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Publications (300)
Objectives
The aetiology of mental disorders involves genetic and environmental factors, both reflected in family health history. We examined the intergenerational transmission of multiple mental disorders from parents and grandparents using population-based, objectively measured family histories.
Methods
This population-based retrospective cohort...
Abstract Background Understanding the relationship between adolescent pregnancy and adult education and employment outcomes is complicated due to the endogeneity of fertility behaviors and socio-economic functioning. Studies exploring adolescent pregnancy have often relied on limited data to measure adolescent pregnancy (i.e. birth during adolescen...
Background
It is well established that maternal mental illness is associated with an increased risk of poor development for children. However, inconsistencies in findings regarding the nature of the difficulties children experience may be explained by methodological or geographical differences.
Aims
We used a common methodological approach to comp...
Objective
The objective is to examine the association between trajectories of childhood residential and school mobility and academic achievement (literacy, numeracy) in Grade 3 using linked whole-population administrative data in Manitoba, Canada. Secondarily, we assessed childhood residential/school mobility based on neighbourhood income levels (m...
Objective
To highlight the potential of multiple file record linkage. Linkage increases the value of existing information by supplying missing data or correcting errors in existing data, through generating important covariates, and by using family information to control for unmeasured variables and expand research opportunities.
Study Design and S...
Background and aims:
Family history of substance use disorder (SUD) affects a child's risk of the disorder through both genetic and shared environmental factors. We aimed to estimate the association between parental or older sibling SUD history with the risk of adolescent SUD diagnosis.
Design, setting and participants:
We conducted a population...
Family health history is a well-established risk factor for many health conditions but the systematic collection of health histories, particularly for multiple generations and multiple family members, can be challenging. Routinely-collected electronic databases in a select number of sites worldwide offer a powerful tool to conduct multigenerational...
We examine whether, among children diagnosed with ADHD, are those whose mothers have a history of psychotropic medication use more likely to treat their ADHD with medication? Children born in Manitoba, Canada from 2000 to 2010 diagnosed with ADHD between their 4th and 8th birthday. Maternal psychotropic medication use was assessed from one year bef...
Data resource basics
Families are important components of society; given their shared genetic and social environments, studying families can provide critical insight into health and social outcomes within family members and across generations. Few places in the world have high-quality linkages within families at a population level; one such locatio...
Importance
Epidural labor analgesia (ELA) has been associated with an increased offspring risk of autism spectrum disorder (ASD). Whether this finding may be explained by residual confounding remains unclear.
Objective
To assess the association between ELA and offspring risk of ASD.
Design, Setting, and Participants
Longitudinal cohort study of v...
Objectives
Previous research suggests intergenerational influence of diabetes on bone health. We examined the association between parental diabetes and major osteoporotic fracture (MOF) risk in offspring.
Methods
This population-based cohort study used de-identified administrative health data from Manitoba, Canada, which capture population-level r...
Introduction
Studies on the relationship between exposure to maternal depression in early childhood and childhood development have been limited by small samples, lack of information on timing of maternal depression, and use of a composite measure of childhood development.
Objectives and Approach
We linked multiple Manitoba datasets to examine the...
IntroductionMajor osteoporotic fractures (MOF) are associated with significant morbidity and healthcare system burden. Objectives and ApproachWe aimed to determine whether sibling fracture history is associated with MOF risk amongst individuals from a population-based cohort using objectively-ascertained measures of fracture history. This retrospec...
We investigated the association of objectively ascertained sibling fracture history with major osteoporotic fracture (hip, forearm, humerus, or clinical spine) risk in a population-based cohort using administrative databases. Sibling fracture history is associated with increased major osteoporotic fracture risk, which has implications for fracture...
Objectives:
To assess the relation between exposure to maternal depression before age 5 and 5 domains of developmental vulnerability at school entry, overall, and by age at exposure.
