Andrew Sofin

Andrew Sofin is a licensed psychotherapist and couples and family therapist with a private practice in Montreal. His clinical focus is on couples and family therapy. He is a Registered Marriage and Family Therapist (RMFT) with the Canadian Association for Couple and Family Therapy (CACFT), a clinical fellow with the American Association for Marriage and Family Therapy (AAMFT), and a member of the International Family Therapy Association (IFTA). Currently, he serves as the president of the CACFT and is the founder of The Belmont Centre, Couples Retreat at Ocean Coral, and Couples Retreat in Montreal. He also co-founded the Brief Crisis Therapy Institute and The Private Practice Consultants. Additionally, he holds the position of visiting professor at the University of Guelph, where he teaches a course in the Advanced Certificate in Couple and Family Therapy Studies program. He has over 25 years of experience in not-for-profit leadership, mental health entrepreneurship, private practice, residential treatment programs, and hospital settings in Boston and Montreal.

About the organization: The CACFT is a professional association whose members are clinicians, educators, and researchers who focus on relational and systemic therapy. CACFT regulates and oversees membership credentials (RMFT) and continuing education, sets accreditation standards for Couple and Family Therapy graduate-level programs, and maintains a Code of Ethics and standards of practice.

Amy Robichaud

Amy is the daughter to Lore, granddaughter to Rae, and great granddaughter to Rita.

She currently serves as CEO at Mothers Matter Canada and previously as Executive Director of Dress for Success Vancouver, Director of Engagement at the Minerva Foundation for BC Women, and as a development and governance consultant to organizations such as the RBC Foundation, the Global Centre for Pluralism, and the Canadian Mental Health Association.

Amy’s passion for practical ways to generate equity, create economic inclusion, opportunity and prosperity for all informs everything she does, including her volunteerism. She is serving her second term as Chair of the Women’s Advisory Committee for the City of Vancouver where she advises Council and staff on enhancing access and inclusion for women and girls to fully participate in City services and civic life. She has previously served as Chair of the Dress for Success Canada Foundation, and was nominated for the YWCA Vancouver’s Women of Distinction Awards in 2023. She’s a member of the Banff Forum and WNORTH.

Amy and her husband have lived all over Canada and now happily and humbly call the unceded, ancestral and traditional territories of the xʷməθkʷəy̓əm, Sḵwx̱wú7mesh, and səlilwətaɬ Nations home, along with their pets and overgrown library.

About Mothers Matter Canada

Mothers Matter Canada (MMC) is a national organization dedicated to empowering socially isolated and economically vulnerable mothers by providing innovative, evidence-based programs that support early childhood education, strengthen parent-child bonds, and promote community integration. Through partnerships and advocacy, MMC works to break cycles of poverty and isolation, ensuring mothers and their children achieve their full potential and thrive in welcoming, inclusive communities. When mothers thrive, children flourish, and communities prosper.

Margaret Campbell

Margaret Campbell received her PhD in Social and Cultural Analysis from Concordia University. Her thesis, which was supported by a grant from the Social Sciences and Humanities Research Council of Canada (SSHRC), explored the diverse ways that people with disabilities make sense of their sexual health and expression. Her PhD research examined barriers to sexual health and expression that many persons with disabilities face and identified diverse ways that they create opportunities for sexual expression despite these barriers. As a post-doctoral fellow with the Vanier Institute, Margaret conducted research aimed at strengthening our understanding of family diversities and family wellbeing, specifically among families with disabilities.

Margaret’s research interests in the wellbeing of families with disabilities and families of those who work in high-risk occupations stem from her upbringing on a family farm in rural Prince Edward Island and her personal experience living with a chronic illness.

Margaret teaches on a part-time basis at St. Thomas University and has a breadth of experience teaching courses in Family Studies, Sociology, and Gender Studies. Her teaching and research practices are informed by critical theories, feminist frameworks, and her belief in the possibility of creating a world that is more equitable, accessible, and, ultimately, more livable.

Annie Pullen Sansfaçon

Annie Pullen Sansfaçon holds a PhD in Ethics and Social Work (De Montfort University, UK, 2007) and has been focused on anti-oppressive approaches and ethics since the beginning of her career. Building on these themes, she developed a research focus aimed at better understanding the experiences of oppression and resistance among gender-diverse youth, such as transgender and non-binary youth, Two-Spirit youth, and youth who detransition, as well as the development of best practices to support them. She is also interested in parental and social support and its impact on these different groups of young people. The research projects she leads, both nationally and internationally, have been published in numerous scholarly articles and five books on the subject. She co-founded and currently co-directs CRI-JaDE (Centre de recherche interdisciplinaire sur la justice intersectionnelle, la décolonisation et l’équité; Centre for Research on Intersectional Justice, Decolonization, and Equity), and is an affiliated researcher with the School of Social Work at Stellenbosch University in South Africa.

Simona Bignami 

Simona Bignami is a demographer specializing in quantitative methods and family dynamics. Broadly speaking, she is interested in the relationship between social influence, family dynamics, and demographic outcomes and behaviours, and the extent to which empirical evidence helps us understand this relationship. Her most recent work focuses on migrants’ and ethnic minorities’ family dynamics, attempting to improve their measurement with innovative data and methods, and to understand their role for demographic and health outcomes. Her research on these topics takes a comparative perspective, and spans from developing to developed country settings. Although her research is quantitative, she has experience collecting household survey data and conducting qualitative interviews and focus groups in different settings.  

Matthew Johnson 

Matthew Johnson is a Professor of Family Science in the Department of Human Ecology at the University of Alberta. His research focuses on the development of couple relationships, and he is the principal investigator of the Edmonton Transitions Study. 

Robin McMillan

Robin McMillan has spent her career of over 30 years working in the early learning sector. For the first eight years, she worked as an Early Childhood Educator with preschool children. She left the front line to develop resources for practitioners at the Canadian Child Care Federation (CCCF). She has been with the CCCF since 1999 and worked her way from Project Assistant to Project Manager to her present role as Innovator of Projects, Programs and Partnerships. Highlights of her career with CCCF have been managing over 20 national and international projects, including a CIDA project in Argentina and presenting a paper with the Honourable Senator Landon Pearson to the Committee on the Rights of the Child in Geneva, Switzerland.  

Robin served as a board member on the Ottawa Carleton Ultimate Association for two years, as well as participated in organizing numerous local charity events. She founded and facilitated a local parent support group, Ottawa Parents of Children with Apraxia, and a national group, Apraxia Kids Canada. She is married and has a 17-year-old son with a severe speech disorder, childhood apraxia of speech, and a mild intellectual disability, which launched her into the world of parent advocacy. She was the recipient of the Advocate of the Year Award in 2010 from the Childhood Apraxia of Speech Association of North America. 

About the Organization: We are the community in the early learning and child care sector in Canada. Professionals and practitioners from coast to coast to coast belong in our community. We give voice to the deep passion, experience, and practice of Early Learning and Child Care (ELCC) in Canada. We give space to excellent research in policy and practice to better inform service development and delivery. We provide leadership on issues that impact our sector because we know we are making a difference in the lives of young children—our true purpose, why we exist—to make a difference in these lives. What gets talked about, explored, and shared in our community is always life changing, and we know that. We are a committed, passionate force for positive change where it matters most—with children.

Donna S. Lero

Donna S. Lero is University Professor Emerita and the inaugural Jarislowsky Chair in Families and Work at the University of Guelph, where she co-founded the Centre for Families, Work and Well-Being. Donna does research in Social Policy, Work and Family, and Caregiving. Her current projects focus on maternal employment and child care arrangements, parental leave policy, and disability and employment, as well as the Inclusive Early Childhood Service System (IECSS) project  and the SSHRC project Reimagining Care/Work Policies.

Liv Mendelsohn

Liv Mendelsohn, MA, MEd, is the Executive Director of the Canadian Centre for Caregiving Excellence, where she leads innovation, research, policy, and program initiatives to support Canada’s caregivers and care providers. A visionary leader with more than 15 years of experience in the non-profit sector, Liv has a been a lifelong caregiver and has lived experience of disability. Her experiences as a member of the “sandwich generation” fuel her passion to build a caregiver movement in Canada to change the way that caregiving is seen, valued, and supported.

Over the course of her career, Liv has founded and helmed several organizations in the disability and caregiving space, including the Wagner Green Centre for Accessibility and Inclusion and the ReelAbilities Toronto Film Festival. Liv serves as the chair of the City of Toronto Accessibility Advisory Committee. She has received the City of Toronto Equity Award, and has been recognized by University College, University of Toronto, Empowered Kids Ontario, and the Jewish Community Centres of North America for her leadership. Liv is a senior fellow at Massey College and a graduate of the Mandel Institute for Non-Profit Leadership and the Civic Action Leadership Foundation DiverseCity Fellows program.

About the Organization: The Canadian Centre for Caregiving Excellence supports and empowers caregivers and care providers, advances the knowledge and capacity of the caregiving field, and advocates for effective and visionary social policy, with a disability-informed approach. Our expertise and insight, drawn from the lived experiences of caregivers and care providers, help us campaign for better systems and lasting change. We are more than just a funder; we work closely with our partners and grantees towards shared goals.

Barbara Neis

Barbara Neis (PhD, C.M., F.R.S.C.) is John Lewis Paton Distinguished University Professor and Honorary Research Professor, retired from Memorial University’s Department of Sociology. Barbara received her PhD in Sociology from the University of Toronto in 1988. Her research focuses broadly on interactions between work, environment, health, families, and communities in marine and coastal contexts. She is the former co-founder and co-director of Memorial University’s SafetyNet Centre for Occupational Health and Safety and former President of the Canadian Association for Work and Health. Since the 1990s, she has carried out, supervised, and supported extensive collaborative research with industry in the Newfoundland and Labrador fisheries including in the areas of fishermen’s knowledge, science, and management; occupational health and safety; rebuilding collapsed fisheries; and gender and fisheries. Between 2012 and 2023, she directed the SSHRC-funded On the Move Partnership (www.onthemovepartnership.ca), a large, multidisciplinary research program exploring the dynamics of extended/complex employment-related geographical mobility in the Canadian context, including its impact on workers and their families, employers, and communities.

Deborah Norris

Holding graduate degrees in Family Science, Deborah Norris is a professor in the Department of Family Studies and Gerontology at Mount Saint Vincent University. An abiding interest in the interdependence between work and family life led to Deborah’s early involvement in developing family life education programs at the Military Family Resource Centre (MFRC) located at the Canadian Forces Base (CFB) Halifax. Insights gained through conversation with program participants were the sparks that ignited a long-standing commitment to learning more about the lives of military-connected family members—her research focus over the course of her career to date. Informed by ecological theory and critical theory, Deborah’s research program is applied, collaborative, and interdisciplinary. She has facilitated studies focusing on resilience(y) in military and veteran families; work-life balance in military families; the bi-directional relationship between operational stress injuries and the mental health and wellbeing of veteran families; family psychoeducation programs for military and veteran families; and the military to civilian transition. She has collaborated with fellow academic researchers, Department of National Defense (DND) scientists, Veterans Affairs Canada (VAC) personnel, and others. Recently, her research program has expanded to include an emphasis on the impacts of operational stress on the families of public safety personnel.

Susan Prentice

Susan Prentice holds the Duff Roblin Professor of Government at the University of Manitoba, where she is a professor of Sociology. She specializes in family policy broadly, and child care policy specifically. She has written widely on family and child care policy, and a list of her recent publications can be found at her UM page. At the undergraduate and graduate level, she teaches family policy courses. Susan works closely with provincial and national child care advocacy groups, and is a member of the Steering Committee of the Childcare Coalition of Manitoba.

Yue Qian

Yue Qian (pronounced Yew-ay Chian) is an Associate Professor of Sociology at the University of British Columbia in Vancouver. She received her PhD in Sociology from Ohio State University. Her research examines gender, family and work, and inequality in global contexts, with a particular focus on North America and East Asia.

Diane-Gabrielle Tremblay

Diane-Gabrielle Tremblay is professor of labour economics/sociology and human resources management at TÉLUQ University (Université du Québec). She was appointed Canada Research Chair on the socio-economic challenges of the Knowledge Economy in 2002 and director of a CURA (Community-University Research Alliance) on the management of social times and work-life balance in 2009 (www.teluq.ca/aruc-gats). She is a Fellow of the Royal Society of Canada and of the Centre of Excellence of the Université du Québec, in recognition of the quality of her research and publications. She works on work-life issues, work organization (telework, coworking), and working time arrangements. Diane-Gabrielle has published many books, including a Labour Economics textbook, a Sociology of Work textbook, three books on working time and work-life issues and she has published in various international journals.

Shelley Clark

Shelley Clark, James McGill Professor of Sociology, is a demographer whose research focuses on gender, health, family dynamics, and life course transitions. After receiving her PhD from Princeton University in 1999, Shelley served as program associate at the Population Council in New York (1999–2002) and as an Assistant Professor at the Harris School of Public Policy at the University of Chicago (2002–2006). In the summer of 2006, she joined the Department of Sociology at McGill, where in 2012 she became the founding Director of the Centre on Population Dynamics. Much of her research over two decades has examined how adolescents in sub-Saharan Africa make key transitions to adulthood amid an ongoing HIV/AIDS epidemic. Additional work has highlighted the social, economic, and health vulnerabilities of single mothers and their children in sub-Saharan Africa. Recently she has embarked on a new research agenda to assess rural and urban inequalities and family dynamics in the United States and Canada. Her findings highlight the diversity of family structures in rural areas and the implications of limited access to contraception on rural women’s fertility and reproductive health.

From Toddlers to Teens – Examining Mobile Work and Its Impact on Family Evolution: Amber’s Story (Families, Mobility, and Work)

Summary of a chapter on the impacts of work-related mobility on family relationships

November 8, 2022

The chapter “From Toddlers to Teens – Examining Mobile Work and Its Impact on Family Evolution: Amber’s Story” is based on a life narrative distilled from multiple conversational interviews with a woman living in rural PEI. Her story describes the evolution of her personal  and family life during 12 years of her husband’s out-of-province rotational work and as her children grew from “tots to teens.” The chapter talks about entry into rotational work, its prolongation and challenges, and the strategies the family developed to overcome those challenges.

This chapter is one of many rich contributions included in Families, Mobility, and Work, a compilation of articles and other knowledge products based on research from the On the Move Partnership. Published in September 2022 by Memorial University Press, this book is now available in print, as an eBook, and as a free-open access volume available in full on the Memorial University website.

“Amber’s narrative provides key insights into the experiences and reflections of women as they adjust and adapt to their diverse roles as parents and partners as these are repeatedly negotiated and dependent on whether a loved one is coming or going for mobile work. These insights relate to time, place, and relationship, and show that Eddie’s participation in mobile work shaped all aspects of Amber’s life as a parent and partner, as well as the evolution of their family lives.” – Christina Murray, PhD, Hannah Skelding, and Sylvia Barton, PhD

Access Families, Mobility, and Work

Chapter abstract

Central to this chapter is a narrative representation of six conversational interviews conducted over seven weeks with one individual, Amber, as part of author Christina Murray’s doctoral research in rural Prince Edward Island. That research consisted of similar interviews with four women whose husbands had been working in other provinces over a period of several years. The contribution opens with a brief description of the research objectives and methods that informed the larger research. This is followed by “Amber’s Story,” where one of the study participants reflects on the evolution of her marriage and family over the 12 years during which her husband, Eddie, had been travelling for work from rural PEI to northern Alberta. He originally left when their children were two and four and was only gone in the winter. Shortly after that, he began working away year-round. At the time of the conversations, the children were 14 and 17 and the son had just spent his first summer working in Alberta with his dad. The story provides an understanding of how labour migration came to permeate Amber’s personal and family life. It touches on pivotal research themes such as specific roles and responsibilities, family evolution and transitions, communication and belonging, and marriage and community relations. The contribution concludes with some recommendations arising from the doctoral research for better support for women and families who have loved ones travelling long distances for employment and information on programming implemented in direct response to these recommendations.

About the authors

Christina Murray, BA, RN, PhD, is an Associate Professor with the Faculty of Nursing at the University of Prince Edward Island. Her nursing practice has been grounded in public health and community development. Since 2015, Dr. Murray has been leading a program of interdisciplinary, collaborative narrative research focusing on labour migration and its impact on the health of individuals, families, and communities. She was the principal investigator on the Tale of Two Islands study and the Families, Work and Mobility community outreach project and is currently leading a project focused on grandparents raising their grandchildren on PEI. Dr.  Murray is also the recipient of the Vanier Institute’s 2018 Mirabelli-Glossop Award.

Hannah Skelding is passionate about exploring the relationships between social, economic, and environmental systems. Hannah attended McMaster University, where she graduated with a Combined Honours in Arts & Science and Environmental Science. She went on to complete her Master’s in Global Affairs through the University of Prince Edward Island and the Universidad Rey Juan Carlos. During her time at UPEI Hannah met Dr. Christina Murray and was exposed to the implications of interprovincial labour mobility. Hannah is currently at the University of Alberta in the Department of Resource Extraction and Environmental Sociology.

Sylvia Barton, PhD, is Professor and Chair of the School of Nursing at the University of Northern British Columbia in Prince George, British Columbia. Throughout her career, she has integrated professional practice, research, teaching, and leadership. Since coming to academia, the focus of this integration has been in three areas: researching health-specific stories and life narratives of human experience, particularly with Indigenous populations; developing innovative change in priority areas of health; and implementing inter-professional clinical teaching and learning models. As a result of her aspirations and goal-oriented stance, she has sought to exhibit excellence through partnership, relevancy, and inspiration.

 

COVID-19 IMPACTS: Youth Well-being in Canada

Edward Ng, PhD, and Nadine Badets

August 27, 2020

Download this article (PDF)

Spring and summer 2020 have been a unique time for children and youth in Canada, as families across the country have been adapting their routines, plans and activities in light of physical distancing and other public health measures in place to prevent the spread of COVID-19. With schools closing their doors and moving online in the spring, nearly 5 million children and youth across the country were no longer spending their days near their friends and peers as they and their families adapted and reacted to the evolving situation.1

While surveys have shown that most youth are adhering to public health measures and have demonstrated resilience, this disruption had been difficult for many. In a poll conducted by UNICEF Canada, the toughest aspects cited by youth have been not being able to leave the house, go to school and spend time with friends.2 This matters for the well-being of children and youth, since research shows that social interaction is fundamental in youth development, as positive influences by and among peers are important for students’ academic achievement and success later in life.3

Youth more concerned about family contracting COVID-19 than themselves

While youth have mostly been homebound and self-isolating themselves, some of their immediate family members have continued commuting to work, and therefore risking infection and transmission.

In the COVID-19 Social Impacts Youth Survey conducted in mid-May jointly by the Association for Canadian Studies, Experiences Canada and the Vanier Institute of the Family, nearly 4 in 10 (39%) youth aged 12 to 17 surveyed expressed concerns of contracting COVID-19 themselves,4 compared with more than half (56%) of adults who were surveyed in early May.5 This may be in part due to the current understanding regarding the perceived lower likelihood of experiencing complications and risk with COVID-19 among younger age groups. As well, the same sets of polling data showed that the fear of someone in one’s immediate family catching the virus is higher for both youth and adults (71% and 67%, respectively).

Most youth bored, but also happy, under public health measures and physical distancing

In the same youth survey, more than 80% of youth reported being bored but, interestingly, a similar proportion also reported being happy (89% among youth aged 12 to 14 and 84% among those aged 15 to 17).6 This may be in part due to shifting time use patterns due to school closures. Nearly 7 in 10 of surveyed youth reported they were relaxing more than before the pandemic, with the common activities including watching videos/movies/television or listening to podcasts (78%), spending time on social media (63%), listening to music (59%) and playing electronic games (51%). Youth who reported feeling bored or happy during the pandemic were more likely to report that they spend more time watching videos/movies/television during the pandemic than before it (79% and 81%, respectively).

Technology may be playing a larger role in many people’s lives, but it is not the only way youth are keeping busy. Nearly half (45%) of youth reported helping with chores around the house more than before, while slightly more than one-third of youth were doing arts or crafts (36%) or puzzles (35%) more so than before the pandemic.7

Meanwhile, even before the pandemic, parents had already been expressing concerns about youths’ preoccupation with technology.8, 9 During the lockdown, approximately 64% of the parents who responded to a Statistics Canada crowdsourcing survey were worried about their children’s amount of screen time use.10 According to UNICEF, however, the most robust studies suggest that moderate use of digital technology tends to be positive for children and youths’ mental well-being, while no use or too much use can have a small negative impact.11 Internet and digital technology, while providing a positive source of help and a sense of inclusion, can also open up possibilities of cyber-bullying, impact mental health and exacerbate sleeping problems.12

More than one-third of surveyed youth experienced a negative impact on their mental health

Prior to COVID-19, youth were known to experience higher rates of mental illness and poor mental health than older age groups in Canada. For example, the rate of depression among youth aged 15 to 24 was higher than any other age group.13 A recent study of Canadian Community Health Survey data show that among youth aged 12 to 17, there was a decline of 6% in reporting excellent or very good mental health from 2015 to 2019 (78% and 73%, respectively).14 Further compounding the issue of youth mental health is that, in 2018, suicide was the leading cause of death among male youth aged 15 to 19 and was the second leading cause of death among female youth in Canada.15

In mid-May, more than one-third (37%) of respondents in the youth survey reported that they have experienced negative impacts to their mental health.16 When compared with adults aged 18 and older surveyed in early May,17 youth aged 12 to 17 were more likely to report feeling sad (57% versus 45%, respectively) and irritable (65% and 39%) than adults, and were more likely to report having trouble sleeping (50% versus 35%).

Another survey of youth and young adults aged 14 to 27, conducted April 10 to 14, 2020 for the Centre for Addiction and Mental Health (CAMH), also found a decline in reported mental health early in the pandemic, both for those with pre-existing mental health issues and those without.18

One immediate effect of the mental health repercussions of the pandemic has been an increased demand for mental health and support services for youth. The Kids Help Phone, a 24/7 national support and crisis line for children and youth, saw a jump in the number of calls and texts for help in mid-March 2020, double that of the previous year, with close to 2,000 calls or texts per day.19 The number of crisis calls has also increased, resulting in more interventions by emergency services than usual, with the organization making 8 to 10 calls to emergency services per day since the pandemic started.

Youth spending more meaningful time with their family, but they miss their friends

The shift to working and schooling from home and the disruption of regular routines and schedules have provided families with more opportunities to connect. The youth survey data from mid-May showed that two-thirds (67%) of youth reported having more meaningful conversations with their families during the pandemic than before.20 By comparison, only 50% of surveyed adults in early May reported having meaningful conversations with their spouse or partner.

In terms of family relationships, close to one-quarter of parents reported spending more time with children under lockdown (24%).21 For both youth and adults, the vast majority reported that they are supporting each other well within the family during the lockdown (74% and 81%, respectively). However, around 43% of youth reported arguing more with their families, while only 19% of adults reported arguing with their spouse or partner.

On the other hand, youth are feeling a strong loss of connection to their friends. About 70% of youth reported that they have been homebound during the pandemic, with the exception of going out for necessities, with only 24% reporting that they visited friends and family during the week before the survey.22

According to Angus Reid, youth reported that missing their friends has been the worst part about being stuck at home (54%).23 More than half of youth indicated that the COVID-19 lockdown has had a negative impact on their relationships with friends (53%).24 Statistics Canada’s crowdsourcing survey also provided the parents’ perspective. Almost three-quarters of participating parents (71%) were concerned about their children’s lack of engagements to socialize with friends, and 54% of parents were concerned about their children’s social isolation.25

Distance learning during the COVID-19 pandemic: A painful lesson?

The virtual home school arrangement has been challenging for many families and teachers across Canada. This pandemic-induced online learning has been described as the biggest distance learning experiment in history.26 Amid the abrupt shutdown of schools, teachers had to adjust their teaching styles with little training or resources.

More than half (51%) of youth indicated that the pandemic has had a very negative effect on their school year and/or their academic success.27 Only 27% reported that they “totally agree,” and another 43% partially agreed, that they are doing a good job at getting schoolwork done from home.

About 41% of youth aged 12 to 17 reported missing going to school “a lot,” and another 31% said they “somewhat” missed school. Lack of access to peer/school/academic resources, motivation, time management and online settings make up just some of the challenges of distance learning.28 Though 75% of youth claimed to be keeping up with school while in isolation, many were also unmotivated (60%) and disliked the arrangement (57%) (i.e. online learning and virtual classrooms).29

Distance learning requires Internet access, and while the 2018 Canadian Internet Use Survey found that 94% of Canadians had home Internet access, there nonetheless exist inequities in the ability of school children to actively participate in online education. The reasons among those who did not have Internet access included affordability of the Internet service (28%), equipment (19%) and unavailability of Internet service (8%).30

In addition, while around 8 in 10 youth said they always have enough money to meet their basic needs, such as for food, clothing, health care and housing,31 meeting basic needs and having access to a comfortable study environment at home during the pandemic may be even more difficult for youth and families living with low-income or newly experiencing job and income loss. In addition, closures of schools may impact food security, as some school meal programs were designed to alleviate family food insecurity for those students in low-income situations.32

Long-term monitoring of COVID-19 impacts important for youth well-being

Without school, extra-curricular activities and other opportunities to see peers, youth are missing out on important and valued time for socializing with friends, classmates, teachers, coaches and more – all of which could be fundamental in their scholastic and character development. Although alleviated somewhat through social media, texting, calling and other communication technologies, the mental health of youth in Canada has been greatly impacted during COVID-19.

Previous studies on the impact of school interruptions, such as teachers’ strikes and school closures during the 1916 polio pandemic, have shown short- and long-term negative effects on academic development and knowledge acquisition.33, 34, 35 A recent study on the potential impact of the pandemic on youth education in Canada highlighted that the adverse effect might increase the socioeconomic skills gap by as much as 30%.36 As provincial authorities and school boards consider how to proceed to re-open schools in a safe way to control COVID-19 spread,37 innovation and adaptation in our education system will be important in avoiding or mitigating gaps in academic achievement, now and in the years to come.

Edward Ng, PhD, Vanier Institute on secondment from Statistics Canada

Nadine Badets, Vanier Institute on secondment from Statistics Canada

 


Notes

  1. Erin Duffin, “Enrollment in Public Elementary and Secondary Schools in Canada in 2017/18, by Province,” Statista (October 29, 2019). Link: https://bit.ly/311SjPn.
  2. UNICEF Canada, U-Report Canada: Impacts of the COVID-19 Pandemic on Young People in Canada – Poll 2: Examining the Issues (May 2020). Link: https://bit.ly/2FvZg41 (PDF).
  3. Shqiponja Telhaj, “Do Social Interactions in the Classroom Improve Academic Attainment?” IZA World of Labor (June 2018). Link: https://bit.ly/3hPqGzR.
  4. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth (May 21, 2020). Link: https://bit.ly/3jlmZn3 (PDF). The Association for Canadian Studies’ COVID-19 Social Impacts Network, in partnership with Experiences Canada and the Vanier Institute of the Family, conducted a nationwide COVID-19 web survey of the 12- to 17-year-old population in Canada April 29–May 5, 2020. A total of 1,191 responses were received, and the probabilistic margin of error was ±3%.
  5. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted May 1–3, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,526 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  6. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  7. Ibid.
  8. Monica Anderson and Jingjing Jiang, “Teens, Social Media & Technology 2018,” Pew Research Center (May 31, 2018). Link: https://pewrsr.ch/30aWglE (PDF).
  9. Wesley Sanders et al. “Parental Perceptions of Technology and Technology-Focused Parenting: Associations with Youth Screen Time,” Journal of Applied Developmental Psychology (May–June 2016). Link: https://bit.ly/30gsCeV.
  10. Statistics Canada, “Impacts of COVID-19 on Canadian Families and Children,” The Daily (July 9, 2020). Link: https://bit.ly/3gIzM0U.
  11. Daniel Kardefelt-Winther, How Does the Time Children Spend Using Digital Technology Impact Their Mental Well-Being, Social Relationships and Physical Activity? An Evidence-Focused Literature Review, UNICEF (December 2017). Link: https://bit.ly/33b3TKQ (PDF).
  12. OECD, “Children & Young People’s Mental Health in the Digital Age” (2018). Link: https://bit.ly/3jXBFcg (PDF).
  13. Leanne Findley, “Depression and Suicidal Ideation among Canadians Aged 15 to 24,” Statistics Canada, Catalogue no. 82-003-X, Health Reports, Vol. 28, no. 1, 3–11, (January 18, 2017). Link: https://bit.ly/3ffdt1A.
  14. Statistics Canada, “Understanding the Perceived Mental Health of Canadians Prior to the COVID-19 Pandemic,” Canadian Community Health Survey, 2019 (August 6, 2020). Link: https://bit.ly/33VJPwj.
  15. Statistics Canada, “Table 13-10-0394-01 Leading causes of death, total population, by age group” (Accessed August 13, 2020). Link: https://doi.org/10.25318/1310039401-eng.
  16. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  17. Association for Canadian Studies. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted May 1–3, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,526 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  18. Robert Cribb, “Youth Mental Health Deteriorating Under Pandemic Stresses, New CAMH Study Reveals,” The Star (May 28, 2020). Link: https://bit.ly/3ikLMaf.
  19. Jeff Semple, “Kids Help Phone Calls for Back Up Amid Record Demand – and Canadians Respond,” Global News (June 28, 2020). Link: https://bit.ly/3gbeDMr.
  20. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  21. Ibid.
  22. Ibid.
  23. Angus Reid Institute, Kids & COVID-19: Canadian Children Are Done with School from Home, Fear Falling Behind, and Miss Their Friends (May 11, 2020). Link: https://bit.ly/3kVRReK.
  24. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  25. Statistics Canada, “Impacts of COVID-19 on Canadian Families and Children,” The Daily (July 9, 2020). Link: https://bit.ly/3gIzM0U.
  26. Paul W. Bennett, “This Grand Distance-Learning Experiment’s Lessons Go Well Beyond What the Students Are Learning,” CBC News (May 11, 2020). Link: https://bit.ly/33bNEgo.
  27. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  28. UNICEF Canada, U-Report Canada: Impacts of the COVID-19 Pandemic on Young People in Canada (May 2020). Link: https://bit.ly/2CUd9Z9 (PDF).
  29. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  30. Statistics Canada, “Canadian Internet Use Survey,” The Daily (October 29, 2019). Link: https://bit.ly/3hWlwSN.
  31. Association for Canadian Studies, Social Impacts of COVID-19 on Canadian Youth.
  32. Canadian Medical Association Journal, “Indirect Adverse Effects of COVID-19 on Children and Youth’s Mental, Physical Health,” EurekAlert (June 25, 2020). Link: https://bit.ly/2BWMvOr.
  33. Michael Baker, “Industrial Actions in Schools: Strikes and Student Achievement,” Canadian Journal of Economics (March 2011). Link: https://bit.ly/3gaona6.
  34. Michèle Belot and Dinand Webbink, “Do Teacher Strikes Harm Educational Attainment of Students?” (2010) Labour Economics 24(4): 391–406. Link: https://bit.ly/3aYuJI3.
  35. Keith Meyers and Melissa A. Thomasson, “Paralyzed by Panic: Measuring the Effect of School Closures During the 1916 Polio Pandemic on Educational Attainment,” NBER Working Paper Series 23890 (September 2017). Link: https://bit.ly/3hSzswU (PDF).
  36. Catherine Haeck and Pierre Lefebvre, “Pandemic School Closures May Increase Inequality in Test Scores,” Research Group on Human Capital Working Paper Series (June 2020). Link: https://bit.ly/30elgbN (PDF).
  37. Carly Weeks, “Rising Rates of COVID-19 in Children, Adolescents Spark Concerns About Back to School Plans,” The Globe and Mail (June 23, 2020). Link: https://tgam.ca/3hTmFuk.

