Grant: Operating Grant

Despite marked reductions in infant mortality over the past several decades, the rate of premature birth, a key determinant of infant mortality and morbidity, has remained the same or even increased over the same period in many countries. Moreover, socioeconomic disparities in pregnancy outcomes such as preterm birth and stillbirth persist in many developing and developed countries, including Canada. The magnitude and patterns of socioeconomic disparities are known to differ across ethnic and cultural sub-groups. Such differences have important implications for the health of Canadians, because approximately one in five Canadians are immigrants, making Canada highly multi-ethnic. Pregnancy and birth outcomes such as the infant mortality rate are not only good measures of current population health but are also predictive of the future health of the population, because health in early life predicts health later in life. Therefore, achieving socioeconomic equity in pregnancy outcomes is an important public health goal. However, existing scientific evidence on socioeconomic disparities in pregnancy and birth outcomes is limited, owing to the lack of detailed socioeconomic and ethno-cultural background information in routinely collected data. Our research will create a national database by linking the national database of pregnancy and birth outcomes (the previously-linked Canadian stillbirth, live birth, and infant death database) with detailed characteristics of parents ascertained in the censuses of 1996 and 2006, so as to be able to systematically examine the patterns of perinatal health in Canada across social, racial, and ethnic groups and over time. This study will provide nation-wide assessment of perinatal health disparities not previously possible in Canada, including robust results of socioeconomic differences in perinatal health for immigrants, visible minorities and Aboriginal people, at both the individual and neighbourhood levels.