Methods:
This cohort study included all children born in Manitoba, Canada, who completed the Early Development Instrument between 2005 and 2016 (N = 52 103). Matern...
Introduction:
When designing longitudinal cohort studies, investigators must make decisions about study duration (i.e. length of follow-up) and frequency of outcome measurement. This research explores these design decisions for longitudinal cohort studies constructed using routinely-collected administrative data.
Objectives:
To illustrate the ef...
Background
The role of parental cardiorespiratory conditions on fracture risk is unclear. We examined the associations between parental cardiorespiratory conditions and offspring fracture risk.
Methods
In this population-based retrospective cohort study, we identified 279,085 offspring aged≥40 years between April 1, 1997 and December 31, 2015 with...
Background and Purpose—
Cryptogenic strokes are often the first clinical manifestation of undiagnosed atrial fibrillation (AF). We designed this study to test whether parental AF is a risk factor for stroke in young adults.
Methods—
Population-based cohort study using linked administrative databases from April 1, 1972 to March 31, 2016 in Manitoba...
Abstract Background Previous studies have reported an intergenerational association between maternal and offspring preterm birth (PTB) but the nature of the association remains unclear. We assessed the association between maternal and offspring preterm birth using a quasi-experimental sibling design and distinguishing between preterm birth types. M...
Background:
Children born into poverty face many challenges. Exposure to poverty comes in different forms, and children may also transition into or out of poverty. In this study, we examine the relationships among various outcomes and different levels of poverty (household and/or neighborhood poverty) at different points during a child's first 5 y...
Background:
Prenatal care is one of the most widely used preventive health services; however, use varies substantially. Our objective was to examine prenatal care among women with a history of having a child placed in out-of-home care, and whether their care differed from care among women who did not.
Methods:
We used linkable administrative dat...
Background & aims:
We performed a population-based study to determine whether there was an increased risk of inflammatory bowel diseases (IBD) in persons with critical events at birth and within 1 year of age.
Methods:
We collected data from the University of Manitoba IBD Epidemiology Database, which contains records on all Manitobans diagnosed...
Objective
This study investigated whether a move to public housing affects people’s use of healthcare services.
Method
Using administrative data from Manitoba, the number of hospitalizations, general practitioner (GP), specialist and emergency department (ED) visits, and prescription drugs dispensed in the years before and after the housing move-i...
The current study examined school readiness for children placed in care of child protection services before age 5. This association was assessed using a population-based cohort of children born in Manitoba, Canada, between 2000 and 2009 (n = 53,477) and subcohorts of discordant siblings (one sibling taken into care, one sibling not taken into care;...
Introduction
Public housing is a form of subsidized housing that is owned and/or managed by government. Previous research suggests that public housing has a positive impact on personal finances and education outcomes, but less is known about if/how it impacts health and healthcare use.
Objectives and Approach
Using linked administrative health and...
Introduction
Large population-based data sets present similar analytic issues across such fields as: population health, clinical epidemiology, education, justice, and children’s services. Step-wise approaches and generalized tools can bring together several pillars: big (typically administrative) data, programming, and study design/analysis. How ca...
IntroductionAdolescent girls in care of child protection services are more likely to become pregnant than adolescent girls not in care, and mothers who were in care are more likely to have their children placed in care. Objectives and ApproachLinkable administrative data were used to determine whether adolescent mothers in care are at greater risk...
Introduction
Mothers have increased mental illness such as anxiety and depression after the death of a child.
Objectives and Approach
The mental health of all mothers who experience the death of an infant (< 1 years old) in Manitoba, Canada between April 1, 1999, and March 31, 2011 (n = 534) is examined in the four years leading up to, and the fou...
Introduction
Separation from one’s child can have significant consequences for parental health and well-being.
Objectives and Approach
We aimed to investigate whether parents whose children were placed in care had higher rates of avoidable (amenable and preventable) mortality. Data were obtained from the Swedish national registers. Mortality rates...