 

In Conversation: Katherine Arnup on Death, Dying and Dignity During COVID-19

Gaby Novoa

August 4, 2020

In May 2018, the Vanier Institute published Family Perspectives: Death and Dying in Canada1 by Katherine Arnup, PhD, which examined the evolution of death and dying across generations, the desires and realities of families surrounding death and dying, the role of families in end-of-life care and its impact on family well-being.

With the current conversation surrounding COVID-19 and post-pandemic context, we joined in conversation with Dr. Arnup to hear her reflections on some of the themes explored in the 2018 report, and on the impact of the pandemic on conversations surrounding death and dying in Canada.


Tell us about how you feel COVID-19 has impacted the conversation and attitudes on death and dying among families and policymakers in Canada.

Death is in many ways in the public eye more now than it was prior to COVID-19, and has been from the get-go, once the virus became a presence in the world, because a number of countries experienced a large number of deaths before it really hit here. People were very aware that something major was happening in terms of death.

In Canada, we’ve had daily deaths, casualties and case counts being reported, much like in wartime. There’s been war imagery accompanying this in many ways, but certainly in my lifetime, I’ve never seen anything like this – it’s almost unavoidable. If you visit the CBC website, the first thing you see is the current counts, which makes you very aware of how many people have died. You can’t really get away from it, with these constant reminders. There’s a sense that we’re “at war” with a virus. Especially at the beginning, there was a sense that it could be anywhere, people nearby could be carrying it, and you could get it and it could kill you. A lot of fear – fear of the virus and a fear of dying.

One of the themes in Family Perspectives: Death and Dying in Canada is that people’s fear of death and dying deters families from having important conversations about it. Do you think the pandemic has forced people to think about death in a more in-depth way, or have anxieties and fears caused more avoidance of the conversation on death and dying?

I think it’s the latter. In my report, I was talking about a kind of acceptance of death and planning for death. But since there are many unknowns around COVID, which has struck so many people throughout the world, it’s different from anything any of us have experienced.

I think one of the biggest ways that COVID-19 and death have been front and centre throughout the pandemic is around seniors and their families. It’s quite true that the virus poses a greater risk for seniors than for anyone else, although certainly other factors make people vulnerable as well. However, seniors, and particularly people in their 80s and 90s and people with comorbidities, are likely to have a bad result and perhaps die as a result of contracting the coronavirus.

That’s especially been the case in long-term care facilities. In Ontario, the long-term care facility in Bobcaygeon was one of the first ones that the public really became aware of, where they had many deaths in a short period of time. Overall in Canada, the most recent data on this showed that 81% of the deaths in Canada were in long-term care, compared with the average of 42% in developed countries in the OECD.2 The numbers are much higher in Canada, so dramatic that the military was called in for assistance in Ontario and Quebec, which also fits with the military and war metaphors. They reported incredibly appalling conditions in those long-term care homes.3

I think a lot about long-term care homes now in a way that I didn’t before. I believe that I was just like most Canadians in that I didn’t think about them, beyond saying “I hope I never end up there,” and I think that’s very typical of Canadians. Maybe true for people in other countries, but I can say it for Canadians and that fits in with some of the things I’ve written about in the 2018 report and elsewhere: we want to live forever, but we want to be healthy, strong and independent – those are huge values for us.

Living in long-term care is something we really don’t want to think about, so most of us haven’t looked at the conditions there – many of which existed before the pandemic. That is, often four people to a room, staff working at several homes, understaffing, staff being very busy rushing from patient to patient and then going to another home. A lot of those things were happening already, and they created the conditions for the pandemic to grab hold and decimate long-term care populations.

I think those who have family in long-term care homes have had a huge wake-up call. They probably knew something about the conditions, and some of them were active caregivers in those homes – that is, going and caring for their loved ones – while some people virtually never visited. My aunt was in a long-term care home in a small town not that far from Bobcaygeon. I visited her when she was dying, and was actually really impressed with that home. She had her own room and you could tell that the staff cared for their patients, for their residents. I don’t think everything negative that we’ve seen is the case for all long term-care by any means. But we mostly just haven’t thought about it.

Pat Armstrong, a major scholar of health care in Canada, has been involved in a 10-year study of long-term care homes.4 She and her team remind people that though we don’t want to think about them, any of us could end up in long-term care almost in the blink of an eye: a major accident or a stroke, a fall that means we can’t care for ourselves, a diagnosis of dementia. Any of those things could mean that I end up in a long-term care home. I don’t want to, like most people, but we always think it’s going to be somebody else and not us. I think that the crisis has made us aware that it can be anyone – our mothers, our fathers, our sisters, ourselves. With change – and only one changed circumstance has to happen – we could be there as well. It’s a reminder that we all need to be fighting to change those institutions and how people die.

I was looking at the list of desires and assumptions discussed in the report, two of which stood out as I read the military report: we want to die at home and we want to die with dignity. It’s very clear that there was no dignity in the way that people were dying in long-term care homes. Indeed, there was no dignity in how they were being cared for, because of the conditions there. It’s also clear that people are there in those facilities because families can’t take care of them. It’s not that families don’t care. It’s that their own lives and the demands of their lives, and the lack of home care, means that they can’t care long-term for a family member who’s got dementia and maybe is acting out, or a family member who really needs 24/7 care.

Many Canadians also assume that they can get all the home care they and their families need. The pandemic has meant that many people had to cancel the home care that was coming in, especially at the beginning, because they were afraid to get COVID from their home care provider. Home care providers, by their very nature, are usually working in several homes. So, they’re potentially carrying the virus to many homes. It’s meant that not only is there not enough home care generally, but in the case of COVID, people were also hesitant to have those carers coming into their homes.

Like the pre-existing challenges in many long-term care homes, we’ve seen certain vulnerabilities and inequities amplified within the pandemic. Do you find any hope in how the conditions of long-term care are now being brought to greater public awareness?  

With long-term care homes, I feel a need to speak out about it, and to press governments to make changes that could have a huge impact, such as federal standards, or for senior care to be included in the Canada Health Act so that it becomes a shared responsibility across governments.

I think families have really mobilized and have seen the shortcomings and some of the reasons why the conditions are so bad. This is partly due to the for-profit homes, which have higher deaths, but also a lack of inspections and of enforcement of what exists in the law. In bringing it to the public attention as it has, in being such a tragedy, I think that there is hope for improvement, and I hope that many more people are now aware that it could be them, that it could be their families.

People who have children with severe disabilities who are living in congregate care are also facing similar issues of not being able to have family with them, as they still aren’t able to go into those homes. I do see a lot more discussion now around families as caregivers, having them recognized as caregivers and not just as visitors, as they’re being talked about. It’s an issue that the Vanier Institute has raised, I’ve done work with the Change Foundation, and there are other organizations that have made progress on that. So, I feel positive and see hope there for a recognition of the role of caregivers and their importance in the health and well-being of those who are cared for.

There has been increased opportunity to talk about advanced care directives. Even if people aren’t necessarily having those conversations, I think that if they’re faced with a family member getting COVID, it will spur the realization that we don’t always know what our family member wants. Even though the conversation around death hasn’t come on to the table in the best way, I think it provides openings for those of us who have been promoting the importance of advanced care. It provides an avenue for discussion, to be able to say to people that this is a realistic concern. We just never know when something will happen, and something will happen. We need to know what each other wants. Our children need to know what we want – I think the pandemic opens the door to that.

I’m writing and have been making videos, and I will be encouraging people in one of my next ones to talk to their family members (if they haven’t already) about what they want and about making advanced care directives, because it’s really important. Family members having to say “I just don’t know what Mom would want” is a mistake that doesn’t have to happen.

I feel optimistic about these things, and optimism in the face of a pandemic is in short supply. I’m optimistic around that sense that we’re all in this together, which we began this pandemic with. Our Prime Minister stressed this idea every day in his talks, and other people did as well. I think there has been significant pulling together around a sense of community and caring for one another. I’ve experienced this in my own neighbourhood – people who never normally talked to one another are checking in. When you go for a walk, people ask how you are doing and it’s genuine. I think that’s a strangely positive thing that is a result of the pandemic. I hope that it lasts, that people are doing things for elderly neighbours and that they’re more aware of who might be in need of help on their street. Anything that increases a sense of community I think is a great thing.

You touch on this point in your video “Expanding Our ‘Bubbles,’”5 on feeling reassured in many ways by this sentiment that we’re all in this together, though you also note that it has become increasingly apparent that we’re not all in the same boat. We might all be in it together, but the way we’re experiencing it varies greatly, whether it’s higher risk among seniors and other groups.6 Could you elaborate?

When you look at the breakdown of the areas that are still COVID hotspots, it’s where there are people living in poverty, people of colour, people who are working high-risk jobs in health care and in the service sector, and people living in large numbers together because they might not be able to afford anything else. Significant outbreaks among migrant workers employed in agricultural work and workers in food processing plants also demonstrate the impact of inequalities in our society on people’s vulnerability in the pandemic.

Another important way in which people haven’t been in it all together has been in families’ inability to have funerals, wakes, services or celebrations of life during the pandemic. I think this is having a huge impact on those who aren’t able to mark the death of a loved one with friends and family. There have been many families who couldn’t have a service of any kind, who couldn’t hug, who couldn’t get together beyond small groups. I just wonder what happens to that grief.

Many of those people who died, died alone. People in long-term care facilities and in hospitals have died alone. None of us wants that to happen. None of us wants it to happen to the people we love, and we don’t want to have it happen to us. It is an important tenet of hospice palliative care: let no one die alone. That this has been happening on a huge scale for the families left behind, it means enormous grief and guilt, feeling that “I couldn’t be there for Mom” or “I couldn’t be there with Mom when she was dying.” That’s heartbreaking. I don’t know what people do with that; you kind of have to push it down. I think about how all the obituaries say, “When it’s possible, we’ll have a service.” It’s hard for me to imagine all those services and where they’ll happen and whether that will provide the closure and support that people need. I certainly haven’t seen anything like that in my lifetime.

What gives you hope going forward? 

I think about these questions: What do we want when we die? But also, what do we want as we grow older? What do we need to support us in that? How are we dealing, in general, with aging and dementia? What do we hope for? How can we create places that are very different from long-term care homes? How can we make that happen?

Katherine Arnup, PhD, is a writer, speaker and life coach specializing in transitions, and a retired Carleton University professor. Author of Family Perspectives: Death and Dying in Canada (and several books, including “I Don’t Have Time for This!”: A Compassionate Guide to Caring for Your Parents and Yourself and Education for Motherhood, she has pioneered studies on family experiences and provided unique insights into family life throughout her career.

Gaby Novoa is responsible for Communications at the Vanier Institute of the Family.

This interview has been edited for length, flow and clarity. 


Notes

  1. Katherine Arnup, PhD, Family Perspectives: Death and Dying in Canada, The Vanier Institute of the Family (May 2018).
  2. Canadian Institute for Health Information, “Pandemic Experience in the Long-Term Care Sector: How Does Canada Compare with Other Countries?” CIHI (June 25, 2020). Link: https://bit.ly/3hGl4bc.
  3. Canadian Armed Forces, “Op LASER – JTFC Observations in Long Term Care Facilities in Ontario,” CAF (May 20, 2020). Link: https://bit.ly/2CJPnit.
  4. Pat Armstrong is a Distinguished Research Professor in Sociology at York University and a Fellow of the Royal Society of Canada. Link: https://bit.ly/3g3XSDn.
  5. Katherine Arnup, “Expanding Our ‘Bubbles,’” (YouTube). Link: https://bit.ly/2X15sqE.
  6. In Family Perspectives: Death and Dying in Canada, Arnup writes that experiences of death and dying are affected by factors of gender, race, class, ethnicity, geography, marginalized status, ability, sexual and gender identity, marital status and Indigenous, First Nation, Inuit and Métis status.

In Conversation: Lucy Gallo on Access, Adaptation and Resilience Among LGBTQI2S Youth

Gaby Novoa

June 29, 2020

Download the article (PDF)

The financial, physical and mental well-being of LGBTQI2S communities in Canada has been disproportionately impacted by the COVID-19 pandemic. A national survey found that 42% of the LGBTQI2S community reported significant impacts on their mental health amid the crisis, compared with 30% of non-LGBTQI2S people.

On June 23, 2020, we connected with Lucy Gallo, Youth Services and Housing Director of Friends of Ruby, to learn about how LGBTQI2S youth in Toronto have been navigating the past few months, and how their organization has adapted to continue to serve and support these youth.


Tell us about how Friends of Ruby has adapted and reacted throughout the COVID-19 pandemic to continue serving and supporting LGBTQI2S youth. 

We closed our drop-in on a Friday and, on the Monday, our counsellors were on the phone connecting with our youth – they jumped right into service and care. Counsellors quickly moved online and have been offering – and are still quite busy doing – phone sessions and video sessions, and we are excited to have just launched a chat counselling program. All staff have now been fully trained to also provide counselling through chat.

We realized there were youth who still live with their families, some of whom they’re not out to, and so they did not have private space to access counselling over the phone. This chat option is now giving them the opportunity to be able to access support, with maybe their parents thinking they’re just texting a friend. This was a feature that we have always wanted to do but never went there because we didn’t have the resources. So, COVID made the push and provided the opportunity to say “we have to react to this right now.” I quickly got the staff trained in two half-days, and they can continue to receive assistance by someone experienced in chat counselling.

As our drop-in program wasn’t available to the youth we serve, one of the themes that we heard in conversations with them at the beginning of the pandemic was the difficulty of accessing food. We responded by providing gift cards, and we were also able to send meals in partnership with an organization, which allowed us to deliver two meals a week to some of our youth.

In adapting to the pandemic, we’ve also tried to provide virtual groups daily to allow youth to continue to have as much access to us as possible. It gave us a chance for people to come together online, connect and share what was going on in their lives. Our Black, Indigenous, People of Colour (BIPOC) discussion group has been a very important one to be running, especially given the amount of racism and what is happening right now in the world. It’s been a difficult time for Black youth. When Toronto started announcing that they were going to card people if they were outdoors when the pandemic first started, and that people could tell on others, a lot of BIPOC youth did not want to come out to the centre; they did not want to experience more racism. We’ve also added some extra check-in times, specifically with our Black staff to support our Black youth.

Some of the other programs we’ve been continuing to run include our art therapy group, virtual drop-ins, gaming and art for change. Also, with the support of the Centre for Mindfulness Studies, two of our counsellors successfully ran a group called Mindfulness-Based Skills for Coping with Stress and Anxiety.

We have begun moving to doing some in-person supports and opportunities for interaction as well. We’ve opened the drop-in again, operating under our own version of “phase two.” We’re providing essentials so people can come in to pick up things like takeaway meals, harm reduction kits, menstrual kits and more. They can now access case management in person – we’ve created a room with enough distance – and plexiglass – and we’ve set up the space in such a way that we could have at least up to six people right now. We’ve also realized that if a youth can’t access their counsellor from home or they don’t want to chat online, they can come to our space and have the privacy to connect with their counsellor virtually.

A lot of the services we’ve been developing or strengthening in the past few months will now also be available post-pandemic. The goal is to offer this new form of modality to all of our youth and also for youth anywhere in Canada who want to access our counselling and/or connect online.

Tell us about any common themes that you’ve observed during the pandemic among the LGBTQI2S youth you serve.

I think a big one is a sense of loneliness. With not being able to access our space, there was a lot of anxiety in the beginning around what does this all mean. How does this affect everyone? Not being able to have our regular sense of community has been difficult, especially when not all youth feel they have the privacy, space or safety at home with their families.

Tell us about some of the lessons you’ve learned while adapting Friends of Ruby to continue serving youth. Have there been any surprises or “aha” moments?

One thing that was interesting, and I’ll just use this as one example of many, is that if someone is experiencing suicidal ideation and you have them in the space, you can do an assessment and hopefully you can de-escalate, as you have them there safe with you. But what I realized was when you’re online and you don’t know where somebody is, how do you provide a sense of safety?

We had to quickly create documents and ask the youth to read them over first and agree to provide information on where they are – such as their address and how to contact them if the line gets disconnected. This protocol also applies in many cases. Even when running our virtual therapeutic groups, how do we know if it was just that someone’s line broke out and that they’re not upset – that they didn’t purposefully drop the call because of something in the group that upset them. So, these are just some of the “aha” moments. When you have someone in person, it’s such a different way of working. These were some of the things that we had to adopt and make available for everyone’s safety.

Tell us about any unique experiences and/or stories of adaptation or resilience from the youth you serve.

There’s been incredible resilience among our youth throughout all this. The folks that we’ve had trouble accessing have been our most transient youth, because they didn’t have contact information for us to reach them when we closed. Because they usually come to see us just by dropping in, being closed made that hard, although a couple of them did come in to say hi and to tell us they’re doing quite well. Obviously, we haven’t been able to see everyone, but the folks we have seen have been demonstrating lots of resilience and coping.

The counsellors have spoken about how a lot of the youth weren’t so sure about doing online counselling. However, one person, for example, has still been working during the pandemic and said they actually liked this option because they can commit to counselling without having to travel to and from the organization. It makes accessing counselling easier for some.

What do you hope to see or do you anticipate in the months ahead?

Right now, we’re planning on opening the drop-in a little bit more, as the city opens more things. The goal is that we will let more people into the space and hopefully foster a greater sense of community again. Each counsellor has a couple of people who are waiting to be seen in person. We’re looking at planning for those counsellors to come in, just to see the specific people who can’t or don’t want to do online counselling. For the BIPOC discussion group, we’re looking at running it virtually, but also in person.

People could come into the space during that time to be part of the group, while others are also connected virtually, so we can meet the needs of people both offline and online. As mentioned earlier, we’re looking to start running another round of Mindfulness-Based Skills for Coping with Stress and Anxiety, hopefully around mid-July. In the next few weeks, staff will continue to talk about the ways that we can expand, and we will continue on with takeaway meals and case management, in person and virtually.

Connect with Friends of Ruby on social media (Twitter, Facebook, Instagram, LinkedIn) to stay up to date as they continue to offer more services and programs. 

Gaby Novoa, Families in Canada Knowledge Hub, Vanier Institute of the Family

This interview has been edited for length, flow and clarity. 

 

Getting Out, Getting Active and Family Well‑Being

Gaby Novoa and Nathan Battams

June 22, 2020

Summer 2020 will be a unique one for families, as communities across Canada cautiously continue to relax public health measures and restrictions and families manage major transitions at home, at work and in their communities.

Many parents are working from home for the first time, which can present some challenges but also opportunities to spend more time with their children and to foster healthy physical activity behaviours, which, after months of being in physical isolation, will likely be a welcome pursuit for many.

Families are shifting summer plans to manage uncertainties

People typically make family decisions based on choice and circumstance, and the coronavirus pandemic and public health measures have had an impact on both. Responding to a variety of factors related to the pandemic – including financial insecurity, a need or desire to remain close to manage work and family, some continued mobility restrictions and uncertainty whether restrictions will return – it’s not surprising that nearly 6 in 10 (59%) parents surveyed in late April reported that they have changed their vacation plans due to the pandemic, and 72% say that it’s unlikely that they will take a holiday this year.

Children and youth will also be adapting their plans and activities, as many summer camps and organized sports or activities will either be postponed or not taking place. While some organizations are set or pending announcements to open, the impact of the pandemic on family finances may deter some parents from registration in order to carefully manage expenses. Others may avoid sending their kids anywhere due to health concerns or anxiety, particularly if their children live with any immunodeficiency.

With more families spending time at home this summer and plans being changed and adapted, there are growing opportunities for many families to get outdoors and be active together.

Family support critical to children’s levels of physical activity

The newly released Family Influence: The 2020 ParticipACTION Report Card on Physical Activity for Children and Youth reports that less than 1 in 5 children and youth in Canada meet national guidelines for physical activity, sedentary and sleep behaviours.1 The report underlines the role of families in promoting healthy habits in its guiding Consensus Statement, which was developed through a national multidisciplinary expert panel:

Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in these pursuits.2

As the report states, youth’s physical activity levels, is greatly influenced by family social support – particularly during early childhood. This support is shown to be most effective when taking self-regulatory approaches and when grounded in specific actions, such as setting goals together. Studies assert that parents who make clearly defined plans – how, when, where – to encourage their child’s healthy movement behaviours are more likely to follow through. As role models, parents can have a significant impact: every additional 20 minutes of physical activity by a parent can mean an additional 5 minutes in their child’s daily physical activity.3

Outdoor play and location linked to well-being

A growing body of research demonstrates the link between well-being and access to parks and green spaces. In 2017, the majority of households in Canada (87%) reported having a park within 10 minutes of their home. Of these households, almost all (85%) reported that they had visited the park within the previous 12 months. Among households that reported that they did not have nearby access (13%), 39% nevertheless reported visiting a park or green space in the previous 12 months.4

Research has shown that a neighbourhood’s built environment can have an impact on the time children spend outdoors, with lower traffic volumes, access to a yard and neighbourhood greenness all associated with more time spent by children playing outdoors in one study.5

Research from Statistics Canada has found a strong association between time spent outdoors and levels of physical activity among children, as well as a positive impact on psychosocial health and lower likelihood of experiencing peer relationship problems.6 More than one-third (36%) of surveyed parents with children aged 5–17 said that they play active games with their kids.7 Since the start of the pandemic, nearly two-thirds (62%) of youth in Canada cited exercising outdoors.8

Outdoor play can foster “freedom, fun, creativity, and skill- and confidence-building.”9 Whether it’s walking through a park, playing a game in the front yard or going for a jog, getting outdoors and practising healthy behaviours with family can play an important role in supporting physical activity and wellness at any time, but are particularly important as families continue to navigate the COVID‑19 pandemic and new and/or adapted ways of coming together.

Gaby Novoa is responsible for Communications at the Vanier Institute of the Family.

Nathan Battams is Communications Manager at the Vanier Institute of the Family.


Notes

  1. ParticipACTION, Family Influence: The 2020 ParticipACTION Report Card on Physical Activity for Children and Youth (June 17, 2020). Link: https://bit.ly/2Zser6r.
  2. Ibid.
  3. Ibid.
  4. Gordon Dewis, “Access and Use of Parks and Green Spaces: The Potential Impact of COVID‑19 on Canadian Households,” COVID‑19: A Data Perspective (June 9, 2020). Link: https://bit.ly/2CfuT0f.
  5. Amalie Lambert et al., “What Is the Relationship Between the Neighbourhood Built Environment and Time Spent in Outdoor Play? A Systematic Review,” International Journal of Environmental Research and Public Health (October 11, 2019). Link: https://bit.ly/2N8nan1.
  6. Richard Larouche et al., “Outdoor Time, Physical Activity, Sedentary Time, and Health Indicators at Ages 7 to 14: 2012/2013 Canadian Health Measures Survey,” Health Reports, Statistics Canada catalogue no. 82-003-X (September 21, 2016). Link: https://bit.ly/2N8VvlU.
  7. ParticipACTION, The Brain + Body Equation: Canadian Kids Need Active Bodies to Build Their Best Brains. The 2018 ParticipACTION Report Card on Physical Activity for Children and Youth (2018). Link: https://bit.ly/2Y7qjJR.
  8. Rubab Arim, Leanne Findlay and Dafna Kohen, “The Health and Behavioural Impacts of COVID‑19 on Youth: Results from the Canadian Perspectives Survey Series 1,” COVID‑19: A Data Perspective (May 15, 2020). Link: https://bit.ly/3e9rmyG.
  9. Lambert et al.

Family Finances and Mental Health During the COVID‑19 Pandemic

Ana Fostik, PhD, and Jennifer Kaddatz

May 26, 2020

Download this article (PDF)

In March 2020, the coronavirus pandemic suddenly brought social and economic activities to a halt across Canada, with data showing serious impacts on labour market activity. Recent estimates from Statistics Canada show that 1 million fewer Canadians were employed in March than in February, and the usual labour market activity of 3.1 million Canadians was affected (i.e. worked fewer hours or lost their job).1

According to survey data for April 10–12, 2020 from the Vanier Institute of the Family, the Association for Canadian Studies (ACS) and Leger,2 38% of men and 34% of women aged 18 and older said that they lost their job temporarily or permanently, or experienced pay or income losses, due to the COVID-19 pandemic. Consequently, 27% of men and 25% of women reported a negative financial impact (i.e. ability to pay mortgage or rent and/or their bills).

Not surprisingly, Statistics Canada recently found that adults who suffered a major or moderate impact of the pandemic were much more likely to report fair or poor mental health than those who were less impacted (25% and 13%, respectively).3

Data collected in mid-April by the Vanier Institute of the Family, the Association for Canadian Studies and Leger show that younger adults have been particularly affected: more than half (52%) of those aged 18–34 reported a negative impact on their labour market activity (job or pay/income losses), compared with 39% of those aged 35–54 and 21% of those aged 55 and older. This is reflected in the shares of adults experiencing immediate negative financial outcomes, which were reported by 33% of adults under 55 and 15% of those over 55.

Adults in financial difficulty are more likely to report mental health issues

Among the core working age population (aged 18–54), just over half reported feeling anxious or nervous (53%), irritable (49%) or sad (48%) often or very often during the COVID-19 pandemic, according to the Vanier Institute/ACS/Leger survey. Four in 10 reported difficulty sleeping (40%) and having mood swings (40%) often or very often.

Among those who experienced immediate negative outcomes, such as not being able to pay rent or mortgage and/or their bills, about 6 in 10 reported anxiety or nervousness (63%), irritability (60%) or sadness (57%) often or very often, whereas half said they have had difficulty sleeping (50%) or experience mood swings (52%) often or very often (fig. 1).

Women in financial difficulty suffer from mental health issues in higher shares than men

According to the 2018 Canadian Community Health Survey, women were slightly less likely than men to report excellent/good mental health (66% and 71%, respectively).4 During the coronavirus pandemic, however, Statistics Canada found a much larger difference, at 49% of women and 60% of men.5

Vanier Institute/ACS/Leger survey data show women aged 18–54 reporting specific mental health issues often or very often in much larger shares than men of the same age. About 6 in 10 women reported experiencing anxiety or nervousness, irritability or sadness often or very often, compared with 4 in 10 men. Similarly, about half women experienced difficulty sleeping or mood swings often or very often, compared with 3 in 10 men (fig. 1).

This difference by gender in reporting mental health issues is maintained even when examining the proportions of men and women who suffered immediate negative financial outcomes and those who did not. For instance, three-quarters of women (76%), compared with half of men (51%), who had difficulty paying mortgage or rent and/or their bills reported feeling nervous or anxious often or very often. Almost 7 in 10 women in financial difficulty experience irritability (67%) or sadness (67%), compared with about half of men in the same situation (53% and 48%, respectively) (fig. 1).

About 6 in 10 of women in financial difficulty (55% and 62%) suffered difficulty sleeping and had mood swings often or very often, compared with 4 in 10 men in the same situation (45% and 42%, respectively) (fig. 1).

