Chapter 3: The Chief Public Health Officer's Report on the State of Public Health in Canada, 2009 – The health of Canadian children

Chapter 3 - The Health of Canadian Children

This chapter provides an overview of the Canadian population up to age 11, including their current state of health and patterns of ill health and disability. It is important to note that data are not always available specifically for this age group. Therefore, when necessary, data may sometimes refer only to a subset of this age group or include those outside the age range of interest. When this is the case, it has been assumed that data specific to the age group of interest, were it available, would show similar results.

Canada's children from birth to 11 years

Based on the 2006 Census, Statistics Canada estimates that of a total population of 31.footnote 6 million people in Canada, 4.3 million are children under the age of 12 (see Table 3.1). A little less than half of those children (2.0 million) are under the age of 6. Approximately 5% are immigrants and 6% are Aboriginal.footnote 128–130

The majority of Canadian children under the age of 12 (79%) live in urban areas. They also tend to live at home with two parents (82%).footnote 129 In 2006, 17% of children under the age of 12 lived in single-parent households, representing a 0.3% increase since 1991.footnote 129 footnote 131 The majority lived with single mothers (84%), and the rest with single fathers.footnote 129 Comparatively, 37% of First Nations children, 31% of Métis children and 26% of Inuit children, under the age of 15, lived in single-parent households, while 8%, 2% and 4% respectively lived with a grandparent or other relatives.footnote 132–134 Roughly 2% of all Canadian children in this age group live in locations other than private dwellings such as shelters, foster care, group homes and institutional facilities.footnote 129

The number of births in Canada has remained fairly stable over the past 30 years at more than 360,000 births each year. The current total fertility rate of 1.6 children per woman aged 15 to 49 years has also changed relatively little since the mid-1970s but is less than half of what it was in 1960.footnote 135–139 Although Aboriginal women in Canada are also experiencing a decrease in fertility rates, their current rate of 2.6 children per woman aged 15 to 49 years is still well above the Canadian average.footnote 134 footnote 140

Increasing lifespans combined with falling fertility rates have resulted in the proportion of the total population between birth and age 11 decreasing from 23% in 1971 to 14% in 2006.footnote 128 footnote 141 Although the percentage of Aboriginals under the age of 25 has also declined over time – from 53% of the population in 1996 to 8% in 2006 – this decrease is far less than what has been experienced in the overall population in Canada.footnote 142 footnote 143 As a result, the Aboriginal population living off reserve is relatively younger than the non-Aboriginal population in Canada, with persons under the age of 25 representing 48% of the Aboriginal population compared to 31% of the non-Aboriginal population (see Figure 3.1).footnote 143

Table 3.1 Children in Canada
  Value Description Year
Population from birth to 11 years
PopulationTable 1 - footnote 1 1 4,310.2 thousand people aged 0 to 11 years 2006
AboriginalTable 1 - footnote 2 2 273.1 thousand people aged 0 to 11 years 2006
First Nations (single ancestry)Table 1 - footnote 1 1 124.6 thousand people aged 0 to 11 years 2006
Métis (single ancestry)Table 1 - footnote 1 1 16.6 thousand people aged 0 to 11 years 2006
Inuit (single ancestry)Table 1 - footnote 1 1 11.3 thousand people aged 0 to 11 years 2006
ImmigrantTable 1 - footnote 1 1 234.1 thousand people aged 0 to 11 years 2006
Urban populationTable 1 - footnote 1 1 3,426.5 thousand people aged 0 to 11 years 2006
Children in private householdsTable 1 - footnote 1 1 4,241.4 thousand people aged 0 to 11 years 2006
Children in two-parent householdsTable 1 - footnote 1 1 3,498.0 thousand people aged 0 to 11 years 2006
Children in single-parent householdsTable 1 - footnote 1 1 743.5 thousand people aged 0 to 11 years 2006
Children living with single mothersTable 1 - footnote 1 1 627.8 thousand people aged 0 to 11 years 2006
Children living with single fathersTable 1 - footnote 1 1 115.6 thousand people aged 0 to 11 years 2006
Birth rates
Total fertility rateTable 1 - footnote 1 1 1.6 births per female reproductive lifetime aged 15 to 49 years 2006
Crude birth rateTable 1 - footnote 1 1 10.9 live births per 1,000 population 2006

Note: First Nations, Métis and Inuit population may not add to Aboriginal total due to identification of single ancestry. More detailed information can be found in Appendix E: Definitions and Data Sources for Indicators.

