Manitoba study drew a link between the health status at the time of birth and an increased risk of vulnerability when entering the school system. While the vulnerability rate for children born at normal birth weights was 28 per cent, for those born at low birth weights, 51 per cent rated as vulnerable in at least one of the five domains when they were tested as five-year-olds.

Similarly, the researchers found higher vulnerability rates among children requiring longer stays in intensive care at birth.
“The EDI results show that groups of children facing multiple risks require more attention, and as early in life as possible, to get the help they need to succeed at school and later in life,” Rob Santos, the MCHP’s lead researcher, said in a news release. “This report provides planners with insights about when and where resources should be applied.”

The researchers also found a correlation between children’s vulnerability and living in lower income areas, as well as higher vulnerability rates for children that fit into at least one of three at-risk groups (children born to teen mothers, those whose families are on income assistance, those in the care of Children and Family Services).

“Children living in the poorest areas in Manitoba, for both urban and rural settings, were about one and one-half times as likely to be not ready in at least one EDI domain when compared with children living in the wealthiest areas,” MCHP co-investigator Marni Brownell said.

The report authors say interventions can help reduce the risk of vulnerability from factors such as poverty. They also found a link between breastfeeding and reduced vulnerability.

Every baby born in a hospital is assessed with what is called an Apgar score, measuring their health at birth. Of those with the low scores and who were not breastfed, 40 per cent later tested as vulnerable in at least one domain, while the rate for those with normal scores who were not breastfed was 32 per cent.

The rates dropped for those breastfed, with a significant narrowing of the health gap at birth: 25 per cent among low Apgar score babies were vulnerable in kindergarten and 22 per cent for normal Apgar scores babies.

The researchers describe their findings as preliminary and recommend further study in light of the money and time invested in interventions for vulnerable children.

There is a summary and a complete version of the report available online at the Manitoba Centre for Health Policy website.

By Mike Chouinard, kidSKAN managing editor. He can be reached at mike.chouinard@usask.ca.