July, 2010Prepared by: The Human Early Learning Partnership’s Screening Unit

The purpose of this regional summary is to provide Fraser Health Authority Dental Evaluation Subcommittee members with updated regional and provincial data from the 2006/07 Kindergarten Dental Survey along with socioeconomic, demographic and early childhood development information. These summaries supplement and update the regional data that were provided in the provincial report, Dental Health of BC Children in Relation to Social Determinants and Early Child Development: Analysis & Mapping of the 2006/07 Kindergarten Dental Survey. Specifically, this summary provides:

• additional results by Health Service Delivery Area (HSDA);

• updated socioeconomic data from the 2006 Statistics Canada Census and 2004 Taxfiler data;

• selected results from the neighbourhood-level analyses; and

• selected findings from the Dental Focus Groups conducted in the summer of 2009.

Please see the provincial report if you require additional details about the evaluation questions, dental survey codes used, and sources for the socioeconomic and early development data.

Early Child DevelopmentIn terms of EDI vulnerability on one or more scales, Fraser is virtually identical to the provincial average (29.2 vs. 29.5%). Students from Fraser show the highest vulnerability on the Communication and General Knowledge scale (15.2%) and the lowest vulnerability in terms of Physical Health and Well-Being (10.5%).

Socioeconomic StatusCompared to BC, Fraser has higher rates of union and professional membership (35.5 vs. 33.9% of tax filers), low-income families (13.0 vs. 10.4%) and non-fluency in English or French (2.6 vs. 1.0%), but a lower rate of no high school completion (13.2 vs. 16.2% of adults age 25-64).

EARLY CHILDHOOD SCREENINGRESEARCH & EVALUATION UNIT

Survey CoverageDental health staff of Fraser surveyed 415 schools and 14,261 out of an estimated 16,196 kindergarten students (88.1%) in the region during the 2006/07 school year. 13 of the 415 schools surveyed (3.1%) had suppressed values on Code 01 (“No Visible Decay”) due to small sample sizes and were not included in the analysis. Survey coverage ranged from a low of 87.2% in Fraser South to a high of 89.7% in Fraser East.

Dental OutcomesOverall, 61.5% of students surveyed in Fraser had no visible dental decay (Code 01), 22.4% had no decay, but previous treatment (Code 02), 14.5% had visible decay (Code 03), and 1.7% had urgent treatment needs (Code 04). Fraser East had the most favorable dental outcomes within the Health Authority, with only 34.2% of students having experienced early childhood caries—5.8% below the provincial target of 40%.

BC Early Childhood Dental Programs Evaluation: a Regional Summary for Fraser Health Authority

Percent of students who fell into each dental category for Fraser and its three Health Service Delivery Areas (HSDAs) along with the provincial average.

Percent of kindergarten children vulnerable on each scale of the Early Development Instrument (Wave Two) as well as vulnerability on multiple scales.

FHA (green) BC (blue)

A comparison of select socioeconomic and demographic indicators for FHA to the province. Data sources are the 2006 Census and 2004 Taxfiler data.

Union/ Professional

No High School

Low Income

Lone Parent

Not Fluent

Residential Mobility

Aboriginal Identity

Percent of students who fell into each dental category for BC and health authorities.

July, 2010Prepared by: The Human Early Learning Partnership’s Screening Unit

Neighborhood Off-DiagonalsA provincial-wide analysis was conducted to identify unexpected or “off-diagonal” results for neighborhoods that have…

(A) a low rate of ECC despite having high rates of vulnerability on the EDI and low SES (resilient); or (B) a high rate of ECC despite low rates of EDI vulnerability and high SES (at-risk).

Seven (7) of these “off-diagonals” were found in Fraser, five in group (A) and two in group (B) (see Table 1). Clearbrook, a neighborhood in the City of Abbotsford, provides an example of a neighborhood that is doing better than expected given its developmental and socioeconomic circumstances. Despite having high vulnerability on the EDI (40.3%) and low SES (10th percentile), only 27.9% of kindergarten students in this neighborhood have ever experienced dental caries.

ECC By Neighborhood/School DistrictHELP has identified 478 neighborhoods in BC comprising anywhere from 390 to over 48,000 residents. The 2006/07 Kindergarten Dental Survey reached 460 of these neighborhoods, 163 of which were located in FHA. Map 1 presents the rates of ECC experience (Codes 02 & 03 + 04’s) for neighborhoods within FHA.

Dental Staff Focus Group Highlights

Table 1. Neighborhood Of-Diagonals in FHA

Neighborhood(s) ECC % EDI % Vul. SES pctile.

Chilliwack West 32.0 55.1 23rd

Second Street 32.8 54.0 25th

Clearbrook 27.9 40.3 10th

Burnaby South 29.8 39.5 22nd

Willingdon Heights 29.6 35.2 20th

Fraser Heights 46.7 19.4 60th

Greendale/Chilliwack Mtn 45.5 23.1 96th

BC 39.1 28.6 --

ECC = Early Childhood Caries estimate (Codes 02 and 03 + 04s). EDI = % vulnerable on one or more scales. SES percentile rankings are based on 460 neighborhoods: ‘100th percentile’ = highest SES.

Focus groups were conducted with public health dental staff across the province in 2009 in order to identify the range of Health Authority dental health risk assessment strategies. Selected themes and quotes that emerged from each region’s focus groups are provided below. For a summary of the focus group project and provincial findings, please see the Dental Health Risk Assessment Focus Groups Provincial Analysis Report.

Fraser Health: Supporting Access to Care for Immigrants and Refugees

In the focus groups, FHA dental staff noted that a very large proportion of refugee and recent immigrant families in the province settle in the Fraser Region, primarily in Surrey, Burnaby, Coquitlam and New Westminster. Several participants described their work in advocating for access to oral health care for families in need. For

example, dental staff worked with a refugee program coordinator to overcome language barriers and provide follow-up:“We had a success story the other day…We saw 21 kids [at a refugee group]…most of them had to go to the dentist. The next day the coordinator took the child with the parent to the dentist and they were able to extract a tooth that was abscessed...[The coordinator] is going to follow up with the rest of the kids…But prior to this coordinator there was no coordinator…and there was no real follow-up with them because there was a huge language barrier.”

“I had a family, basically English wasn’t the first language, they weren’t eligible for Healthy Kids, they hadn’t been here long enough…We had a 10-year-old [with serious treatment needs and] five children in the family. We ended up…working with that family, ‘cause they had no one else to work with…and all the children got treatment.”

BC Early Childhood Dental Programs Evaluation: a Regional Summary for Fraser Health Authority continued ...

Map 1. ECC rates by neighborhood/school district for FHA.