Sources:

Footnote 1
1Statistics Canada
Footnote 2
2Indian and Northern Affairs Canada.

Figure 3.1 Aboriginal and non-Aboriginal population distribution by age group, Canada, 2006 footnote 147

Text Equivalent – Figure 3.1

Summary: The Aboriginal population shows a pyramid distribution, where the younger age groups (0-14 and 15-24) form nearly 50% of the overall population. In contrast the same age groups represent less than 40% of the overall non-Aboriginal population.  Conversely, the older age groups (55-64 and 65+) represent only 12% of the total Aboriginal population, and more than 26% of the non-Aboriginal population.

Source: Statistics Canada.

Enlarge Figure 3.1

Source: Statistics Canada.

The health of Canada's children

While patterns of health issues and outcomes for young children are, for the most part, unique to that age group, there are some outcomes that are shared with adults and others which can have serious repercussions when these children reach adulthood.

Table 3.2 presents indicators of the current health of Canadian children. These include measures of life expectancy, birth outcomes, and the main measures and causes of death, ill health and disease experienced by this age group.

Life expectancy, births and birth outcomes

Table 3.2 Health of children in Canada
  Value Description Year
Health status
Life expectancy, births and birth outcomes
Life expectancyTable 2 - footnote 1 1 80.8 years of expected life at birth 2006
MalesTable 2 - footnote 1 1 78.4 years of expected life at birth 2006
FemalesTable 2 - footnote 1 1 83.0 years of expected life at birth 2006
Health-adjusted life expectancyTable 2 - footnote 1 1 69.6 years of expected healthy life at birth 2001
MalesTable 2 - footnote 1 1 68.3 years of expected healthy life at birth 2001
FemalesTable 2 - footnote 1 1 70.8 years of expected healthy life at birth 2001
Births and birth outcomes
Pre-term birth rateTable 2 - footnote 1 1 7.9 percent of live births with gestation less than 37 weeks 2006
Low birth weightTable 2 - footnote 1 1 6.1 percent of live births with birth weight less than 2,499 grams 2006
Multiple births 3.1 percent of live births 2006
Mortality
Population under 1 year of age
Infant mortality rate (under 1 year)Table 2 - footnote 1 1 5.0 deaths per 1,000 live births in the same year 2006
Neonatal mortality rate (0 to 27 days)Table 2 - footnote 1 1 3.7 deaths per 1,000 live births in the same year 2006
Congenital malformations, deformations anchromosomald abnormalitiesTable 2 - footnote 1 1 1.3 deaths per 1,000 population under 1 year 2005
Disorders related to length of gestation and fetal growthTable 2 - footnote 1 1 0.7 deaths per 1,000 population under 1 year 2005
Sudden infant death rateTable 2 - footnote 1 1 0.3 deaths per 1,000 population under 1 year 2005
Population aged 1 to 11 years
Intentional and unintentional InjuriesTable 2 - footnote 1 1 4.9 deaths per 100,000 population per year 2004
Malignant cancersTable 2 - footnote 1 1 2.7 deaths per 100,000 population per year 2004
Congenital malformations, deformations and chromosomal abnormalitiesTable 2 - footnote 1 1 1.4 deaths per 100,000 population per year 2004
Ill-health and disease
Chronic diseases
AsthmaTable 2 - footnote 1A *Table 2 - footnote 3 3 15.6 percent of population aged 4 to 11 years 2000
DiabetesTable 2 - footnote 3 * 0.3 percent of population aged 1 to 19 years 2005–2006
CancerTable 2 - footnote 2 2 15.0 new cases per 100,000 children aged 0 to 14 years 2000–2004
OverweightTable 2 - footnote 1 1 16.9 percent of population aged 2 to 11 years 2004
ObeseTable 2 - footnote 1 1 7.4 percent of population aged 2 to 11 years 2004
Vaccine-preventable diseases
MeaslesTable 2 - footnote 3 3 0.4 cases per 100,000 population aged 0 to 5 years 2004–2005
Meningococcal Group CTable 2 - footnote 3 3 0.6 cases per 100,000 population aged 0 to 5 years 2004–2005
Mental and behavioural disorders
Emotional problem-anxiety scoreTable 2 - footnote 1A *Table 2 - footnote 5 5 14.7 percent of children aged 2 to 5 years exhibiting high levels of emotional and/or anxiety problems 2004–2005
Hyperactivity-inattention scoreTable 2 - footnote 1A *Table 2 - footnote 5 5 6.6 percent of children aged 2 to 5 years exhibiting high levels of hyperactivity and/or inattention 2004–2005
Physical aggression scoreTable 2 - footnote 1A *Table 2 - footnote 5 5 14.2 percent of children aged 2 to 5 years exhibiting high levels of physical aggression, opposition and/or conduct disorder 2004–2005

