Improving the Health of Canada’s Kids: Dr. Leitch’s Prescription
The state of Canada’s children and youth is not good. Canada ranks 22nd out of 29 OECD countries for preventable childhood injuries, 27th in childhood obesity. Overall Canada ranks only 12th out of 21 wealthy countries in the 2007 United Nations rankings of child well-being.Injuries kill more Canadian children and youth than all other causes of death combined. In 2004, 26% of children aged 2 to 17 were overweight or obese; in Aboriginal children rates of overweight and obesity were 41%. Obesity and physical inactivity are now at epidemic levels and are estimated to reduce the life expectancy of Canada’s children to less than that of their parents. Wait times for the evaluation and treatment of children with behavioral and mental health problems can be a year or longer and such delays can lead to irreversible damage to these children and their families. Finally, we have little if any knowledge of how environmental contaminants affect children’s health and development.
Recently, the Minister of Health received Dr. K. Kellie Leitch’s final report, Reaching for the Top: A report by the Advisor on Healthy Children and Youth. In Dr. Leitch’s words, “Canada can and must do much better if it hopes to be the number-one nation for a child to live and grow up.” In her prescription, she makes a number of recommendations. Implementing many of those recommendations will require research: the creation of new knowledge and a commitment to work with governments at all levels and community-based organizations to ensure this knowledge is applied to solve these critical child health challenges.
To combat the problem of injuries, Canada needs to start thinking seriously about new designs for cars, car infant and booster seats, and sports equipment, as well as new community-wide approaches to improve the safety of roads, parks and playgrounds. For example, University of Windsor researcher Dr. Anne Snowdon who has studied why kids and parents are not using booster seats and found that only 28% of school-aged kids ride in booster seats – an “astounding” number according to Dr. Leitch. This project, supported by the Government of Canada, opened the door to an innovative collaboration with DaimlerChrysler and auto parts giant Magna Inc. and the successful launch of a new booster seat.
Clearly, a new approach is needed to tackle the growing epidemic of obesity in kids. Research is improving our understanding of the underlying causes and long-term consequences of child obesity as well determining the effectiveness of policies and programs. Dr. Charlene Elliott from the University of Calgary is examining how food marketing practices using cartoon characters affects the food purchases of kids and their parents. Dr. Janis Randall Simpson’s team at the University of Guelph have developed an assessment tool for parents, caregivers or community professionals to help identify preschoolers who might need nutritional interventions to prevent obesity.
In the area of mental health, new ways of delivering care to the children who need it is required. Dr. Patrick McGrath of IWK Health Centre/ Dalhousie University and Dr. Charles Cunningham of McMaster University are leading a cross-Canada series of studies on reducing wait times for children with mental health problems. This project is evaluating a new telephone coaching service, Family Help, that provides guidance and advice to parents and children by means of handbooks, videos and a trained coach.
Much more needs to be learned from the potential harm from chemicals and particles in the water children drink, the air they breathe, the foods they eat and the products they use. Dr. Malcolm Sears from the McMaster University and a large, multi-disciplinary team of researchers from across the country are examining how indoor air quality and other environmental exposures in the home affect the risk of developing asthma and allergies in children.
One of our most pressing issues is the health of Canada’s Aboriginal children. Both accidental and intentional injuries are more frequent among Aboriginal than non-Aboriginal children, particularly those living on reserve. The scarcity and high cost of fresh fruits and vegetables, the easy availability of inexpensive high-energy “junk” foods and the lack of opportunities for physical activity have worsened the obesity epidemic in many Aboriginal communities. Mental health and addiction problems are more common among Aboriginal youth than among their non-Aboriginal peers. All of these problems have strong historical and social roots and no obvious “quick fix”, but research can help point the way forward. For example, Dr. Norreen Willows from the University of Alberta is studying diet and physical activity and body weight among First Nation kids in the James Bay region. Another project by Dr. Laura Arbour of the University of Victoria is looking for reasons why congenital heart defects are nearly five times higher among kids in Nunavut and Nunavik than kids in the rest of Canada.
Dr. Leitch has it right. Her report is timely and on target: the health problems of Canada’s kids can and must be improved. Innovative approaches are needed, and research is necessary to develop and evaluate these approaches. By creating and applying new knowledge through collaborative approaches, research is helping to fill Dr. Leitch’s prescription and make Canada “the number one place in the world for a child to live and grow up.”
Dr. Michael S. Kramer
Canadian Institutes of Health Research
Institute of Human Development, Child and Youth Health