Marni D Brownell

• University of Manitoba

Objectives To quantify developmental vulnerability at age 5 by child protection contacts before school in two Australian states. Methods All children with birth, child protection and/or 2009, 2012, 2015 and 2018 Australian Early Development Census (AEDC) data in New South Wales (NSW) and South Australia (SA) were grouped according to child protect...

IntroductionChildren who experience maltreatment have worse health and development outcomes than other children. Early prevention relies on opportunities to respond to system contacts that reliably indicate the population burden of children’s future developmental risk. Objectives and ApproachWe quantified the population burden of developmental vuln...

Objective First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve a...

Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). There is little empirical evidence documenting survival or comparing outcomes to those without IDD. This study investigated the association between IDD and cancer survival among adults with breast (female), colorectal, or lung cancer. A pop...

Background: The effects of the decline in health care use at the start of the COVID-19 pandemic on the health of children are unclear. We sought to estimate changes in rates of severe and potentially preventable health outcomes among children during the pandemic. Methods: We conducted a repeated cross-sectional study of children aged 0-17 years...

Introduction Traumatic physical injuries are the number one cause of hospitalization and death among children in Canada. The majority of these injuries are preventable. The burden from injury can be reduced through prevention programs tailored to at-risk groups, however, existing research does not provide a strong explanation of how social factors...

Background Cancer is a leading cause of death among people living with intellectual or developmental disabilities (IDD). Although studies have documented lower cancer screening rates, there is limited epidemiological evidence quantifying potential diagnostic delays. This study explores the risk of metastatic cancer stage for people with IDD compare...

This study, a partnership between <Organization 1> and <Organization 2>, investigated whether attending full-time kindergarten (FTK) was associated with better educational outcomes for Metis students in Manitoba, who may face unique barriers to academic success. We utilized linked administrative data from the Manitoba Population Research Data Repos...

Objective: We aimed to estimate the changes to the delivery of routine immunizations and well-child visits through the pandemic. Methods: Using linked administrative health data in Ontario and Manitoba, Canada (1 September 2016 to 30 September 2021), infants <12 months old (N=291,917 Ontario, N=33,994 Manitoba) and children between 12 and 24 mon...

Problem: In Canadian society, public policies guide the development and administration of social services and systems, including the public education system, the justice system, family services, social housing and income support. However, because social services are often planned and implemented in a ‘siloed’ manner, coordination and collaboration...

Objectives Adolescent vaping has become a public health concern. The aim of this study was to examine the associations between adolescent vaping and subsequent use of other substances and risk factors for polysubstance use. Methods The Well-being and Experiences Study is a longitudinal, intergenerational study conducted in Manitoba, Canada. The sa...

It is well established that adverse childhood experiences (ACEs) are associated with detrimental health outcomes in adulthood. Less is known about the relationships between ACEs and education outcomes and among adolescents. The aim of this study was to examine the associations between ACEs and adolescents’ self-reported education outcomes and provi...

Objective Manitoba has one of the highest incarceration rates among Canadian provinces, and because of Canada’s racist and colonial policies, the number of Métis women in custody is disproportionately high. In this study, we examined birth outcomes among Métis and all other Manitoba women who were incarcerated while pregnant. ApproachUsing linked a...

Objectives Lack of consistent and relevant Indigenous identifiers in Canadian data sources leads to misclassification and under-recognition of the health and social issues impacting Indigenous Peoples, further perpetuating the harms of colonization. We are evaluating and optimizing our approach for identifying First Nations (FN) individuals in admi...

Objectives Indigenous children in Canada, including Metis children, are taken into care by the child welfare system at a disproportionately high rate. The objective of this study was to explore factors related to having a child taken into care from Metis families in Manitoba, and specifically from Metis mothers experiencing incarceration. ApproachT...

ObjectivesPAX, a mental health promotion approach, has been shown to decrease negative mental health outcomes and improve academic achievement. These effects have yet to be shown among Indigenous children. We evaluated PAX for improving First Nations children’s outcomes following a research process wherein community members and researchers work mor...

Objectives Red River Métis are Indigenous people hailing from the Canadian Prairies who have historically experienced poor health outcomes due to colonial practices. Researchers from the Manitoba Métis Federation (MMF) partnered with health services researchers to test whether MMF-led COVID initiatives were associated with access to COVID-19 testin...

Objectives First Nations (FN) organizations worked with public health and governments to improve FN access to COVID-19 vaccines by prioritizing FN communities in vaccination initiatives. FN researchers and data scientists partnered to test whether these efforts were associated with increased access to COVID-19 vaccines among FN compared with all ot...