Note: More detailed information can be found in Appendix E: Definitions and Data Sources for Indicators.

Sources:

Footnote *
*Reported data (self, parental or other)
Footnote 1
1Statistics Canada
Footnote 2
2Canadian Cancer Society
Footnote 3
3Public Health Agency of Canada
Footnote 4
4Government of Canada
Footnote 4
5Indicators of Early Childhood Health & Well-Being in British Columbia

Assuming mortality patterns continue as they were in their birth year, children born in Canada in 2005 can expect to live an average of approximately 80 years, with females expected to live longer than males on average (83 years and 78.4 years respectively).footnote 144 When their health is taken into consideration, they can also expect, on average, that the equivalent of almost 70 of those years, spread throughout their life, will be spent in full health.footnote 145 However, not all Canadians experience these high levels of life expectancy. In 2001, life expectancy for Aboriginal males was only 71 years and for Aboriginal females was only 77 years.footnote 134

Most babies born in Canada are born healthy and at full term. In 2006, almost 8% of births were considered preterm and roughly 6% of newborns weighed less than the low birth weight threshold of 2,500 grams.footnote 146 footnote 147 Low birth weights have been linked to lower intelligence quotient (IQ) scores, poorer memory and information recall, as well as learning, behavioural and emotional difficulties.footnote 148

Children of multiple births (two or more children born at one time) tend to be smaller in size than their single birth counterparts, with 52% being considered low birth weight and 9% having a very low birth weight (less than 1,500 grams).footnote 149 Additionally, just over half (53%) of multiple births are born pre-term (before 37 weeks gestation), while only 6% of single births are pre-term.footnote 150 In Canada, the number of multiple births has increased from 2.7% of live births in 2000 to 3.1% of live births in 2006.footnote 151 Some of this increase is likely attributable to a rise in medically assisted conception and delayed childbearing – two factors known to increase the chances of multiple births.footnote 152

Mortality

As noted in Chapter 2, Canada's IMR declined alongside those of other similarly developed countries up until the end of the 20th century. However, while the decline has continued in other countries, the current Canadian rate of 5 deaths per 1,000 live births has changed little over the past decade.footnote 153 The most common causes of infant death are congenital malformations, deformations and chromosomal abnormalities (which include a range of conditions such as spina bifida and Down Syndrome) followed by disorders due to premature birth or low birth weight.footnote 154 footnote 155 Sudden Infant Death Syndrome (SIDS) is the fifth leading cause of death for Canadian infants, however, the rate of SIDS deaths in 2005 (approximately 33 deaths per 100,000 infants less than one year of age) is significantly lower than the rate of 66 deaths per 100,000 infants only a decade earlier.footnote 141 footnote 156 footnote 157

After the first year of life, the leading causes of death for children change. For those between the ages of 1 and 11 years, unintentional injuries – especially injuries related to motor vehicle crashes – are the leading cause of death.footnote 141 footnote 158 footnote 159 In 2005, unintentional injuries resulted in 3.9 deaths per 100,000 population in this age group, accounting for 33% of all deaths among these children. Still, almost half (47%) were due to transport accidents despite the advances made in child passenger safety over the last few decades.footnote 141 footnote 158 footnote 159 After transport accidents, drowning, threats to breathing and fire are the most common causes of unintentional injury deaths.footnote 141 footnote 158 159 Aboriginal children are at higher risk of unintentional injuries and early deaths as a result of drowning and other causes.160 161

