The early years – Health equity from the start

May 28, 2014

Patricia Daly

Chief Medical Health Officer

Vancouver Coastal Health

Our Health Care Report Card

30 measures of overall health system performance and population health

Early Childhood Development Index

Time frame: 2011-2013Target: ≤ 29.5%Year to date: 33%

http://www.vch.ca/about_us/accountability/report_card/report_card

Vancouver EDI

Vulnerability RatesBC & Vancouver 2001-2013

Vancouver EDI – 2011-2013Scale Vancouver - Low Vancouver - High

Physical Health & Well-Being 4%Marpole, Uni Lands

28%G/W, Strathcona

Social Competence 6%Kitsilano

27%Kerrisdale

Emotional Maturity 6%University Lands

25%Strathcona

Language & Cognitive Development

1%West Point Grey

16%Grandview Woodlands

Communication Skills & General Knowledge

8%Kitsilano

30%Renfrew Collingwood

Kitsilano: 18%Strathcona: 52%

Developmental Trends - VCH

• Physical health & well-being

• Social competence

• Emotional maturity

• Language & cognitive development ↑• Communication skills and general

knowledge

Language & Cognitive Development

• “Strong Start” programs

• Early literacy coordinators in every community

• Libraries• Pre-schools and

daycares

VCH Early Childhood Development Framework

1. Creating healthy environments

VCH Early Childhood Development Framework

2. Facilitating community capacity

VCH Early Childhood Development Framework

3. Prevention, early risk identification and intervention

Issues - Access

• Can vulnerable clients access services?

• Strategies:– Earlier referrals– Outreach strategies: Toddler Assessment

Program for immigrant and refugee groups– Cultural competency– Client supports: Meals, transportation– Friendlier formats

Issues – Identifying the Vulnerable

• Can we find vulnerable mothers and children?

• Strategies:– Pre-natal classes, physicians, midwives– Targeted and universal approach: Most

vulnerable children are not in vulnerable neighbourhoods

– Proportionate universalism?VCH Objective: Reduce health inequities in the populations we serve

Issues – Enough Support

• Do we provide enough services for long enough?

• Strategies:– Services for children 1-5 years– Parent infant groups– Parent education and skills– Parent mental health services– Collaborative, multidisciplinary approach

VCH – Target Population• 9,500 births per year

– Healthiest Babies Possible• Support up to age 18 months• Newcomers, mothers living in poverty

– Yippee• Support up to age 2 years• Mothers ≤ 24 years old

– Nurse-Family Partnership• Support up to age 2 years• First time mothers living in poverty }

500 – 600 babies per year

72 babies per year at target

}

Lessons Learned

Public health not enough• Helps individual children and families

Community capacity building important

Broad policy changes essential• Investment in early child care

Acknowledgements

• Joanne Wooldridge – Regional Leader, Early Childhood Development

• Lianne Carley – Policy Consultant, Population Health

• John Carsley – Medical Health Officer