Background
Separation from one’s child can have significant consequences for parental health and well-being. We aimed to investigate whether parents whose children were placed in care had higher rates of avoidable mortality.
Methods
Data were obtained from the Swedish national registers. Mortality rates among parents whose children were placed in...
Objectives This study examines whether mothers involved with child protection services (CPS) at the birth of their first child had higher rates of postpartum depression and anxiety. Methods A retrospective cohort of mothers whose first child was born in Manitoba, Canada between April 1, 1995 and March 31, 2015 is used. Postpartum depression and anx...
Background:
Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use.
Methods:
We used linked population-based administra...
Background:
Individuals involved in out-of-home care are at higher risk of death by suicide. We aimed to determine whether parents with two generations of involvement in out-of-home care (themselves as children, and their own children) are at increased risk of death by suicide than parents with no involvement or parents with one generation of invo...
Objectives:
To determine if adolescent mothers who were in the care of child protection services (CPS) when they gave birth to their first child are more likely to have that child taken into CPS care before the child's second birthday than adolescent mothers who were not in the care of CPS.
Methods:
Linkable administrative data were used to crea...
This study examines whether mothers who had a child taken into care by child protection services have higher mortality rates compared with rates seen in their biological sisters who did not have a child taken into care. We conducted this retrospective cohort study with 3,948 mothers whose oldest child was born in Manitoba, Canada between April 1, 1...
Background:
Mothers have increased mental illness such as anxiety and depression after the death of a child. We examine the duration of this worsening of mental health.
Methods:
The mental health of all mothers who experience the death of an infant (< 1 years old) in Manitoba, Canada between April 1, 1999 and March 31, 2011 (n = 534) is examined...
Social stratification and life course approaches are enlisted to study the effects of health and social events on early adult welfare use. Given the strong link between individual and parental economic disadvantage, the mechanisms by which social context affects welfare use are examined. This unique approach is made possible by the linkage of sever...
Background
Understanding the processes across childhood and adolescence that affect later life inequalities depends on many variables for a large number of individuals measured over substantial time periods. Linkable administrative data were used to generate birth cohorts and to study pathways of inequity in childhood and early adolescence leading...
P-values of likelihood ratio tests against full models and AIC (Selected models are in bold).
(PDF)
Pearson Correlation Coefficients for time-varying covariates.
(PDF)
Pearson Correlation Coefficients for time-invariant covariates.
(PDF)
Odds ratios for failure to graduate from high school, cohort B.
(PDF)
Objectives:
Female family members affect both the likelihood of adolescent pregnancy and the outcome of that pregnancy. We examined the degree to which an older sister's adolescent reproductive outcomes affect her younger sister's reproductive behavior, and whether relationships in adolescent pregnancy among sisters born to adolescent mothers diff...
Objective:
The objective of this study is to examine suicide attempts and completions among mothers who had a child taken into care by child protection services (CPS). These mothers were compared with their biological sisters who did not have a child taken into care and with mothers who received services from CPS but did not have a child taken int...
Objective:
The objective was to compare mental illness diagnoses and treatment use among mothers who lost custody of their child through involvement with child protection services and those seen in mothers dealing with the death of a child.
Methods:
We studied mental health outcomes of a cohort of women whose first child was born in Manitoba, Ca...
IntroductionEducational attainment is known to be related to family size, birth order, and the educational achievement of an older sibling. Objective
This study examines younger siblings in large families, exploring the extent to which each older sibling’s educational attainment is associated with attainment of the younger sibling. Methods
Linkable...
Background
We investigated whether mothers experience changes to their health and social situation after having a child taken into care by child protection services, then compared these outcomes with those found in mothers whose children were not taken into care.
Methods
The cohort includes mothers whose first child was born in Manitoba between 1...