Adults with financial difficulties report similar mental health issues, whether living with young children or not

If women are significantly less likely than men to report positive mental health during the pandemic, even when financial outcomes are controlled for, what factors might be at play in creating these gender differences? Could these mental health challenges be related to family responsibilities?

An analysis of the April 10–12, 2020 data indicates that heightened symptoms of poor mental health do not appear to be linked to the presence of children in the home. Women who live with children aged 12 and younger in the household report experiencing anxiety (69%), irritability (60%), sadness (59%), difficulty sleeping (51%) and mood swings (51%) often and very often in similar proportions as women who do not live with children (63%, 57%, 60%, 47% and 48%, respectively). Men who live with young children also report these problems in similar proportions as those who do not (fig. 2).

Among women in financial difficulty, there is little difference in the share reporting any of these mental health problems whether they have young children living in the household or not. This is also true among women who did not experience immediate negative financial outcomes: living with children aged 12 and under in the household does not appear to make a difference (fig. 2).

Analysis of self-reported mental health status shows that some of the differences by gender persist when controlling for province of residence, age, financial difficulty, job/pay loss, presence of children aged 12 and under, household income, marital status and educational attainment. Controlling by these variables and compared with men who are in financial difficulty, women in financial difficulty are about twice as likely to suffer from anxiety, sadness or mood swings. Among adults who have not suffered financial negative outcomes, there are no significant differences between men and women in mental health outcomes once controlling for these factors.

While this analysis could not pinpoint potential reasons why women are more likely than men to report poor mental health symptoms, future research may seek to focus on psychological differences between women and men in crisis situations in order to determine whether or not women and men react differently in crisis situations or when there is an immediate threat to personal or family health and well-being. More research on the impact of gendered aspects of household work and caregiving, including the mental burden associated with these types of unpaid work, might also shed light on these differences.

Ana Fostik, PhD, Vanier Institute on secondment from Statistics Canada

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada

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Notes

  1. Statistics Canada, “The Impact of COVID-19 on the Canadian Labour Market,” Infographics (April 9, 2020). Link: https://bit.ly/3geJKro.
  2. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted March 10–13, March 27–29, April 3–5, April 10–12, April 17–19 and April 24–26, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. All samples, except for the March 10–13 and April 24–26 samples, also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  3. Statistics Canada, “Canadian Perspectives Survey Series 1: Impacts of COVID-19 on Job Security and Personal Finances, 2020,” The Daily (April 20, 2020). Link: https://bit.ly/2Y9y42h.
  4. Leanne Findlay and Rubab Arim, “Canadians Report Lower Self-Perceived Mental Health During the COVID-19 Pandemic,” STATCAN COVID-19: Data to Insights for a Better Canada, Statistics Canada catalogue no. 45280001 (April 24, 2020). Link: https://bit.ly/2xMorvZ.
  5. Ibid.

 

Parents’ Thoughts on Post-Pandemic Future in Canada

Nadine Badets

May 6, 2020

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The COVID-19 pandemic restrictions have transformed family life in Canada. With the closure of schools, daycares, restaurants and many businesses, as well as major job losses and new work-from-home measures, many parents and children are spending a lot more time together.

So how do families feel about life after the pandemic? Six weeks of data from the Vanier Institute of the Family, the Association for Canadian Studies and Leger show that families with children are not ready to send them back to school this year, but parents are ready to go back to their workplaces after the pandemic, among other findings from this ongoing series of surveys.1

Fear of coronavirus greater among families caring for children

As of May 6, 2020, children and youth 19 years and younger represent a small portion of COVID-19 cases in Canada (5%).2 Nevertheless, almost 30% of adults living with children and youth under 18 are very afraid that someone in their immediate family will contract COVID-19, compared with 22% of people not living with children3 (fig. 1).

Even so, more than half of adults living with children (56%) said they would support a government policy that relaxes social (physical) distancing restrictions for everyone under 65, whereas 42% of people living without children said they would support this policy.

Most parents don’t want children to attend summer school to catch up

Over 80% of parents are living with their children during the pandemic, and 7% are sharing custody of their children with a parent in a separate household. Six in 10 parents (60%) reported they are now talking to their children more often than before the lockdown. Parents of school-aged children are also navigating the education system with their children as newly instated teachers, tutors and homework helpers. Home schooling is challenging for many families,4 raising concerns about students falling behind.

Most provinces have not yet announced plans to reopen schools, whereas all three territories have confirmed they will keep schools closed until September. However, Quebec has pledged to reopen most elementary schools on May 11 and, as of April 29, 2020, Ontario and Nova Scotia have tentative opening dates closer to June, but their deadlines keep shifting.5 When surveyed, two-thirds (66%) of parents indicate that even if schools in Canada open before the end of June, they would prefer for their children to return to school in September, rather than attend school over the summer (July and/or August) to catch up for missed time.

More than half of parents are ready to return to work but don’t want to use public transit

The COVID-19 pandemic has created enormous job losses across the country,6 and parents living with children who view the COVID-19 outbreak as a “major threat” to their jobs were more likely to report feeling sad and anxious or nervous, compared with people living without children.7

Of those still employed, people living with children were more likely to report satisfaction with the measures their employer put in place to fight COVID-19 (59%) than people without children (37%). This could be because they can work from home and care for their children given that daycares and schools are closed. About 55% of adults living with children reported they are now working from home (fig. 2). People living with children were also more likely to say they would be comfortable returning to their workplace once the COVID-19 restrictions are lifted (54%) than people without children (37%).

However, more than 60% of parents said they would not be comfortable riding public transit, even when COVID-19 restrictions start being relaxed, which could have implications for commuting once people return to their workplace (fig. 3). Adults living with children were more likely to say they would prefer to commute to work only when needed (39%) than people without children (27%).

 

Parents abandoning vacation plans, most won’t travel in 2020

In addition to expressing discomfort with commuting in public transit, parents are also not comfortable with travel. About 6 in 10 (59%) adults living with children reported that they had to change vacation plans due to the 2020 coronavirus pandemic, which was likely affected by Canada’s lockdown and borders closing around March break. When asked if they now plan to take a vacation during 2020, 72% of parents said it was unlikely.

Nadine Badets, Vanier Institute on secondment from Statistics Canada

 


Notes

  1. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted March 10–13, March 27–29, April 3–5, April 10–12, April 17–19 and April 24–26, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. All samples except for the March 10–13 and April 24–26 samples also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  2. Public Health Agency of Canada, Coronavirus Disease 2019 (COVID-19): Epidemiology Update (accessed May 6, 2020). Link: https://bit.ly/2yXbD68.
  3. See note 1.
  4. Jessica Wong, “Frustrated Parents in Ontario Pivot from Official Distance-Learning Program Amid COVID-19,” CBC News (April 30, 2020). Link: https://bit.ly/3aTOMFR.
  5. CBC Kids News, When Will Your School Reopen? Check Out This Map (April 29, 2020). Link: https://bit.ly/2KMhcGW.
  6. Statistics Canada, “Labour Force Survey, March 2020,” The Daily (April 9, 2020). Link: https://bit.ly/2YABzPR.
  7. Jennifer Kaddatz, “Families Struggle to Cope with Financial Impacts of the COVID-19 Pandemic,” Vanier Institute of the Family (April 9, 2020).

 

Who Is Your COVID‑19 Crisis “Extended and Chosen Family”?

Jennifer Kaddatz

May 1, 2020

My family moved to Ottawa from British Columbia for my job, nearly eight years ago now. It still feels like yesterday. Moving was a big, scary life change. There was considerable upset in the wake of the extraction of our three young boys as we left the kids’ grandparents and their aunt on the West Coast. The rest of our relatively small extended family is spread between three countries, with the majority residing in the South Pacific, so there were no grandchildren left in BC to be hugged.

My husband and I were pretty much left to fend for ourselves in Ontario after we relocated, but we have now settled, after eight wonderful years. During this time, we have developed strong relationships with our new neighbours and, while it’s no substitute for family, our relationships with our neighbours are a precious alternative.

Always know where to go in a zombie apocalypse

Within a year of moving to Ottawa, my family and I made some of the most amazing new friends – adults and kids we met through our involvement with Scouts Canada. These friends – our “chosen family” – are the ones my family now celebrates with every holiday or special event, including Christmas, New Year’s, Easter, St. Patrick’s Day, Victoria Day, Canada Day, Labour Day, Thanksgiving and birthdays in between.

These are the friends with whom we play, boil maple syrup, have new adventures (axe throwing and/or karaoke, anyone?) and vacation during the summer. We know each other’s biological extended families and our kids have grown together (like siblings or cousins), watching the youngest morph out of his baby fat and diapers and watching the eldest get his driver’s licence and embark upon a committed relationship with a girlfriend.

These three families are the friends that we always joked we would team up with in a zombie apocalypse. Turns out it was a COVID‑19 apocalypse, but at least we were ready! Need toilet paper or flour? Someone will bring it. Need a smile? Someone will make you laugh. Mid-pandemic, the boys are in contact with one another virtually 24/7 online, chatting through homework and gaming sessions alike.


  • 90% of adults in Canada agree that they currently have people to count on in case of an emergency.1
  • 44% of Canadians say that one of the main precautions they have taken as a result of the COVID‑19 situation is to make a plan for communicating with family, friends and neighbours.2

Get close to your neighbours, but no closer than 2 metres

But that’s not my only local community. I think I’ve pretty much got the most awesome neighbours on the planet. My ruralish neighbourhood has fairly quickly changed from a place where most of the “kids” were in their early 20s to a place where every second house and yard is now home to the noise and energy of approximately three children and youth, most of whom are under 12. We have skating in winter, an annual Easter egg hunt, campfires, bike rides, an informal “tick and wild animal” alert system, a vegetable-seed sharing club and a diverse group of incredibly hard-working, compassionate, giving and, let’s not forget, pretty darn tired mothers and fathers.

When I was undergoing cancer treatment earlier this year, it was these neighbours who took care of me, making sure my family had everything we needed, including some of the most delicious homemade meals ever shared. This morning, my breakfast was bread, freshly baked in gratitude by one of my neighbours who works in health care, because I’ve been sewing personal protective equipment for her during the pandemic.


  • Nearly three-quarters (74%) of the population feels very attached (35%) or somewhat attached (39%) to their neighbourhood.3
  • Four in five (80%) people in Canada say that their neighbours are strictly (29%) or somewhat strictly (51%) following the guidance of public health authorities to social distance from others.4

Stay in touch with family and friends using technology

Thanks to technology, my community doesn’t end at the Ontario border. I grew up in a farming and fishing village, where the high school mascot was a horse and blackberries were a dominant feature on the main road. This kind of childhood can make for long-lasting ties and my best friends from childhood are still with me now. During the COVID‑19 pandemic, we chat via text messaging and social media apps throughout the day every day, even though they are living way out west under the cherry blossoms, while I’m still feeling kind of shivery out here in eastern Canada.

These beautiful women make me laugh, give me hope and get me exercising. They are the ones I share with when I need a shoulder to lean on. We are all experiencing different aspects and effects of the pandemic – and in quite different ways – but we support one another through everything and anything.


  • 41% of people in Canada have been on social media more often since the start of the COVID‑19 pandemic.5
  • 88% of adults in Canada are very attached or attached to their friends, a share just lower than the 93% of adults who are very attached or somewhat attached to their family.6

But it’s not just for the fun and games

For me, staying in touch with my long-time besties, my Ottawa axe-throwing friends and my amazing-but-tired neighbours isn’t just about having a good time. This inner circle of people form my “extended extended family” and my relationships with them are critical for my positive mental health. During a time of crisis, like the COVID‑19 pandemic, they are my lifeline.


  • Half (50%) of Canadians report a worsening of their mental health during the COVID‑19 period, with 1 in 10 (10% overall) saying it has worsened a lot.7
  • Asked to describe how they have been primarily feeling in recent weeks, Canadians are most likely to say they are worried (44%), anxious (41%) and bored (30%), although fully one-third (34%) also say they are grateful.8

Where else can you go for support?

The Canadian government has acknowledged that COVID‑19 results in varying degrees of stress for many people who do not have ready access to the friend, community and neighbourhood networks for which I am grateful.

As a result, they have developed Wellness Together Canada, which provides an entire suite of tools offering different levels of support depending on need.9 It even offers an opportunity to chat with peer support workers and other professionals.

Visit Wellness Together Canada to connect with others during difficult times.

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada


Notes

  1. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted March 10–13, March 27–29, April 3–5, April 10–12 and April 17–19, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. All samples except for the March 10­–13 sample also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  2. Statistics Canada, “How Are Canadians Coping with the COVID‑19 Situation?” Infographics (April 8, 2020). Link: https://bit.ly/2wVzkuL.
  3. April 17–19 survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger (see note 1).
  4. Nanos conducted an RDD dual frame (land- and cell-lines) hybrid telephone and online random survey of 1,013 Canadians, 18 years of age or older, March 14–17, 2020. The margin of error for this survey is ±3.1 percentage points, 19 times out of 20.
  5. April 10–12 survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger (see note 1).
  6. April 17–19 survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger (see note 1).
  7. Angus Reid Institute. Worry, Gratitude & Boredom: As COVID‑19 Affects Mental, Financial Health, Who Fares Better; Who Is Worse? (April 27, 2020). Link: https://bit.ly/3eWWzGd.
  8. Ibid.
  9. Health Canada. Government of Canada Connects Canadians with Mental Wellness Supports During COVID‑19 (April 15, 2020). Link: https://bit.ly/3bWq4FS.

Families in Canada Express “Major Concern” for Senior Health and Well-being During COVID-19

Nadine Badets and Ana Fostik, PhD

April 30, 2020

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The Public Health Agency of Canada identifies older adults as being particularly vulnerable to COVID-19 and at high risk for severe illness and death.1 In 2019, 9.1 million people in Canada were aged 60 and older, representing about one-quarter of the total population.2

As of April 27, 2020, about 37% of confirmed COVID-19 cases in Canada were diagnosed in adults aged 60 and older, and this age group accounted for more than half (56%) of all coronavirus cases with pneumonia. Adults aged 60 and older had the highest proportions of severe outcomes with 66% of reported COVID-19 hospitalizations, 63% of Intensive Care Unit (ICU) admissions and 95% of deaths.3

The higher susceptibility of older adults to the virus has created heightened levels of stress for seniors and their families and caregivers as they navigate the COVID-19 pandemic.

Key facts and statistics

  • Approximately 37% of confirmed COVID-19 cases in Canada were diagnosed in adults aged 60 and over (April 27, 2020).
  • Adults aged 60 and over have accounted for 66% of reported COVID-19 hospitalizations, 63% of Intensive Care Unit (ICU) admissions and 95% of deaths (April 27, 2020).
  • 70% of adults aged 18 and older indicated that they are somewhat/very afraid that a member of their immediate family will contract COVID-19 (April 27, 2020).
  • 15% indicated that some senior relatives are currently living in nursing homes or long-term care facilities, 85% of whom expressed concern about the health of these family members (April 27, 2020).
  • Nearly 8 in 10 (79%) of coronavirus deaths in Canada occurred in nursing and long-term care homes (April 28, 2020).

Families with senior relatives in nursing homes are most concerned

In a survey conducted on April 17–19, 2020 by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, close to 70% of adults aged 18 and older indicated that they are somewhat or very afraid that a member of their immediate family will contract COVID-19.4 For context, in 2018 Statistics Canada found that about 7.8 million adults aged 15 and older provided care to a family member or friend,5 and almost 4 in 10 care recipients in Canada 2018 were aged 65 and older.6

During the COVID-19 pandemic, 11% of adults reported that at least one senior relative was living with them.7 Close to 47% indicated that the seniors in their family live in their own separate homes, and 15% indicated that some senior relatives are currently living in nursing homes or long-term care facilities.

Most adults (85%) whose senior family members live in care facilities expressed concern about the health of these family members, while a slightly lower share of adults who live with seniors (77%), or whose senior family members live in separate homes (72%), expressed concerned for their health.

Seniors in long-term care facilities are struggling to cope with pandemic restrictions

A large part of the devastation caused by the coronavirus pandemic has been occurring in nursing homes and long-term care facilities. Dr. Theresa Tam, Canada’s Chief Public Health Officer, announced in mid-April 2020 that about half of COVID-19 deaths in Canada have been linked to outbreaks in long-term care homes for seniors,8 and, as of April 28, 2020, nearly 8 in 10 (79%) of coronavirus deaths in Canada occurred in nursing and long-term care homes.9

Almost 61% of relatives reported that they are somewhat or very worried about the quality of care seniors are receiving in nursing homes and long-term care facilities. Furthermore, close to two-thirds (63%) of adults whose senior relatives live in long-term care homes think these family members are having a somewhat or very difficult time coping with COVID-19 restrictions, such as staying in their rooms and no contact/visits from others. About 12% aren’t sure how their relatives are coping with the restrictions.

Nadine Badets, Vanier Institute on secondment from Statistics Canada

Ana Fostik, PhD, Vanier Institute on secondment from Statistics Canada

 


Notes

  1. Public Health Agency of Canada, People Who Are at High Risk for Severe Illness from COVID-19 (April 20, 2020). Link: https://bit.ly/2SjxfAz.
  2. Statistics Canada. Population Estimates on July 1, by Age and Sex (Table 17-10-0005-01). Link: https://bit.ly/2VA2TeX.
  3. Public Health Agency of Canada, Coronavirus Disease 2019 (COVID-19): Epidemiology Update (April 29, 2020). Link: https://bit.ly/3cPclRD.
  4. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted March 10–13, March 27–29, April 3–5, April 10–12 and April 17–19, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. All samples except for the March 10–13 sample also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  5. Statistics Canada, “Caregivers in Canada, 2018,” The Daily (January 8, 2020). Link: https://bit.ly/2NKyQgc.
  6. Statistics Canada, “Care Counts: Care Receivers in Canada, 2018,” Infographics, Statistics Canada catalogue no. 11-627-M (January 22, 2020). Link: https://bit.ly/2TNql8c.
  7. April 17–19 survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger (see note 4).
  8. Olivia Bowden, “Long-Term Care Homes with the Most Coronavirus Deaths in Canada,” Global News (April 17, 2020). Link: https://bit.ly/2Y2Lihn.
  9. Beatrice Britneff and Amanda Connolly, “Coronavirus Spread Slowing in Canada; Death Rate Rises Due to Long-Term Care Fatalities,” Global News (April 28, 2020). Link: https://bit.ly/2xlWjQ4.

 

Health Habits During the COVID-19 Pandemic

Jennifer Kaddatz and Nadine Badets

April 27, 2020

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Canada’s lockdown for the COVID-19 pandemic has placed heavy restrictions on individuals and businesses, which have altered many commonplace activities, from preparing and consuming foods to shopping, exercising and spending time outdoors. The health of adults in Canada is changing, and not just because of the virus, but also because of pre-existing and newly emerging health habits.

Throughout this period of social isolation, adults are spending more time preparing meals and drinking alcohol at home, but spending less time exercising and going outside, according to four weeks of recent survey data from the Vanier Institute of the Family, the Association for Canadian Studies and Leger1 and other pandemic data sources.

These patterns will be important to watch throughout the duration of the pandemic, given the potential impacts on both physical and mental health among families across the country.

About 4 in 10 adults spend more time preparing meals at home

Healthy eating is fundamental to good health, is a key element in healthy human development and is important in reducing the risk of many chronic diseases. Preparing and cooking food at home can reduce the amount of sodium, sugar and saturated fat in meals while at the same time increasing the intake of vegetables, fruit, whole grains and plant-based proteins. On the other hand, eating out or ordering in can negatively impact a person’s health because of the potential for the meals to be more highly processed, with lower quantities of vegetables, fruits and whole grain foods.2

Not surprisingly, during COVID-19 isolation more people in Canada are eating home-cooked meals. In fact, 41% of adults say that they are spending more time preparing meals now than they were before the pandemic, according to April 9–12 data (fig. 1). Women, in particular, seem to be spending more time in the kitchen, with 44% saying they are preparing meals “more often” as compared with 38% of men. In fact, nearly half (48%) of women aged 35–54 are spending more time preparing meals, as are 44% of men in that age group.

In contrast, a lower share of women (18%) than men (24%) picked up take-out food from a restaurant in the week before the April 9–12 survey, although women are about equally as likely (18% vs. 16%) to get food delivered to their home or business (figs. 2 and 3). Young men, aged 18–34, are most likely to pick up take-out food (24%) in the past week, whereas young women aged 18–34 are the gender/age group most likely to order in (27%).

One in 5 adults are drinking more alcohol at home

Alcohol can have significant consequences for physical and mental health if consumed in large quantities, by exacerbating pre-existing mental health issues, increasing the short-term risk of injury or acute illness, and increasing the long-term risk of serious diseases like liver disease and some cancers.3 Accordingly, if alcohol consumption goes up during the coronavirus crisis, there could be significant post-pandemic impacts on individual and family health and on the health care system in Canada.

A survey by Statistics Canada carried out March 29–April 3 found that 20% of Canadians aged 15–49 are drinking more at home during the COVID-19 pandemic than they were before it started.4 Similarly, a March 30–April 2 poll by Nanos/Canadian Centre on Substance Use and Addiction found that 21% of adults aged 18–34 and 25% of those aged 35–54 have started drinking more at home since the start of the COVID-19 crisis.5

Respondents to the Nanos poll who report staying home more and consuming more alcohol say that their drinking has increased most often because of the lack of a regular schedule (51%), boredom (49%), stress (44%) and/or loneliness (19%).

According to data collected April 9–12 by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, 14% of adults had gone to a liquor store in the previous week, with more men (18%) having done so than women (11%).

Nearly 4 in 10 are exercising less often

Although being confined to home may have increased the amount that adults are drinking, it does not seem to have increased the amount that they are exercising.

On the contrary, nearly 4 in 10 women (38%) and 33% of men say as of April 9–12 that they are exercising “less often” now than they were before pandemic. People living in Quebec (42%) most commonly report a decrease in their frequency of exercise as compared with those in the other provinces.

Notably, it appears that younger families may be spending more time exercising. A greater share of adults who live with children (23%) report they are exercising more often since the pandemic began compared with those who were not living with children (18%) (fig. 4). Additionally, nearly 3 in 10 adults aged 18–34 (28%) say that they were exercising more often since the start of the crisis compared with 14% of adults 55 years and older.

Increased COVID-19 anxiety and decreased exercise may be linked

According to the Canadian Psychological Association, regular physical activity can reduce day-to-day stress, can prevent depression and anxiety disorders, and may be as effective as psychological and pharmaceutical treatments for depression and anxiety.6 At the same time, however, mental health challenges, such as anxiety and depression, can also make it difficult to adopt or continue with an exercise program, particularly during unusual times.

In fact, April 9–12 data reveal that people who “very often” report anxiety or nervousness during the COVID-19 crisis are more likely to say they are exercising “less often” (20%) now than they were before the pandemic, whereas 13% say they are exercising “equally as often” as before the COVID-19 crisis started.

In comparison, adults who say that they have felt anxious or nervous “not often at all” since the beginning of the pandemic are more likely to say that the frequency with which they exercise has not changed since the start of the pandemic (24%) than to say that they are exercising more often (17%) or less often (17%) now.

Almost half of adults are going outside less often

Spending time outdoors in nature has a significant impact on mental health and wellness.7 Furthermore, in 2016, Statistics Canada’s General Social Survey found that 7 in 10 Canadians participated in one or more outdoor activities, showing that spending time outdoors is an important part of Canadian lifestyles.8

Nevertheless, during the COVID-19 pandemic, almost half of women (46%) and men (45%) say that they are going outside less often now than they were before the crisis. The shares of those saying they are going outside less often vary by province, from a low of 39% in Quebec and Manitoba/Saskatchewan to a high of 49% in Ontario.

What is of particular interest, however, is the variation in the share of people going outside less often by urban or rural area of residence. More than half (54%) of urban dwellers indicate that they are going outside less often now than before the pandemic, compared with 45% of suburban adults and 29% of people living in rural areas.

At the other end of the spectrum, when it came to those who say they are going outside more often, a higher proportion of women (25%) than men (15%) report a positive change.

It will be interesting to see, as spring changes to summer, whether the shares of people in Canada who are going outside, and who are exercising more often, increase with the warmer temperatures.

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada

Nadine Badets, Vanier Institute on secondment from Statistics Canada

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Notes

  1. The survey, conducted March 10–13, March 27–29, April 3–5 and April 9–12, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. The March 27–29, April 3–5 and April 9–12 samples also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  2. Health Canada, Canada’s Food Guide. Link: https://bit.ly/2VsffFO.
  3. Peter Butt, Doug Beirness, Louis Gliksman, Catherine Paradis and Tim Stockwell, Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low Risk Drinking. Ottawa, ON: Canadian Centre on Substance Abuse (November 25, 2011). Link: https://bit.ly/3avfCne (PDF).
  4. Statistics Canada, “How Are Canadians Coping with the COVID-19 Situation?” Infographics (April 8, 2020). Link: https://bit.ly/2wVzkuL.
  5. Nanos conducted an RDD dual frame (land- and cell-lines) hybrid telephone and online random survey of 1,036 Canadians, 18 years of age or older, between March 30 to April 2, 2020 as part of an omnibus survey. Participants were randomly recruited by telephone using live agents and administered a survey online. The margin of error for this survey is ±3.1 percentage points, 19 times out of 20. The research was commissioned by the Canadian Centre on Substance Use and Addiction and was conducted by Nanos Research. Link: https://bit.ly/3aybEue (PDF).
  6. Canadian Psychological Association, “Psychology Works” Fact Sheet: Physical Activity, Mental Health, and Motivation (November 2016). Link: https://bit.ly/2yvVXXb (PDF).
  7. Canadian Parks Council, Connecting Canadians with Nature: An Investment in the Well-Being of Our Citizens (2014). Link: https://bit.ly/2SIeu9q.
  8. Statistics Canada, Canadians and the Outdoors (March 26, 2018). Link: https://bit.ly/34VPdy1.

Do Adults in Couples Have Better Mental Health During the COVID‑19 Pandemic?

Ana Fostik, PhD, and Jennifer Kaddatz

April 22, 2020

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Nearly half of adults aged 18 years or older in Canada report feeling anxious/nervous (47%) or sad (45%) “very often” or “often” since the beginning of the COVID-19 crisis, according to survey data from the Vanier Institute of the Family, the Association for Canadian Studies and Leger, which was collected from April 9 to 12, 20201 (fig. 1).

Four in 10 report feeling irritable (39%) and about one-third report experiencing sleep-related problems (35%) and mood swings (32%) “very often” or “often” since the start of the crisis (fig. 1).

But are adults currently in a couple – whether common-law or married – as likely as those who are single or separated, divorced or widowed to experience feelings of unsettledness?

Anxiety/nervousness and difficulty sleeping during the pandemic don’t appear to be linked to marital status

Feeling anxious or nervous very often/often is equally likely to be reported by adults who are part of a couple (48%) as by those who are single (47%) or separated, divorced or widowed (43%) (fig. 1).

Similarly, very often/often having difficulty sleeping is equally likely among those in a couple (35%) as among single adults (36%) or those who are separated, divorced or widowed (35%).

Whether single or in a couple, anxiety and sleeping problems are reported more by women than by men

Previous studies of mental health have found that women are more likely to experience anxiety disorders and depression compared with men.2 This appears to be the case in a pandemic environment as well.

Women are far more likely than men to report very often or often experiencing anxiety during the coronavirus pandemic: almost 6 in 10 women who were in a couple (58%) or were single (59%)3 report feeling anxious or nervous very often/often, compared with fewer than 4 in 10 men who were either in a couple (37%) or single (37%) (fig. 2).

As for challenges during the night, more than 4 in 10 women report difficulty sleeping very often/often since the beginning of the pandemic, whether or not they are in a couple (44%) or single (44%). This compares with fewer than 3 in 10 men, whether in a couple (26%) or single (29%).

Single people are more likely to experience irritability and mood swings

Irritability and mood swings are more common among individuals who are currently single (fig. 1). Almost half of single adults (48%) report feeling very often/often irritable since the start of the pandemic, compared with 37% of those in a couple and 30% of those who are separated, divorced or widowed. Single adults (39%) also report mood swings in higher shares than those in a couple (31%) and those who are separated, divorced or widowed (27%).

Again, women, regardless of their marital status, are more likely than men to experience irritability or mood swings. About 6 in 10 single women (59%) and 42% of those in a couple report feeling irritable very often/often since the start of the pandemic. Men report being irritable very often/often in lower proportions than women, whether single (38%) or in a couple (32%) (fig. 2.).

Single women (46%) are the most likely to report mood swings very often or often since the start of the COVID-19 crisis, followed by women in a couple (38%). Men are less likely than women to report frequent mood swings, but those who are single (31%) tend to report mood swings very often/often in higher shares compared with men in a couple (23%).

Separated, divorced or widowed women most likely to feel sad

Feeling sad very often/often during the coronavirus crisis is more commonly reported among separated, divorced or widowed (51%) and single (48%) adults, compared with those in couples (43%) (fig. 1).

Frequently feeling sad is also more common among women, whether single (59%) or in a couple (53%) than among men, whether single (37%) or in a couple (33%) (fig. 2).

