Svare Chair focuses on child health and well-being Canada-wide

Dr. Deborah Marshall, PhD, has been appointed the Svare Chair in Health Economics in the Cumming School of Medicine at the University of Calgary. Under Marshall’s leadership, the Svare Chair will address traditional health economics, and expand its scope to reflect the broader elements of measuring value and impact. Marshall is an internationally recognized scholar in health economics with a focus on health preference research, patient-partnered research, and socioeconomic impacts. She leads the Value, Impact and Knowledge Mobilization Accelerator of the national One Child Every Child initiative. 

In recent years Marshall’s research has included child health and wellness, including the health economics of juvenile idiopathic arthritis (JIA).

“The Svare Chair allows me to expand on work we are currently doing with children and families with JIA to investigate the socio-economic impact on children and youth with other chronic complex diseases,” Marshall says.

Marshall leads integrated health economics in the international UCAN CAN-DU and CURE research program focused on improving the diagnosis and care for children with arthritis, the associated socioeconomic impacts, and addressing the challenges faced by children and their families.

JIA is a complex chronic disease that dramatically impacts children's lives, causing pain, stiffness, and swelling in their joints. It can significantly diminish children’s quality of life. For parents and families, managing JIA extends far beyond medical costs, encompassing hidden burdens such as out-of-pocket expenses, and missed work. Its toll on mental and physical well-being weighs heavily, with a particularly harsh impact on moms and female caregivers.

The UCAN study reveals a sobering reality: around 40 per cent of parents of children with JIA report mental health challenges, and 45 per cent experience physical health problems. Nearly 10 per cent of parents have had to alter their work commitments over the past year, mostly by reducing their work hours to meet the demands of caregiving. Help for caregivers is crucial, but unfortunately, many parents feel they lack sufficient support. 

"We travelled once a month for Lauren’s appointments; this involved a four hour drive each way or sometimes flying, gas and expensive parking, overnight stays and meals. These trips could cost $1,000 to $2,000,” says Betts Macdonald. “This took me out of the workforce ... and when I went back part-time, I had to pay for caregiving support."

Betts and her daughter Lauren McClinton are partners in Marshall’s research. Lauren began having JIA symptoms at just two years old and is now a young adult advocating for JIA families. 

“The rheumatology office was a two-hour bus ride or I had to pay for an Uber. This was especially challenging when having a flare, and maybe having to travel for joint injections. I now need to think about insurance coverage for the biologic medication I take when I am considering job choices. It takes a huge amount of time, several days, and a lot of co-ordination with my doctor, the insurance company, and others to navigate this. The reality is I cannot consider new employment opportunities the way that a young adult without JIA can,” says Lauren. 

The study also highlights the effect of JIA on children's education and future career opportunities. Nearly half of children with JIA miss school days due to their condition.

“Focusing on personalized treatment approaches and understanding the real-life context of managing JIA will significantly improve the quality of life for children living with this chronic disease and their families,” says Marshall. 

The Svare Chair enables Marshall’s team at the Alberta Children’s Hospital Research Institute to enhance connections with the O’Brien Institute for Public Health, and collaborate with Alberta Health Services, Alberta Health, Health Canada, and the Public Health Agency of Canada.