The objective of this study is to determine which maternal events and diagnoses in the two years before childbirth are associated with higher risk for having a first child taken into care at birth by child protection services. A population-based retrospective cohort of women whose first child was born in Manitoba, Canada between 2002 and 2012 and l...
p> OBJECTIVES: This study examines the socio-economic gradient in utilization and the risk factors associated with hospitalization for four pediatric ambulatory care sensitive conditions (dental conditions, asthma, gastroenteritis, and bacterial pneumonia). Dental conditions, where much care is provided by dentists and insurance coverage varies amo...
The growth of administrative data repositories worldwide has spurred the development and application of data quality frameworks to ensure that research analyses based on these data can be used to draw meaningful conclusions. However, the research literature on administrative data quality is sparse, and there is little consensus regarding which dime...
Background:
Women who give birth to children with fetal alcohol spectrum disorder (FASD) may be at increased risk for suicide; however, there are few data in this area. The objective of this study was to compare rates of suicide between women who had given birth to children with FASD and women who had not given birth to children with FASD during c...
Linkable administrative data have facilitated research incorporating files from various government departments. Examples from Canada, Australia, and the United Kingdom highlight the possibilities for improving such work. After expanding on comparisons of linkable administrative data with several famous studies, we forward suggestions on improving r...
Objective:
To investigate differences in physician-diagnosed psychiatric disorders between women who gave birth to children with a fetal alcohol spectrum disorder (FASD) diagnosis (study group) compared to women who gave birth to children without FASD (comparison group).
Methods:
We linked population-level health and social services data to clin...
The objective of this study was to test the validity of offspring-reported parental hip fracture in a unique bone mineral density (BMD) registry linked to administrative databases spanning 4 decades. Population-based data were from Manitoba, Canada, and included hospital abstracts, health insurance registrations, and the provincewide BMD registry....
Objective
Failing to graduate high school is linked to many risk factors, including family history academic achievement. This research examines how important an older sibling’s academic achievement is in predicting whether a younger sibling will graduate high school. Method
This study used linkable administrative databases housed at the Manitoba Ce...
Objective
Public housing residents, who live in low income government rental housing, are often in poorer health than the rest of the population. However, few studies have been able to untangle the relationships between health and public housing residency, and to assess whether health contributes to the decision to apply. We used linked population-...
Background
An older sister's teenage pregnancy status is known to influence whether or not a younger sister also has a teenage pregnancy. This study examines whether a younger sister’s odds of teenage pregnancy are impacted by her older sister’s teenage pregnancy status (no pregnancy, teenage mother, termination), and if she does become pregnant, i...
Background
Risk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother’s teenage childbearing or an older sister’s teenage pregnancy more strongly predicts teenage pregnancy in a younger sister. Methods
This study used linkable administrative databases house...
Administrative data have been used to determine the occurrence of suicide attempts and deliberate self-harm, but research about the accuracy of these sources is limited. This study used a clinical sample (n = 5719) containing psychiatry consultations from the emergency departments and inpatient units of the two major tertiary hospitals in Winnipeg,...
Background:
We aimed to determine whether maternal antenatal or perinatal infections (and thereby use of antibiotics) increase the risk of developing inflammatory bowel disease (IBD) in their offspring.
Methods:
The University of Manitoba IBD Epidemiology Database contains records of all Manitobans diagnosed with IBD from 1984 to 2010. Each indi...
Parental hip fracture (HF) is associated with increased risk of offspring major osteoporotic fractures (MOFs; comprising hip, forearm, clinical spine or humerus fracture). Whether other sites of parental fracture should be used for fracture risk assessment is uncertain. The current study tested the association between objectively-verified parental...
Introduction
Fetal alcohol spectrum disorder (FASD) is a significant public health concern. To prevent FASD, factors that place women at risk for giving birth to children with FASD must be investigated; however, there are little data in this area. This paper describes the development of the Manitoba mothers and FASD study, a retrospective cohort of...
Objectives:
A life course approach and linked Manitoba data from birth to age 18 were used to facilitate comparisons of two important outcomes: high school graduation and Attention-Deficit/Hyperactivity Disorder (ADHD). With a common set of variables, we sought to answer the following questions: Do the measures predicting high school graduation di...