Mental health impacts the well-being of families

Mental health trends, by marital status and gender but also by other factors, will be important to monitor in the short, medium and long term of the COVID-19 pandemic. An initial analysis has shown that income or job loss and immediate financial strain also affect mental health symptoms, such as anxiety and difficulty sleeping during the pandemic. Furthermore, mental and physical health are linked – people with a mood disorder are at much higher risk of developing a long-term medical condition than are those without.4

Problems with mental health can have a serious impact on an individual’s education, work, social life and interactions with their family.5 Among Canadians who had at least one family member with a mental health problem in 2012, over one-third (35%) thought that their lives had been affected by their family member’s mental health and approximately 71% of those who perceived that their lives were affected by a family member’s mental health problem reported they had provided care to their family member.6

As such, the well-being of families in Canada is dependent upon on the mental health of the individuals who make up those families. Evidence-based decision making will better drive targeted social supports both for individuals and for families as the coronavirus progresses, as well as after the present crisis is over.

Ana Fostik, PhD, Vanier Institute on secondment from Statistics Canada

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada

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Notes

  1. A survey by the Vanier Institute of the Family, the Association for Canadian Studies and Leger, conducted March 10–13, March 27–29, April 3–5 and April 9–12, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. The March 27–­29, April 3–5 and April 9–12 samples also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.
  2. Caryn Pearson, Teresa Janz and Jennifer Ali, “Mental and Substance Use Disorders in Canada,” Health at a Glance, Statistics Canada catalogue no. 82-624-X (September 2013). Link: https://bit.ly/3btTtHk.
  3. Comparisons by sex are not possible for separated, divorced or widowed adults in this case due to low response counts.
  4. Patten et al. (2005). “Long-Term Medical Conditions and Major Depression: Strength of Association for Specific Conditions in the General Population,” Canadian Journal of Psychiatry 50:195–202 (2005). As cited on Centre for Addiction and Mental Health (CAMH), Mental Illness and Addiction: Facts and Statistics. Link: https://bit.ly/3eEjyWc.
  5. Mental Health Commission of Canada. Changing Directions, Changing Lives: The Mental Health Strategy for Canada (Calgary, Alberta, 2012). Link: https://bit.ly/2xEs4UI (PDF).
  6. Caryn Pearson, “The Impact of Mental Health Problems on Family Members,” Health at a Glance, Statistics Canada catalogue no. 82‑624‑X (October 7, 2015). Link: https://bit.ly/3bsRnaR.

 

Canadians Turning to Their Screens to Keep Busy During COVID-19 Isolation

Jennifer Kaddatz, Ana Fostik, PhD, and Nathan Battams

April 17, 2020

In some ways, Canadians are making the best of their time in social isolation, according to four weeks of March and April 2020 survey data1 from the Vanier Institute of the Family, the Association for Canadian Studies and Leger.

As of the April long weekend (April 9–12, 2020), half of the country’s population aged 18 or older say they are relaxing “more often” now than they were before the pandemic.

Six in 10 adults are watching movies, television and videos or listening to podcasts more often than before the COVID-19 crisis started. Four in 10 are on social media more frequently.

More than 2 in 10 adults in Canada have increased the amount of time they spend listening to music, reading and playing games during the pandemic.

Half of adults are relaxing more, but some families report decreases in down time

Good news in these challenging times: people in Canada report that they are relaxing more.

Nearly half (49%) of Canada’s population aged 18 and older say that they are relaxing more often now than they were before the pandemic started, according to survey data from April 9 to 12, 2020 (fig. 1). Another 38% say that they are relaxing equally as often, while 13% say they are relaxing less often.


A slightly higher share of men (50%) than women (47%) report relaxing “more often” since the start of the crisis, with most of the difference attributable to younger adults aged 18­–34: 64% of young adult males say they are relaxing more often since the start of the pandemic, compared with 56% of young adult females (fig. 2).

Perhaps not surprisingly, adults with young children at home (43%) are less likely than with no children or youth at home (48%) to say that they are relaxing more during the COVID-19 pandemic (fig. 3).

Almost 1 in 4 (24%) of adults who were living in the same home as at least one child under the age of 13 actually reported relaxing less often than before the crisis began.

Three in 10 are listening to music and reading for pleasure more often

About 3 in 10 adults in Canada are listening to music more often now (28%) than before the start of the COVID-19 crisis (fig. 1). This is similar to the share of those saying that they are reading for pleasure more frequently (27%).

According to an analysis of trends over time during COVID-19, there is a significant upwards tendency toward reading, with 23% of the population having said they were reading more often as of March 27–29 compared with 27%, who reported reading more often as of April 9–12.

Women are about as likely as men to spend more time listening to music (27% and 29%, respectively), but a larger share of women than men (29% and 24%) report reading more often since the start of the crisis.

Electronic- or screen-based pastimes are popular and show biggest increases in uptake

Survey data from April 9–12 show that many adults in Canada are turning to their screens to keep busy, as public health measures are keeping them at home.

Of all the activities for which adults were surveyed, “watching movies, television, videos or listening to podcasts” and “being on social media” had highest shares of adults, at 59% and 41% respectively, who say they do these activities “more often” since the start of the COVID-19 crisis (fig. 1).

The share of people saying they had increased the amount of time spent watching movies, television, videos or listening to podcasts was more than double the share of people saying they were reading for pleasure (27%) or listening to music (28%) more often now than in the past.

Furthermore, there appears to be an increasing tendency toward screens as the pandemic continues:  53% of adults in Canada had said they were watching movies, television, videos or listening to podcasts more often in week 2 of the survey (March 27–29) compared with 59% in week 4 (April 9–12).

The playing of electronic games also appears to be on the rise: 24% of all adults, or 26% of men and 22% of women, say that they are playing electronic games more now than they did before the pandemic started, according to the April 9–12 survey (figs. 4 and 5). These findings were similar to those published by Statistics Canada for the period of March 29–April 3, based on data collected in a web-based panel, which reported that 22% of all Canadians were now spending more time playing video games.2

Younger adults, especially men, have significantly increased the time they spend playing electronic video games since the start of the pandemic. More than half of men (54%) and one-third of women (36%) aged 18–34 report that they play electronic video games more often now than they did before (figs. 4 and 5).

As well, adults who had at least one child under the age of 13 living in their household (28%) were slightly more likely than those who had only teenagers at home (26%) and those who did not live with children at home (22%) to report playing video games more often since the COVID-19 crisis began.

Women increase time playing board games and doing puzzles, men increase time playing electronic games

Despite the apparent popularity of screen time in general among adults in Canada, the share of those who report having increased their electronic gaming time since the start of the pandemic (24%) is only slightly higher than the share who have increased the amount of time they spend playing board games or doing puzzles (21%) (fig. 1). The share of adults who say that they now undertake these activities “less often,” at 22% and 22%, respectively, is also very similar. However, differences exist by gender and the presence of children and youth in the household.

Similar shares of women say that they play electronic games more often now than they did before the pandemic (22%) say they play non-electronic video games or do puzzles (23%). In comparison, for men there was an 8 percentage point difference in the uptake of the two pastimes, with 26% of men reporting they were electronic gaming more often now and 18% of men saying they were playing board games or doing puzzles more often now than they were before the pandemic.

Furthermore, a slightly larger share of younger women than men have increased the time they spend on non-electronic games or puzzles: about one-third of women (33%) and about one-quarter of men (27%) aged 18–34 report spending more time on this type of activity.

Relatively few older people in Canada report playing board games or doing puzzles more now than before the coronavirus pandemic: about 1 in 10 (9%) men aged 55 or older and 1 in 7 women (15%) of women aged 55 or older.

A significant proportion of women (54%) and men (55%) reported that they play video games “equally as often” as before the COVID-19 pandemic (figs. 4 and 5), though it is important to note that, in some instances, this could just reflect that they didn’t play video games to begin with.

Families with children more often play board games and do arts and crafts

Adults who had at least one child under the age of 13 living in their household (28%) or teenagers at home (22%) are considerably more likely than those who did not live with children (14%) to say that they have been playing non-electronic games and doing puzzles more often now than before the coronavirus pandemic started (fig. 6).

Furthermore, when young kids were in the house, adults are almost twice as likely as those with no children or youth at home to have increased their time spent making arts, crafts or music since the start of the COVID-19 crisis. As of April 9–12, 3 in 10 (31%) adults who lived in a home with at least one child under the age of 13 say that they have been making arts, crafts or music more often since the start of the pandemic, compared with 27% of those with only teenagers at home and 17% of those with no children under 18 at home (fig. 7).

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada

 Ana Fostik, PhD, Vanier Institute on secondment from Statistics Canada

Nathan Battams is the Communications Manager at the Vanier Institute of the Family.


Notes

1. The survey, conducted March 10–13, March 27–29, April 3–5 and April 9–12, 2020, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. The March 27–29, April 3–5 and April 9–12 samples also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20. Figures may not add up to 100% as a result of rounding.

2. Statistics Canada, “How Are Canadians Coping with the COVID-19 Situation?” Infographics, Statistics Canada catalogue no. 11-627-X (April 8, 2020). Link: https://bit.ly/2z6fm1g.

 

Couples Find Support in One Another During the COVID-19 Pandemic

Ana Fostik, PhD, Jennifer Kaddatz and Nora Spinks

April 21, 2020

A family is a system of relationships with actions and reactions that occur over time. Family well-being hinges on the capacity of all members of a family to love, care and support one another in times of hardship as well as in times of ease. Like any and all systems, the strengths and tensions in those family relationships are magnified, amplified and intensified when put under stress.

While the COVID-19 pandemic marks one of the most potentially challenging times in Canada’s history, couples in this country seem to be faring relatively well to date. Data collected over four weeks during the pandemic[i] reveal that most people in committed relationships have strengths in those relationships and that they are leaning on each other and are having positive actions/reactions as they manage social distancing together.

Most couples in Canada are supporting each other, having meaningful conversations and arguing about the same amount as before home isolation.

Eight in 10 adults in couples say they have been supporting one another well

According to data collected April 9–12, 2020, 8 in 10 people aged 18 or older (80%) who are married or living common-law agree that they and their spouse are supporting one another more since the start of the COVID-19 pandemic. These shares are about the same for those with children or youth at home (77%) as for those without children under 18 years of age in the household (82%).

Adults have been supporting one another more than before regardless of how the pandemic has affected their labour market situation: 82% of those whose job situation deteriorated (lost their job temporarily or permanently, or lost income or salary) and 81% of those whose job situation was not affected report more support from their partners.

Middle-aged people were less likely than older people to agree that they and their partner are supportive of one another, with 75% of 35- to 54-year-olds agreeing with the statement, compared with 84% of those aged 55 and older.

Interestingly, men agree in larger numbers than women (84% and 77%, respectively) that they have a supportive relationship with their partner.

More than 4 in 10 adults are having more meaningful conversations with their significant other

Clear communication is a key component of family well-being. More than 4 in 10 (43%) of adults in committed relationships in Canada report that they have been having more meaningful conversations since the start of the COVID-19 pandemic, according to April 9–12 data. This is especially true among those whose labour market situation deteriorated since the start of the pandemic: 51% of them report having more meaningful conversations with their partners, compared with 36% of those whose job and/or income was not impacted by the pandemic. Just 10% of adults disagree that they are having more meaningful talks with their spouse.

Men are slightly more likely than women to agree that they have been having more meaningful conversations with their spouse or partner since the start of the COVID-19 pandemic, at 45% versus 40%. Younger people, too, report this in higher numbers (52% of 18- to 34-year-olds) than older adults (40% of 35- to 54-year-olds and 41% of those 55 and older).

People who were married or common-law and had children or youth in the house were about as likely as those without kids to agree that they are having more meaningful conversations with their partner since the start of the crisis, at 44% and 42%, respectively.

Four in 10 adults feel closer to their spouse

Perhaps because they are supporting one another well and having meaningful conversations, nearly 4 in 10 adults in committed relationships (41%) agree that they feel closer to their spouse or partner since the start of the COVID-19 pandemic. This share is even higher among Canadians who lost their job or who lost income or salary due to the pandemic: 48% of them report increased closeness in their relationship, compared with 34% among those whose job was not impacted by the pandemic.

The share of those feeling closer to their spouse is about the same for men (44%) as for women (38%) and is also relatively stable by age group and by whether or not children were living in the home. As of April 9–12, 43% of people in married or common-law relationships with kids under 18 years of age in the house agree they feel closer to their spouse since the start of the pandemic.

By region, the percentage agreeing that they now feel closer to their spouse is highest in Ontario and B.C., at 48% and 43%, respectively, and lowest in the Prairies, at 30%.

Ontario is the only province currently showing an increase in the share of adults feeling closer to their spouse now as compared with earlier in the pandemic, the proportion having risen from 39% in the March 10–13 survey to 48% in the April 9–12 survey.

Fewer than 2 in 10 adults in committed relationships have been arguing more

Only 18% of those who are married or living common-law reported that they have been arguing more with their spouse or partner since the start of the pandemic. In fact, approximately 54% disagree that they are arguing more and 28% neither agree nor disagree with that statement.

However, young adults in committed relationships – either with someone their own age or someone older – were more likely to report that they are arguing more with their partner than were those in older age groups. Nearly 3 in 10 (28%) of 18- to 34-year-olds say that they have been arguing more with their spouse or partner since the start of the COVID-19 pandemic, compared with 19% of those aged 35- to 54-year-olds and only 12% of those aged 55 and older.

Canadians who experienced job or income loss due to the pandemic tend to argue more than before in greater proportions than those whose job remained unchanged: 26% and 16% report increased arguing.

Arguing with a partner is often linked to stress and other well-being indicators and, according to the data from April 9–12, about 6 in 10 younger women, aged 18–34, report “very often” or “often” feeling anxious or nervous (64%), irritable (64%) or sad (59%) and 45% report difficulty sleeping. These shares were significantly higher than for their male counterparts and were also higher than for women over the age of 55, among whom about 5 in 10 are “very often” or “often” experiencing anxiety or nervousness (46%) or sadness (50%), fewer than 3 in 10 (28%) are feeling irritable and 36% are having difficulty sleeping.

Ana Fostik, PhD, Vanier Institute on secondment from Statistics Canada

Jennifer Kaddatz, Vanier Institute on secondment from Statistics Canada

Nora Spinks is CEO of the Vanier Institute of the Family.


Note

  1. The survey, conducted March 10–13, March 27–29, April 3–5 and April 9–12, included approximately 1,500 individuals aged 18 and older, interviewed using computer-assisted web-interviewing technology in a web-based survey. The March 27–29, April 3–5 and April 9–12 samples also included booster samples of approximately 500 immigrants. Using data from the 2016 Census, results were weighted according to gender, age, mother tongue, region, education level and presence of children in the household in order to ensure a representative sample of the population. No margin of error can be associated with a non-probability sample (web panel in this case). However, for comparative purposes, a probability sample of 1,512 respondents would have a margin of error of ±2.52%, 19 times out of 20.

A Snapshot of Family Caregiving and Work in Canada

At some point in our lives, there is a high likelihood that each of us will provide care to someone we know – and receive care ourselves. Family members are typically the first to step up to provide, manage and sometimes pay for this care.

Families are highly adaptable and most of the time people find ways to manage their multiple work and family responsibilities, obligations and commitments. However, juggling work and care can sometimes involve a great deal of time, energy and financial resources, and employers can play an important role in facilitating this care through accommodation, innovation and flexibility.

In A Snapshot of Family Caregiving and Work in Canada, we explore some of the family realities and trends that shape the “landscape of care” across the country. This resource highlights how our family, care and work responsibilities intersect, interact and have an impact on each other.

Highlights include:

  • 28% of Canadians (8.1M) report having provided care to a family member or friend with a long-term health condition, disability or aging need in the past year.
  • Three-quarters of family caregivers (6.1M) were employed at the time, accounting for 35% of ALL employed Canadians.
  • Most (83%) surveyed caregivers say their experience was positive, and 95% say they are effectively coping with their caregiving responsibilities.
  • 44% of employed caregivers report having missed an average 8–9 days of work in the past 12 months because of their care responsibilities.
  • More than one-third of young carers (36%) arrived to work late, left early or took time off due to their caregiving responsibilities.
  • Employers across Canada lose an estimated $5.5 billion annually in lost productivity due to caregiving-related absenteeism.
  • Research shows that caregiving provides a variety of benefits to caregivers, including a sense of personal growth, increased meaning and purpose, strengthened family relationships, increased empathy and skill development.

 

Reconciling care and work requires understanding, respect and recognition from employers that sometimes an employee’s family circumstances need focused attention. Research shows that family caregivers and their employers benefit from policies that are inclusive, flexible and responsive, and when employees have a clear understanding of the process for handling individual requests for accommodation and customizing work arrangements.

For nearly all Canadians, caregiving is inevitable at some point over the course of their lives. Care is not always predictable and does not always arise outside working hours. Open communication and creative approaches to harmonizing work and care in a flexible manner benefits employees, employers, the economy and society.

Download A Snapshot of Family Caregiving and Work in Canada from the Vanier Institute of the Family.

 

In Conversation with Lisa Wolff, Director, Policy and Research, UNICEF Canada

Nathan Battams

Download In Conversation with Lisa Wolff, Director, Policy and Research, UNICEF Canada

November 20 is National Child Day and United Nations Universal Children’s Day, special observances commemorating the adoption of the UN Declaration of the Rights of the Child and the UN Convention on the Rights of the Child. For those who study, serve and support children in Canada, these observances provide an opportunity to recognize and celebrate the diverse and unique contributions of children to society while promoting and raising awareness about their well-being.

As the 60th anniversary of the UN General Assembly’s signing of the Declaration of the Rights of the Child and the 30th anniversary of the adoption of the Convention on the Rights of the Child, 2019 marks a special year for understanding children and youth. This understanding has been strengthened through the publication of Where Does Canada Stand?, the baseline report for the Canadian Index of Child and Youth Well-being.

Lisa Wolff, Director of Policy and Research at UNICEF Canada, recently joined Vanier Institute Communications Manager Nathan Battams to discuss this innovative and groundbreaking snapshot of child and youth well-being, its development and future directions.


How did the Canadian Index of Child and Youth Well-being come into being?

For decades, we’ve been tracking the state of children in Canada and around the world using population-level data to help understand where progress is being made on child and youth well-being, where challenges remain and where there might be no progress or things might be getting worse. This data facilitates the work of policy-makers, researchers, advocates and influencers in creating better conditions for children and youth to grow up in.

More than 30 years ago, UNICEF started the State of the World’s Children reports, which have been influential in terms of measuring child and youth well-being. Since then, there have been many “state of” reports on many different conditions that also use indicators and population data.

In more recent years, UNICEF started to focus on high-income countries as well and, in 2007, established an Index of Child and Youth Well-being, which brought together a number of indicators of how children in rich countries are doing in different aspects of life into one composite number and ranking. We’ve since published iterations of that. In the most recent, 2017 index, Canada ranked 25th of 41 countries in overall child and youth well-being.

Through this index, we discovered that Canada’s ranking among our peer countries – rich countries that have similar resources to spend on children and should therefore be getting reasonably similar outcomes and can be compared in regard to how they’re doing – is consistently in the middle and making very little progress relative to some other countries who were able to actually advance their standing over time.

This prompted us to question how some countries such as the United Kingdom were able to move up the rankings with a fair degree of speed and why we were stuck in the middle. At the same time, we were finding that many organizations were keen to use the UNICEF rankings in their own advocacy and in creating their own statistical dashboards for children and youth. For example, the Growing Up in BC project was inspired by the UNICEF Index.

We also recognized that Canada has data about children and youth that can’t be compared to other countries, because it’s unique to Canadian surveys, and that this rich data could provide additional valuable insight into what’s going on in children’s lives and how things are changing. There was already the example of the Canadian Index of Wellbeing, which does that at the general population level as well as compares how social progress relates to economic progress. So, we decided that we would create a Canadian Index of Child and Youth Well-being, inspired by the UNICEF model and the Canadian Index of Wellbeing – one that would bring together richer, focused data and insights about how children are doing and, if we could iterate the index over time, would look at progress and gaps.

The first thing we did was to assemble an advisory group. It was a large and diverse group that grew over the three-year period when we were developing the index. We started with around 40 advisors from across Canada – multidisciplinary, coming from research and government and community organizations from across the country, to ask them about their thoughts on what an index should do.

Our resulting vision has two purposes. First, we want it to serve as a communication tool for Canadian decision makers and influencers across the country – one that highlights how our youth are doing and identifies opportunities for change and progress. Second, by compiling diverse data points, not just in a dashboard but as a comprehensive view across different dimensions of children’s lives, we can look for patterns and focus on some of the big actions that could really “move the needle” on child and youth well-being and focus on what actions might actually address big gaps.

The index, therefore, takes a comprehensive view of childhood, one that isn’t based solely on the indicators that have mattered traditionally to adults (and are therefore more likely to be funded in population surveys), such as education outcomes and health status. Those things really matter to adults, and they matter to young people too, but what our advisors and what the youth themselves told us (because young people were an instrumental part of the index development process) is that their lives have a lot of other important aspects as well. For example, how much play and leisure time they have? How much do they get to participate in their families and in society? What relationships are important to them and how are they doing? How do they feel about school – not just in terms of grades, but about the experiences of school itself?

The index takes a comprehensive view of childhood, one that isn’t based solely on the indicators that have mattered traditionally to adults (and are therefore more likely to be funded in population surveys).

We settled on nine dimensions representing broad, conceptual aspects of children’s lives that are measured by a total of 125 statistical indicators. Although it’s a lot of indicators, this approach provides a more comprehensive view of their well-being, and by organizing them into dimensions, we’re able to define child and youth well-being in a broader way and elevate some things that are important to young people as well as to some of the adults who were involved in the project.

The process to get there brought together several strands of inquiry. We looked at how others were creating indices and measuring child and youth well-being in Canada and around the world. We did a scan of practice, exploring some of the innovative and exciting approaches being taken, as well as some of the things that were already agreed upon that were important to measure and were validated in the research. We explored a lot of the literature, including research and knowledge brought into the development by our advisors, and we incorporated the lived experience of young people by asking them what’s important in their lives. A prototype of the index was created, which we brought back to young people to ask what they liked about it, what we were missing and what was problematic about our approach – it was an iterative process.

In some cases, the views of adults and youth clashed, and when this occurred, we let the young people decide. Family meals came up as an example. Some of the indicators you often see cited when people are talking about youth health ask if they have regular family meals. We know through research that has been validated, that young people who tend to eat more meals with their families often have a better sense of belonging, better mental health, fewer risk behaviours and better grades.

In some cases, the views of adults and youth clashed, and when this occurred, we let the young people decide.

But in talking to young people – and we made sure we talked to those furthest from opportunity, including First Nations communities and youth in closed custody facilities, where youth often have severed relationships with their families – many told us that family meals feel a bit too normative, are stigmatizing and made them feel badly about their lack of family relationships or otherwise weren’t realistic. This was true even for some in higher-income families, in which we heard statements such as “We don’t do that, we’re too busy.” Instead, we focus on measuring the outcomes – Are kids healthy? Do they feel they belong? – and less on what contributes to that. We can explore that in other ways.

Another clash was around the importance of pets. A research expert might say, “Well, pets were never really studied as important to well-being,” though there’s some emerging evidence in some other countries. But time and time again, when you ask young people about the important relationships in their lives, they go beyond what research has focused on in terms of parents, teachers, peers and other supportive adults in the community.

Time and time again, when you ask young people about the important relationships in their lives, they go beyond what research has focused on.

The children frequently made statements such as my pet is what makes me feel good, my pet is one of the primary relationships in my life. So, we included an indicator for it, because we want to track it over time to see how many youth are caring for pets and have this important relationship in their lives. Their pets can become important to stave off loneliness and to create a sense of acceptance. It may be that pets become more important as an indicator when other relationships are more difficult. It was something interesting that we heard way too often to omit – so it’s included in the index to honour that.

What did your team do to ensure that diverse experiences were captured, such as those of Indigenous children or immigrant youth?

Predating the development of the index, we held a series of roundtables, similar to the Vanier Institute’s Families in Canada Listening Tour events, with child-serving organizations and leaders. One roundtable was focused specifically on Indigenous organizations and leaders. We asked the question “What does well-being mean to you?” to get a community definition, since there is no single, official definition of well-being. That really centred the kinds of things we chose to measure.

There was also a lot of diversity in the advisory group, and not just in terms of culture, age and social and economic location in Canada, but also in disciplines and academic approaches.

From Indigenous leaders, we heard about the importance of access to culture and the integrity of the ecosystem and environment in all their relations around children and youth. So that shows up in the index in a dimension called Are we connected to our environment?, which was actually a fairly uncommon inclusion in measuring child and youth well-being, and there are measurable climate-related indicators such as exposure to air pollution and access to natural spaces. That environmental sensibility didn’t surface at any of the other roundtables – only the Indigenous perspectives. It’s also validated by the Sustainable Development Goals (SDGs), which we also measure in the index with indicators that are aligned to the child-focused SDGs.

There was also a lot of diversity in the advisory group, and not just in terms of culture, age and social and economic location in Canada, but also in disciplines and academic approaches.

What are the next steps, and what is your vision on how the index will be used?

We would like to see governments at the provincial, territorial and federal levels track a broader set of indicators and dimensions of children’s lives and focus just as much on things like their freedom to play and participate as we currently do on academic performance and drug use. Better benchmarking and monitoring of the state of children and youth can help guide decision makers and policy-makers with evidence-based insights.

In fact, the index is already being used, for instance, in the Region of Waterloo, which comprises a number of municipalities and rural communities. They voted on a new set of goals for children in the region aligned with the nine dimensions of the index, to broaden the scope of their focus and progress at the regional level. There are hundreds of organizations that come together in a child and youth planning table in the region and work together on providing services for children and informing policies, and this provides them with a wider lens.

Partners such as the Ontario Trillium Foundation are working with us to create a local survey tool aligned with the index. Any community could implement this survey to gather data about children and youth, which is really hard to come by on a local scale. This data tends to be missed in the big national surveys, either due to being overlooked entirely or because the sample size is too small. If communities choose to, they could benchmark how their youth are doing against other communities or against the national averages.

Better benchmarking and monitoring of the state of children and youth can help guide decision makers and policy-makers with evidence-based insights.

The Foundation of Greater Montreal has already started to do that. For instance, they created a Montreal-based report on the state of children using the UNICEF index of well-being in 2017, and they found that they were lagging behind the national average on food security. As a result, that has localized greater attention and more programs, and efforts are under way to address food and security in the region.

So these are some of the ways UNICEF’s data and analysis are being used across Canada, and we’re glad it’s resonating and opening new ways of thinking about ourselves, because this wider and more comprehensive lens on children and youth can facilitate and strengthen policies and programs to have a significant impact on well-being for children and youth across the country.

Lisa Wolff is Director of Policy and Research at UNICEF Canada, where she promotes public policy and practices that align with the principles and standards of the UN Convention on the Rights of the Child. Lisa leverages UNICEF’s global strengths, including data and innovation, and works across sectors with diverse partners to advance the rights of children in Canada – work for which she received the Queen Elizabeth II Diamond Jubilee Medal in 2012.

This interview has been edited for clarity and length.

 

Facts and Stats: Maternal Mental Health in Canada

Download Facts and Stats: Maternal Mental Health in Canada

Maternal health and well-being is an important public health issue, of which mental health is a key component. Data shows that while most new and expectant mothers report good mental health and high life satisfaction, experiences of postpartum depression (PPD) and anxiety are common in Canada.

Research shows that PPD and poor mental health are detrimental to the well-being of mothers and can, if left untreated, adversely affect infant development (e.g. low birth weight, preterm birth, increased risk of mental health problems in the child later in life), as well as leave partners and other family members (including fathers, who are at an elevated risk for depression or anxiety) feeling overwhelmed.

Fortunately, multiple effective and well-researched treatment options are available to help women recover, and research shows that social and emotional support from partners and other family members throughout the perinatal period can reduce the likelihood of PPD and emotional distress for both mothers and newborns.

This edition of Facts and Stats explores the mental health of new and expectant mothers in Canada, with a focus on family well-being.

Highlights include:

  • In 2018–2019, most (60%) mothers who recently gave birth rated their mental health as excellent or very good, while nearly one-quarter (23%) reported feelings consistent with PPD or an anxiety disorder.
  • In 2018–2019, 30% of mothers who recently gave birth under the age of 25 reported feelings consistent with PPD or an anxiety disorder, compared with 23% among those 25 or older.
  • In 2018–2019, nearly one-third (32%) of recent mothers who reported feelings consistent with PPD or an anxiety disorder said they have received treatment for their emotions or mental health since the birth of their child.
  • Maternal mental health is affected by socio-economic status, with research showing higher rates of PPD and depressive symptoms among mothers from marginalized groups, including people living with disabilities; recent migrant mothers, asylum-seekers and refugees; and mothers self-identifying as Black or First Nations.
  • Mothers with adverse life experiences are also at a higher risk of developing mental disorders, such as those living in food-insecure households or in emergency or conflict situations, and those who have experienced violence (domestic, sexual or gender-based) or natural disasters.

Download Facts and Stats: Maternal Mental Health in Canada

This resource will continue to be updated as new research and data emerges (previous versions will be continually available on our fact sheets page).

Source information available on the PDF version of this resource.

