Previous research has demonstrated that exposure to adverse environments early in life, including the prenatal period, is associated with later adult health outcomes such as obesity, cardiovascular disease, diabetes and mental health conditions. Obesity has a complex etiology that includes genetic, metabolic, behavioural, psychological, environmental and social factors such as income and education levels [5]. It is known to be an important risk factor for chronic diseases (CD), which in turn increase complex care needs that are both challenging and costly to address (ref).
Increasing proportions of adults and children in Canada suffer from obesity. These proportions are higher in the Maritime Provinces compared to the national average and so is the prevalence of CD across all age groups (ref.). Childhood overweight and obesity have increased steadily. Between 1978/79 and 2004 in Canada, the combined prevalence of overweight and obesity among those aged 2 to 17 years increased from 15% to 26% (PHAC, 2012). A landmark study suggests that when children are overweight or obese by the time they enter kindergarten, they are four times more likely to be overweight or obese in high school [4]. A systematic review of early markers for obesity in adulthood [5] found that maternal markers including BMI, smoking and weight gain during pregnancy are important determinant of offspring health. Adult determinants of obesity also include high birth weight, rapid growth in early years and being overweight or obese by the age of 5 [5]. Statistics Canada data show that the rates of children with normal weight have dropped from 78% in 2004 to 66% in 2011 [3].
Early interventions in expectant families and families with young children are a promising approach to promoting health and preventing or delaying the development of CD. However, there is widespread recognition that sufficient evidence is often unavailable to support effective health-related decisions (ref). This is in contrast with the ubiquitous presence of useful data available. The discrepancy between the unavailability of evidence and availability of data to provide such evidence is explained by single datasets not containing all of the required information on their own, the rare occurrence with which datasets are linked together, and the infrequent recourse to longitudinal analyses . Building on existing primary care strategies for children’s health and early-years prevention, the proposed project will develop a better understanding of the predictors of CD among young children and their families and will enable the evaluation of early-years approaches to primary prevention.