Background
Risk factors for teenage pregnancy are linked to many factors, including a family history of teenage pregnancy. This research examines whether a mother’s teenage childbearing or an older sister’s teenage pregnancy more strongly predicts teenage pregnancy.
Methods
This study used linkable administrative databases housed at the Manitoba C...
Background Residents of public housing are often in poor health. However, it is unclear whether poor health precedes residency in public housing. We compared the health of people who applied to public housing to people who did not apply and had similar socioeconomic characteristics.
Methods Population-based administrative databases from Manitoba, C...
Parental hip fracture (HF) is considered a major risk factor for offspring major osteoporotic fracture (MOF) in the offspring, but all studies to date have relied on self-reported information of uncertain accuracy. We tested the association of objectively verified parental HF with offspring MOF and HF. We used a population-based historical cohort s...
Different categories of services present different policy issues for financing health care. This conceptual paper suggests four categories: (1) public health services for the entire population; (2) basic health care to individuals, where anticipated costs are small and relatively homogeneous; (3) potentially catastrophically expensive services to i...
Mode of birth affects development of the intestinal microbiota, and microbial dysbiosis has been associated with inflammatory bowel diseases (IBD). We performed a population-based analysis to determine if mode of delivery (Cesarean section vs vaginal delivery) affects risk of IBD.
We collected data from the University of Manitoba IBD Epidemiology D...
Administrative databases are often used to manage systems or to investigate research questions. The data may be derived from population registries, vital statistics or other records of life events, or from information on services. Questions that may be addressed by administrative datasets include the determinants of variation in utilization, costs,...
Many countries are currently studying the possibility of mass vaccination against varicella. The objective of this study was to provide a comprehensive picture of the pre-vaccine epidemiology of the varicella zoster virus (VZV) to aid in the design of immunization programs and to adequately measure the impact of vaccination. Population-based data i...
Two studies reported an increased risk of autistic disorder in children conceived less than 12 months after a previous birth. Our objective was to examine the association between the interpregnancy interval (IPI) and autism spectrum disorder (ASD) in a Canadian cohort.
Using administrative datasets housed at the Manitoba Centre for Health Policy, w...
To determine grade 12 academic performance for children with inflammatory bowel disease (IBD).
Children diagnosed with IBD at age <17 years identified from the population-based University of Manitoba IBD Epidemiology Database were matched by age-, sex-, and area of residence to 10 randomly selected controls. Grade 12 educational outcomes (scores on...
Purpose/Rationale for the project How important are early childhood predictors in the presence of later childhood and early adolescent predictors when examining several late adolescent health and education outcomes? How well do the models work? A sibling design examines a set of time-varying predictors on two health outcomes (ADHD/Conduct Disorders...
The impact of the Manitoba Centre for Health Policy (MCHP) on policy development has resulted from an integrated approach to knowledge translation (KT), combined with a close relationship between the proposed/ongoing research and those working on provincial programs. Under a 5-year funding agreement with Manitoba Health, the director of MCHP negoti...
The “Data Repository” at the Manitoba Centre for Health Policy (MCHP) is a cornerstone of the organization and one of the three “pillars” on which it stands (the other two being Research Program and Knowledge Translation). For 25 years, MCHP has maintained one of the most extensive collections of government administrative, survey, and clinical data...
Background:
Obstructive sleep apnea (OSA) is associated with increased risk of postoperative complications. The authors investigated whether preoperative diagnosis and prescription of continuous positive airway pressure therapy reduces these risks.
Methods:
Matched cohort analysis of polysomnography data and Manitoban health administrative data...
Background
Well-organized administrative data with large numbers of cases (building on linked files from several government departments) and a population registry facilitate new studies of population health and child development. Analyses of family relationships and a number of outcomes--educational achievement, health, teen pregnancy, and receipt...