In Focus 2019: Food Insecurity in Canada

Food insecurity in Canada is an issue deeply intertwined with the health and economic well-being of families. While there is no single cause for food insecurity, research shows that both economic insecurity and geographical isolation (in particular, the higher food costs in Northern communities resulting from a lack of year-round rail, road or marine access) contribute to families not having access to sufficient, safe and nutritious food to meet their dietary needs for a healthy life.1

Food-insecure families are more likely to experience adverse effects to their health and well-being, which include restricted mobility and chronic conditions, poor mental health and mental distress.2 This impacts individuals, families and communities, and incurs considerable costs on the health care system – it’s a matter of family well-being and public health.

In recognition of Hunger Action Month, which raises awareness on national, provincial and local levels about hunger in Canada, this edition of In Focus highlights data on food insecurity across the country.

Many Canadians – including children and youth – continue to experience food insecurity

  • In 2018, 1 in 4 children and youth under 18 (23%) say they go to bed or school hungry at least sometimes because there is not enough food at home.3
  • In 2018, children and youth under 18 accounted for 20% of the population in Canada but 35% of those who accessed food banks in March of that year.4
  • In 2015–2016, approximately 16% of households in reporting provinces and territories across Canada5 experienced food insecurity.6

Northern populations and marginalized groups experience disproportionately high rates of food insecurity

  • In March 2018, six in 10 people who accessed food banks (59%) were on social assistance or disability-related supports.7
  • In 2015–2016, more than half (51%) of households in Nunavut were food insecure – by far the highest rate in Canada and more than three times the average rate of the remaining reporting provinces and territories (11%).8
  • In 2015–2016, nearly three-quarters of the children in Nunavut (72%) and one-third of the children in the Northwest Territories (32%) lived in food-insecure households, compared with 16% to 23% among the remaining reporting provinces and territories.9
  • Despite the launch of Nutrition North – a food retail subsidy designed to improve food access and affordability in isolated communities – annual rates of food insecurity actually increased in Nunavut between pre-implementation (33% to 40% between 2007 and 2010) and the years following implementation of the program (46% to 56% between 2013 and 2016).10, 11
  • Research from 2014 showed that rates of food insecurity among Black people (29%) and Indigenous people (26%) were more than twice as high as the national average (12%).

Data gaps leave us without a clear picture of the prevalence and impact of food insecurity among diverse groups

  • The Canadian Community Health Survey (the main source for information on food insecurity in Canada) doesn’t collect data from First Nations reserves, resulting in approximately half of all status First Nations peoples (approximately 300,000) being left out of the picture, and thus underestimating the prevalence of food insecurity.12
  • Other diverse groups, including full-time members of the Canadian Armed Forces, people living in institutions and the 235,000 Canadians who experience homelessness in any given year are not represented in national food insecurity data (despite the latter being more vulnerable to food insecurity than the general population).13

Notes

  1. Paula Arriagada, “Food Insecurity Among Inuit Living in Inuit Nunangat,” Insights on Canadian Society, Statistics Canada catalogue no. 75-006-X (February 1, 2017). Link: https://bit.ly/2maW9oN.
  2. Ibid.
  3. UNICEF Canada, Where Does Canada Stand? The Canadian Index of Child and Youth Well-being: 2019 Baseline Report (September 3, 2019). Link: https://bit.ly/2kpOeDv.
  4. Food Banks Canada, Hunger Count 2018 (February 5, 2018).
  5. Newfoundland and Labrador, Ontario and Yukon opted out of food insecurity measurement in 2015–2016.
  6. PROOF Food Insecurity Policy Research, Latest Household Food Insecurity Data Now Available (June 25, 2018).
  7. Food Banks Canada, 2018.
  8. PROOF Food Insecurity Policy Research, 2018.
  9. Ibid.
  10. Research suggests this may be the result of the program’s focus on perishable, nutritious foods, as well as the exclusion of most non-perishable foods and all non-food items from the subsidy.
  11. Andrée-Anne Fafard St-Germain, Tracey Galloway and Valerie Tarasuk, “Food Insecurity in Nunavut Following the Introduction of Nutrition North Canada,” Canadian Medical Association Journal, 191:20 (May 21, 2019). Link: https://bit.ly/2m5FJhb.
  12. PROOF Food Insecurity Policy Research, Household Food Insecurity in Canada: A Guide to Measurement and Interpretation (November 2018). Link: https://bit.ly/2kAs2qd.
  13. Ibid.

 

The Impact of Post-Traumatic Stress on Canadian Armed Forces, First Responders and Their Families

Supporting Families of Serving and Retired Members of the Canadian Armed Forces and First Responders Living with Post-Traumatic Stress is a report based on a roundtable convened by Medavie between Wounded Warriors Canada, the Mental Health Commission of Canada and the Vanier Institute of the Family that took place in February 2019. The report explores the challenges faced by families impacted by post-traumatic stress (PTS) experienced by first responders and serving or retired members of the Canadian Armed Forces (CAF). Though there is a growing awareness of the risk of PTS and the potential of developing post-traumatic stress disorder (PTSD), families often lack the support they need to both help their loved one and address the impact on their own health and their daily lives.

While PTSD is most often used in public discussion, categorizing it as a disorder means it is a clinically diagnosed condition. During the roundtable, and subsequently throughout this report, the concept of PTS is the focus, as it includes those who experience symptoms but may not have a formal diagnosis.

Families are often the first source of support an individual living with PTS will turn to and they can play a key role in ensuring their loved one receives care. Family members who may feel the impact of PTS on their lives include adult children, parents, siblings and spouses. They may need to adjust, adapt and respond to expanding and/or evolving roles at home and/or changing behaviours, moods and attitudes exhibited by their loved one. Individuals and families need tools to help them communicate their experiences, emotions and feelings with each other to address the impact that PTS is having on their lives.

Access to resources for mental health support across military and first responder communities varies, with more funding for programs aimed solely at the individual experiencing PTS. CAF has been developing nationally accessible programs for serving and retired members and, to an increasing degree, their families.

Download the report Supporting Families of Serving and Retired Members of the Canadian Armed Forces and First Responders Living with Post-Traumatic Stress

Download the media release

 


Published on August 27, 2019

Research Recap: Beyond “Snapshots” to “Lifetimes” of Family Care

Janet Fast, Norah Keating, Jacquie Eales, Choong Kim and Yeonjung Lee

Download (PDF)

According to the most recent General Social Survey (GSS) on Caregiving and Care Receiving, 28% of Canadians provided care to a family member or friend in the previous year.1 But “snapshots” in time such as this don’t paint a complete picture of caregiving experiences. Looking across the life course provides more insight into how Canadians are engaged in care across their lives and reveals a number of lifetime “pathways” of care that are commonly experienced.2 In fact, half (46%) of all Canadians have provided care at some time in their lives, showing that family care is a much more common experience than many people had imagined. It’s time to move beyond snapshots to focus on lifetimes of family care.

Groundbreaking research at the University of Alberta, using data from Statistics Canada’s 2012 GSS shows, for the first time, five distinct care trajectories (pathways) across the life courses of 3,299 adults aged 65 and older: Late Bloomer, Encore, All at Once, Enduring and Serial. This innovative perspective shows not only how care evolves across the life course but that it evolves in diverse ways for different individuals. We now can examine the cumulative lifetime impact of caregiving to identify carers at greatest risk of poor health, social isolation and poverty in later life to better target policy interventions.

A life course approach highlights diverse patterns of caregiving across carers’ lives

Research shows that 1 in 2 Canadians aged 65 and over – or more than 2 million people – have cared for others one or more times across their lives.

CARE TRAJECTORIES

Late Bloomer

One in 2 carers (54%) follow a Late Bloomer pathway. Its defining feature is a single, short episode of providing care (fewer than 5 years), mostly to spouses or parents. This pathway starts in the early 60s (average 63 years); 43% of Late Bloomer carers are men and 57% are women.

Encore

One in 4 carers (25%) follow an Encore pathway. Its defining feature is a first long episode of providing care, mostly to parents or spouses, followed by shorter episodes increasingly to same-generation friends or neighbours. This pathway starts in the early 50s (average 52 years) and lasts nearly 14 years; 41% of Encore carers are men and 59% are women.

All at Once

One in 10 carers (11%) follow an All at Once pathway. Its defining feature is a decade or more of providing care, mainly to parents or parents-in-law, and usually for more than one parent at the same time. This pathway starts in the early 50s (average 52 years); 36% of All at Once carers are men and 64% are women.

Enduring

One in 16 carers (6%) follow an Enduring pathway. Its defining feature is a first very long episode of providing care to close family, followed by a second long episode of providing care to close family or friends. Care to children or siblings with chronic health conditions/disabilities was notable. This pathway starts in the early 30s (average 34 years) and has the longest duration (average 33 years); 37% of Enduring carers are men and 63% are women.

 

Serial

One in 25 carers (4%) follow a Serial pathway. Its defining feature is a long-term pattern of caring for others (close relatives, distant relatives, friends or neighbours), often at the same time. This pathway starts in the mid-30s (average 36 years) and spans more than three decades (31 years on average). Of all care pathways, the Serial pathway has the largest proportion of women carers (71%).

 

Read the full “Life Course Trajectories of Family Care” open access study through Intenga Connect.

Authors

Janet Fast, PhD, is a Family Economist and Professor, Department of Human Ecology, University of Alberta.

Norah Keating, PhD, is a Family Gerontologist and Director, Global Social Issues on Aging (International Association of Gerontology and Geriatrics).

Jacquie Eales, MSc, is a Communication and Knowledge Translation specialist and Research Manager, Department of Human Ecology, University of Alberta.

Choong Kim is an Applied Economist and PhD candidate, Department of Human Ecology, University of Alberta.

Yeonjung Lee, PhD, is a specialist in Comparative Welfare States and Gerontology and Assistant Professor, Faculty of Social Work, University of Calgary.

 

Notes

  1. Maire Sinha, “Portrait of Caregivers, 2012,” Spotlight on Canadians: Results from the General Social Survey, Statistics Canada catalogue no. 89-652-X (September 2013). Link: http://bit.ly/1jxgAAm.
  2. Joohong Min, Yeonjung Lee, Janet Fast, Jacquie Eales and Norah Keating, “Life Course Trajectories of Family Care,” Innovation in Aging, 2:1 (November 2018). Link: https://bit.ly/2MwiXf8.

 

A Snapshot of Grandparents in Canada (May 2019 Update)

Canada’s grandparents are a diverse group. Many of them contribute greatly to family functioning and well-being in their roles as mentors, nurturers, caregivers, child care providers, historians, spiritual guides and “holders of the family narrative.”

As Canada’s population ages and life expectancy continues to rise, their presence in the lives of many families may also increase accordingly in the years to come. With the number of older Canadians in the workforce steadily increasing, they are playing a greater role in the paid labour market – a shift felt by families who rely on grandparents to help provide care to their grandchildren or other family members. All the while, the living arrangements of grandparents continue to evolve, with a growing number living with younger generations and contributing to family households.

Using newly released data from the 2017 General Social Survey, we’ve updated our popular resource A Snapshot of Grandparents in Canada, which provides a statistical portrait of grandparents, their family relationships and some of the social and economic trends at the heart of this evolution.

Highlights:

  • In 2017, 47% of Canadians aged 45 and older were grandparents, down from 57% in 1995.1
  • In 2017, the average age of grandparents was 68 (up from 65 in 1995), while the average age of first-time grandparents was 51 for women and 54 for men in 2017.2, 3
  • In 2017, nearly 8% of grandparents were aged 85 and older, up from 3% in 1995.4
  • In 2017, 5% of grandparents in Canada lived in the same household as their grandchildren, up slightly from 4% in 1995.5
  • In 2017, grandparents who were born outside Canada were more than twice as likely as Canadian-born grandparents to live with grandchildren (9% and 4%, respectively), the result of a complex interplay of choice, culture and circumstance.6

Download A Snapshot of Grandparents in Canada (May 2019) from the Vanier Institute of the Family.

Battams, N. (2019). A snapshot of grandparents in Canada. The Vanier Institute of the Family. https://doi.org/10.61959/disx1332e


Published on May 28, 2019

1 Statistics Canada, “Family Matters: Grandparents in Canada,” The Daily (February 7, 2019). Link: https://bit.ly/2BnyyFO.
2 Ibid.
3 No comparator provided because this is the first time the question has been asked in the General Social Survey.
4 Ibid.
5 Statistics Canada, “Family Matters: Grandparents in Canada.”
6 Ibid.

Work and Family: The Impact of Mobility, Scheduling and Precariousness

Elise Thorburn, PhD (Memorial University)

Download this article in PDF format

There is an immense shift underway in the workforce across Canada that is clear to many people who are working and to those who are looking for work. In recent years, there has been a rise in unstable and precarious employment, as well as a growing number of jobs with long commuting times and those involving long travel times during work. Furthermore, the use of shift-scheduling technology – which automates labour distribution in a workplace – is increasing across a variety of sectors. These evolving contexts can have a significant impact on workers and their families.

The use of shift-scheduling technology – which automates labour distribution in a workplace – is increasing across a variety of sectors.

A recent study conducted as part of the On the Move Partnership1 surveyed and interviewed union representatives and union members in Canada to explore how they manage unpaid family care responsibilities along with their often erratic work schedules and long or arduous commutes. The goal was to explore how these workers reconcile the rhythms of work and life in increasingly mobile and precarious sectors, and what unions are doing to foster harmony for these workers and their families.

Research from On the Move has shown that a large but difficult-to-document number of Canadians work in municipalities, provinces and even countries far from their homes and families, and their employment-related mobility often follows complex and nuanced patterns.2 These workers often invest considerable time and other resources managing and negotiating the impacts of this mobility.

This study focused on two particular types of mobility:

1. Lengthy and/or complex commuting, such as jobs that involve travelling an hour or more each way per day to the place of work (including the time it takes to drop off or pick up children, spouses, parents, etc.).

2. Mobility during/for work, such as jobs in which workers move around from worksite to worksite throughout the day, as with personal support workers or homecare nurses.

These categories aren’t exclusive; for some workers, these two categories – long commutes and mobility throughout the day – overlap. Study participants were all in the Greater Toronto Area, and they either worked in or represented employees within in the home health care sector, the airport and airline sector, or the higher education sector. While these workplaces differ greatly in the wages, skill sets and demographics of the workers, their diversity serves to highlight how the issues presented here can appear in different settings with different employee characteristics.

Unpaid idle time can represent “time taken from family”

One of the impacts of modern shift-scheduling practices and mobility is a greater amount of unpaid idle time for these diverse types of workers: time when they are not at home but not officially on the clock. Many of them referred to this as time taken from family, and it can have an impact on family finances. For example, if an employee was paying for child care but stuck with unpaid idle time, it could actually result in negative earnings. One airport worker, for example, recalled being scheduled for a shift that began at 2:30 a.m., but the last bus to leave from his neighbourhood to work left at midnight. Therefore, he regularly arrived at work an hour or more before his start time to ensure he was on time, and would then sleep or wait around at the airport – unpaid – until his shift began.

Home health care workers with long waits between clients also experience unpaid idle time, as reported by Kathleen Fitzpatrick and Barbara Neis.3The workers in their study were paid only for direct care time and the travel time between clients, regardless of how long they had to wait between scheduled visits. For example, one personal support worker said:

I start at 9:30 in the morning, work with a client for two hours, and then wait until 1:30 to see another client. When it’s not cold outside I sometimes sit on a park bench, but most of the time I find a Tim’s or a mall to sit in. I don’t have money to buy coffee at Tim Hortons every day while I wait for another shift to begin, but I am too far from home to go back there.

Her mobility between clients pulled her far from her home in her unpaid time, and for workers like her with children in daycare or with babysitters, that two hours of unpaid time between patients represented even greater negative earnings.

Aside from lost or negative earnings, idle time also represents unpaid time away from family. Some workers reported trying to resolve this lost family time by multi-tasking – for example, some parents of older children often “parent by phone” during long commutes, in idle time between clients or as they moved between worksites. One union representative in the home health care sector spoke of a member who texted constantly with her daughter throughout the workday. Another spoke of workers talking to their children about general life issues through meal preparation, homework and while commuting. During long commutes or drives between clients, the phone becomes a lifeline to more engaged parenting for many, helping to alleviate some of the stress of “leaving your children alone when you would not otherwise,” as one worker put it.

Aside from lost or negative earnings, idle time also represents unpaid time away from family.

University workers in the study reported that long commutes to rigidly scheduled classes can serve as time to catch up on sleep or to engage in preparatory work, reading or marking student papers. One university worker with a very young child, whose commute often stretched to more than 3.5 hours, said that the travel time by train was often the only time he could find to catch up on uninterrupted sleep. That said, he and other university workers also found that the long commutes and rigid schedules were the cause of significant mental health issues and troubled familial and social relationships.

Mobility and scheduling can affect employee and family well-being

The mental health ramifications of precarious work, as well as work with extended commuting and demands of child care, are well documented.4 The convergence of scheduling and mobility, paired with the responsibilities of family, had a negative impact on the mental health and well-being of interviewed university workers (e.g. stress, fatigue, anxiety). One said that his mental health was severely impacted by the pressures of the commute and the schedule, causing things at home to become “bad.” He noted, “I was feeling so very desperate earlier in the fall, even just seeking therapy became difficult.” The convergence of scheduling, onerous mobility and family care responsibilities made finding the time and energy needed to manage his mental health was an insurmountable task. The schedule and commute mitigated the rejuvenating aspects of his work, and he said exhaustion was very common by the end of the term. As well, maintaining his social circle outside of his immediate family was almost impossible and, he noted, “It [took] intense planning to even schedule a haircut.”

Accessing child care – quality, affordable child care that works for non-traditional schedules – is a major issue for mobile workers.

Another university and union worker noted that the time spent on transit exacerbated exhaustion and made the transition for children from daycare or school to home that much more fraught. “You are tired and cranky, and so is your child,” she said, and “you are never really able to honour the schedule of your child or yourself, which leads to you feeling guilty and just bad.” The need to always be up early and rushing to a long and onerous commute also caused her to have residual anxiety issues – issues she says stayed with her long after she left that particular job. “I always feel like everything is being done at the last minute and I’m constantly anxious about that,” she explained. The anxiety that she felt had an effect on her children, she believed, giving them their own sense of urgency or anxiety, and the feeling that the adults around them – those that are caring for them – are constantly in a state of heightened stress. This mirrors what Stephanie Premji found in her research on precarious immigrant workers in Toronto – the worry about work-related economic insecurity caused the children of these precarious workers to become depressed and it contributed to familial stress.5

Other union representatives and workers I spoke to also noted that family responsibilities and mobility paired with schedules that are out of one’s control increased their unpaid caring labour in the home, which in turn contributed to social isolation and the loss of support networks. They also spoke of their frustration in being unable to address or alter the situation they felt trapped in – they could not move closer to their workplace because it may often change, for example, or because they could not afford to live in areas with better employment opportunities. Other On the Move researchers have found that many aren’t able to overcome these barriers and improve their labour market experiences (and hence mental health) over time.

Non-standard work hours often don’t align with child care availability

All of the worksites in this study operate on non-traditional, often 24-hour schedules. Non-standard work hours include a variety of now-common schedule possibilities and working patterns – from slightly extended hours (beginning from 6 a.m. and ending around 7:30 or 8 p.m.) to later shifts (e.g. those that last until 11 p.m. or later) as well as full overnights and weekends.6

Non-standard hours of work have been steadily increasing in Canada, and Statistics Canada reports that the period from 2005 to 2015 saw a growing shift from traditional to more flexible, non-standard work schedules.7 Yet both transit systems and child care centres have been set up to meet the needs of a standard 9-to-5 work schedule, and have done little to change over this same time period. Many of the interviewed workers and union representatives said that the standard hours of transit and child care conflicted with the rhythms of their workplaces, meaning that daycare centres – formal, regulated and licensed to ensure quality and safety – were not an option for them.

Accessing child care – quality, affordable child care that works for non-traditional schedules – is a major issue for mobile workers. For many low-income, precarious workers on non-standard schedules, informal child care providers are the only accessible option. Such providers may be available by negotiation at a moment’s notice and during non-traditional hours, leading to situations of “trickle-down precarity.” These workers may also supplement child care providers with occasional help from family, friends and neighbours, or rely entirely on them – one union representative and worker at Toronto Pearson International Airport noted that his wife’s parents moved into their home for five years to care for their young children while he and his wife worked non-standard schedules for an airline.

For many immigrant workers, the social support systems they may have had in their home countries are absent, and thus accessing child care becomes a significant source of anxiety.

However, this reliance on family is not an option for everyone. For many immigrant workers, the social support systems they may have had in their home countries are absent, and thus accessing child care becomes a significant source of anxiety, especially as mobility and scheduling disrupt the rhythms of necessary care work in their home.8 Even with formal child care, long commutes and worker mobility paired with unpredictable or non-standard schedules can have emotional and mental health impacts on workers who engage in unpaid caring labour at home. One worker noted that her schedule and commute paired with traffic meant she was often arriving very close to the daycare’s closing time and, she noted, “There is the horrible shame of being the last person to pick your kids up.”

This was especially acute for women workers, who felt that their tardiness to collect children from care was a reflection of their quality as a parent. This shame and even fear is not entirely unwarranted: while most daycares have fines for picking children up after closing time – often in the range of $1 per minute – in 2016, a daycare in Etobicoke, Ontario instituted fines as high at $300 per hour, as well as a possible call to Children’s Aid Society if no parents or emergency contacts could be reached.9

One worker noted that punitive measures such as these are an enormous source of stress for her as she commutes between worksites on the subway, because while underground she has no cellphone access. She continually fears a subway delay or breakdown, since she would not be able to call and alert the daycare if she was going to be late. For her, this is a source of anxiety and stress that does not end when her commute does, but that carries with her into her interactions with her children and at home. Thus, to add to the sense of shame, anxiety and stress associated with mobility, family and non-standard schedules, the possibility of losing access to one’s children entirely is introduced, as well as the potential complication to immigration applications if Children’s Aid Society is ever involved.

Non-standard work scheduling can be complex and time-consuming

The challenges of non-standard work schedules, mobility and limited incomes, and the friction between schedules and child care, means that workers often spend unpaid time outside of work scheduling and coordinating work and family responsibilities, which further encroaches upon family time. In her research on call centre workers in Quebec, Karen Messing found that parents made use of eight different babysitting resources to fill caregiving needs over a two-week period, and spent considerable unpaid leisure time trying to switch shifts with co-workers to make up for the rest.10

When some workers cannot harmonize their schedules, commutes and family responsibilities, the only option may be to take fewer shifts or remain in casual positions – even if they are entitled to a full-time or permanent job.

When some workers cannot harmonize their schedules, commutes and family responsibilities, the only option may be to take fewer shifts or remain in casual positions – even if they are entitled to a full-time or permanent job. Some union representatives said their members in the home health care sector, for example, “choose” to remain in more precarious positions, because family life simply cannot be coordinated around work life. But as one mentioned, “It’s a tricky thing to say when it’s a choice and when it’s an obligation.” Another union representative said, “I’ve seen people quit entirely over this,” and reiterated that if not quitting, remaining casual was often a way that workers sought to assert more control over their work schedule and life.

Questions remain on mobility and the “duty to accommodate”

One avenue to support those balancing work and family responsibilities has been the human rights codes. In the Canadian Human Rights Act and in all provincial acts aside from New Brunswick (where reviews to add the ground are ongoing), “family status” is considered a prohibited ground for discrimination.11 This means that employers have a “duty to accommodate,” which means that employers “have an obligation to adjust rules, policies, or practices to enable you to participate fully.”12 But “family status” and “duty to accommodate” are ill-defined across the human rights acts and codes in Canada, and accommodation does not guarantee a new or similar position with similar wages for a worker, or reassignment to a job with similar duties and a more amenable schedule. As well, accommodation requests can be rejected due to “undue hardship” on the part of the employer, the definition of which is equally vague.

Awareness of the duty to accommodate as an avenue for mitigating the impacts of scheduling on work and family was low among workers and union representatives, and few had tried to use the legislation. Among those who had attempted to make use of family status accommodations, some representatives for home health care workers, for example, said that the legislation had not been particularly useful to them, suggesting that its relative lack of usefulness “speaks to certain biases within the document around what people’s relationships to the employer are.”

One union representative in the study explained that a member of their union had been moved from her position due to layoffs in the organization. The new position the member was bumped into required hours and commuting times that would not allow her to be home for her child either before or after school. As a single parent, newly immigrated and without extended family in the country, she had no one to share caregiving responsibilities with, and so her union made an accommodation request on her behalf. The employer made an undue hardship claim, and then offered the member a different position with significantly reduced hours. Weighing her hourly wage against the cost of child care before and after school meant that the original job with more hours wasn’t going to be financially worth it, so in the end, the member simply “didn’t have a choice,” according to the union representative. As a result, the member “had to take the reduced hours and now struggles financially.” Another union representative with a similar case said that this is “an example of how the system means well but operates on the basis of older forms of employment relationships.”

It remains unclear how mobility specifically converges with human rights code recommendations around the duty to accommodate.

Further, it remains unclear how mobility specifically converges with human rights code recommendations around the duty to accommodate. Can a homecare worker or any other worker request a schedule that takes commute time and work time in relation to family status into account? Can a worker cite rush-hour traffic or winter travel or transit delays and overcrowding as part of a duty to accommodate application? Can poor transit options converging with inconvenient schedules be grounds for a request for accommodation? Can workers cite the likelihood of commuting times from certain work schedules causing increased child care late-pickup fees? These are questions that have no clear answer in the current human rights legislation but are serious concerns for workers today.

Unions adapting to evolving work and family contexts

What emerges from this research is that workers in jobs across multiple sectors have complex lives and multiple, evolving demands on their time. The voices of union representatives and workers presented here highlight the need for labour representatives to begin to consider mobility and care work as an aspect of their negotiations, especially as it converges with increasingly erratic, unpredictable and around-the-clock work schedules.

What emerges from this research is that workers in jobs across multiple sectors have complex lives and multiple, evolving demands on their time.

Several union representatives who were involved in collective bargaining said that they often felt at an impasse, unsure of how to deal with the impacts of work on their members’ after-work lives. Because there seemed little in the way of other options, most union representatives put the focus on increasing wages for workers, so as to alleviate some of the stressors of mobility and unpaid care work. But a focus on wages to the exclusion of other options may allow untenable situations for some workers to persist.

There are some interesting examples of possible models for unions to consider. One worker who was active in his union said that all gains cannot be won at the bargaining table, and that workers and unions need to build relationships with non-unionized workers, their neighbours and community members, and community-based organizations to help build holistic solutions to the problems mobile workers on erratic schedules with caregiving responsibilities face. He cited the example of the Toronto Airport Workers Assembly (TAWC), which is made up of unionized and non-unionized airport workers, and partnered with community environmental and transit groups to ultimately win a reduced rate on the UP Express train line to the airport. Originally priced at $27.50 per ride, the efforts of the TAWC in alliance with community partners contributed to the decision to lower the price to $3.50 for airport workers and $12 for regular riders.

As well, the Ontario Human Rights Code recommends considering inclusive design in workplaces.13 Usually understood as “Universal Design,” inclusive design asks employers to consider the ways that workplaces can become more family-friendly. How are schedules, workloads and descriptions of work designed, and how can the beneficial elements of mobile work on flexible schedules be emphasized while the negative impacts are mitigated? How might inclusive design be implemented within collective agreements is a question union leaders could begin to consider as the landscape of work continues to shift and change.

Download Work and Family: The Impact of Mobility, Scheduling and Precariousness (PDF)

Elise Thorburn is an Adjunct Professor in the Department of Sociology at Brock University and a researcher with the On the Move Partnership. On the Move is a research project involving the Vanier Institute of the Family and universities across Canada and abroad investigating workers’ extended travel and related absence from their places of permanent residence for the purpose of (and as part of) their employment.


Published on August 21, 2018

 

Notes


  1. The On the Move Partnership (OTM) is a project of the SafetyNet Centre for Occupational Health and Safety Research at Memorial University. It is supported by the Social Sciences and Humanities Research Council through its Partnership Grants funding Opportunity, Innovate NL, CFI and multiple universities and community partners. This research was also supported by an internship with the Vanier Institute of the Family.
  2. Learn more on the On the Move Partnership website. Link: https://bit.ly/2I0nijg.
  3. Kathleen Fitzpatrick and Barbara Neis, “On the Move and Working Alone: Policy Implications of the Experiences of Unionised Newfoundland and Labrador Homecare Workers,” Policy and Practice in Health and Safety, 13(2) (January 2016). Link: https://bit.ly/2tmVC30.
  4. Stephanie Premji, “‘It’s Totally Destroyed Our Life’: Exploring the Pathways and Mechanisms Between Precarious Employment and Health and Well-being Among Immigrant Men and Women in Toronto,” International Journal of Health 48(1) (January 2018). Link: https://bit.ly/2K3j2Vl.
  5. Ibid.
  6. Shani Halfon and Martha Friendly, Work Around the Clock: A Snapshot of Non-Standard Hours Child Care in Canada (Toronto: Childcare Resource and Research Unit, 2015). Link: https://bit.ly/2K4vyDZ.
  7. Statistics Canada, “Labour in Canada: Key Results from the 2016 Census,” The Daily (November 29, 2017). Link: https://bit.ly/2yl9VL1.
  8. See Stephanie Premji, “Precarious Employment and Difficult Daily Commutes,” Relations Industrielles / Industrial Relations, 72(1) (January 2017).
  9. Amanda Ferguson, “Etobicoke Daycare Hikes Late Fees for Parents Who Don’t Pick Up Kids on Time” City News Toronto (October 4, 2017). Link: https://bit.ly/2yi15O2.
  10. Karen Messing, Pain and Prejudice: What Science Can Learn About Work from the People Who Do It (Toronto: Between the Lines, 2014).
  11. Learn more with Family Caregiving in Canada: A Fact of Life and a Human Right (Vanier Institute of the Family, 2016).
  12. Canadian Human Rights Commission, What Is the Duty to Accommodate? (n.d.). Link: https://bit.ly/2JORML1.
  13. Ontario Human Rights Commission, Inclusive Design and the Duty to Accommodate (Fact Sheet) (n.d.). Link: https://bit.ly/2I1pmYm.

