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}

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