| Background. Children's health, particularly in the early years, forms the basis of future health and development and plays a significant role in predicting individual life and opportunities. Thus, studies which enhance the understanding of the determinants of children's health status are needed. Previous research on children's health had focused on the family's and infant's characteristics and ignored the potential impact of macro-level influences. The objectives of this thesis were (i) to examine the independent effects of neighbourhood factors on childhood health outcomes, (ii) to explore neighbourhood moderating effects on the associations between some individual risk factors and childhood health outcomes, and (iii) to quantify the contribution of neighbourhood factors to childhood health outcomes.;Conclusion. Both individual and neighbourhood characteristics determined childhood health outcomes examined. Neighbourhood factors acted as independent risk factors as well as moderators on the association between individual risk factors and health outcomes. The contribution of neighbourhood factors to children's health outcomes was quite substantial. The findings suggest that future interventions aimed at improving children's health status in Saskatoon may be enhanced by targeting both high risk individuals and high risk neighbourhoods. The geographical variations in children's health outcomes reported in this study are modifiable; they can be altered through public policy and urban planning, and through the efforts of families and children. (Abstract shortened by UMI.).;Method. The study population included 9,888 children born to women residing in Saskatoon during three years, 1992-1994. The data used in this study were extracted from three sources. The information related to birth outcomes and the mother's characteristics was extracted from the birth registration files maintained by Saskatchewan's Vital Statistics Branch. The health services utilization information was generated from Saskatchewan Health's computerized administrative databases. The information related to the neighbourhood characteristics was obtained from Statistics Canada's 1991 Census, from local sources such as the Planning Department of the City, and two specialized neighbourhood surveys. Six domains of neighbourhood were examined in this study: socio-economic disadvantage, social interaction, physical condition, population density, local programs and services, and unhealthy lifestyle norm. This study was divided into two focused topics corresponding to two children's health outcomes: low birth weight (LBW) and children's hospitalizations (both incidence and length of stay). Multilevel modelling was employed to examine the independent/moderating impacts of neighbourhood characteristics on these children's health outcomes. GIS mapping was used to visualize the associations between neighbourhood characteristics and children's health outcomes. |
