BORNA CODE RED PROJECT

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THE HAMILTON SPECTATOR l THE SPEC.COM SATURDAY, NOVEMBER 26, 2011 WR3

Which means, he added, any solutionsto the problems of high rates of teenmothers or low-birth-weight babies orpoor access to prenatal care will re-quire a broad range of initiatives.

“We can throw all the money wewant at health services — which we doanyway — but until such time as wetake seriously these kind of gradients,particularly those that affect the healthof children, frankly we may as well bepissing into the wind,” said Johnston.

“You can fix people up to some extentbut by the time they reach adulthood,in effect the die is cast.

“They may change their behaviour,they may give up smoking, they may dothis, they may do that, but fundamen-tally, from that point on, their life is go-ing to roll out in a fairly preordainedfashion.”

Of the 20 neighbourhoods in On-tario with the worst rates of low-

birth-weight babies, three of them arein the lower part of the former City ofHamilton.

In the neighbourhood bounded byWellington and James streets betweenKing and Cannon streets, nearly 15 percent of all babies born between 2006and 2010 had low birth weights.

That’s more than twice the Ontariorate of 6.5 per cent, according to TheSpectator’s analysis.

This forlorn chunk of the city facesthe same social and economic challeng-es as the downtown Brantford neigh-bourhood.

In this part of Hamilton, 74 per centof children live below the poverty line, arate four times higher than the provin-cial average.

More than a quarter of all incomecomes from government sources, themedian household income is just$25,500, according to census data, andnearly 28 per cent of families are head-ed by a single mother.

A few blocks east, it’s pretty muchthe same story.

In the neighbourhood marked bySherman and Gage avenues, betweenCannon Street and the rail line north ofBarton Street, nearly one in seven ba-bies is born with low birth weight,which puts it in 17th place among 2,100Ontario neighbourhoods.

Nearly half of all children in thisneighbourhood live below the povertyline. The unemployment rate is morethan 15 per cent and nearly one in threefamilies is headed by a single mom.

In fact, the low-birth-weight story issimilar to the story in last Saturday’sopening instalment of The Spectator’sBORN investigation.

Much like the concentration of teenmothers, the distribution of low-birth-weight babies is disproportionatelyhigh in Hamilton’s inner city, where in-comes are lower and poverty is heavilyconcentrated.

In the area bounded by Queen Streetand Kenilworth Avenue, the rate oflow-birth-weight babies is 8 per cent.For the rest of the amalgamated City ofHamilton, the rate is 6.1 per cent.

In Ancaster, for example, the low-birth-weight rate is 5.9 per cent. InDundas, it’s 5 per cent; in Stoney Creek,it’s 4.5 per cent; and in Glanbrook therate is 4.1 per cent.

The 18 Hamilton neighbourhoodswith the highest rates of low-birth-weight babies are all found in the for-mer City of Hamilton, and 14 of thoseare in the lower city.

Smoking during pregnancy is onesignificant risk factor that can lead tolow-birth-weight babies.

Smoking rates are also inversely re-lated to income — the lower the income,the higher the rate of smoking — so it’snot surprising there’s a connection be-tween smoking, poverty and increasedrates of low-birth-weight babies inHamilton’s lower inner city.

According to a 2007 report preparedby Hamilton’s public health depart-ment, there were parts of the city where

the rates of smoking by pregnant moth-ers may have exceeded 40 per cent.

“It wasn’t that long ago that womenwould smoke to have a smaller baby sothey’d have an easier delivery,” said Dr.David Price, chair of McMaster’s de-partment of family medicine.

He’s also the founding director of theMaternity Centre on James StreetSouth, which counts a high proportionof low-income and at-risk pregnantwomen among its clientele.

About one-quarter of the womentreated at the centre were smoking atthe beginning of their pregnancies,Price said.

With a lot of intervention, he added,the centre has been able to reduce thesmoking rate to below 20 per cent — animprovement, he noted, but still worri-some.

