Childhood lasts forever: The need to invest in the early years

CPS President Elect Dr. Robin Williams spoke at the recent Innovating Child and Family Health Conference hosted by the Canadian Institutes of Health Research. Delegates included clinicians, researchers, philanthropists, business leaders, and policy experts, who examined the complex issue of the health status of Canadian children and youth. Dr. Williams shares some thoughts from her presentation. 

As a practicing paediatrician in the 1980s, I typically focused on the physical parameters of ‘health’: height and weight, the motor milestones and some speech and language. That’s what most clinicians did back then.

Today, that’s not enough.

We now know that children develop best on a base of secure attachment: a lap for every baby and at least one adult to adore every child. For many, secure attachment is most easily enabled through breastfeeding: the associated touch, warmth, singing, bantering, rocking and face-to-face interaction.

Neuroscience research from institutions like Harvard University’s Center on the Developing Child has taught us much about the developing brain:

• Brains are built over time from the bottom up.
• Genes and experience interact to shape the developing brain.
• The brain’s capacity for change decreases with age.
• Cognitive, emotional and social capacities are intertwined throughout life.
• Toxic stress damages the developing brain and can lead to lifelong challenges in learning, behavior and physical and mental health.

So what role does childhood play in lifelong health? No longer must we focus so singularly on the physical indicators of health; increasingly, we need to focus on strong social and emotional beginnings for children to be the best that they can be.

Children live in the context of their families. Getting them off to a good start creates a whole series of protective factors that will affect how they will do throughout their lives.

In other words, childhood lasts forever.

The Adverse Childhood Experiences Study illustrates this concept very well. Results show a link between adverse experiences early in life (such as abuse, neglect and family dysfunction) and social, emotional and cognitive impairment, adoption of health risk behaviours, disease, disability and social problems, even early death.

Likewise, the work of the late Dr. Clyde Hertzman demonstrated a connection between difficult experiences in early life and health issues in adulthood like depression and anxiety, substance use, obesity, elevated blood pressure, heart disease and signs of premature aging.

Clearly, investments in children have benefits not only to individual children and families, but to society in general, today and down the road.

So how is Canada doing when it comes to investing in children?

In the latest Innocenti Report Card from UNICEF, Canada ranks 17th among 29 developed countries on five dimensions. The Canada Companion to UNICEF Report Card 11, aptly named Stuck in the Middle, explores this ranking in further detail.

Overall, Canada is indeed stuck in the middle. More concerning though, are individual rankings that place us even closer to the bottom:

• Relative child poverty: 21 of 29 nations
• Infant mortality: 22 of 29 nations
• Immunizations: 28 of 29 nations
• Participation in further education: 24 of 29 nations
• NEET (not in education, employment or training): 22 of 28 nations
• Overweight: 27 of 29 nations
• Cannabis use: 29 of 29 nations
• National homicides: 22 of 29 nations
• Bullying: 21 of 29 nations

So what do we do to improve it?

Tackling relative child poverty would be a great place to start.

In fact, if you’re a child living in Canada, you are more likely to live in poverty than if you are over the age of 65.

According to The Standing Senate Committee on Social Affairs, Science and Technology, social and economic environment account for 50 per cent of health outcomes.

Aboriginal children are even more at risk than most Canadian kids, as they may not have access to necessities that many of us take for granted such as safe water, adequate housing or ease of access to education and medical care. 

Addressing poverty would make a huge difference for Canada’s kids, but doing so requires more money, more data (i.e., measurement) and more cooperation among health professionals, researchers, policy makers and social agencies.

Making these three key investments will make a difference for Canadian kids, and will allow us to foster their development and well-being in early life, decreasing the risk of negative health outcomes into adolescence and adulthood.

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The information on this blog should not be used as a substitute for medical care and advice. The views of blog writers do not necessarily represent the views of the Canadian Paediatric Society.