Chapter 4: The Chief Public Health Officer's report on the state of public health in Canada 2008 – Early childhood development
Social and Economic Factors that Influence Our Health and Contribute to Health Inequalities
Early childhood development
The earliest years are pivotal to a child’s growth and development. Nurturing caregivers, positive learning environments, good nutrition and social interaction with other children all contribute to early physical and social development in ways that can positively affect health and well-being over a lifetime.8 A poor start to life often leads to problems that can impact health and long-term prospects.
There are three main areas critical to healthy child development:
- adequate income – family income should not be a barrier to positive childhood development, and support mechanisms should be in place for all children to have a good start in life;
- effective parenting and family functioning– effective parenting skills are fundamental to child development, however, parents may also require employer support for flexible work hours and maternity/parental leaves, as well as broader social support for family based opportunities and resources; and
- supportive community environments – all members of the community have a responsibility for the healthy development of children. Communities need to provide accessible health and social programs and resources for families with children.8
Overall, Canada’s children are developing well in terms of physical, mental and emotional well-being. The Well-Being of Canada’s Children: Government of Canada Report 2008, indicates that the majority of Canadian children show average or advanced levels of development in terms of motor and social development (83.6%), verbal (86.5%), number (83.7%) and cognitive (85.2%) development. As well, most Canadian children do not show signs of emotional anxiety (85.3%), physical aggression (85.8%), or behaviours associated with hyperactivity or inattention (93.4%).294
However, there is evidence that a health gradient in childhood development exists according to social and economic factors. Generally, children from families with lower income and lower levels of education have poorer overall health and higher rates of cognitive difficulties, behavioural issues, hyperactivity and obesity through childhood.294, 295, 296, 297, 298
Readiness to learn, a measure of children’s early success in terms of abilities, attitudes and behaviours as children start school, is an indicator of the benefits of positive early experiences.299 Vancouver’s Community Asset Mapping Project found that children who lived in lower-income families scored lower on measured outcomes of school readiness such as knowledge, skills, maturity, language and cognitive development.300 Figure 4.4 shows that a child’s receptive vocabulary score increases as household income level increases. It also indicates that parental involvement in children’s early learning is important to success across all incomes. In each income group, especially among families with the lowest incomes, children who were read to daily had better receptive vocabulary scores than children not read to daily.299
Figure 4.4 Receptive vocabulary scores* of children, age 5, by household income levels, who were or were not read to daily, Canada, 2002-2003
LICO – Low-income cut-off.
*A score of 75 corresponds to the lower 5th percentile of the receptive vocabulary score distribution.
Source: Public Health Agency of Canada using Statistics Canada, National Longitudinal Survey of Children and Youth, 2002/2003.
The inability to access early childhood programs as a result of distance, availability or affordability is a significant barrier. Aboriginal and immigrant children may experience additional barriers if local child programming is not culturally relevant or delivered in a familiar language (see text box). The consequences of these disadvantages include children growing into adults with lower educational attainment, weaker literacy and communication skills, fewer employment opportunities and poorer overall physical and mental health.301, 302
Culturally Relevant Programming for Children
Aboriginal Head Start Program
Canada's Aboriginal Head Start in Urban and Northern Communities (1995) and Aboriginal Head Start On Reserve (1998) programs were established to address the unique challenges facing First Nations, Inuit and Métis children and their families. The programs are designed to prepare Aboriginal children (up to the age of six) for their school years by helping to meet their emotional, social, health, nutritional and psychological needs. They provide an opportunity for preschoolers to learn traditional languages, culture and values – along with school readiness skills – while acquiring healthy living habits.303 At the same time, their parents and caregivers learn about healthy child development, practical child safety tips, and available community resources and services. Due to the role of each community in the establishment of the program for their children, the spiritual and cultural dimensions of Aboriginal life are included in the activities. A recent evaluation of Aboriginal Head Start in Urban and Northern Communities has shown:
- significant gains for children in the areas of physical, personal and social development and health;
- positive changes in family nutrition and health practices;
- demonstrated school readiness with strong skills among graduates; and
- increased practice of cultural traditions and use of native languages.304
Today more than 13,600 children and their families in urban and northern communities and on reserve across Canada are benefiting from the Aboriginal Head Start programs.305, 306
There is clearly recognition in Canada of the importance of early childhood development. As noted in a recent report issued by the federal Minister of Health’s Advisor on Healthy Children and Youth, the nation’s growth is dependent on investing in children’s health. This report also states, however, that Canada can and should do better in terms of the health and wellbeing of its children and youth.307 As previously noted, rates of childhood poverty in this country continue to be higher than other similarly developed nations. Although caution must be used when comparing international health and development indicators, it is also of concern that among 21 similarly developed nations Canada ranks 12th on average across six dimensions of child well-being.307, 308 In addition, while the United Nations Report Card on Child Well-being in Rich Countries ranks Canada high on the dimensions of educational and material well-being (2nd and 6th), we fair much worse in terms of family and peer relationships (18th) and behaviours and risks (17th).308
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