Since the original Code Red serieslast year, the city has been developing astrategy to deal specifically with theproblem of low-birth-weight babies.

“This is one where I would hold ev-ery level of government and every ma-jor institution in our community ac-countable,” said Dr. Chris Mackie, aHamilton associate medical officer ofhealth. “We haven’t handled this issue.

“We haven’t solved this problem andit’s been known for some time that it’s amajor problem.

“We’re looking for opportunities topartner with the community,” Mackieadded.

“We really think that governmentcan’t do it alone because the issues areso embedded in the culture of thosecommunities.”

Meet the Carniellos: Michelle, Mike and Ella.For weeks, home away from theirHamilton home was the neonatal in-tensive care unit at McMaster Chil-dren’s Hospital, after Ella made an un-expected appearance at 3:25 a.m. onSept. 12.

That was 11 weeks before the date shewas due to arrive.

At just 28 weeks of gestation, Ella’sfragile lungs, heart and nervous systemwere under tremendous stress — aswere her parents.

In this case, the tiny apple didn’t fallfar from the tree.

Back in 1978, Michelle herself was apremature baby, also born around 28weeks, and also a patient in McMaster’sneonatal ICU.

She still has a yellowed Spectatorclipping, a feature piece about the unitthat includes a picture of her ownmother, Debbie Beaulieu, pregnantwith Michelle.

Michelle was four years old whenBeaulieu died, so she doesn’t have thechance now to seek her mother’s adviceor commiserate.

Michelle kept the article close to herdaughter’s incubator as a bit of inspira-tion for both mother and child.

Less access to prenatal care leads to issuesin adult health in a ‘preordained fashion’

Neighbourhoods where at least 10% of babies are considered low birth weight

Where the rate is highest

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Starting life at a disadvantageOf the 20 neighbourhoods in Ontario with the highest rates of low-birth-weight babies, three of them are in the lower part of the former City of Hamilton.

SOURCE: BORN ONTARIO Patrick DeLuca // McMASTER UNIVERSITY CENTRE FOR SPATIAL ANALYSIS; THE HAMILTON SPECTATOR

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Per cent low birth weight

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5.1% - 6.0%6.1% - 7.0%

7.1% and higherNo data

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HAMILTONUPPER CITY

You may have problemswith the fetus or with thepregnancy that wouldnormally have beendiagnosed early on.MAUREEN VESCIOTHUNDER BAY REGIONAL HEALTHSCIENCES CENTRE

This is one where I wouldhold every level ofgovernment and everymajor institution in ourcommunity accountable.DR. CHRIS MACKIEHAMILTON ASSOCIATE MEDICALOFFICER OF HEALTH

BORN continued from // WR2

BORN continues // WR4

Many of the communities in Ontario’s FarNorth with alarming rates of teen mothers,highlighted in last Saturday’s opening instal-ment of the BORN series, exhibit low rates oflow-birth-weight babies.

Kenora, for example, has a low-birth-weightrate of 1.9 per cent. In Thunder Bay, the rate is 2.1per cent, and in Dryden it is 2.2 per cent, basedon The Spectator’s analysis of 535,000 birthoutcomes across Ontario.

But that isn’t necessarily a sign the babies arehealthier in these communities.

In fact, it’s a problem in reverse.Ontario’s far northern communities have

elevated rates of babies with excessive birthweight, which can also result in health problemsfor the newborn.

Excessive birth weight, defined as more than4,500 grams or approximately 10 pounds, islinked to maternal obesity and diabetes that iseither pre-existing or brought on by pregnancyitself. Both are problems seen in the Far North,particularly among aboriginal communities.

“Ten pounds is almost average for us,” saidMaureen Vescio, manager of maternal andnewborn care at Thunder Bay Regional HealthSciences Centre.

An overweight baby can sometimes becometrapped during delivery, leading to a lack ofoxygen. Excessive weight at birth is associatedwith a higher lifelong risk of obesity.

FAR NORTH, HIGHS AND LOWS