Table reports overall sample descriptive statistics, and also subdivides the sample into those children classified as having a health problem by at least one of the four indicators (n = 7196; 52.2% of the entire sample) and those who were classified as not having a health problem by any indicator, i.e., healthy children (n = 6594; 47.8% of entire sample). Compared to those classified as healthy, children with health problems were significantly more likely to be male, more likely to have been born in Canada, and more likely to come from single-parent families. Nevertheless, the effect sizes of these differences are relatively small (0.16, 0.13, and 0.12 respectively). However, in examining the differences in health status measures, children classified as having health problems had significantly poorer ratings on all health status measures, and the effect sizes of these differences were small to moderate.
In Figure , a Venn diagram was used to depict graphically children with health problems in terms of the proportion identified by each of the four key indicators, as well as the proportion identified by more than one indicator. The area encompassed by all four circles represents all 7196 children defined as having health problems. The area of each circle corresponds to the number of individuals identified as having health problems by that particular indicator, while the overlap between circles approximately describes the proportion of individuals identified by more than one indicator. The diagram shows both considerable overlap between certain indicators and comparatively little overlap between others. Of the 767 individuals identified as having an activity limitation, only 5.0% (38/767) were not captured by any other indicator, signifying that the vast majority of those with activity limitations are also found to have a health problem by at least one other indicator. By contrast, the other three indicators identified proportionately much larger 'single indicator only' groups: 27.8% (351/1263) of the SHD group was captured only by that construct, 36.1% (1580/4374) for chronic conditions, and 41.8% (2110/5044) for elevated service use. Overall, over half the children in our sample of children with health problems (56.7% or 4080/7196) were captured by only one of the four indicators, while fewer (43.3% or 3116/7196) were captured by two or more indicators.
Figure 1 Venn diagram of overlap between four indicators of ill health, n = 7196. The circles denote each of the four indicators and are proportional in size to the sample captured by each; the intersections are not proportional. Colour legend: Red = Chronic Conditions, (more ...)
Table describes and compares the characteristics of children identified by each of the four indicators. One child characteristic (i.e. age) and three family characteristics (i.e. income, parental education, and number of parents) distinguished the children between groups. Children identified by the elevated service use indicator were more likely to be younger than children in the other groups (40.5% 4-6 years versus 23%–33% for the other indicator groups, SIs ranging from 0.15 to 0.36), while children with SHDs were significantly older than the others (35.9% 10-11 year olds versus 23%–28% for the other indicator groups, SIs ranging from 0.18 to 0.30). Children with SHDs were also from families with significantly lower household incomes (mean income = $44,498, sd = $42,423, SIs ranging from 0.10 to 0.13), were more frequently from families with caregivers with less than a high school education (22.41% versus 19.71%, 16.46% and 16.01%, for the other indicator groups, SIs ranging from 0.16 to 0.17), and were less frequently from two-parent families than the other groups (73.63% versus 76.67%, 79.79% and 82.26% for the other indicator groups, SIs ranging from 0.15 to 0.22). Lastly, children with chronic conditions were significantly less likely than others to be from single-parent families (26.37% versus 23.33%, 20.21% and 17.74%, for the other indicator groups, SIs ranging from 0.06 to 0.22).
Descriptive statistics for individuals captured by each indicator and comparison across indicator categories (n = 7196)
Child health measures differed between groups. PMKs' ratings of the child's general health mirrored group size, with the smallest group (Activity Limitation; n = 767) having the lowest proportion of children with excellent/very good health (53.6%), and the largest group (Elevated Service Use; n = 5044) having the highest proportion (78.0%). Other health status characteristics, however, did not conform to this pattern. The proportion of individuals with a serious injury in the past year did not vary between groups. The proportion hospitalized in the past year was highest for those in the Activity Limitation group (15.7%), while those in the SHD and Chronic Conditions groups showed the lowest rates (8.5% and 7.1% respectively; these rates did not differ significantly). The proportion of reported behaviour problems was highest among the SHD group (62.1%) and lowest for the Chronic Conditions and Elevated Service Use groups (34.9% and 35.0%, respectively). The proportion of children taking medications regularly was highest for the Activity Limitations group (58.3%), and lowest for the SHD group (21.4%). These findings suggest that children in the Activity Limitation group had the poorest health while children in the Elevated Service Use group did not necessarily experience large health implications, even though they accessed the health care system and health resources more often than other children.
Table compares the characteristics of children in the "single indicator" subgroups to those in the "two or more indicators" group. The Activity Limitation Only subgroup was very small (n = 38), resulting in low power to detect statistically significant differences and suppression of some estimates.
Characteristics of those identified by a single indicator only compared with those identified by two or more indicators (n = 7196)
Children in the SHD Only subgroup (n = 351) did not differ from the Two or More Indicators group on any of the child- or family-specific measures. However, they were significantly more likely to be rated by their PMKs as being in excellent or very good health (81.4% vs. 70.0%, SI = 0.25) and less likely to have been injured in the past year (7.7% vs. 15.6%, SI = 0.22) than those identified by two or more indicators, with those identified by two or more indicators, with small effect sizes. Those in the SHD Only subgroup were also significantly more likely to show symptoms of a cognitive deficit as measured by the HUI than those in the Two or More Indicators group (72.1% vs. 16.3%, SI = 1.35).
Children in the Chronic Conditions Only subgroup (n = 1580) were more frequently from two-parent families than children in the Two or More Indicators subgroup (87.3% vs. 78.5%, SI = 0.23) and showed better health (excellent/very good health 90.8% vs. 70.0%, SI = 0.49) and less frequent injury (9.7% vs. 15.6%, SI = 0.17). Among the chronic conditions reported, 81.8% of children in the Chronic Conditions Only subgroup reported being diagnosed with asthma and/or allergies, a significantly higher proportion than among children in the Two or More Indicators subgroup (67.4%, SI = 0.32).
Finally, the Elevated Service Use Only subgroup (n = 2110) consisted of children who were younger, more likely to be female (51.7% vs. 40.1%, SI = 0.23), possessed higher levels of family income ($56,239 vs. $50,330, SI = 0.07), and had better health (excellent/very good health, 89.8% vs. 70.0%, SI = 0.48; fewer behaviour problems, 26.7% vs. 42.0%, SI = 0.32; regular medication, 7.1% vs. 43.2%, SI = 0.80) than those in the Two or More Indicators subgroup. They also had fewer doctor visits and consulted fewer physicians in the past year than those in the Two or More Indicators group (6.8 vs. 9.1 visits, SI = 0.13; 1.7 vs. 1.8 physicians, SI = 0.09, respectively).