Canada has had success in reducing child injury deaths (including both intentional and unintentional), although there is still room for improvement.163 In the 20-year period from 1971–75 to 1991–95, Canada moved from 22 to 18 out of 25 Organisation for Economic Co-operation and Development (OECD) countries based on the World Health Organization's (WHO's) ranking of deaths due to injuries (both intentional and unintentional), for children aged 1 to 14 years (see Figure 3.2).162 While Canada's shift in ranking may not seem significant, it represents the fourth largest decrease in rates during the measured period with nearly two-thirds (65%) fewer deaths per 100,000 children in 1991–95 than in 1971–75. Germany, the Netherlands and Finland had the top three greatest decreases in their rates (decreasing by 71%, 67% and 67% respectively).162 During the 1991–95 period, Sweden, Italy, the United Kingdom and the Netherlands had the lowest rates of deaths due to childhood injuries with fewer than 7 deaths from injuries per 100,000 children (aged 1 to 14 years). Canada and the United States had rates of 9.7 and 14.1 injury deaths per 100,000 children respectively during the same period.162

Following unintentional injuries, cancers and congenital malformations, deformations and chromosomal abnormalities represent the second and third leading causes of mortality for children in this age group.141 158

While not a leading cause of death, it is of concern that 27 children (0.6 per 100,000) between the ages of 1 and 11 years died as the result of an assault in 2005 (this value has remained relatively unchanged since 2000).141 159

Figure 3.2 Rate of child injury deaths, ages 1 to 14 years, in select OECD countries, 1970s and 1990s 166

Figure 3.2 Rate of child injury deaths, ages 1 to 14 years, in select OECD countries, 1970s and 1990s
Text Equivalent – Figure 3.2

Summary: Between 1971-1975 and 1991-1995 the rate of injury deaths per 100,000 children decreased in Sweden from 13.0 to 5.2; Italy from 16.3 to 6.1; United Kingdom from 14.3 to 6.1; Netherlands from 20.1 to 6.6; Norway from 21.6 to 7.6; Greece from 13.5 to 7.6; Denmark from 19.9 to 8.1; Spain from 13.7 to 8.1; Finland from 24.7 to 8.2; Germany from 28.4 to 8.3; Ireland from 17.2 to 8.3; Japan from 22.4 to 8.4; France from 19.4 to 9.1; Belgium from 20.0 to 9.2; Austria form 23.7 to 9.3; Australia from 22.3 to 9.5; Switzerland from 22.5 to 9.6; Canada form 27.8 to 9.7; Hungary from 16.1 to 10.8, Czech Republic from 19.6 to 12.0; Poland from 22.5 to 13.0; New Zealand from 23.7 to 13.7; United States from 24.8 to 14.1; Portugal from 31.1 to 17.8; and Mexico form 29.3 to 19.8.

Source:  UNICEF.

Figure 3.2 - Rate of child injury deaths ages 1 to 14 years in select OECD countries 1970s and 1990s
Country Deaths per 100,000 children 1971-1975 Deaths per 100,000 children 1991-1995
Mexico 29.3 19.8
Portugal 31.1 17.8
United States 24.8 14.1
New Zealand 23.7 13.7
Poland 22.5 13.0
Czech Republic 19.6 12.0
Hungary 16.1 10.8
Canada 27.8 9.7
Switzerland 22.5 9.6
Australia 22.3 9.5
Austria 23.7 9.3
Belgium 20.0 9.2
France 19.4 9.1
Japan 22.4 8.4
Ireland 17.2 8.3
Germany 28.4 8.3
Finland 24.7 8.2
Spain 13.7 8.1
Denmark 19.9 8.1
Greece 13.5 7.6
Norway 21.6 7.6
Netherlands 20.1 6.6
United Kingdom 14.3 6.1
Italy 16.3 6.1
Sweden 13.0 5.2

Enlarge Figure 3.2

Source: UNICEF.