ObjectivesSPECTRUM is a unique multi-disciplinary, cross-sector collaborative research partnership between academics, government, and community organizations in Manitoba working together to address complex social problems. In our first research project, partners identified the need for quantitative evidence around outcomes of children involved with...

Objectives Given the impact of colonization and responding to Canada’s Truth and Reconciliation Commission, we aimed to provide baseline measures of First Nations children’s health and social outcomes in Manitoba, Canada. We also aimed to create a research process where Indigenous and non-Indigenous researchers work collaboratively and in culturall...

Objectives The overarching research objective was to examine, culturally adapt, and further evaluate a mental health promotion approach called the PAX within 8 First Nations communities. This presentation describes a research process whereby First Nations community members and researchers worked in collaborative and culturally safe ways to reach th...

Objectives Over three decades ago, the Aboriginal Justice Inquiry identified structural racism in Canada’s justice system. Although rates of youth criminal charges and incarcerations have declined substantially since then, it is unclear whether First Nations youth are treated differently than non-First Nations youth for similar offences. Our study...

Objective The objective was to examine the relationship between maternal intimate partner violence (IPV) victimization and children’s developmental health using linked population-wide administrative datasets. We examined developmental vulnerability (DV) at kindergarten of children exposed to maternal IPV victimization aged 0 to 5 using provincial p...

Objective Using population-wide administrative data, the objective was to provide Canadian evidence on the longitudinal relationship between maternal intimate partner violence (IPV) victimization and children’s developmental health. Using provincial prosecution records, we examined developmental vulnerability (DV) at kindergarten of children prenat...

Objectives Responding to the Truth and Reconciliation Commission of Canada’s (TRC) Call to Action #19 to close the gap in maternal/child outcomes, the goal of this study was to provide a baseline for select outcomes and demonstrate how an Indigenous/decolonizing framework can be applied to population health research involving Indigenous people. App...

IntroductionOut-of-school or after-school programs are designed to support healthy behaviours, boost academic achievement and strengthen social skills. The Boys and Girls Clubs of Winnipeg (BGCW) in Manitoba, Canada, have been offering out-of-school programs to children and adolescents in low-income neighbourhoods for more than 40 years. Many BGCW...

Introduction: Out-of-school or after-school programs are designed to support healthy behaviours, boost academic achievement and strengthen social skills. The Boys and Girls Clubs of Winnipeg (BGCW) in Manitoba, Canada, have been offering out-of-school programs to children and adolescents in low-income neighbourhoods for more than 40 years. Many BG...

Importance: Insulin pumps improve glycemic control and quality of life in children with type 1 diabetes (T1D). Canada's provinces have implemented universal pediatric programs to improve access. However, these programs provide differing financial coverage, allowing for unique cross-jurisdictional comparisons. Objective: To evaluate possible soci...

Importance: Insulin pumps improve glycemic control and quality of life in children with type 1 diabetes (T1D). Canada's provinces have implemented universal pediatric programs to improve access. However, these programs provide differing financial coverage, allowing for unique cross-jurisdictional comparisons. Objective: To evaluate possible socioe...

Background Early life exposures can have an impact on a child’s developmental trajectory and children born late preterm (34–36 weeks gestational age) are increasingly recognized to have health and developmental setbacks that extend into childhood. Objectives The purpose of this study was to assess whether late preterm birth was associated with poo...

Despite anxiety being a prevalent mental health problem in children, little data exist on the pervasiveness and levels of anxiety symptoms in kindergarteners. Data from the Early Development Instrument , a teacher-completed, population-level measure of child development, were collected across Canada from 2004 to 2015. The final analytic sample cons...

For more than 30 years, the Manitoba Centre for Health Policy has been conducting research and evaluation to provide timely and critical evidence to answer real-world policy questions. Our experienced team of research scientists, analysts and other staff work extensively with policy-makers at the macro, meso and micro levels of government to suppor...

Objective: To evaluate the effects of early pregnancy loss on subsequent health care use and costs. Data sources: Linked administrative health databases from Manitoba, Canada. Study design: This was a population-based cohort study. The exposure of interest was first recorded ectopic pregnancy or miscarriage (EPM). Outcomes included visits to a...

Background The potential influence of asthma control in early life on long-term outcomes in childhood remains largely unknown. Objective To examine whether asthma control trajectories in the 2 years post-diagnosis in preschoolers are associated with long-term unsatisfactory asthma control. Methods We conducted a multicenter population-based retro...