Research Recap: School Experiences of Children in Military Families

Emily Beckett

Download Research Recap: School Experiences of Children in Military Families

There are more than 64,000 children growing up in military families in Canada.1 Many of these children experience high mobility, as studies show that military families move three to four times more often than their civilian counterparts.2 While most military families are highly adaptive and resilient during relocations, a growing body of research has found that these frequent moves can have an impact on family well-being.3

Nearly three in 10 surveyed military spouses (27%) report they have been relocated at least four times due to military postings.4

While frequent moves can affect multiple aspects of family life, some research suggests that the greatest disruption on youth is related to school and school-related activities.5 Parents in military families are aware of these disruptions, with more than half (54%) of surveyed military spouses agreeing that “military children are at a disadvantage because civilian public schools do not understand military life.”6 However, research also shows that a child’s school environment can facilitate the transition and have a positive impact on the well-being of youth in military families.

In recent review of available literature, School Participation and Children in Military Families: A Scoping Review, Heidi Cramm, PhD, and Linna Tam-Seto, PhD(C), explored existing research on how transition affects the well-being of children and youth in military families with regard to school participation. Through an examination of 112 academic articles, they found that experiences common in military families, such as separation from a deployed parent, relocation, parental deployment in dangerous conflict situations and changes to family dynamics during and after deployments, can all shape the quality and quantity of children’s participation in school-related activities. While the vast majority of the articles in the literature review are based on U.S. data, military families in Canada seem to share many of the same experiences and concerns, as reflected in data from the Canadian Armed Forces (CAF) Community Needs Assessment: 2016 Overall Results report.7

Resettling into a new community takes time

While starting at a new school doesn’t necessarily mean a child from a military family will experience academic difficulties, research in the literature review suggested that it takes students approximately four to six months to academically re-establish themselves each time they move. Though this period is temporary, these disruptions can have a long-term effect on opportunities later in life, specifically in regard to a child’s willingness to take risks or pursue challenges.

Based on the predominantly American research, Cramm and Tam-Seto noted that difficulties in transition among students were found to be associated with the duration of deployments (total number of months that the child’s parents are away on deployment), the mental health of the non-deployed parent and decreasing resiliency. Research also acknowledges the potentially difficult period of reintegration of a military member into family structures and routines after their deployment. Given that there is some evidence that the accumulation of months deployed is associated with these types of negative effects, it will be critical to determine what the experience is for military families in Canada.

Academic experiences and access to supports can be impacted by military life

Cramm and Tam-Seto found that students in the research, who were primarily from U.S. military families, can experience negative impacts on their academic performance (e.g., academic gaps and redundancies) when they move across jurisdictional boundaries: factors such as standards, credit requirements and the age of kindergarten can change from region to region. They also found that stress at home during deployment and reintegration can often affect in-school behaviour and class dynamics, as these students may act out emotionally and experience difficulties with concentration, anxiety and conflicts with peers. Though the survey doesn’t specify whether the problems exhibited in the children of the respondents to the CAF Community Needs Assessment were associated solely with mobility, 13% of respondents reported that their child exhibited emotional or behavioural problems at school in the past year. Further research is needed to provide a greater understanding and focus on military families in Canada.

In 2016, more than 1 in 7 surveyed CAF members (13%) reported that their child exhibited emotional or behavioural problems at school in the past year.

Studies found an association between behavioural and emotional adjustment and academic performance (e.g., conduct, attendance, attitudes toward school and approaches to learning). The difficulties associated with transitioning to a new school can be compounded when a student requires access to special education resources.8 Many of the 8.2% of surveyed CAF families who report having children with special needs9 require access to resources and supports, and the process of accessing them can be disrupted with every move.

Like any family with a member with special needs, many military parents of children with autism spectrum disorder (ASD) can face difficulties navigating health care and education systems, not only to acquire appropriate resources but to secure assessments and diagnoses as well.10 Obtaining a diagnosis can be difficult as families can spend months or even years on a wait-list, which can result in military families relocating before they receive care or services.

Many special education resources cannot be accessed without a diagnosis, and Cramm and Tam-Seto found that schools may delay providing resources based on the assumption that a student’s academic struggles are related solely to military life or a temporary reaction to a deployed parent. Alternatively, special education resources are occasionally provided rather than taking the larger step of addressing gaps in education due to relocation. Many U.S. school staff report that they feel unable to appropriately identify students in military families for clinical referrals.

Building community in the face of high mobility

Research shows that in the context of high mobility, military students can experience difficulties initiating and maintaining meaningful personal relationships and building social circles with children their age. Many civilian peers may not understand or be able to empathize with parental deployment or frequent moves, which can have an impact on relationships with military children. Social connections between military and civilian youth are common, since 85% of military families in Canada now live off-base in civilian communities, compared with only 20% in the mid-1990s.11

Cramm and Tam-Seto found that children of military families living in U.S. civilian communities are particularly vulnerable to feelings of isolation and loneliness – important measures, since the connection between strong social networks and well-being has been well established in research.12 Conversely, research shows that a sense of community belonging can be a factor in protecting mental health and enhancing resiliency.13

Participation in extracurricular activities can be affected by mobility among youth in military families. For example, opportunities for a child in a military family to sign up for a soccer team may have passed by the time they move, as the tryouts may have already been held and the team was set before the beginning of the academic year. Higher levels of sports teams or leadership programs may pass over military students to avoid complications that could arise if the student needs to relocate again.

The 2016 CAF Community Needs Assessment report found that among respondents who cited their child’s well-being as the most significant problem in the past year, nearly three in 10 (29%) reported requiring help with activities (e.g., bolstering fitness, stress relief, family bonding) to aid in the child’s well-being. Circumstances may not allow a parent to organize transportation to extracurricular activities or manage without the student’s support at home due to increased child care responsibilities during parental deployment, as 23% of all respondents reported experiencing issues with child care, such as quality, distance, expense and hours of availability.

Educational professionals have unique opportunities to facilitate transitions

Research suggests that teachers, counsellors and other educational professionals have unique opportunities to facilitate transitions for military youth. American research in the review suggested that the school environment can act as a protective factor during relocation, and that educators can support students in military families by strengthening the child’s resiliency and adaptive coping skills.

Due to the inherently disruptive nature of relocation and the potential loss of stability and routine in their lives, military families and students can be particularly reliant on school personnel and structure for social and emotional support. Among surveyed CAF parents who selected child well-being issues to be the most significant problem in the past year, more than one-third (34%) reported requiring emotional or social support. When families are able to get involved in their child’s schools, studies suggest it can enhance school engagement, academic success and their likelihood of graduating and pursuing post-secondary education.

However, Cramm and Tam-Seto also found that many U.S. educational staff report feeling overwhelmed by the magnitude of their students’ needs and struggle to deal with military family-specific issues, such as repeated transitions, parental deployment, fear of death or injury of a deployed parent, and how to meet those needs and communicate effectively with military families.

While many of the studies and research explored and cited by Cramm and Tam-Seto were from abroad, the findings are important in better understanding military families in Canada, who share many of the same “military life stressors” as their American counterparts – in particular, high mobility, frequent periods of separation and risk.14 The research in this scoping review study suggests that schools and educational professionals with a high degree of military literacy (awareness of these stressors and military family experiences) can play a major role in facilitating transitions among youth. Canadian-specific research with school communities will be important in the coming years.

Resources and information facilitate support for military youth

Enhancing military literacy among educational professionals can play an important role in supporting military youth and their families, and many have expressed a desire for resources to help them with this goal. Resources such as School Counsellors Working with Military and Veteran Families, published in 2017 in collaboration with the Canadian Counselling and Psychotherapy Association and the Canadian Military and Veteran Families Leadership Circle, can play an important role in creating and strengthening “military-literate” teams of school counsellors (and their colleagues) in schools across Canada by providing information about the military and Veteran lifestyle and sharing tailored resources.

Military and Veteran families are strong, diverse and resilient, and they make unique and valuable contributions to communities across the country. Many experience high mobility, which affects the well-being of military-connected children and youth, and, in turn, on the well-being and operational effectiveness of serving CAF members.15 Enhancing understanding of their experiences and the “military lifestyle” among educational professionals and others who study, serve and support families will be key to ensuring that communities and workplaces are inclusive environments in which these families can thrive.

 

Read the full study:

Heidi Cramm, PhD, and Linna Tam-Seto, PhD(C), “School Participation and Children in Military Families: A Scoping Review,” Journal of Occupational Therapy, Schools, & Early Intervention (March 1, 2018). Link: https://bit.ly/2qiWfcU.

 

Download Research Recap: School Experiences of Children in Military Families


 

Emily Beckett is a professional writer living in Ottawa, Ontario.

Published on May 22, 2018

This article was reviewed by Col. (retd) Russ Mann, Special Advisor to the Vanier Institute of the Family and former Director of Military Family Services, as well as Heidi Cramm, PhD, and Linna Tam-Seto, PhD(C).

Notes

  1. Heidi Cramm et al., “The Current State of Military Family Research,” Transition (January 19, 2016).
  2. Kerry Sudom, “Quality of Life among Military Families: Results from the 2008/2009 Survey of Canadian Forces Spouses,” Director General Military Personnel Research and Analysis, Chief Military Personnel (August 2010). Link: http://bit.ly/2b8Hp3U.
  3. Learn more with A Snapshot of Military and Veteran Families in Canada.
  4. Sudom, 2010.
  5. Pamela Arnold et al., “Needs of Military-Connected School Divisions in South-Eastern Virginia,” Old Dominion University Center for Educational Partnerships (September 2011), link: https://bit.ly/2EQGs9F; Angela J. Huebner et al., “Parental Deployment and Youth in Military Families: Exploring Uncertainty and Ambiguous Loss,” Family Relations 56(2) (April 2007), link: https://bit.ly/2qT6zrH; and Kristin N. Mmari et al., “Exploring the Role of Social Connectedness among Military Youth: Perceptions from Youth, Parents, and School Personnel,” Child and Youth Care Forum, 39(5) (October 2010), link: https://bit.ly/2vm4aey.
  6. Sanela Dursun and Kerry Sudom, “Impacts of Military Life on Families: Results from the Perstempo Survey of Canadian Forces Spouses,” Director General Military Personnel Research and Analysis, Chief Military Personnel (November 2009). Link: http://bit.ly/1pbjBgC.
  7. Prairies Research Associates, CAF Community Needs Assessment: 2016 Overall Results (September 2017).
  8. Cramm, 2016.
  9. Heidi Cramm, “Health Care Experiences of Military Families of Children with Autism,” Transition (November 6, 2017).
  10. Cramm, 2017.
  11. Ibid.
  12. Maire Sinha, “Canadians’ Connections with Family and Friends,” Spotlight on Canadians: Results from the General Social Survey, Statistics Canada catalogue no. 89-652-X (page last updated November 30, 2015). Link: https://bit.ly/1waJ2MQ.
  13. Statistics Canada, “Community Belonging,” Healthy People, Healthy Places, Statistics Canada catalogue no. 82-229-X (January 2010). Link: https://bit.ly/2Jl4MmX.
  14. National Defence and Canadian Forces Ombudsman, “On the Homefront: Assessing the Well-being of Canada’s Military Families in the New Millennium,” Special Report to the Minister of National Defence (November 2013). Link: https://bit.ly/2q6hi2a.
  15. National Defence and Canadian Forces Ombudsman, 2013.

 

Family Perspectives: Death and Dying in Canada

Death is a natural part of life, but many Canadians are hesitant to have essential conversations about the end of their lives. The Vanier Institute of the Family seeks to change this with the publication of Family Perspectives: Death and Dying in Canada, a conversation catalyst intended to spark dialogue in households, workplaces and communities across the country by exploring death and dying through a family lens.

Family Perspectives: Death and Dying in Canada examines the evolution of death and dying in Canada across generations, the desires and realities of families surrounding death and dying, the role of families in end-of-life care and its impact on well-being. Through current data and trend analysis, interviews with caregivers and families, and reflections on hospice volunteering from author Dr. Katherine Arnup, this study discusses death and dying within the current and emerging social, cultural and policy landscapes.

Highlights:

– Hospice palliative care can play an important role in helping dying people and their families, yet most Canadians don’t receive any.

  • Palliative care benefits up to 85% of dying people at the end of their lives.
  • An estimated 16% to 30% of Canadians receive some form of palliative care, depending upon where they live.
  • Three-quarters (74%) of surveyed Canadians report having thought about end-of-life care, but only one-third (34%) have actually had a conversation with a family member. 

– Medical assistance in dying (MAID) is having an impact on the conversation on death and dying in Canada. 

  • Since June 2016, more than 2,600 people across Canada have obtained medical assistance in dying.
  • More than one in eight seniors in Canada (12%) say they or a family member have talked to a health care provider about access to MAID.

– Death is becoming less taboo in Canada, thanks to care providers and community initiatives. 

  • Hospice staff and volunteers, death doulas and other end-of-life practitioners are providing diverse forms of support to many families in Canada, including facilitating advance care planning and discussions about end-of-life care, coordinating care and providing grief support.
  • “Death Cafés” are helping people across Canada to gather and discuss their thoughts about death and dying.

“While many people are hesitant to talk about death and dying with their families and health care providers, some of the silence surrounding death and dying in Canada has been broken – a step in the right direction,” says Dr. Arnup. “Talking about death with family, planning for what we hope for and supporting others can help us to see that death is a natural part of life that is not inherently undignified, and to appreciate the present, thereby enriching our lives.”

“Birth and death are among the few universal family experiences,” says Vanier Institute CEO Nora Spinks. “Many Canadians and their families are hesitant to discuss death despite the importance of these conversations in providing and arranging for the care of loved ones at the end of life. It is our hope that Family Perspectives: Death and Dying in Canada helps to move the conversation forward as we recognize and celebrate National Hospice Palliative Care Week.”

Download Family Perspectives: Death and Dying in Canada 

 


Published on May 7, 2018

 

Alan Mirabelli: Hub Hospice and the Palliative Care Experience

Alan Mirabelli was the Vanier Institute of the Family’s Executive Director of Administration, who retired in 2007 after more than 30 years of service. He was diagnosed with cancer the first time in 2015 and again in 2017. Throughout his treatment and following his terminal diagnosis, he continued to be of service, mentoring many emerging artists and seasoned photographers, community leaders and elected officials. His characteristic kindness, generosity and mentorship had a significant impact on many people across Canada and abroad.

Over the years, Alan gave countless presentations, keynote addresses and lectures, and he facilitated many workshops with diverse groups in hotel ballrooms, quaint retreats and boardrooms and conference rooms. His final presentation was hosted by Hub Hospice Palliative Care, a unique community-based hospice-at-home organization in Almonte, Ontario that Alan came to know, as a recipient of their caring and compassionate services. He spoke to a large audience of community members, academics, health care professionals, end-of-life service providers/volunteers and their families. You could hear a pin drop as people clung to his wise and perceptive words. Alan invited people to donate to Hub Hospice, and died only weeks after giving the presentation.

This article is based on Alan’s presentation, which has been edited for print.


 

Hello, how are you?

In the Maasai culture, the common greeting is quite different – and it leads to a different result. Their greeting is, “How are the children? Are the children well?” By paying close attention to greetings, you can learn a lot about what matters to a people. When you consider the Maasai greeting, there’s a vision in the culture that goes beyond today. It’s not just a casual, passing remark – it reflects a sense of care and a sense of direction for the culture’s future.

When you live in a culture in which you are truly vulnerable, where there aren’t systems of health care and they don’t have all the things we take for granted, this expression of care is from the heart. The answer they expect is that all of the children are doing well, not just some of the children.

I use that story to point out the difference in cultures where care is expressed daily, and people aren’t simply asking if the children are well. What they’re doing, in fact, is preparing the next generation to look after them when they’re old. It’s anticipating the needs; if you don’t acculturate the young people and society to be interdependent and of service, you might not have access to the things you need in your times of vulnerability.

I think it’s very appropriate to what I want to tell you today, because it’s why Almonte has become my home since 1981. I have felt the daily care and concern for the future. It’s different in Almonte. It’s developed in a manner that’s consistent with what I see in the Maasai and the question of the greeting.

This presentation was prepared by me at 3:00 a.m. this morning. There is a reason for that. Some of you know me personally, and you know what an incredibly positive journey I have been on since being diagnosed with cancer.

I have been filtering things so that they become meaningful to somebody else, to other people who have not had this experience themselves. From these notes, which are only eight pages, triple-spaced, I could talk for 10 hours about this community of Almonte and about the people who have supported me thus far and will continue to do so until the end.

On a personal note, if you hear a negative undertone anywhere in this presentation, it is an accident of a mind. It is because it is becoming fogged. This afternoon is really tough for me mentally. If you hear any negativity, discount it. My heart is 100% positive and enlivened by the emotions, which are felt with joy and gratitude.

“If you don’t acculturate the young people and society to be interdependent and of service, you get none of the things you require and need in your times of vulnerability.”

Now I was asked to introduce myself, and rightly so, because anything I’ve done professionally – the fact that I was doing A, B, C in the past, giving hundreds of speeches per year – doesn’t help here. This is the toughest one.

What makes this conversation – and it is a conversation – is that I’d really like you to interrupt and ask a question when it is appropriate for you to ask that question. It is the equivalent of you saying, “Are the children well?” This matters to me. I want to understand you.

What makes this a unique case? Well, it is a case of one, me. You can diagnose this old guy on your own. I am a single person. Most people who turn to hospice turn because spouses and family members need the support as they go through the process of watching somebody they care about die.

By the way, you will not hear, as much as I can help it, euphemisms come out of my mouth. You will not hear of someone “passing” here. You die – that’s it. Euphemisms keep us from focusing on what really matters; and we have a culture that will talk at length about children and how much goes into that end of life, but we never want to talk about the other side.

I knew this day was coming since March 11, 1948. I didn’t know how and when I would die, I just knew that one day I would. There it is.

The second reason I’d like to talk about this is I’ve had the luxury of time – and it is a luxury. To be told you have cancer and you have four to six months (now down to one), it gives me time to say thank you, and to not do all of the things that my head says I have to. It is lovely to see my lawyer here, because she took care of the logistics around death and dying in the first week after I received the terminal diagnosis. Now I can speak from the heart, which is the only thing that matters to me. It really is.

As I said, I’m a case of one. I’m a single person, and I’m male. Usually there are people who surround you during times of illness, such as a spouse, who provides support and helps arrange for care. I’m very clear about how I want to leave this earth. I needed to find the people who would help me get there in the manner that I chose, not in the manner in which they wished to impose upon me. Therein lies a very nice bridge in this community.

I knew Hub Hospice existed, but I had a completely false image of what it was. I thought it was bricks and mortar, and they parked me in there, and I’d live my last days there. It’s a far more intelligent system than that, for which I am grateful. It is just what I need. I want a chance to express my gratitude, to be able to say “Thank you.” I want a chance to encourage the development of this model of care further in ways that really are meaningful not only to me, but to the family I choose to define for myself.

The other thing that this journey has taught me is that with the help of the volunteers that I have – and I have unbelievable volunteers, they’re really friends on call; that’s the way I can describe them – the experience that you get, through no other way than by doing what they do, is not an intellectual exercise but very much an emotional one. From my point of view, because I’ve had the luxury of time and I have a very clear vision of how I want to leave, I could ask for what I wanted clearly.

“Euphemisms [about death] keep us from focusing on what really matters, and we have a culture that will talk about children and how much goes into the beginning of life, but we never want to talk about the other end of life.”

Choosing Love and Life

Now I want to talk about why that matters. Just because I’ve been diagnosed with terminal cancer doesn’t mean that I choose to stop living! I wanted to find volunteers who, if asked, would help me live – fully – not watch me die and hold my hand while I do it. That time will come, but that is not what I want right now. As some of you know, art and photography is a lifeline for me. It is a meditation. It is everything that feeds my soul. I wanted two people who, if I said, “Could you drive me somewhere,” would say, “What time?” And they both have.

If I need to go downtown because I want to get something from the store, even though I’m weakening, “What time and when?” You know, just getting that opportunity to nourish that little piece of me has done more to enliven me. These days are getting harder and harder, but both of the volunteers are interested in what I’m doing, so the conversations become real and not sort of passing time.

When I was clear in asking for what I wanted, they were able to respond in a manner that works for them and works for me, and I tell you, it is what keeps me going every day. Every day is a surprise and they’re part of it somehow. Whether it is anticipating the next visit, arranging the next visit or outlining what we might do – and it might have to change on that day because I’m not up to it – that possibility is so vital to me.

Life can be just two emotions: fear and love. The moment I got the diagnosis, I chose the latter. It could be morbid. Ultimately for me, choosing that was probably the wisest thing I could do because it led to an increased sense of spirit. The number of people who have texted me and emailed me and said, “You’re showing courage doing that.” I said, “There’s no courage involved. It is what I want.” It is who I am. Why should I change that?

Let me switch tracks for a minute. Some of you know that I used to work for the Vanier Institute of the Family as Co-Director with Bob Glossop: an incredible 30-year history. I thought a number of things had changed over those years, but either we haven’t perceived them or if we did perceive them, we have chosen to ignore them at our peril.

We’re making assumptions at the level of public policy when it comes to care, possibly at local policy, in the service sector, about who is home to look after people – anybody – and provide the care they need. If you think about families becoming smaller and the demands of the economy, a need has been created for community groups like Hub Hospice. This evolution in our families and communities wasn’t sudden.

These are changes that are continuing. The first institution in society that reacts to change is never government, it is never our public institutions – it is always family. If you can’t make ends meet at the end of the month, you do one thing and one thing only, you send another member of the family out to work. How many double-income families do we have here? A lot of them. Who is home to provide care? Grandparents now are active, and they are not necessarily available to provide care.

Finally, families in the 1940s had on average five people in the household, but this has since fallen to three and it continues to fall. For many single people, there’s really nobody available to provide care.

If you look at mobility rates (how often people move), 50% of Canadians move every five years between cities, actually between streets, cities, provinces, countries. Try that with a bush and see how long it survives. When there is no one, who do you call when you’re told you’re terminally ill? Who?

Well, my family is no different. I have one sister who lives five hours away and one son who has five children under 11 years of age. So the question is, how do I arrange for the things that I know I would need, when I know I want them in a particular manner so that I don’t become a victim of cancer?

In my case, I learned about Hub Hospice services that were available in in my community by accident. That’s why I offered to make this presentation: to help others learn about the exemplary services available. I heard about the hospice service and how it works; I chose to reach out and make contact because, for me, it was an element of hope.

“Life can be summed up in two emotions: fear and love. The moment I got the diagnosis, I chose the latter.”

Getting the News: “It’s Terminal”

I am going to stop here for a moment and describe what it was like to get the news that you have a terminal illness.

In April 2015, I was diagnosed with throat cancer. The oncologists in the medical system in general were superbly amazing. Everyone I met through my treatment showed me care and compassion.

The compassion part is what I was looking for. I don’t expect it from the medical system, as well organized as it is. This isn’t a blame game; there are simply too many patients, too many sick people, too many fears. There’s got to be some middle ground to transition to the human side. Then when you try to invoke it from the medical system, of course, you get their impatience, and I understand it. However, when you really need the health care system, it really comes through for you and there’s nothing better.

I was standing in the Mill Street Bookstore, talking to Mary (the store owner) when my cellphone rang. It was my family physician, who had received the radiology report. He asked if I could talk. It is not very often that you get a doctor calling you directly, and also hard to get them back on the phone, so I said yes as I stood in front of Mary. He told me that my cancer had metastasized and was terminal.

Mary knew something was serious, and she looked at my face with care and compassion. That look kept me grounded. Without knowing the details, she understood that something real and important had happened, so right there – in the community – that first moment of human connection made a difference that day and has ever since.

I thanked my doctor and I was taken aback for no more than 30 seconds – literally. It didn’t take any longer than that. It was: This is it… this is the road I am now on.

The metaphor I have used to describe this journey is my life being a run-on sentence. I do what I do, and I don’t give it much thought, because it is who I am. Then suddenly I got that call and it was like somebody put a comma in that sentence. That’s what I felt. In seeing that comma – which was my diagnosis – I was at a point of choice: What am I going to do after the comma and before the period? The choice took a nanosecond. It was that clear.

I then walked out the door and ran into a friend whom I knew through photography. He said, “You look a little white.” I said, “Well, I just got this news…” My fear of cancer just washed away. That point of choice was vital for me. For somebody else, it might take longer. But here was my concern, which had nothing to do with dying, end of life or my physical well-being: This will be a huge strain on my family. How do I manage that?That was my first reaction.

My second concern was that our health care system, as good as it is, has become so complicated. I had no idea where to start. I needed a navigator from the point of view of the system. I knew I needed help. But what I also knew was, and in my state, I’m a very emotional man by nature. I have no fears of expressing it. You’ll see me cry somewhere along the way. I’m very comfortable with that. But I was also concerned about where I would get the emotional support I needed without overtaxing the people in my life… my small, busy family… the people who care about me… the people who will be caring for me? Yet I knew that, if I was going to get through this with the joy and the sense of purpose that I have, I would need a circle of support around me.

“My life has been a run-on sentence… Then suddenly I got that call and somebody put a comma in that sentence… What am I going to do after the comma and before the period?”

What that led to was a question of how one prepares for death long before one faces it. I lived with depression throughout my adult life. Medication wasn’t the solution for me. So instead I took a year-long sabbatical and focused on developing a spiritual approach to my life, a life that you see in my photographs. My photographs are based on the beauty I see and the joy it brings to me. I share my images so they bring joy to others. It is a short way of saying how I have lived the last 20 years. I’ve chosen to live with daily meditations, focusing on meaning, creating meaningful relationships or receiving meaning by mentoring a sincere group of photographers who have given me purpose and joy in my life.

Jamming on the Brakes

I will give you some advice: don’t get involved in the love/fear debate, but develop an attitude and a set of actions that really do invite you in and provide clarity of what matters. My life was moving forward like everyone else’s, at considerable speed, when with that phone call from my doctor, it was like somebody had jammed on the brakes: the whole world continued to move forward, and I was right there at the windshield, stopped. It felt like I was pressed against this windshield and that I was alone. It is the aloneness that got me, and the burden that I’d become on others.

I can’t describe the aloneness because it is not loneliness. It is a wholeness that haunts. You want to say something to somebody because they mattered and yet you haven’t got the voice. You haven’t got the capacity to articulate something that is life-giving. It is a very strange feeling. Then I started to think, What if I were married? All of everything I’ve encountered as the patient has been absolutely superb. Absolutely superb! If I need something, I can probably figure it out. I can see if I can find somebody who can point me in the right direction.

I thought for that moment, at the windshield, that what I’m feeling has got to be better than what a spouse or family member is feeling, watching their relationship of a lifetime just fade into the haze in front of their eyes. Feeling that aloneness and that incapacity to make a significant difference beyond a certain point, I just couldn’t imagine.

 

Hub Hospice in Almonte: Authentic Kindness

When I first learned about Hub Hospice in Almonte and its unique approach to hospice at home, I thought, Somebody really thought this through. They understood the experience of the family caregiver; they started there in the family and the home. They understood the patient, but they also understood the spouse.

I cannot imagine the conversations around the boardroom table that developed the vision that created this unique hospice model. Having negotiated many a vision and tried to implement them, they can be a nightmare! There are competing interests, there are competing visions, there are the big bricks-and-mortar people, there are the little keep-it-simple people… there is a wide range. It is a palette. To find one that actually feels right and to fulfill it, I just thought, Wow.

What is unique about Hub Hospice is its focus on family. First of all, it started from the position of the spouse. Second, whatever arguments, and I’m sure they weren’t pleasant, that derived from this model, delivered so consistently… the compromise is elegant. I can’t say it any other way. There is a volunteer perspective that I now have come to respect and give that is based on kindness. It is authentic. It is a kindness that provides a very human foundation for what I’m going through and what I imagine a spouse would be going through.

I have two volunteers. Each has a personal style. What amazes me is how complementary they are. Let me describe to you a meeting that I convened in my home a few months ago. I brought my care team together to plan and prepare for my end-of-life journey and the living I want to do along the way. My team included my palliative care nurse (a hero in my books); my son; my power of attorney for personal care, who is the person who ultimately makes all of the decisions for me when I can’t; and my Hub Hospice volunteers. I sat at the head of my dining room table, and I felt like I was the chairman of my destiny because of who was present. When I got emotional – and I did because there was such kindness at that table – whenever an issue arose, the appropriate person had a contribution to make. The team had only respect for me and my wishes. That’s when the tears started.

To have a team, who didn’t know each other before the meeting, set aside the things that usually divide a group and focus on developing the care plan – and occasionally have a hand reach out and just hold mine with no words – that comes from this notion that we start from: kindness.