Ill health and disease

Many of the issues of ill health and disease that children live with, although not fatal, are of serious concern. Some are of concern specifically in the childhood years, while others can have serious repercussions for these children upon reaching adulthood.

Asthma, diabetes and cancer

Three important chronic conditions affecting children are asthma, diabetes and cancer. Approximately 16% of Canadian children between the ages of 4 and 11 years were reported to have asthma in 2000.164 This may be an underestimate of the true prevalence, as children under four years of age are not included due to their inability to properly complete the diagnostic test.footnote 164 Looking only at the older half of the age group, asthma is found among 17% of children aged 8 to 11 years.footnote 164 While the prevalence of asthma has increased from the 11% diagnosed in 1994/95, the number of severe cases has decreased from 41% to 36% over the same period.footnote 165 In 2005–06, 0.3% of young people aged 1 to 19 years were considered diabetic.footnote 166 Although the vast majority have been diagnosed with Type 1 diabetes, which is linked primarily to genetic factors, Type 2 diabetes – formerly seen only in adults – is increasingly being seen in Canada's children due to poor dietary habits and rising rates of obesity.footnote 167

It is difficult to estimate how many Canadian children are living with cancer at any particular time, but it is estimated that on average over 800 children aged 0 to 14 years (15.0 per 100,000) are diagnosed with cancer each year.footnote 168 The most commonly occurring cancer in this age group is leukemia, which accounts for roughly onethird of all new cases in this age group.footnote 168

Vaccine-preventable diseases

Rates of vaccine-preventable infectious diseases are low in Canada since the majority of Canadian children have been immunized against a range of potentially serious illnesses (see Appendix B: Routine Immunization Schedule for Infants and Children). It is estimated that in 2004, 94% of two-year-olds had been immunized against measles, mumps and rubella, 78% against diphtheria, 74% against pertussis, 73% against tetanus and 89% against polio.footnote 169

Coverage rates are not consistent, however, which has resulted in some populations being more susceptible to vaccine-preventable diseases.52 Reduced coverage rates may be the result of barriers to awareness and access, or because of differing cultural norms.52 As there is currently no mechanism to consistently collect immunization records in Canada, the Public Health Agency of Canada has established interim collection guidelines for jurisdictions so that immunization coverage can be estimated.footnote 170

Unintentional injuries

Unintentional injuries are not only a significant cause of death for Canadian children, but also the leading causes of morbidity and disability for children and youth in Canada. They accounted for 15% of the hospitalizations of children under the age of 12 in 2005.171 Falls, transport accidents and injuries due to inanimate objects were the main reasons for these hospitalizations (see Figure 3.3).171 RHS 2002/03 reports that 18% of First Nations children experienced an injury in the previous year that was serious enough to require medical attention (e.g. major cuts, fractures or major sprains/strains).footnote 50

The most severe injuries involve the head and brain, with seemingly minor head injuries capable of causing permanent brain damage. Twenty percent of injuries involving serious trauma result in serious head injuries and lifelong disability.footnote 163 The main causes of head injuries include motor vehicle collisions, falls and sports injuries.footnote 174 Those injuries can lead to mental health issues such as depression, anxiety or post-traumatic stress disorder (PTSD).footnote 175 In children, PTSD can sometimes develop a year or more after an event. If left untreated, PTSD can become chronic and lead to additional emotional and behavioural problems (e.g. eating disorders, increased risk-taking activities, depression, violent behaviour and difficulty concentrating).footnote 176–178

Figure 3.3 Rate of hospitalizations for select unintentional injuries for children aged 0 to 11 years, Canada, 1995, 2000 and 2005 footnote 171–173

Figure 3.3 Rate of hospitalizations for select unintentional injuries for children aged 0 to 11 years, Canada, 1995, 2000 and 2005
Text Equivalent – Figure 3.3

Summary: Between 1995 and 2000 the rate per 1,000 hospitalization for children aged 0 to 11 years changed from 14.1 to 12.4 due to falls; 5.7 to 3.8 due to transport accidents; 5.9 to 4.1 due to exposure to inanimate mechanical forces including being struck by a projectile and firearms discharges; 1.2 to 1.3 due to exposure to animate mechanical forces includes being struck by a person or animal; 3.3 to 1.9 due to accidental poisoning by and exposure to noxious substances; and 5.0 to 3.7 due to all other causes.