Background Vaping among adolescents and young adults is a significant public health concern worldwide. Understanding which risk factors are associated with vaping is important to help inform evidence-based prevention and intervention strategies. There are several gaps in the current literature examining these associations such as limited longitudin...

Social capital is thought to buffer the negative effects of low income on health and thereby flatten the social gradient. Child development research on social capital has suggested that social networks of adults and children in a neighborhood may play a protective role in children’s outcomes. Yet little is known about how this relationship applies...

Background: There were large disruptions to health care services after the onset of the COVID-19 pandemic. We sought to describe the extent to which pandemic-related changes in service delivery and access affected use of primary care for children overall and by equity strata in the 9 months after pandemic onset in Manitoba and Ontario. Methods:...

Introduction Decades of research demonstrate that First Nations, Metis and Inuit (FN/M/I) populations have differential access to diagnostic and therapeutic healthcare. Emerging evidence shows that this continues to be the case during the SARS-CoV-2 pandemic. In an effort to rectify these differences in access to care, our team, which is co-led by...

The incidence of intimate partner violence (IPV) varies according to IPV definitions and data collection approaches. The criminal Justice system assesses IPV through a review of the evidence gathered by the police and the court hearings. We aimed to determine the association between IPV, as identified in criminal Justice disposition records, and su...

Background In Manitoba, Canada, low-income pregnant women are eligible for the Healthy Baby Prenatal Benefit, an unconditional income supplement of up to CAD $81/month, during their latter two trimesters. Our objective was to determine the impact of the Healthy Baby Prenatal Benefit on birth and early childhood outcomes among Manitoba First Nations...

Background Pregnancy loss is common and several factors (e.g. chromosomal anomalies, parental age) are known to increase the risk of occurrence. However, much existing research focuses on recurrent loss; comparatively little is known about the predictors of a first miscarriage. Our objective was to estimate the population-level prevalence of miscar...

The prevalence of Fetal Alcohol Spectrum Disorder (FASD) may be underestimated as it can be difficult to diagnose in early childhood possibly reflecting unique developmental trajectories relative to other Neurodevelopmental Disabilities (NDDs). Using data collected via the Early Development Instrument (EDI) between 2010 and 2015, we examined the pr...

Background Intimate partner violence (IPV) during pregnancy is a substantial public health concern, yet little is known about the developmental trajectory of these women and their children after birth. Objective The objective was to examine maternal and child health as well as social outcomes from birth to 5-years post-delivery associated with a p...

Introduction Roughly 30% of children in Manitoba are vulnerable in one or more important areas of development at school entry. The Healthy Baby Community Support Program (HBCSP) is a universally accessible supported playgroup that operates across Manitoba to support mothers and babies up to 1 year postpartum. Objectives and Approach This study use...

Introduction: Early disease morbidity has been associated with asthma persistence in wheezing preschoolers; however, whether asthma control trajectories shortly after diagnosis could influence remission is unknown. We examined the association between asthma control trajectories 2 years post-diagnosis in preschoolers and subsequent disease remissio...

Introduction High dimensional propensity scores (HDPS) aim to account for unmeasured confounding. However, it is unclear to what extent HDPS are able to attain this. Objectives and Approach This study aimed to test how well HDPS can account for confounding due to social determinants of health when using only health data. A retrospective cohort stu...

Introduction Routine health care information systems only capture a portion of violence against women because some victimized women may not seek health care and some events may not require medical attention. Population-based estimates of the risk of violent injury (VI) among women with a history of intimate partner victimization (IPV) are lacking....

Introduction Early education outcomes influence children’s educational trajectories with long-term effects extending into adulthood. Aboriginal peoples face numerous systemic barriers to academic success. It remains unknown if full-day kindergarten (FDK) is associated with improved academic outcomes among Metis children – a distinct Aboriginal peop...

Introduction In Manitoba, low-income pregnant women are eligible for the Healthy Baby Prenatal Benefit (HBPB), a prenatal income supplement. Research has demonstrated positive outcomes associated with HBPB, but it remains unknown if Metis women and children – who are of mixed European and Aboriginal descent and one of the most marginalized populati...

Introduction Administrative data studies routinely report that First Nations mothers and children experience a disproportionate burden of poor health. Due to the nature of administrative data, research often takes a deficits-oriented approach. First Nations health research needs to consider the role that community- and individual-level strengths pl...

Introduction The leveraging of multi-sector, whole-population, linked administrative data is advantageous for conducting research on complex real-world problems. However, such large and complex data repositories can sometimes appear impersonal and overwhelming. Establishing organizational empathy (OE) in the context of a multi-sector partnership be...

