Below average

Data shows Hastings Prince Edward region lagging in reproductive health measures.

One in ten new mothers smoke between 10 and 20 cigarettes a day in Hastings and Prince Edward Counties. Despite the well-documented harm this behaviour does to still-developing lungs and overall newborn health, new mothers in this region are four times more likely to smoke a pack of cigarettes than the provincial average.

This is one of the findings presented to the board of the regional health unit, Hastings and Prince Edward Public Health (HPEPH), last week. The data is uniformly bad. By every measure—from the size of babies, to the proportion of mothers younger than 20 years old and the rate of low-birth-weight babies—the challenges facing newborns in Hastings and Prince Edward are worse than the provincial average. In some cases, much worse.

THE DATA
Until 2008, the region’s incidence of underweight babies tracked the experience across Ontario, but since then, the proportion of babies born weighing less than 2,500 grams has climbed to nearly nine per cent while the provincial average has remained flat at about six per cent.

The number of mothers under 20 years of age has fallen in recent years from about eight per cent to about six per cent—yet the proportion of younger mothers in Hastings Prince Edward is nearly triple the average of 2.3 per cent for the rest of Ontario.

But for some, the most disturbing data points to the number of new mothers who smoke. Fully one per cent of the mothers surveyed reported smoking more than 20 cigarettes per day—20 times the provincial average.

WHAT’S GOING ON?
Shelly Brown presented these findings in her report on Reproductive Health to the public health board. She is a program manager with HPEPH. She told The Times it is important to note that the trend is improving across all metrics with the exception of low-birth-weight babies.

But so, too, are provincial trends improving. Yet this region lags persistently behind the average.

Brown speculates that the region’s rural population may be a factor.

“We also know that socioeconomic factors tend to be worse in our area,” said Brown.

The data, however, doesn’t distinguish between rural and urban centres, so it is impossible to know if the challenges are focused in one area or another.

She adds that the rate of cigarette smoking is higher in Hastings Prince Edward, with one in five adults smoking at least one cigarette a day.

Brown acknowledges these are not fully satisfactory explanations, given that Ontario comprises many rural regions and communities struggling with economic issues.

“Do we know the exact causes? No.” said Brown. “Do we know the issues are complex? Absolutely. Obviously, there is room for improvement in our numbers. We are working toward making changes in our community and changing outcomes. Using this and other data, [the] local Health Unit is developing new programs and activities as well as revising others to narrow this region’s performance relative to the provincial average.”

Developing workable remedies or strategies, however, requires a thorough understanding of the problem. That is something the Health Unit admits it doesn’t yet have.

“I am not sure there is one single answer,” said Brown. These are complex issues. There is the educational component— but it is a much broader challenge than extending awareness. Some people know the issues but lack the means to access services.”

But neither does the limited transportation options in the region fully explain the gap.

Brown says that fully 92 per cent of new mothers visit a health care professional in the first trimester of their pregnancies— a much higher percentage than the provincial average of 82 per cent.

Yet participation in pre-natal, birthing and breastfeeding programs is behind the provincial average and falling.

Another mystery is the spike in low weight babies in Hastings Prince Edward relative to the provincial average since 2008.

“I wish we knew,” said Brown. “Hastings Prince Edward was granted access to the Better Outcome Registry and Network—the province’s newborn information system—recently. We will be using this system to look at low-birth-weight babies in our area.”

The health unit’s report has revealed a worrying prospect for newborns in the region, relative to other communities. But it points to an equally troubling gap in our understanding of the issues behind it.

Brown says these messages should come much earlier than they do now.

“Experts agree that it is important to intervene before pregnancy,” said Brown.

The Times invites your feedback. You will find the complete Reproductive Health report by clicking here.