Exposed: Examining the Generational Impact of Maternal Substance and Alcohol-Use on Family Health and Social Outcomes

The proposed project will analyze the presence of risk and protective factors that may contribute to an exposed pregnancy such as the mortality and morbidity rates of birthing people and their families, compared by exposed or non-exposed births; and the comparison of key social constructs such as family history and separation, education, income, and employment. This will be facilitated through a data linkage of data collected from participants in the Parent Child Assistance Program (PCAP) to government administrative data. PCAP was designed to help mitigate the cycle of generational substance use, while supporting mothers through their addiction recovery journey, centered on the principles of harm reduction. This linkage will facilitate a population-level analysis of the impact of substance and alcohol use in birthing people on the health and social outcomes of them and their families. We propose a 10-20-year analysis of the precursors and outcomes of two primary groups for this analysis: birthing people with non-exposed pregnancies, and birthing people with exposed pregnancies, including a subset of PCAP clients. When considering generational impacts, it is beneficial to include at least three generations, to understand if any risk or protective factors can be identified within the data when it comes to the birthing people's parents/guardians. This will include the definition of several constructs that can be built from existing administrative data and will encompass information from multiple timepoints through the primary subject group's (the birthing person's) life. We will seek to identify and understand how these constructs may have contributed to the birthing person's risk for having an exposed birth and formulate policy recommendations based on mitigating gaps and barriers in the system and identifying opportunities with a trauma-informed approach.