Introduction Resilience is a key factor in healthy development of children who have experienced adversity in early life. Current methods of assessment involve using questionnaires - few of which are appropriate for young children, most are time consuming and rely on parent recall, thereby introducing bias. Additionally, widespread implementation of...

Introduction The Boys & Girls Clubs of Winnipeg (BGCW) provide out-of-school programs to children and youth living in low-income neighbourhoods in Winnipeg, Canada. These programs aim to set participants on a path to success by supporting healthy behaviours, academic achievement and social skills. First Nation children and youth make up a substanti...

Introduction The Boys & Girls Clubs of Winnipeg (BGCW) provide out-of-school programs to children and youth living in low-income neighbourhoods in Winnipeg, Canada. These programs aim to set participants on a path to success by supporting healthy behaviours, academic achievement and social skills. Metis children and youth make up a substantial prop...

Background In Manitoba, low-income pregnant women are eligible for the Healthy Baby Prenatal Benefit (HBPB), which provides up to CAD $81.41/month during the second and third trimesters of pregnancy. In research conducted in partnership with the Manitoba Metis Federation, we examined the association of the HBPB with Metis birth and early childhood...

School‐based healthy living interventions are widely promoted as strategies for preventing obesity. The peer‐led Healthy Buddies™ curriculum has been shown to improve obesity‐related outcomes in school‐aged children. We examined whether these improvements existed among subgroups of children stratified by sex, income level and urban/rural geography....

Neighbourhoods encompass the social, institutional, and environmental determinants that influence the developmental health of the children who reside in them. A number of different socioeconomic indices have been developed to determine which neighbourhood-level indicators are most strongly associated with early child development outcomes in Canada....

Introduction Children who have a history of involvement in child protection services (CPS) are over-represented in the youth and adult criminal justice systems. There are significant health and socioeconomic implications for individuals involved in either or both CPS and the justice system. Understanding the ‘overlap’ between these two systems woul...

Background: Abnormal microbiota composition induced by prenatal exposure to antibiotics has been proposed as a potential contributor to the development of attention-deficit/hyperactivity disorder (ADHD). We examined the association between prenatal antibiotic exposure and risk of ADHD. Methods: We conducted a population-based retrospective cohor...

Objectives: To determine if in utero selective serotonin reuptake inhibitor (SSRI) or selective serotonin norepinephrine inhibitor (SNRI) exposure is associated with developmental vulnerability in kindergarten among children whose mothers were diagnosed with prenatal mood or anxiety disorder. Methods: Linkable administrative data were used to cr...

Objective To examine the relationship between developmental health and neighbourhood socioeconomic status (SES) in kindergarten children with disabilities. Design Cross-sectional study using population-level database of children’s developmental health at school entry (2002–2014). Setting 12 of 13 Canadian provinces/territories. Measures Taxfiler...

Methods Using data from a provincial newborn screen and healthcare database for 12,587 children born in 2004, maternal distress was defined as: prenatal, and self-limiting, recurrent or late-onset postpartum. Atopic dermatitis (AD) and asthma at ages 5 and 7 were diagnosed from hospitalization, physician visit or prescription records. Associations...

IntroductionStudies have consistently demonstrated a gradient between median neighbourhood income and child developmental outcomes. By investigating statistical outliers—neighbourhoods with children exhibiting less or more developmental vulnerability than that predicted by median neighbourhood income—there is an opportunity to identify other neighb...

Socioeconomic gradients in health exist in Canada. Although multiple Canadian area-based socioeconomic measures (ABSM) have been developed, none have been specifically validated against pediatric outcomes. Our objective was to compare the strength of association between key pediatric health outcomes and a number of ABSM, including income quintile....

Background: Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children's developmental health, a concept reflecting holistic child development - encompassing physical,...

Background Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassing physical, em...

Background Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassing physical, em...

Background Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassing physical, em...

Background The Families First Home Visiting (FFHV) program aims to enhance parenting skills and strengthen relationships between parents and their children. Previous research found FFHV to be effective at decreasing child maltreatment in the general population of Manitoba, but whether it is beneficial specifically for First Nation families has not...

Objectives In Manitoba, government policy is for public health nurses to screen families with newborns within 1-week post-discharge for risk factors associated with poor child developmental health. The purpose of this study was to compare the characteristics of families who are screened for intimate partner violence (IPV) with families without a do...

Purpose: The purpose of this study was to identify prenatal, maternal, and early childhood factors associated with surgery to treat severe-early-childhood-caries (S-ECC) using general anesthesia (GA). Methods: A case-control study using administrative health care and social services data examined factors associated with surgery under GA. Subjects...

