A1.2 What Gets Counted Counts_Ruth Sanderson

What Gets Counted Counts: Leveraging Primary Care Data to Enhance Ontario’s Data and Surveillance Systems for Child Health Ruth Sanderson, Manager Analytic Services Prevent More to Treat Less: Public Health and Primary Health Care Together June 5, 2014 10:30-12:15, 2014

CFPC Conflict of Interest

Disclosure of Commercial Support Presenter Disclosure Presenter:

Ruth Sanderson

Relationships with commercial interests: • • • •

Grants/Research Support: None Speakers Bureau/Honoraria: None Consulting Fees: None Other: None

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The simple question…

• What proportion of children are overweight and obese in Ontario?

Source: Ontario Agency for Health Protection and Promotion (Public Health Ontario).

Addressing obesity in children and youth: evidence to guide action for Ontario.

Toronto, ON: Queen’s Printer for Ontario; 2013

www.publichealthontario.ca/en/eRepository/Addressing_Obesity_Childre n_Youth_Sept2013.pdf PublicHealthOntario.ca

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Monitoring Need • Ontario requires an approach to assess progress related to achieving childhood healthy weights • Monitoring is key to: • assessing what’s happening (e.g., trends) • informing where we should increase our efforts (e.g., priority populations) • understanding how our efforts are making a difference (e.g., assess against target)

• It is challenging to: • measure childhood height and weight and related risk and protective factors systematically • connect with children whether during physician visits, on entry to the school system, during schooling or at home

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What we know Measured Overweight and Obesity in Children and Youth Using WHO BMI-For-Age Cut-Offs, by Sex, Canada, 1978-79 (Ages 2-17), 2004 (Ages 2-17), 2009-11 (Ages 5-17)

Sources: 1) Shields M, Tremblay MS. Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. Int J Pediatr Obes 2010 May 3;5(3):265-273; 2) Roberts KC, Shields M, de Groh M, Aziz A, Gilbert JA. Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey. Health Rep. 2012 Sep;23(3):37-41. In: Ontario Agency for Health Protection and Promotion (Public Health Ontario). Addressing obesity in children and youth: evidence to guide action for Ontario. Toronto, ON: Queen’s Printer for Ontario; 2013.

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How we tell it

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Key features for a monitoring system • Common indicators • BMI-for-age, using WHO cut-offs (measured preferred over self-reported) • determinants and related risk and protective factors • socio-demographics for assessing priority populations

• Common collection point • community, school, primary health care setting (each has strengths/ limitations)

• Information collection system (both IT and human resources) • Central co-ordination • standardization, training, analysis, reporting, feedback/ quality improvement

• Sustained effort (to ensure comparison over time etc.)

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