Health Inequities in Manitoba: Is the Socioeconomic Gap

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Chapter 4: Child Health 72 University of Manitoba • The disparity between U1 and U5 decreased significantly. The rate ratio of U1 compared to U5 was 0.76 in the first time period and 0.82 in the last time period, for a statistically significant decrease in inequality. The absolute difference of breastfeeding initiation rates comparing U1 to U5 also statistically significantly decreased over time, from around 20 per 100 fewer breastfeed children in the first time period compared to 16 fewer children per 100 in the last time period. Lorenz Curves: Rural over time: • In the first time period T1, 22.1% of the breastfed newborns were in the 25.5% of the births in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.040 indicating a statistically significant disparity. • In the last time period T7, 22.3% of the breastfed newborns were in the 27.7% of the population in the lowest neighbourhood income quintile group R1, with the Gini coefficient of 0.070 indicating a statistically significant disparity. • The Gini coefficient increased from the first to the last time period (p=.0004), showing a statistically significant increase in inequality over that time period. Urban over time: • In the first time period T1, 20.5% of the breastfed newborns were in the 24.1% of the newborns in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.051 indicating a statistically significant disparity. • In the last time period T7, 23.2% of the breastfed newborns were in the 26.2% of the newborns in the lowest neighbourhood income quintile group U1, with the Gini coefficient of 0.039 indicating a statistically significant disparity. • The Gini coefficient was statistically similar in the two time points, indicating that the inequality in breastfeeding stayed similar over time in the urban areas. Rural compared to urban in most recent time period: • In the most recent time period T7, there is a statistically significantly higher Gini coefficient in rural compared to urban (0.070 vs. 0.039, p
Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time? What is this telling us? • The socioeconomic gap in breastfeeding initiation rates is widening over time for rural, but lessening in urban Manitoba. • By all measures, the socioeconomic gap is larger in rural than in urban Manitoba. • The lowest neighbourhood income group in rural Manitoba shows no improvement in breastfeeding initiation rates over time, whereas the rates increased over time for the lowest neighbourhood income group in urban Manitoba. Most other neighbourhood income quintile groups in rural and urban Manitoba showed improvement in breastfeeding initiation rates over time. • The largest socioeconomic gap in breastfeeding initiation is seen in rural Manitoba during the most recent time period of 2005/06–2007/08, where around 26 fewer babies per 100 were being breastfed when discharged from hospital in R1 compared to R5. Where to from here? • Breastfeeding interventions that work in low neighbourhood income groups need to be promoted in rural R1 areas in particular. The urban “shrink” in inequality in the lowest neighbourhood income quintile could be explored for information about what policies and programs are operating in Winnipeg and Brandon (refer to the 2008 “What Works” deliverable by Martens et al.). Manitoba Centre for Health Policy 73
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HEALTH INEQUITIES IN MANITOBA: Is t
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About the Manitoba Centre For Healt
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Dr. Patricia Martens acknowledges t
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Key findings: High School Completio
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List of Figures Figure 1.1 Distribu
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Figure 4.27 Adjusted Lorenz Curve f
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Figure 6.15 Hospitalization Due to
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List of Tables Table E.1 Changes in
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Figure A3.6 Adjusted Lorenz Curve f
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Executive Summary Health status and
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(derived from Table E.1’s columns
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Table E.1: Continued Indicator RURA
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Table E.1: Continued Indicator RURA
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Table Table E.2: E.2: Is Is the the
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This page edited May 18, 2011. Tabl
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References Commission on Social Det
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Health Inequities in Manitoba: Is t
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Table 2.1: Neighbourhood Income Qui
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Table 2.3: Neighbourhood Table 2.3:
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Page 59 and 60: Figure 3.2: Premature Mortality Rat
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Page 69 and 70: Cumulative Percent of Potential Yea
Page 75 and 76: Figure 3.18: Under Five Mortality R
Page 83 and 84: Figure 4.2: Teen Pregnancy Rates Ov
Page 91 and 92: Figure 4.10: High School Completion
Page 99 and 100: Figure 4.18: Dental Extraction Rate
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Page 107 and 108: Figure 4.26: Breastfeeding Initiati
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Page 133 and 134: Figure 5.18: Ischemic Heart Disease
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Figure 6.10: Hospitalization Due to
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CONFIDENTIAL -- NOT FOR DISTRIBUTIO
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Figure 7.2: Prevalence of Cumulativ
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Dementia Health Inequities in Manit
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Figure 7.10: Dementia Prevalence Ov
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Figure 7.18: Prevalence of Complete
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Reference Health Inequities in Mani
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Figure 8.2: Post-AMI Care: Beta-Blo
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Reference Health Inequities in Mani
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Table 9.1: Continued Indicator RURA
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Table 9.1: Continued Health Inequit
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Table A2.3: Crude Numbers of Mortal
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Table A2.5: Crude Numbers for High
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Table A2.7: Crude Numbers for Denta
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Table A2.11: Crude Numbers for Isch
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Table A2.13: Crude Numbers for Cont
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CONFIDENTIAL ‐‐ NOT FOR DISTRIB
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Table A2.17: Crude Numbers for Cumu
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Figure A3.2: High School Appendix C
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Health Inequities in Manitoba: Is the Socioeconomic Gap

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