Prevalence and sociodemographic correlates of marriage among adolescent mothers in Canada, 1989-2018.

OBJECTIVES: Female marriage before age 18 is a global health issue related to gender inequality, but it is understudied in Canada. This study examined marriage trends among mothers aged < 18 versus older mothers and the sociodemographic correlates of marriage among adolescent mothers aged < 18 and older adolescent mothers. METHODS: Using the Canadian Vital Statistics - Birth Database, marriage prevalence was estimated by maternal age groups (< 18-year, 18-19-year, 20-24-year, and 25-49-year) between 1989-1990 and 2017-2018 (n = 10,399,250). Multivariable logistic regression was then used to examine the sociodemographic characteristics associated with marriage within adolescent maternal age group (< 18-year, 18-19-year, and 20-24-year) among births registered between 2000 and 2018. RESULTS: From 1989-1990 to 2017-2018, marriage prevalence declined 80.5%, 60.2%, 47.3%, and 16.0% in the < 18-year, 18-19-year, 20-24-year, and 25-49-year groups, respectively. Within the < 18-year, 18-19-year, and 20-24-year adolescent maternal age groups, older maternal age, larger parental age gap, foreign-born parents, rurality, and earlier birth period were associated with higher adjusted odds of marriage. Higher maternal neighbourhood income was associated with marriage among births to mothers aged 18-19 and 20-24 years but not among those to mothers aged < 18 years. CONCLUSION: Marriage prevalence declined among mothers of all ages, but the shifts away from marriage appear stronger among younger mothers. The sociodemographic correlates of marriage are generally similar among mothers below age 18 and slightly older adolescent mothers.

RéSUMé: OBJECTIFS: Le mariage des filles de moins de 18 ans est un problème de santé mondial lié aux inégalités entre les sexes, mais il est insuffisamment étudié au Canada. Notre étude porte sur les tendances du mariage chez les mères de < 18 ans comparativement aux mères plus âgées et sur les corrélats sociodémographiques du mariage chez les mères adolescentes de < 18 ans et les mères adolescentes plus âgées. MéTHODE: À l'aide de la Base canadienne de données de l'état civil ­ Naissance, nous avons estimé la prévalence des mariages selon le groupe d'âge maternel (< 18 ans, 18-19 ans, 20-24 ans et 25-49 ans) entre 1989-1990 et 2017-2018 (n = 10 399 250). Au moyen d'une analyse de régression logistique multivariée, nous avons ensuite examiné les caractéristiques sociodémographiques associées au mariage dans les groupes d'âge des mères adolescentes (< 18 ans, 18-19 ans et 20-24 ans) pour les naissances enregistrées entre 2000 et 2018. RéSULTATS: De 1989-1990 à 2017-2018, la prévalence des mariages a baissé de 80,5 %, 60,2 %, 47,3 % et 16,0 % dans les groupes de < 18 ans, de 18-19 ans, de 20-24 ans et de 25-49 ans, respectivement. Dans les groupes d'âge des mères adolescentes de < 18 ans, de 18-19 ans et de 20-24 ans, un âge maternel plus avancé, une plus grande différence d'âge des parents, la naissance des parents à l'étranger, la ruralité et la période de naissance plus précoce étaient associées à une probabilité de mariage ajustée plus élevée. Le revenu maternel plus élevé selon le quartier était associé au mariage pour les naissances de mères de 18-19 et de 20-24 ans, mais pas chez les mères de < 18 ans. CONCLUSION: La prévalence du mariage a baissé chez les mères de tout âge, mais l'abandon du mariage semble plus prononcé chez les mères plus jeunes. Les corrélats sociodémographiques du mariage sont généralement semblables chez les mères de moins de 18 ans et les mères adolescentes légèrement plus âgées.

Marital status, immigration, and reproductive health among adolescent mothers in Canada, 1990-2018: A population-based, observational study.

Immigrants to Canada increasingly come from regions where child marriage (<18 years) is prevalent. We described the prevalence, demographic characteristics, and reproductive health correlates of marriage among births to Canadian-born and foreign-born adolescent mothers. Using Canadian birth registrations from 1990 to 2018, marriage prevalence, parental birth region, and parental age gap were examined by maternal birthplace (Canada and 12 world regions) among births to mothers <18 years. Adjusted odds ratios (AORs) of preterm birth (PTB), small for gestational age (SGA), and repeat birth were estimated for the joint associations of adolescent maternal age group (<18-year, 18-19-year, and 20-24-year), marriage, and nativity status (n = 1,904,200). Depending on maternal birthplace, marital births represented 2.6% to 81.8% of births to mothers <18 years. Marriage among mothers giving birth at <18 years was associated with higher proportions of parents from the same birthplace and larger parental age gaps. AORs of PTB tended to increase with lower maternal age. AORs of SGA were generally higher among births to foreign-born mothers. Marriage was associated with lower AORs of PTB and SGA among births to Canadian-born mothers and PTB among births to foreign-born mothers in the older adolescent age groups, but no association existed in the <18-year group. Marriage was positively associated with repeat birth in all adolescent age groups, with stronger associations in the <18-year group. The reproductive health correlates of marriage are similar between births to Canadian-born and foreign-born mothers <18 years but some differ between births to mothers <18 years and those to older adolescent mothers.

One little, too little: Counting Canada's indigenous people for improved health reporting.

The way state governments, worldwide, count or do not count Indigenous peoples has contributed to inconsistent reporting of Indigenous health statistics. To address unreliable reporting in Canada, we reviewed laws on Indian status and the development of a national Indian Registration System (IRS) to track Indian status and eligibility. With this information as a guide, we linked the IRS to the Manitoba provincial health registry systems and were able to identify individuals with Indian status for health reporting. To improve reporting, we identified individuals often missed in this type of linkage. For instance, we identified children and adult children who were eligible for Indian status but not yet registered. Equally as important, we identified individuals not eligible for Indian status but have Indian heritage and/or represent potential individual Indian status eligibility cases before the courts to right a historic form of identity sex discrimination that has made them invisible in Canadian society and health reporting. A familial kinship approach was used to identify Indian children and adult children typically missed when a strict legal entitlement criteria is used for data linkage. Our reflective socio-legal data linkage approach expanded the number of Indian peoples for health reporting purposes and demonstrated a feasible, inclusive way to report on the health of Indians in Canada.

The queer sensitive interveners in the Little Sisters case: a response to Dr. Kendall.

Three queer sensitive organizations intervened before the Supreme Court of Canada in Little Sisters v. Canada, a case that challenged whether and how Canada Customs treated cross border shipments to a gay and lesbian bookstore. This paper reviews the queer sensitive organizations' arguments on some of the issues in the case, especially the scope of obscenity law, and challenges misconceptions about their positions, including those presented in Dr. Kendall's paper (appearing in this volume).