Source: Public Health Agency of Canada.

Figure 3.3 - Rate of hospitalizations for select unintentional injuries for children aged 0 to 11 years, Canada, 1995, 2000 and 2005
Cause of unintentional injury Rate per 1,000 hospitalisations in 1995 Rate per 1,000 hospitalisations in 2000 Rate per 1,000 hospitalisations in 2005
Falls 14.1 14.0 12.4
Transport accidents 5.7 5.7 3.8
Exposure to inanimate mechanical forces 5.9 6.0 4.1
Exposure to animate mechanical forces 1.2 1.1 1.3
Accidental poisoning by and exposure to noxious substances 3.3 2.7 1.9
All other 5.0 5.5 3.7

* Exposure to inanimate mechanical forces includes being struck by a projectile and firearms discharges.

† Exposure to animate mechanical forces includes being struck by a person or animal.

Source: Public Health Agency of Canada.

Obesity

Between 1978 and 2004, rates of measured obesity almost tripled among Canadian children and youth aged 2 to 17 years.footnote 179 The most recent rates show that of those between the ages of 2 and 11 years, almost 17% are overweight and just over 7% are obese.footnote 179 Differences in rates can be found within sub-populations, with children from lower-income neighbourhoods and from families with lower levels of parental education having higher rates of excess weight.footnote 180 footnote 181

Aboriginal children and children who reside in rural areas are also more likely to be overweight and obese.footnote 182 footnote 183 In 2004, 58% of First Nations children on reserve aged 3 to 11 years were considered to be overweight or obese, based on parental or guardian reported measures of height and weight, compared to 35% of their off-reserve counterparts aged 2 to 11 years. Among Métis children this number was slightly lower (29%), and although no data were available for the number of overweight Inuit children, 13% of them were identified as obese.footnote 50 footnote 184 Factors likely influencing the higher prevalence of being overweight and obese in those populations include the fact that a greater proportion of these children live in low-income families.footnote 185 Living in low income can exacerbate existing food security issues caused by the already high cost of nutritious food in many Northern and remote areas in which these children live.footnote 186

Research suggests that childhood obesity is a strong predictor of adult obesity.footnote 187 Approximately 33% of obese preschool-aged children and 50% of obese school-aged children remain obese as adults, while a child who reaches his or her second birthday at a healthy weight is less likely to become overweight at a later age.footnote 188 footnote 189 Being overweight or obese in adulthood can lead to serious ill health due to obesity's link to heart disease, certain types of cancers (endometrial, breast, colon), Type 2 diabetes, osteoarthritis and other adverse health outcomes.footnote 190–192 The psychosocial effects of childhood/adolescent obesity are also important to consider.footnote 193–195 Overweight children as young as five years old can develop a negative selfimage and low self-esteem, which can be accompanied by sadness, loneliness, nervousness and high-risk behaviours at a later age.footnote 194–196

Mental and behavioural disorders

Since the 1950s, the importance of understanding and collecting data on children's mental health and behavioural disorders has been increasingly recognized and advocated.footnote 197 Data collected on children's mental health and well-being comes from multiple sources, including provincial/territorial mental health care providers, children, parents, teachers and peers, but the information ascertained is not always comparable.footnote 197 As the onset of most mental illnesses are known to manifest in the early years and persist later into life, having the ability to construct a longitudinal picture of children's mental health would be an asset.footnote 27 footnote 197 footnote 198

Mental health is the capacity of each of us to feel, think and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity.footnote 202

Mental illnesses are characterized by alteration in thinking, mood or behaviour – or any combinations thereof – associated with some significant distress and impaired functioning. Mental illnesses take many forms, including mood disorders, schizophrenia, anxiety disorders, personality disorders, eating disorders and addictions such as substance dependence and gambling.footnote 202