Background and Objective Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassin...

Sex differences in early child development (ECD) are well documented, as is the socioeconomic status (SES) gradient in early development outcomes. However, relatively little is known about whether the SES gradient in ECD outcomes varies by sex. This study examines whether the association between neighbourhood SES and developmental health outcomes o...

Background: Indigenous Australian children are twice as likely to score poorly on developmental outcomes at age 5 years than their non-Indigenous peers. Indigenous children are also more likely to be born to younger mothers. We aimed to quantify the relationship between maternal age at childbirth and early childhood development outcomes in Indigen...

Objective: This qualitative study explores teens' perspectives on facilitators and barriers to accessing school-based clinics, emphasizing the importance of youth self-report. Methods: We conducted in-person interviews with teens (N = 25) at 2 high schools that had school-based clinics in Winnipeg, Manitoba (Canada). We supplemented the interviews...

Research examining the effects of subsidized childcare prior to school entry for child development is inconsistent. This population-based study examines the relationship between two poverty levels (extreme poor and working poor) and children’s developmental outcomes, as measured by the Early Development Instrument. It also determines the extent to...

Early childhood antibiotic exposure induces changes in gut microbiota reportedly associated with the development of Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted a population-based cohort study to examine the association between antibiotic use in the first year of life and ADHD risk. We included children born in the Manitoba, Canada...

Background and Objective Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassin...

Background Prenatal antibiotic exposure induces changes in infants’ gut microbiota composition and is suggested as a possible contributor in the development of autism spectrum disorders (ASD). In this study, we examined the association between prenatal antibiotic exposure and the risk of ASD. Methods This was a population-based cohort study utiliz...

We explored the particularities of the Healthy Baby Prenatal Benefit (HBPB), an unconditional cash transfer program for low-income pregnant women in Manitoba, Canada, which aims to connect recipients with prenatal care and community support programs, and help them access healthy foods during pregnancy. While previous studies have shown associations...

Objective: Little is known about how prenatal care influences health outcomes in Canada. The objective of this study was to examine the association of prenatal care utilization with maternal, fetal, and infant outcomes in Manitoba. Methods: This retrospective cohort study conducted at the Manitoba Centre for Health Policy investigated all delive...

Objective To determine whether the Families First Home Visiting (FFHV) programme, which provides home visiting services to families across Manitoba, is associated with improved public health outcomes among First Nations families facing multiple parenting challenges. Design Retrospective cohort study using population-based administrative data. Set...

Introduction Caregivers of children with health problems experience poorer health than the caregivers of healthy children. To date, population-based studies on this issue have primarily used survey data. Objectives We demonstrate that administrative health data may be used to study these issues, and explore how non-categorical indicators of child...

Background We describe early health services utilization for children diagnosed with medium-chain acyl-CoA dehydrogenase (MCAD) deficiency through newborn screening in Ontario, Canada, relative to a screen negative comparison cohort. Methods Eligible children were identified via newborn screening between April 1, 2006 and March 31, 2010. Age-strat...

Background: Caregivers of children with health problems (CHPs; usually mothers) experience more physical and psychological health problems than those of children without health problems (non-CHPs). Primarily cross-sectional and survey-driven, this literature has not yet explored whether these health differences existed before the birth of the CHPs...

Objectives Autism spectrum disorders (ASD) are among the leading causes of disabilities in children. We examined the annual prevalence and incidence rate of ASD between 2004 and 2015 in children aged 1 to 5 years residing in Manitoba. Methods A population-based study was conducted using the Manitoba Population Research Data Repository. The study i...

Objective:: To examine health services, social services, education, and justice system outcomes among First Nations children and youth with fetal alcohol spectrum disorder (FASD). Methods:: In this retrospective cohort study, health and social services, education, and justice data were linked with clinical records on First Nations (FN) individua...

Background Ensuring high quality and equitable maternity services is important to promote positive pregnancy outcomes. Despite a universal health care system, previous research shows neighborhood-level inequities in utilization of prenatal care in Manitoba, Canada. The purpose of this population-based retrospective cohort study was to describe pren...

The Canadian Neighbourhoods Early Child Development (CanNECD) database is a unique resource for research on child developmental health and well-being within the socioeconomic and cultural context of Canadian neighbourhoods. This paper describes the CanNECD database and highlights its potential for advancing research at the intersection of child dev...

Introduction On their 18th birthday children in custody of provincial Child and Family Services (CFS) age out, and are adults in control of their own care. An additional extended transitional services program was introduced several years ago to address gaps in the provicion of, and access to, adult social services during this change. Objectives an...