Despite universal healthcare in Canada, it appears that babies with chronic health conditions who live in poor neighbourhoods tend to die and be hospitalized more often than infants with similar conditions from high-income areas.
A study conducted by researchers at the Institute for Clinical Evaluative Sciences (ICES), The Hospital for Sick Children, and the University of Toronto, found a strong link between family income and hospital admissions and deaths among Ontario babies with chronic conditions and birth defects.
Previous studies have already noted that people in low income areas tend to die earlier and end up in hospital more that those from richer neighbourhoods.
But Dr. Chengning Wang, lead author on the study and a resident at SickKids, says they were surprised to find the link with medically fragile infants--a group that should be well connected to the health care system on discharge.
"We expected that with universal health insurance, infants with chronic complex conditions, identified at birth, would have equal access to medical care and discharge follow-up plans that should take account of social vulnerability," she said in a release.
"But sadly, what we discovered was the effects of low income on health outcomes are not minimized in this group of chronically ill infants."
The study looked at more than 500,000 babies born in Ontario hospitals between April 1, 1996, through March 31, 2000, focusing on those with complex chronic conditions.
They found that those babies living in neighbourhoods with low average family income had more deaths and admissions to hospital in their first year than infants with similar conditions from high income neighbourhoods.
Those infants living in the poorest neighbourhoods had a rate of death and hospital admission 25 per cent higher than those living in the richest neighbourhoods.
Infants with complex chronic conditions accounted for 37.8 per cent of infant deaths and 11 per cent of hospital admissions.
The study also found that one in every 50 infants born in Ontario had at least one complex chronic condition, such as a major birth defect, organ disease, or metabolic disorder.
The authors say that understanding the reasons for the income disparities was beyond the scope of their study. They note that would require looking at the causes of death and the causes of the hospital admissions, which their study did not do.
But they note that access to proper health care, as well as other factors such as safety in home care and environmental risks, could all have contributed to their findings.