Existing international estimates of the proportion of children affected by mental disorders range from 10% to 20%.footnote 200 In Canada, the final report of the Standing Senate Committee on Social Affairs, Science and Technology (2004) estimated that as many as 15% of Canadian children and youth are affected by a mental disorder at any given time.footnote 201 202 According to RHS 2002/03, an estimated 29% of First Nations children on reserve aged 0 to 11 years were reported by a parent or guardian as having behavioural or emotional problems in the previous six months.footnote 50

Estimates show the most common mental disorders affecting Canadian children are anxiety, attention-deficit hyperactivity disorder (ADHD), conduct disorders and depressive disorders (see Figure 3.4).footnote 203 footnote 204 Although specialized treatment services exist, less than one-quarter of children receive those services.footnote 203 204

Evidence indicates that mental disorders and emotional health problems that occur during childhood and youth may affect children throughout their lives, especially in terms of overall health, happiness and productivity.footnote 27 For example, the development of physically aggressive behaviours in children generally occurs between the ages of two and three years.footnote 205 These behaviours may continue as children age and can increase their risk for delinquency, substance use and mental disorders in adulthood.footnote 205

Learning disabilities refers to a number of disorders which may affect the acquisition, organization, retention, understanding or use of verbal or non-verbal information. They range in severity and may interfere with the acquisition and use of one or more of the following: oral language; reading; written language; and mathematics. They may also involve difficulties with organizational skills, social perception, social interaction and perspective taking.footnote 206

Data on the prevalence of learning disabilities among Canadian children are not readily available at the national level. It is difficult to establish the prevalence among Canadian children for many reasons, including lack of diagnosis and reluctance of parents to identify their children as learning disabled due to stigmatization. But the long-standing rate of 1 in 10 Canadians – although thought to be a low estimate – can most likely be applied to children as well as the population as a whole given that learning disabilities are lifelong.footnote 207

The prevalence of pervasive developmental disorders, including autism, Rett syndrome and Asperger syndrome, is estimated to be between 27.5 and 70 per 10,000 children aged 1 to 14 years.footnote 208–211 Early diagnosis of these conditions may be difficult since children can experience a wide range of symptoms, from problems with verbal and non-verbal communication and poor motor skills to repetitive routines and high functioning knowledge and skills about a single object or subject.footnote 211–215

Figure 3.4 Estimated prevalence of mental disorders in Canadian children under 15 years of age, 2001 footnote 203 footnote 204

Figure 3.4 Estimated prevalence of mental disorders in Canadian children under 15 years of age, 2001
Text Equivalent – Figure 3.4

Summary: In 2001 it was estimated that 6.4% of children aged 5 to 17 years were affected by any anxiety disorder; 4.8% of children aged 4 to 17 years were affected by ADHD; 4.2% of children aged 4 to 17 years were affected by conduct disorder; 3.5% of children aged 5 to 17 years were affected by any depressive disorder; 0.3% of children aged 5 to 15 years were affected by pervasive developmental disorders; 0.2% of children aged 5 to 15 years were affected by obsessive compulsive disorder; and 14.3% of children aged 4 to 17 years were affected by any mental disorder.

Source: Waddell, C., McEwan, K., Shepherd, C. A., Offord, D. R., & Hua, J. M. (2005).

* Data represents children aged 5 to 17 years.

† Data represents children aged 4 to 17 years.

‡ Data represents children aged 5 to 15 years.

Source: Waddell, C., McEwan, K., Shepherd, C. A., Offord, D. R., & Hua, J. M. (2005).

Summary

Most Canadian children are born healthy. Their life expectancy and potential years in good health are among the highest in the world and rates of disease, death and disability among these children are low. However, not all children in this age group experience these health outcomes, and there are patterns of ill-health and disability within this population that are worrisome. Issues such as unintentional injuries, obesity, and mental and behavioural disorders are of particular concern given their sustained or increasing prevalence, as well as their ability to influence long-term health outcomes.

There are several key factors that can contribute – either positively or negatively – to the overall health of children. Some of these factors can have an immediate health impact and are therefore more evident, while others are less obvious with impacts on health that develop and/or accumulate over time and generations, making the connection between exposure and outcome less apparent. Chapter 4 will discuss these factors and examine their current impact on the health of Canadian children.

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