There were no competing interests; I trusted everything that was communicated. I had confidence that the journey would be as I wanted it to be, and everyone around the table agreed to work together to see that it did. That they could work so coherently together so quickly speaks volumes to everyone in the room. The way they treated my son, trying to hear and elicit his concerns, that was probably the most touching moment for me. In terms of how hospice acted, they were mandated to support me and my family in this manner.

“There is a volunteer perspective that I now have come to respect and give that is based on kindness. It is authentic.”

My biggest joy was when I first met with the staff person and, subsequently, my volunteers. One of the first questions in the interview that I asked with the volunteers and my staff person was who they would talk to and who they wouldn’t talk to. The response I got just made my heart burst, because they understood completely the modernity of life. Family is like an elastic band: it stretches, it contracts, depending on the economy, the culture and a variety of other things. For many now, particularly the young, they create their own tribe or family. They really do, and I have as well.

I can’t tell you how appreciative I am of the flexibility that allows me to define who is intimate, equal to a blood tie, because some blood ties are very messy.

I have assurance that the right people are looking out for me when I define who is “family” and who needs to be provided with the information. To have an organization willing to do that, it is what I want now – and that is what they provide. I have alluded to the fact that, for me, palliative care is not about death and dying: it’s about finding a group that will support life and living.

The Importance of Listening

I’ve just told you how much family means to me in terms of not just being limited by blood. Why? Because that’s how we form lasting relationships in this culture at this time. I certainly have. The reason I cherish the people who are part of the hospice, and I mean cherish, is because when I talk to them, first of all, they listen. They have probably the most acutely developed sense of being rather than doing. It is a rare commodity. Everybody shows up on my door wanting to do something.

What amazes me is that each Hub Hospice volunteer whom I have dealt with is perceptive enough to recognize that, and to make the space to be quiet when it’s necessary, to laugh when it’s important and to cry when it matters. When I say palliative care is what supports life and living, the people at Hub Hospice do it. When I ask for a perspective, a point of view because of their experience, I get clear responses to consider.

“Palliative care is not about death and dying: it’s about finding a group that will support life and living.”

I don’t get told what to do, I don’t get told how to do it. To have a palette – and some of it I refer to as my emotional guides, some of it I refer to as a topographical map that helps me navigate my day and the care I receive because I have no idea how to manage it all… I have never done this before! – to have people who have experience and the human side of attentiveness is what I cherish every day.

“Defining end of life care is… to make the space to be quiet when it’s necessary, to laugh when it’s important and to cry when it matters.”

Now I am going to change to another part of this: the palliative part of it that I’ve come to understand, unfortunately. You notice when you’re around young families who want to talk about education or you’re around young teachers who want to talk about education, they never talk about learning. They talk about money and unions and the board of education, but not learning.

It is the same when you try to form an organization of any kind. You define your end, but then you get a hundred reasons why you can’t do it. Maybe it’s that you don’t have enough money, that you have to go through this step, that step.

A Different Model of Palliative Care

The way Hub Hospice is modelled is brilliant. There is nothing that can’t be done because they’re not depending on grants or bricks and mortar – they are dependent on volunteers, who work to ensure that I’m where I want to be.

Where do I want to be? In my home with the things I adore, with the things that make me alive. To be removed from my home to go to a “hospice” or “day program” in the cold or extreme heat would be uncomfortable. But these wise people have adopted a system that is flexible, responsive and allows me to stay at home. What I’ve come to appreciate is that Hub Hospice has a model that supports human needs. They’re based on kindness, not on the currency of efficiency.

Each cancer patient is complex and receives care from a well-developed medical model in our publicly funded health care system. From my experience, all the techs, all the doctors, all the nurses are fantastic, but it’s patient-focused. Hospice is all about support and guidance for the family – the family as defined by the patient.

For families, it is asking the right questions at the right time. When I need help, whom do I call? Will it be given freely? Will it be given begrudgingly or generously? Those are the things that matter. Support for those who care is vital, and palliative care supports dying with dignity and grace, peace and joy, and love and care. That’s it for me.

Palliative care speaks to and supports those who care for the patients and who ultimately ease the anxiety of the patients – the family. As I’ve told you, my life has been a run-on sentence – and then comes the comma, a terminal diagnosis. I’m moving toward the period and the end of my journey is coming. I’ve chosen a path and I’m choosing to speak about it. I’m not battling anything. I’ve chosen to live fully until I can no longer do so with or without support.

Making Images Is Like Palliative Care

When I make an image, and most of you will know and have seen my images, I always stand behind the camera and the tripod for 45 minutes or more before I make the image, because that time is an invitation. A slight shift from here to there or from this position to that position changes everything. The whole interpretation changes – the whole meaning changes – the whole experience changes. It is that focus, positioning and patience that is crucial.

Hub Hospice is like the photographer in me. The organization and the volunteers stand there observing, waiting for 45 minutes or more to see if they need to make a slight adjustment in order to make a big difference for the patient and their family. I can’t think of a better metaphor, because, in my experience, it’s the small gestures that make the biggest difference.

“Palliative care speaks to and supports those who care for the patients and who ultimately ease the anxiety of the patients – the family.”

In this day and age, it is very hard to find volunteers who will do anything more than once – forget about doing something more than once, twice, three times over a month. To get somebody to commit for an indefinite period of time to care for someone is challenging, and for someone they don’t know seems impossible. Making that commitment is heroic on the part of the volunteer and speaks volumes about the organization. Volunteers don’t make their commitment alone; I find it incredible that there are families in this community that will support the volunteers to sacrifice a good part of their lives for an extended and indefinite period of time. That is a demonstration of how the community supports one another directly and indirectly, a fact I don’t take for granted for a minute. It is to be celebrated and to be honoured.

It leads to a more potent question: how did Almonte develop this kind of caring and compassionate culture? These things don’t happen by accident. I chose to live in Almonte in 1981 because it is a community I felt I wanted to live in. Partly because community matters to me and I really have a sense of what community means to me. I can honestly say Almonte is my home. Having lived in different countries, having lived in different cities, Almonte is my home. It is partly because of its scale, but also because of who chooses to live here, its history and its traditions.

This is what has made this experience so enlivening. It is not an accident, for me, that the hospice was therefore created as it was. First of all, you have a community that has a long history: where a lot of people didn’t move every five years, where families have deep roots, where those roots are visible and talked about. Stories are shared. When somebody like me comes in where families are scattered all over the world, I see them as kind of memories. Somebody mentions a name and somebody at the table will spend the next 20 minutes telling the family history. The fact that people here tell stories, stories about their history, their families for generations, that’s what it’s meant.

It’s not always cute, it’s not always nice and pleasant, but the roots are deep and they’re real. I, the city guy, don’t have to come in and do anything. I just have to absorb tradition. This is a traditionally rich area having large families. They are still in the area. They still talk to each other. They still make contributions. It is the stories we tell each other that remind us that we live in a community that has provided a solid foundation for places like Hub Hospice.

We have an incredibly well-educated community; the people who come from afar tend to want to stay. They’re here to absorb this tradition, understand it, feel it and see how modern culture can be fitted in so that Almonte keeps up but doesn’t lose its strength of tradition. That’s how I see the palliative care process having been formed. People at that table remembering how it used to be done, recognizing it can’t be done that way, but rather how it can be adapted within a legal framework and within compassionate frameworks. It has that think and feel. It is not make-believe. It is why I like what they’ve done with Hub Hospice.

“Almonte is my home. It is partly because of its scale, but also because of who chooses to live here, its history and its traditions.”

I may be making all of this up because this is a case of one, and you can’t generalize. But from a case of one, I’ll tell you it’s made a huge difference.

Today my state of mind may be very fogged, but my state of heart is clear as crystal. It really is. My state of emotions is high and comfortable. The emotions are about gratitude and appreciation for our community that is responsive and chooses to be caring and compassionate. I no longer worry. It has become a conversation that is evolving as it needs to, with comfort, dignity, respect, tenderness and I can’t think of enough words to express how it feels.

The decision I made to come here in 1981 is the best decision I ever made. The decision to say this is my home and to really believe it is the best decision I ever made. I can’t imagine going along this journey any other way but with the joy and gratitude that you’ve afforded me. To the board, to the staff, to the volunteers at Hub Hospice, I thank you. You’ve made the difference. Not just intellectually, but to the heart and to the soul.

I thank you for listening.

Download Alan Mirabelli: Hub Hospice and the Palliative Care Experience


Alan died on December 20, 2017, a few weeks after he gave this presentation at Hub Hospice Palliative Care. Along with family and friends, his Hub Hospice volunteers were with him as he took the last few steps on his journey. In his final days, every time he woke up he would say, “I am so lucky, I am so blessed, I am so grateful.”

Published on April 3, 2018 with permission from Alan’s family (Marilyn Mirabelli and Michel Mirabelli)

Photo (top of page) by Peter Waiser 

In Focus: Senior Caregivers in Canada

Caregiving is a part of family life, and family caregivers play a crucial role in providing, arranging and sometimes paying for care for their loved ones. While there has been progress over the past decade in recognizing and celebrating the importance and impact of Canada’s 8.1 million caregivers, senior caregivers are often overlooked in the narrative despite accounting for more than 1 in 8 caregivers in 2012.1

Senior caregivers make unique and valuable contributions to family caregiving in Canada, though they can also have unique needs resulting from their advanced age. It can be a complex caregiving experience, as many provide care while managing their other responsibilities in workplaces and communities across the country (sometimes while receiving care themselves).

Seniors make significant contributions to caregiving in Canada2

  • In 2012, nearly 1 million seniors in Canada (966,000) provided care to a family member or friend with a long-term health condition, disability or aging need (12% of all caregivers).3
  • In 2012, senior caregivers were most likely to spend the longest hours per week providing care, partly due to their higher likelihood of caring for a spouse (spouses typically require greater time commitments for care).4
    • Nearly one-quarter (23%) of senior caregivers provided 20 or more hours of care per week, approximately twice the rate of carers aged 45 to 54 (13%) and young carers aged 15 to 24 (10%).5

Many senior caregivers balance their caregiving with paid work and volunteering6

  • In 2017, 14.2% of seniors were in the paid labour market (18.7% of men, 10.4% of women), more than double the rate in 2000 (6%).7
  • In 2015, one in five (19.8%) seniors in Canada (1.1 million) worked at some point – nearly twice the rate in 1995 (10.1%). Men were more likely than women to report having worked at some point that year (25.7% and 14.6%, respectively).8
  • In 2013, nearly 3 in 10 seniors aged 75 and older (27%) were volunteers.9

Caregiving can have an impact on the well-being of senior carers

  • Research shows that caregiving can have a positive impact on the well-being of caregivers themselves, providing them with a sense of personal growth and renewed meaning and purpose in life, assurance and greater awareness of the care being provided, and a sense of “giving back” to someone who has cared for them.10
  • Caregiving can also have a negative impact on the well-being of caregivers. Nearly 3 in 10 people (28%) who provided care in 2012 said that they found it “somewhat or very” stressful, and 1 in 5 (19%) said that their “physical and emotional health suffered” as a result of their caregiving responsibilities.11

Download In Focus: Senior Caregivers in Canada.

The Vanier Institute of the Family is a national, independent, charitable organization dedicated to understanding the diversity and complexity of families and the reality of family life in Canada. The Institute offers access to a range of publications, research initiatives, presentations and social media content to enhance the national understanding of how families interact with, have an impact on and are affected by social, economic, environmental and cultural forces.

 

Notes


  1. Maire Sinha, “Portrait of Caregivers, 2012,” Spotlight on Canadians: Results from the General Social Survey, Statistics Canada catalogue no. 89-652-X (September 2013). Link: http://bit.ly/1jxgAAm.
  2. Learn more in A Snapshot of Family Caregiving and Work in Canada.
  3. Sinha, 2012.
  4. Ibid.
  5. Ibid.
  6. Learn more in Modern Family Finances: Seniors in Canada and Modern Family Finances: Income in Canada.
  7. Statistics Canada, Labour force characteristics by sex and detailed age group, annual (x 1,000) (CANSIM Table 282-0002), page last updated February 26, 2019. Link: http://bit.ly/2p38FWs.
  8. Statistics Canada, “Census in Brief: Working Seniors in Canada,” Analytical Products, 2016 Census, Statistics Canada catalogue no. 98-200-X-2016027 (November 29, 2017). Link: http://bit.ly/2AIjwMn.
  9. Learn more in Facts and Stats: Volunteering in Canada.
  10. American Psychological Association, “Positive Aspects of Caregiving,” Public Interest Directorate Reports (January 2011). Link: http://bit.ly/1KMuMRA.
  11. Sinha, 2012.

 

Facts and Stats: Families and Mental Health in Canada

At some point, most families find themselves affected by mental illness, whether it’s because a family member (or multiple family members) personally experiences a mental health condition or because they’re providing care to someone else – or both. With appropriate treatment and support, however, most people who experience a mental illness will recover,1 and families often play an important role in providing, arranging or helping pay for care.

Our new fact sheet provides an overview of families and mental health in Canada, including rates of mental health conditions within families, factors that contribute to mental illnesses and the roles family members can play in mental health treatment.

Download Facts and Stats: Families and Mental Health in Canada from the Vanier Institute of the Family.

Notes


  1. Centre for Addiction and Mental Health, Mental Illness and Addiction: Facts and Statistics (n.d.), accessed September 20, 2017. Link: http://bit.ly/2jLyV6Y.

Health Care Experiences of Military Families of Children with Autism

Download this article in PDF format.


Heidi Cramm, Ph.D.

Military families in Canada are highly mobile, relocating three to four times more often than their civilian counterparts.1 This mobility has been found to complicate access to health care for these families, most of whom live off-base (85%, compared with only 20% in the mid-1990s) and rely on provincial and territorial civilian health care systems. This has an acute impact on the 8.2% of military families who have children with special needs, including those living with Autism Spectrum Disorder (ASD).2

Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder with an estimated prevalence of 1 in 68 children. While this condition primarily affects social communication, often making it difficult for people living with ASD to share enjoyment or emotional experiences with others, it has a range of symptoms and associated behaviours:

  • Approximately 25% of people living with ASD are non-verbal, unable to use or respond to non-verbal communication (or are otherwise delayed in its use), such as pointing, gesturing and so forth, especially to indicate something of interest.
  • People with ASD often have difficulties understanding abstract language/communication such as metaphors, sarcasm, colloquialisms and jokes.
  • Repetitive behaviours, such as rocking, hand-flapping, finger movements and so forth, are common among people with ASD.
  • People living with ASD are often highly sensitive to change, and they are “creatures of habit.”
  • Most people with ASD have a range of sensory dysfunctions that vary widely (e.g., extreme sensitivities to noise, touch, smells, tastes, etc.) while many also exhibit a high pain threshold.
  • Some children with ASD have exceptional abilities in music, visual and academic skills.
  • In addition, up to 90% of children with ASD will have a co-existing medical and/or psycho-behavioural disorder, such as ADHD, anxiety, sleep disorders, feeding disorders, seizures, intellectual disability and gastro-intestinal disorders.

Early Intervention Supports Treatment for Children with ASD

Research suggests that early intervention is most impactful to the prognosis of ASD,3 and it can enhance the development of learning, communication and social skills for people living with the condition. Autism is typically diagnosed in early childhood, even as early as 18 to 24 months of age.

In many provinces, families experience long waiting times when seeking early diagnosis and/or intervention due to a “bottlenecking” of access to appropriate diagnostic centres – delays that can sometimes exceed two years.

Between 21% and 27% of military families do not have a family doctor, compared with 15% among the general population.4 Since many health services and treatments are accessed through family doctors, this discrepancy means that military families can have a harder time accessing services for children with special needs, including those with ASD. With each move, families who are moving toward the top of wait-lists for services find themselves back at the bottom.

Since many health services and treatments are accessed through family doctors, this discrepancy means that military families can have a harder time accessing services for children with special needs.

Exploring the Experiences of Military Families of Children with ASD

In a recent qualitative study, military families who have a child with ASD were interviewed to explore and describe their experiences navigating health care systems on behalf of their children.5

Many of these families reported that they had a hard time getting their child’s condition noticed, validated and medically diagnosed. Families generally found it difficult to get the assessment for ASD, and this delay in assessment and subsequent diagnosis meant that, for many, their access to intervention services was held up significantly.

One parent explained that their family experienced delays in accessing care for their son after moving because many of the programs available in their new community were for people living with autism who have a diagnosis. Since the family didn’t realize that they would need to have the diagnosis in hand when they sought care in their new neighbourhood, they went ahead and moved without having one, only to find that their son couldn’t access these programs as a result. Access to care for their child was delayed by months.

Difficulties accessing care can have an impact on family finances. Frustrated with wait-lists and the implications of delayed services for their child’s long-term development, many families opted instead to pay directly for private assessment services. One participant described making the decision to seek out private assessment and intervention because the wait-lists would exceed their posting tenure: “We paid privately… because the wait-list was too long. Once we had that diagnosis, [a community organization] put us on a wait-list for [Applied Behaviour Analysis] therapy. That wait-list is two years long. So we were never going to see the end of that wait-list either. So… we started paying privately for him.”

Frustrated with wait-lists and the implications of delayed services for their child’s long-term development, many families opted instead to pay directly for private assessment services.

At times, families waiting for care said they wound up moving again before their child’s name made it to the top of the local wait-list. For some families, service access was within sight, and then another posting forced them to move and start all over again. One participant shared that after waiting for some time for their child to get into a program, they finally received confirmation from their intervention team that the child would be able to start in September – which was of little help to them at that point, since they were going to be moving again in July.

With services varying widely from province to province (along with the corresponding eligibility and funding), some families reported consternation over losing services that they had previously had access to but were simply not available in their new location. One participant described this experience, “We realized the school [in the current province] didn’t offer the same things that they do in [the previous province]… there was nothing they could do…”

These variations also exist from region to region within the same province. For example, another participant described having to remove her child from a highly beneficial education program because they were moving, but then found they were unable to place him in a similar program in the new city because the program didn’t exist there (even though they were in the same province). Families in several other provinces described similar circumstances when moving interprovincially or intraprovincially.

Ongoing Pursuit of Health Care Affects Family Well-Being

While military families are highly resilient, difficulty accessing health care services for their children with ASD can have an impact on their own and their family’s well-being. Participants in the study commonly described frustration and confusion over the daunting tasks of sorting out how to get their children whatever services were possible. One participant described “bursting into tears” after finally getting to the top of a wait-list for intervention only to find the service did not meet expectations.

Some participants described having to draw on support from extended family to help care for their children. One participant said her parents retired and moved to the family’s current posting to assist because “they knew [our son] needed more help and we needed a break.” Others lamented the fact that extended family were too far away to really provide any assistance and were “just not able to be there.” Participants’ experiences with Military Family Resource Centres (MFRCs) were diverse, as the available services varied from base to base.

Parents often experienced strain on their relationships with their spouse or partner as their efforts to find caregiver supports and develop local networks can be complicated by training exercises, deployments and postings. As a result, hard choices are sometimes made related to whether or not a new posting, which comes with career opportunity, is feasible given the health care implications for the child with ASD.

Parents often experienced strain on their relationships with their spouse or partner as their efforts to find caregiver supports and develop local networks can be complicated by training exercises, deployments and postings.

Some participants described the Canadian Armed Forces (CAF) member making career decisions such as changing trades or requesting a specific posting for the benefit of the child, even though it could have an impact on their career trajectory and, by extension, the family as a whole. One participant said their family would consider living apart (i.e., imposed restriction) if it meant the child would receive the services needed, even though this would create a protracted separation that could have a significantly negative impact on the family as a whole.

In some military families, a civilian spouse may need to limit their involvement in the paid labour force to offset the caregiving requirements of the child. Such “trade-offs” are common in military families, with more than half (51%) of surveyed CAF spouses reporting that they have made some career sacrifices because of their partner’s military service, according to a 2009 study from the Director General Military Personnel Research and Analysis (DGMPRA). This limited workforce involvement can further constrain family finances that may be needed to pay for private services for their children. This can have a greater impact on dual-service families (families with two serving CAF members).

Military Families Express Desire for Navigation Support

Some military family members identified a few ways that could be considered to enhance the support for other military families who have children with ASD. Many expressed the desire to connect with other military families who are already at the new location to help map out options for how to access ASD-related services; some wanted this to be a formalized opportunity whereas others felt it would be important that it happen outside of official channels.

Many [families] expressed the desire to connect with other military families who are already at the new location to help map out options for how to access ASD-related services.

Opportunities to provide augmented and current information for families were also discussed, with some expressing a desire for a single point person who can help them navigate across school, community and health services. However, one participant indicated this type of formalized approach could result in parents receiving “filtered information” without any indication of how effective the services really are.

This qualitative study raised some important issues, but there is much left to learn. How might some of these opportunities be realized within existing formal and informal networks for incoming families? How could the disruptions and delays to health care access that military families report be reduced across provinces? What, if any, kinds of options might there be to offset the financial implications for parents when publicly funded services are absent or inaccessible? Are the differences for those who move within provinces similar to those who move across provinces? Exploring these questions through further research – with the insights and participation of families – will be key in supporting Canada’s diverse military families.

 

Dr. Heidi Cramm is the Interim Co-Scientific Director at the Canadian Institute for Military and Veteran Health Research (CIMVHR) and recipient of the 2016 Colonel Russell Mann Military Family Health Research Award.

 

Notes


  1. Heidi Cramm et al., “Making Military Families in Canada A Research Priority,” Journal of Military, Veteran and Family Health 1:2 (November 2015). Link: http://bit.ly/2zx46G1.
  2. Learn more with A Snapshot of Military and Veteran Families in Canada. Link: https://bit.ly/2fM3xmP.
  3. Geraldine Dawson, “Early Behavioral Intervention, Brain Plasticity, and the Prevention of Autism Spectrum Disorder,” Development and Psychopathology 20:03 (July 7, 2008). Link: https://bit.ly/2SWK2Lj.
  4. Nathan Battams, “A Snapshot of Military and Veteran Families in Canada,” Statistical Snapshots (November 2016). Link: https://bit.ly/2fM3xmP.
  5. Most of the families who participated in the study were married, and one-third of them had both parents serving in the Canadian Armed Forces (CAF). Most of the families represented serving members in the Regular Forces, primarily in the Army.

A Snapshot of Families and Food in Canada

Food is at the heart of family life. A biological necessity for our survival and well-being, food is also much more than that. What we choose to eat is often more than just a matter of personal preferences and whims; in many instances, what we eat reflects our cultural, community and family identities. Sometimes, our choices are made for us based on the availability and accessibility of food.

Regardless of the context, families adapt and react to ensure that dietary needs are being met. Some families have many opportunities to eat together, and these family meals provide a setting where family dynamics and relationships often “play out,” whether it’s in the delegation of cooking roles, discussing an upcoming family vacation or arguing over who has to do the dishes. Sometimes families – particularly those with busy schedules or high mobility – opt to eat meals “on the go.”

A Snapshot of Families and Food in Canada explores the evolving relationships between families and food in Canada, including research and statistics about family meals, eating patterns, nutrition, food security and more.

Highlights include:

  • More than 6 in 10 Canadians (62%) surveyed in 2017 said they eat dinner as a family at least five times per week.
  • More than one-quarter (26%) of Canadians surveyed in 2017 agree with the statement, “My work–life balance does not permit me to prepare and/or eat my meals at home.”
  • The most recent data indicates that 12% of households across Canada (1.3 million) experienced food insecurity in 2014, home to 3.2 million people.
  • More than half (52%) of Inuit living in Inuit Nunangat1 aged 25 and over lived in food-insecure households in 2012.
  • In 2015, households across Canada spent an average $8,600 on food, an increase of 9.9% since 2010.
  • 4 in 10 of those who said it’s become more difficult to afford groceries said they’ve been choosing less healthy options in the aisle to manage the rising prices.
  • According to a 2017 study, more than three-quarters of Canadians aren’t meeting Canada Food Guide recommendations for fruit and vegetable consumption, with a resulting estimated economic burden to society of is $4.39 billion per year.
  • More than 863,000 people across Canada accessed food banks in March 2016 alone (40% of whom lived in family households with children), 28% higher than in 2008.
  • Research shows that the widespread malnutrition experienced by Indigenous children in Canada’s residential school system has had (and continues to have) a multi-generational impact on the health and well-being of their children and grandchildren, contributing to higher rates of chronic conditions.

This bilingual resource will be updated periodically as new data emerges. Sign up for our monthly e-newsletter to find out about updates, as well as other news about publications, projects and initiatives from the Vanier Institute.

Download A Snapshot of Families and Food in Canada from the Vanier Institute of the Family

 


This Statistical Snapshot publication is dedicated to David Northcott, CM, OM, retired Executive Director of Winnipeg Harvest Food Bank and a founder of both the Canadian Association of Food Banks and the Manitoba Association of Food Banks. David recently completed his second full term on the Vanier Institute Board of Directors, where his enthusiasm, dedication to family well-being and generous heart has had an impact on the entire Vanier Institute team.

 

Notes


  1. From Statistics Canada: “Inuit Nunangat is the homeland of Inuit of Canada. It includes the communities located in the four Inuit regions: Nunatsiavut (Northern coastal Labrador), Nunavik (Northern Quebec), the territory of Nunavut and the Inuvialuit region of the Northwest Territories. These regions collectively encompass the area traditionally occupied by Inuit in Canada.” Link: http://bit.ly/2gbzaqo.

Grandparent Health and Family Well-Being

Rachel Margolis, Ph.D.

Download this article in PDF format.

Canada’s 7.1 million grandparents and great-grandparents make unique, diverse and valuable contributions to families and society, serving as role models, nurturers, historians, sources of experiential knowledge and more. As with the general population, the grandparent population in Canada is aging rapidly, sparking some concern in the media and public discourse about the potential impact of this “grey tsunami.”

However, despite being older, data show that the health of grandparents has improved over the past 30 years. This trend can positively impact families, since healthy grandparents can have a higher capacity to contribute to family life and help younger generations manage family responsibilities such as child care and household finances.

Improving grandparent health enhances their capacity to contribute to family life and help younger generations manage family responsibilities.

Canada is aging, and so are its grandparents

The aging of the grandparent population mirrors broader population aging trends across the country. According to the most recent Census in 2016, 16.9% of Canada’s population are seniors, nearly double the share in 1981 (9.6%) and the highest proportion to date. This growth is expected to continue over the next several decades: projections show that nearly one-quarter (23%) of Canadians will be 65 or older by 2031. Furthermore, the oldest Canadians (aged 100 and over) are currently the fastest-growing age group: there were 8,200 centenarians in 2016 (up 41% since 2011), and projections from Statistics Canada show that this group is likely to reach nearly 40,000 by 2051.

In this context, it’s perhaps no surprise that the overall grandparent population is also aging. The share of grandparents who are seniors grew from 41% in 1985 to 53% in 2011, and the share of grandparents who are aged 80 and older has grown even faster, nearly doubling from 6.8% in 1985 to 13.5% in 2011.

Life expectancy increases fuel grandparent population aging

One of the underlying factors fuelling the aging of the grandparent population is the fact that Canadians are living longer. According to Statistics Canada, life expectancy at birth has continued to rise steadily, reaching 83.8 years for women and 79.6 years for men in 2011–2013. This represents an increase of about a decade over the past half-century, with women and men gaining 9.5 years and 11.2 years, respectively, since the years 1960–1962.

In addition, more people are reaching seniorhood than in the past because of mortality declines at ages below age 65. Data from Statistics Canada shows that the average share of female newborns who can expect to reach age 65 rose from 86% for those born in 1980–1982 to 92% for those born in 2011–2013, while this share increased from 75% to 87% for males during the same period.

People are also living longer as seniors, as reflected in ongoing increases in life expectancy at age 65 – a useful measure of the well-being of older populations since it excludes mortality for those who do not reach seniorhood. According to estimates from Statistics Canada, life expectancy at age 65 in 2011–2013 was 21.9 years for women and 19 years for men – up by 3 years and 4.4 years, respectively, from 1980 to 1982.

Delayed fertility contributes to the aging of the grandparent population since it increases the age of transitioning into grandparenthood.

Another contributing factor to the aging of grandparents is the fact that on average, women are having children at older ages than in the past – a fertility trend that increases the age of transitioning into grandparenthood. The average age of first-time mothers has risen steadily since 1970, from 23.7 to 28.8 years in 2013. The number of first-time mothers aged 40 and older has also grown, rising from 1,172 in 1993 to 3,648 in 2013 (+210%). As more women postpone childbearing until later in life, their transition to grandparenthood will also likely occur later. Today’s new grandparents are baby boomers, a generation in which many women delayed fertility for education and work experience. Their children are also having children later, and the fertility postponement of two generations together is influencing the pattern of later entry into grandparenthood.

Despite the aging of grandparents, grandparenthood accounts for a growing portion of many people’s lives. Even though people are becoming grandparents later, they are living longer as grandparents. The longer period of time spent in the grandparent role can extend opportunities for forming, nurturing and strengthening relationships with younger generations. According to my recent research, the average number of years that someone can expect to spent as a grandparent given today’s demography in Canada is 24.3 years for women and 18.9 years for men – that’s approximately two decades in which they can continue to play a major role in family life.

Despite being older, grandparents are healthier

In addition to living longer, data from the General Social Survey (GSS) suggest that grandparents in Canada today are far more likely to report living in good health than in the past. The proportion who rate their health as “good/very good/excellent” has increased from 70% in 1985 to 77% in 2011, while the share reporting “fair/poor” health has fallen from 31% to 23%. Overall, the odds of grandparents reporting that they are in good health are 44% higher in 2011 than in 1985.

A number of trends have contributed to health improvements among grandparents and older Canadians in general over the past half-century. There have been significant advances in public health that have facilitated disease prevention, detection and treatment. Among other factors, this has led to major reductions in deaths from circulatory system diseases (e.g. heart disease), which has been one of the biggest contributors to gains in life expectancy among men over the past half-century.

Another factor contributing to improvements in the health of grandparents in Canada is the rising educational attainment of this population. Research shows that education can improve health both in direct and indirect ways throughout life. Direct impacts can include enhancing one’s health literacy, knowledge, interactions with the health care system and patients’ ability and willingness to advocate for themselves when engaging with health care providers. Indirect impacts can include an increase in one’s resources (e.g. income) or occupational opportunities (e.g. being less likely to have a physically demanding and/or risky job, and more likely to have a job with health benefits).

Education has been associated with greater health, which is significant because the share of grandparents who have completed post-secondary education has more than tripled over the past three decades.

These are important factors to consider in the Canadian context, since the share of grandparents who have completed post-secondary education has more than tripled over the past three decades, from 13% in 1985 to nearly 40% by 2011.

Healthy grandparents can facilitate family well-being

Grandparent health can have a significant impact on families. When a grandparent (or multiple grandparents) is living in poor health, families are often the first to provide, manage or pay for care that supports their well-being. This is particularly true for senior grandparents receiving care at home; the Health Council of Canada estimates that families provide between 70% and 75% of all home care received by seniors in Canada.

Data from the 2012 GSS show that nearly 3 in 10 Canadians (28%) reported providing caregiving to a family member in the past year, and aging-related needs were the most commonly cited reason for care (reported by 28% of caregivers). Grandparents accounted for 13% of all Canadians who received care, and they were also the most frequent recipients of young caregivers’ (aged 15 to 29) assistance, 4 in 10 of whom cited a grandparent as the primary recipient.

While 95% of caregivers say they’re effectively coping with their caregiving responsibilities, research has found that in some contexts, it can have a negative impact on their well-being, career development and family finances. This can be particularly true for the three-quarters of caregivers who are also in the paid labour force, accounting for more than one-third of all working Canadians.

On the other hand, when grandparents are living in good health, families can benefit in a variety of ways. In addition to the fact that it means they are less likely to require caregiving assistance, they are also more likely to be able to make positive contributions to family life, such as providing child care and contributing to family finances.

Grandparents provide child care to younger generations

Many grandparents play an important role in caring for their grandchildren, which can help parents in the “middle generation” manage their child care and paid work responsibilities. A number of economic, social and environmental trends have converged in recent decades that have increased the significant contributions they make to families with regard to child care.

Many grandparents play an important role in caring for their grandchildren, which can help parents in the “middle generation” manage their child care and paid work responsibilities.

Over the past four decades, the share of dual-earner couples in Canada has increased; in 1976, 36% of couples with children included two earners, a rate that nearly doubled to 69% by 2014. In more than half of these couples (51%), both parents worked full-time, which means they were more likely to rely on non-parental care for their children. This is supported by data from the 2011 GSS: while nearly half (46%) of all parents reported relying on some type of child care for their children aged 14 years and younger in the past year, the rate was higher (71%) for dual-earner parents with children aged 0 to 4 and children aged 5 to 14 (49%).

The evolution in family structure and composition across generations has also contributed to more families relying on non-parental care for their children. The share of lone-parent families has increased significantly over the past 50 years, rising from 8.4% of all families in 1961 to approximately 16% in 2016. Data from the 2011 GSS show that nearly 6 in 10 lone parents of children aged 4 and under (58%) report that they rely on non-parental care.

Sometimes grandparents are solely responsible for raising their grandchildren when no middle (i.e. parent) generation is present. The 2011 GSS counted 51,000 of these “skip-generation families” in Canada, which was home to 12% of all grandparents who live with their grandchildren. Some of those who live with their children are more likely than others to live in skip-generation homes, such as people reporting a First Nations (28%), Métis (28%) or Inuit (18%) identity (compared with 11% among the non-Indigenous population).

Lastly, many parents may rely on grandparents for help with child care if they can’t find quality, regulated child care spaces in their communities. In 2014, the availability in regulated, centre-based child care spaces was only sufficient for one-quarter (24%) of children aged 5 and under across Canada. While this is a significant increase from 12% in 1992, it still leaves more than 3 in 4 children in this age group without an available regulated child care space. The availability of child care (or a lack thereof) is significant, since it can affect whether or not parents in coupled families can both participate in the paid labour market.

The cost of child care can also lead parents to turn to grandparents for child care assistance. This is particularly true for families living in urban centres. One 2015 study on the cost of child care in Canadian cities, which used administrative fee data and randomized phone surveys conducted with child care centres and homes, found that the highest rates in Canada were in Toronto, where estimates showed median unsubsidized rates of $1,736 per month for full-day infant care (under 18 months of age) and $1,325 for toddlers (aged 1½ to 3).

Grandparent involvement can enhance child well-being

Regardless of the reason grandparents spend time with their grandchildren, their involvement in family life can benefit the well-being of children. Studies have shown that grandparent involvement in family life is significantly associated with child well-being – in particular, it has been associated with greater prosocial behaviours and school involvement. The benefits aren’t limited to children, either, as other research has shown that close relationships between grandparents and grandchildren can have a positive impact on mental health for both. Among First Nations families, grandparents have also been found to play an important role in supporting cultural health and healing among younger generations.

Research shows that grandparent involvement in family life is significantly associated with child well-being, including greater prosocial behaviours and school involvement.

The broader context of improving grandparent health is good news for many families, since their better health can make it easier to participate in activities with children and grandchildren, and research shows that these interactions with younger kin can be more rewarding in this context.

Many grandparents play an important role in family finances

Improvements in grandparent health can also enhance their capacity to engage in paid work, which can improve their own finances and facilitate contributions to younger generations.

Improvements in grandparent health also enhance their capacity to engage in paid work, which can improve their own finances and facilitate contributions to younger generations.

While there isn’t much recent data on the employment patterns of grandparents in Canada per se, rising rates of working seniors have been well documented over the past several decades. Between 1997 and 2003, the paid labour force participation rate for seniors ranged between 6% and 7%, but this has steadily increased to around 14% in the first half of 2017 (and an even higher rate of 27% for those aged 65 to 69). Since approximately 8 in 10 seniors in Canada are grandparents, it’s clear that a growing number of grandparents are working today.

The potential for grandparents to contribute to family finances through paid work can be particularly important for the 8% who live in multi-generational households. According to data from the 2016 Census, this is the fastest-growing household type, having grown in number by nearly 38% between 2011 and 2016 to reach 403,810 homes. Similar to patterns found among skip-generation families, this living arrangement is more common among Indigenous and immigrant families, which both represent a growing share of families in Canada.

Skip-generation living arrangements are more common among Indigenous and immigrant families, which both represent a growing share of families in Canada.

Data from the 2011 GSS showed that among the 584,000 grandparents living in these types of homes, more than half (50.3%) reported that they have financial responsibilities in the household. Some were more likely than others to contribute to family finances: rates were significantly higher for those living in skip-generation households (80%) and multi-generational households with a lone-parent middle generation (75%).

Opportunities are growing for grandparent–family relationships

While the aging of the general and grandparent population in Canada presents certain societal challenges, notably with regard to community care, housing, transportation and income security, their rising life expectancy and improving health present growing opportunities for individuals and families. Many grandparents already help younger generations with fulfilling family responsibilities, such as child care and managing family finances, and this will continue in the years ahead – a positive side of the story that is often lost in narratives about the “grey tsunami.”

As the health of grandparents has improved over the years, many have been able to enjoy a greater quantity and quality of relationships with younger family members. As families adapt and react to their evolving social, economic and cultural contexts, they will continue to play an important – and likely growing – role in family life for generations to come.

 


Rachel Margolis, Ph.D., is an Associate Professor in the Department of Sociology at the University of Western Ontario.

 

All references and source information can be found in the PDF version of this article.

Published on September 5, 2017

Facts and Stats: Families and Active Leisure in Canada (2017 Update)

Whether it’s swimming at the beach in the summer, tobogganing in the winter or playing organized sports throughout the year, many families enjoy being physically active in their leisure time, and this exercise can have a positive impact on our individual and family well-being. However, there is growing concern that many people aren’t meeting the recommended guidelines for physical activity, as busy schedules and “screen time” can interfere with our best efforts to keep moving.

Learn about how Canadians of all ages are keeping fit and having fun with our updated fact sheet on families and active leisure in Canada!

Download Facts and Stats: Families and Active Leisure in Canada from the Vanier Institute of the Family.

 


Published on July 25, 2017

In Context: Understanding Maternity Care in Canada

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If it takes a village to raise a child, it certainly takes one to bring a child into this world. New and expectant mothers receive care from many people throughout the perinatal period, and the networks and relationships that support them can play a major role in ensuring the health and well-being of new mothers and their newborns.

Childbirth is a milestone, an exciting time when the family grows and a new generation begins. It’s also a period of significant child development – a time of great vulnerability but also of great opportunity to benefit from healthy nurturing.

The experience of pregnancy, childbirth and postnatal care continues to evolve through the generations. Rates of maternal mortality (women dying as a result of pregnancy and childbirth), maternal morbidity (women developing complications as a result of childbirth) and infant mortality all saw significant declines throughout the 20th century following medical advances and improvements in maternal care, nutrition and general living standards.

Maternal and Infant Mortality in Canada

Maternal mortality dropped from 508 deaths per 100,000 live births in 1931 to 7 per 100,000 in 2015.

Infant mortality rates fell from an average of 76 deaths per 1,000 live births in 1931–1935 to 4.9 per 1,000 in 2013.

In the 1800s to the mid-1900s, maternity care in Canada typically took place in the local community and birth occurred in the home, with families and midwives routinely providing care to new and expectant mothers. However, with the development of medicare throughout the 20th century, births and maternity care gradually moved into hospitals and medical clinics, with care being delivered primarily by medical professionals such as doctors and obstetricians – a trend sometimes referred to as the “medicalization of childbirth.”

By the early 1980s, the vast majority of births occurred in regional hospitals, where family physicians or obstetricians were present and assisted by obstetrical nurses. Partners and other family members became largely left out of the childbirth process, often relegated to waiting rooms. Following birth, babies were placed in nurseries, separated from their mothers – a situation that was sometimes traumatic for mothers and their newborns.

Hospitals eventually started allowing the rooming in of mother and baby to facilitate mother–infant attachment and support breastfeeding for the health and well-being of both. During the rooming-in period, nurses would provide new mothers with information for the recovery period, such as instruction about breastfeeding and postnatal care. Throughout this transition in postnatal care practices, the length of time women spent in hospital after having a baby decreased significantly, from an average of nearly five days in 1984–1985 to 1–2 days after vaginal delivery today.

Today, partners are more involved in the birthing process and the perinatal period generally than in the past. Most are present for births, taking on a greater role in these first moments of their children’s lives and in the child rearing in the years that follow. It is more common for couples today to conceptualize childbirth as a shared experience, and many people use language that reflects this trend (“We’re expecting,” etc.).

What is maternity care?

Maternity/perinatal care (hereafter referred to as maternity care) is an umbrella term encompassing a continuum of care provided to the mother and child before, during and after birth. This includes prenatal/antenatal care (care during pregnancy), intranatal care (care during labour and delivery) and postnatal/postpartum care (care for the mother and newborn following birth). Since both mothers and infants undergo major changes throughout the perinatal period, maternity care entails a diverse range of health monitoring and care.

Prenatal/antenatal care (hereafter referred to as prenatal care) monitors and supports the health and well-being of mothers and the developing fetus prior to birth. Fetal health is monitored through screening and diagnostics, such as ultrasounds and blood tests. Health providers also closely track the mother’s health during this period; expectant mothers are provided with information about pregnancy, fetal development, physical comfort, testing, planning for delivery and preparing for parenthood.

Most women (87%) say they were supported by a partner, family or friends throughout the prenatal period.

According to the 2009 Canadian Maternity Experiences Survey, most women (87%) say they were supported by a partner, family or friends throughout the prenatal period. This support, as well as the care provided by health practitioners, can be particularly important during this time when many (57%) women report most days as being stressful. During pregnancy, maternal stress can have an impact on the well-being of the baby, leading to premature birth and/or low birth weight.

Nearly all expectant mothers (95%) report that they started prenatal care in their first trimester. Certain groups were more likely than others to report that they did not start prenatal care in the first trimester, however, such as women aged 15–19 years, those with less than high school education or those who live in low-income households. One of the main reasons cited for not starting care early in the pregnancy was lack of access to a doctor or health care provider.

Intranatal/intrapartum care (hereafter referred to as intranatal care) refers to the care and assistance provided to mothers during labour and childbirth. This involves facilitating the delivery itself in a safe and hygienic manner as well as monitoring the health of mother and child throughout the delivery process. This care is most often provided in hospitals, with mothers receiving care from a variety of health practitioners including obstetricians/gynecologists (reported as the main health care provider during labour and birth by 70% of surveyed mothers), family doctors (15%), nurses or nurse practitioners (5%) or midwives (4%).

Whether provided by a spouse, partner, friend, family member, midwife or doula (or some combination thereof), emotional support during this time is important. Research shows that women who receive continuous social support are more likely to have a shorter labour (i.e. fewer hours) and a vaginal birth, are more likely to report feeling happy with their labour and birth experience and are less likely to use pain medication.

Research shows that women who receive continuous social support are more likely to have a shorter labour and a vaginal birth, and are more likely to report feeling happy with their labour and birth experience.

Postnatal/postpartum care (hereafter referred to as postnatal care) supports mothers and newborns following childbirth, and involves health monitoring and routine assessments to identify any deviation from expected recovery following birth, and to intervene, if necessary.

The postnatal period accounts for the first six weeks of a child’s life – a “critical phase” in which examinations and care from health practitioners play an important role in ensuring the well-being of the mother and child, according to the World Health Organization (WHO).

In their 2013 postnatal care guidelines, WHO outlines best practices including postnatal care in the first 24 hours to all mothers and babies (regardless of where the birth occurs), ensuring that healthy women and their newborns stay at a health facility at least 24 hours and are not discharged early, and have at least four postnatal checkups in the first 6 weeks following childbirth.

According to the Maternity Experiences Survey, more than 7 in 10 women (73%) rated their health as “excellent” or “very good” by 5 to 14 months postpartum. However, more than 4 in 10 women in Canada (43%) said they experienced a “great deal” of problems with at least one postpartum health issue during the first three months following childbirth, such as breast pain (16% of women), pain in the vaginal area or in the area of the caesarean incision (15%) and back pain (12%).

Postnatal support can be important in mitigating postpartum depression, which is reported by 10%–15% of mothers in developed countries. Research has shown that maternal stress during pregnancy, the availability of social support and a prior diagnosis of depression are all significantly associated with developing postpartum depression. Studies have also shown that emotional support from partners and other family members throughout the perinatal period can reduce the likelihood for postpartum depression and emotional distress for mothers and newborns.

Postnatal care services vary across regions and communities in Canada. These can include informational supports, home visits from a public health nurse or a lay home visitor, or telephone-based support from a public health nurse or midwife.

Privately delivered postnatal services have become more prevalent over the past several decades, with postpartum doulas advertising high-intensity supports such as newborn care, breast- and bottle-feeding support, child-minding services, meal preparation, household chores and more. However, these private services often involve out-of-pocket costs that can limit accessibility for some families.

Who provides maternity care?

In addition to the care and support provided by family members and friends, modern maternity care is delivered by a range of health practitioners including family physicians, obstetricians/gynecologists, nurses, nurse practitioners, midwives and birth doulas – all of whom make unique contributions in the continuum of care.

Family physicians provide care to most new mothers throughout the perinatal period and can be involved in all stages of maternity and infant care, though not all provide the full range of care. Fewer physicians across Canada are providing maternity care than in previous decades: the share of family physicians in Canada delivering babies declined from 20% in 1997 to 10.5% in 2010. Today, a growing number of care tasks and responsibilities are being delivered by other medical practitioners, such as obstetricians and midwives.

Most family physicians who report being involved in maternity and newborn care provide “shared care,” offering prenatal care to a certain point (often between 24 and 32 weeks), after which they transfer care to another provider (e.g. obstetricians, midwives or another family physician who delivers babies). Some attend deliveries, but rates vary widely between provinces and the availability of other health providers.

Obstetricians and gynecologists (OB/GYNs) are providing a growing amount of intranatal care in Canada – though not all do so, and rates vary across the provinces. With specialized knowledge and expertise in pregnancy, childbirth and female sexual and reproductive health care (including surgical training, such as caesarian sections), many also serve as consultants to other physicians and are involved in high-risk pregnancies.

Nurses constitute the largest group of maternity care providers in Canada. They can be involved throughout the entire perinatal period, providing a range of care services including childbirth education, pre-birth home care services to women in high-risk situations, assistance during childbirth and sometimes follow-up care to new mothers. Following childbirth, nurses often provide information to new mothers while preparing them for discharge, educating them about topics such as breastfeeding, bathing, jaundice, safe sleep, postpartum mental health, nutrition and more.

Nurse practitioners (NPs) are registered nurses who play a wide variety of roles in health care. They sometimes serve as primary care providers for low-risk pregnancies, performing a variety of tasks such as physical examinations, screening and diagnostic tests, and postnatal care. When providing or facilitating maternity care, NPs often work in interdisciplinary teams with other health professionals such as physicians and midwives. In hospital settings, they also work in labour and delivery units, postpartum units, neonatal intensive care units and outpatient clinics. Due to the breadth of their training and expertise, NPs play important roles in rural and remote communities, where many provide a full range of health care services.

Due to the breadth of their training and expertise, nurse practitioners play important roles in rural and remote communities, where many provide a full range of health care services.

Midwives provide primary care to expectant and new mothers throughout the entire perinatal period, and are playing a growing role in modern maternity care in Canada. They provide a range of care services, including ordering and receiving tests, accompanying women at home or in birthing centres, admitting women for hospital births, as well as assisting with breastfeeding, the early days of parenting and monitoring postpartum healing. Midwives work collaboratively, consulting with, or referring to, other medical professionals when appropriate.

The role of midwives has evolved over the past several decades, with a growing number assisting in all settings where care may be needed – at home, in the community and in hospitals, clinics or health units. There has been increasing emphasis on specialization and training, as midwives have become recognized by and incorporated into most (but not all) provincial/territorial health care systems across the country.

Doulas provide non-clinical/medical support, working with new mothers and their families as well as health care practitioners such as physicians, midwives and nurses. Doulas are not regulated; they focus largely on emotional and informational support, and they do not provide direct health care or deliver babies.

There are different types of doulas for different stages in the childbirth process. Antepartum doulas provide emotional, physical and informational support during the prenatal period. This can include informing new mothers and their families about support groups, techniques for enhancing physical comfort and helping with home care tasks such as errands and meal preparation. Birth doulas support new mothers and their partners during labour and delivery, including emotional and informational assistance and supporting physical comfort. Postpartum doulas support new mothers after the baby is born, providing information about topics such as infant feeding and soothing techniques, and sometimes helping with light housework and childcare.

Perinatologists provide care in the event of high-risk pregnancies (e.g. pregnancy in the context of chronic maternal health conditions, multiple births or genetic diagnoses). They are trained as OB/GYNs and then receive specialized education to facilitate complicated pregnancies. OB/GYNs refer patients to perinatologists when needed, but continue to work collaboratively to support maternal health.

Unique experiences: childbirth in rural and remote areas in Canada

Maternity care in rural and remote areas (including Canada’s northern regions) faces unique challenges due to distances from medical facilities and specialized equipment, less peer support for care providers, as well as a limited number of physicians available for on-call services, and fewer caesarean section and anaesthesia capabilities/services compared with urban centres.

Rural maternity care is most often provided by teams of family physicians, nurses and midwives – in fact, in some communities, they’re the only health practitioners providing maternity care. Rural family physicians are far more likely to provide obstetrical care than their urban counterparts, though over the past several decades, many rural communities have seen a reduction in the number of family physicians providing maternity care and closures of maternity wards.

Due to the limited availability of maternity care providers and services in rural and remote regions, many expectant mothers travel to urban centres to give birth. According to a 2013 report from the Canadian Institute for Health Information, more than two-thirds of rural women in Canada (67%) report that they gave birth in urban hospitals, 17% of whom travelled more than two hours to deliver their babies. Rates are far higher in the North: two-thirds of surveyed mothers in Nunavut and half of those in the Northwest Territories report that they gave birth away from their home community.

Two-thirds of surveyed mothers in Nunavut and half of those in the Northwest Territories report that they gave birth away from their home community.

This has an impact on the well-being of many Indigenous women living in northern regions, many of whom have had to fly to hospitals far from their homes, land, languages and communities to receive maternity care at tertiary or secondary care hospitals (see Indigenous Midwifery in Canada textbox). When surveyed, the majority of mothers reported that leaving home to have their babies was a stressful experience and that it had a negative impact on their families. In April 2016, the federal government announced that it would provide financial compensation to allow someone to travel with Indigenous women who need to leave their communities to give birth.

The number of community hospitals offering obstetrical care in northern regions has fallen since the 1980s. However, a number of birthing centres have opened to fill this care gap, such as in Puvirnituq (Nunavik), Rankin Inlet (Nunavut) and in Inukjuak (Quebec). These facilities have helped women with low-risk pregnancies remain in their communities; however, those with complications or requiring a caesarian birth often still have to travel to give birth.

Unique experiences: new and expectant mothers new to Canada

Canada is home to many immigrant families, which have represented a growing share of the total population. In 1961, 16% of people in Canada reported that they were born outside the country – a rate that increased to 21% by 2011.

Immigration has an impact on the maternity experiences, such as when women decide to have children. Research shows that immigrants have relatively fewer births in the two-year period before migration, which is often followed by a “rebound” in fertility afterward. According to researchers Goldstein and Goldstein, “Fertility preferences of movers may more closely resemble those of the destination country than those of the source country even before they arrive.”

Studies have explored a number of reasons why fertility can be affected by the immigration experience, including temporary separation of spouses during the migration process, a conscious decision to delay childbearing until access to supports such as child allowances is ensured and economic disruption during migration and in the early period (while parents are securing paid employment).

Recent immigrants are significantly more likely than their Canadian-born counterparts to live in multi-generational households (those with three or more generations living under one roof); 21% of immigrants aged 45 and older who arrived in Canada between 2006 and 2011 reported that they live in shared homes, compared with 3% of the Canadian-born population. As such, new and expectant mothers in multi-generational homes may benefit from having more family members nearby to provide care and support.

With regard to accessing maternity care services, research has shown that many immigrant women generally have the opportunity to receive the necessary maternity care services, but rates of satisfaction with maternity care vary greatly across Canada. Some report having faced barriers to accessing and utilizing maternity care services, including (but not limited to) a lack of information about or awareness of the services (sometimes the result of language barriers), insufficient support to access the services (i.e. navigation of the health care system) and discordant expectations between immigrant women and service providers. In some areas, doulas provide valuable emotional, informational and navigation support to immigrant women during the perinatal period.

Social support (e.g. from family, friends and community members) has been identified by immigrant parents as a key factor in accessing maternity care. This circle of support can play an important role in connecting new and expectant mothers from outside Canada with maternity care, and can work with health care and service providers to ensure these women receive “culturally congruent and culturally safe” maternity care.

Maternity care: supporting Canada’s growing families

Pregnancy and childbirth are major life events, not only for new mothers, but also for their families, friends and communities. While there have been many changes in family experiences over the generations regarding pregnancy, childbirth and the postnatal period, there have also been some constant threads: the value and importance of quality care, the diversity of experiences across Canada, and the joy and excitement that can accompany this memorable and life-changing milestone.


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This content was reviewed by Dr. Marilyn Trenholme Counsell, OC, MA, MD, retired family physician and former Lieutenant Governor (New Brunswick), former Minister of Family (N.B.) and Senator (N.B.).

All references and source information can be found in the PDF version of this article.

Published May 11, 2017

Lived Experience: Understanding Families Affected by Incarceration

Farhat Rehman

Incarceration has an impact on thousands of families across Canada. When a person is sentenced to time in prison, their families are often profoundly affected; they are separated from a son, daughter, sibling, parent or other relative. Feelings of stigma, guilt and shame are common, and can be compounded when the sentenced family member is also living with a mental health condition – a reality for many incarcerated individuals and their families.

My family life has been profoundly affected by incarceration ever since my son was sentenced in 2001. When the chasm of the prison system had swallowed him up, the world appeared dark with no hope of seeing daylight. Our lives took a drastic turn on that ominous day. Our family’s lives and relationships were forever changed.

As a mother, I couldn’t help but wonder over and over again why my son had committed such a serious criminal act. Why did his mind work this way? What could have been done to prevent this catastrophe? Why, after years of treatment in the mental health system, had he still fallen through the cracks? What could I have done differently that would have prevented this crime from taking place and tearing apart two families? Since then, there have been daily reminders as I speak to him and visit him in prison. For us, his family, the impact of my son’s action have sunk in gradually over time. The nightmare of prison has played havoc with his mental health conditions with all the ups and downs of a roller coaster, and it’s become a constant source of worry for our family.

The nightmare of prison has played havoc with his mental health conditions with all the ups and downs of a roller coaster, and it’s become a constant source of worry for our family.

 

Incarceration affects family relationships, family traditions and family futures

As we have learned, in-person visits can be traumatic for the visitor. When visiting someone in prison, you have to first pass through layers of security such as the ion scanner (a drug-scanning device known for detecting false positives). Otherwise, you risk being turned away, which can seriously impact the inmate’s prison life.

There is no occasion that is celebrated as a family where I don’t feel my son’s absence. The festivities, the good food and laughter lack the genuine happiness that can come from family gatherings. This is never really talked about openly.

Family members will occasionally ask about my son and he may receive birthday cards from family and friends, but there is a kind of hesitation to discuss such a sad subject and ruin a festive atmosphere. The fact a family member has not been seen among you for almost 16 years registers low on the Richter scale of family life.

These days, as I contemplate the possibilities of the future, I wonder if this will be the time that my son will be able to start to turn his life around. Will he convince the authorities that he is deeply remorseful and resolved to never offend again? Will he be seen as worthy of being allowed to be paroled out of prison and into the community, where he can start the long process of healing and repairing the ravages of a lengthy period of incarceration? Will he be able to reintegrate himself into our family, one that misses him terribly but has adapted to life in his absence?

The love and light of support gets families through

While I contemplate these questions daily, I am grateful for the support of those around me. When my son – and my family – first began our journey with the justice system, I felt like I was travelling down an uncharted road. Despite being well connected to community, there was no real support I could turn to where others would understand what it was like to have a son in prison.

Despite being well connected to community, there was no real support I could turn to where others would understand what it was like to have a son in prison.

In November 2010, a community activist and expert connected to the Church Council on Justice and Corrections and a crisis worker at the John Howard Society (JHS) introduced me to ‬another mother with a son in prison. We all met for the first time at JHS in December 2010 – three mothers coming together with common experiences and goals.

From this shared experience, Mothers Offering Mutual Support (MOMS), a support group for women, was born. The first formal MOMS meeting occurred on December 15, 2010. Our meetings take place at the local JHS building, during the first Thursday of the month. JHS has generously donated this space to us so we can meet in a location with privacy.

We now total more than 45 members, all of whom feel immensely grateful to be able to come together and climb out of the black hole we fell into when our children were convicted of an offence resulting in their incarceration. Now we come together to support each other and find ways to help them in a meaningful and constructive way. Mothers whose sons have completed their sentence or are on parole continue to support and guide the new members who join the group.

A loving family on the outside can play an important role in advocating, financially supporting and providing loving contact to offset the indelible ravages of incarceration. Through MOMs, we are able to support each other as we support our incarcerated children.

A loving family on the outside can play an important role in advocating, financially supporting and providing loving contact to offset the indelible ravages of incarceration.

The harsh realities of incarceration are with us, but together we encourage each other to take one day at a time. We have been working to ensure the justice system facilitates rehabilitation and education, with a focus on physical and mental well-being and supporting our sons or daughters while they serve their sentences and plan for their futures. This has provided us with opportunities to engage in dialogue with government and community leaders about human rights. Policies and programs benefit from understanding our lived experiences and our perspective as mothers. We have been encouraged by increased public awareness of these issues.

As you can imagine, for some moms and family members, issues of stigma and safety keep us fearful of speaking out publicly, even though we are worried sick and lose sleep thinking about the condition of our children. We do not want to add to our shame and worry by being on the receiving end of insensitive or negative comments.

As mothers affected by incarceration, we meet regularly to share our experiences and our shock, pain and heartbreak. Working together gives us energy to focus on strategies to equip ourselves with knowledge and best practices to keep ourselves and our loved ones hopeful and healthy. We are determined to achieve humane and just treatment for our loved ones in prison as we work together to strengthen the ties that bind us in our struggle as families affected by incarceration.

 


Farhat Rehman is co-founder of Mothers Offering Mutual Support (MOMS), a support group for women with incarcerated family members.

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Published on March 14, 2017