Is Canada Doing Enough for its Children and Youth? University of Ottawa May 2016

Outline of Presentation Canadian child and youth health status Current government commitments to children and youth The Canadian Paediatric Society Report – Are We Doing Enough?

Health Status of Canadian Children and Youth Unintentional injuries are the leading cause of death for children aged 1 to 14 accounting for about 40% of deaths In just two decades, the combined prevalence of obesity and overweight has almost tripled for Canadian children. Under 85% of Canadian children have been immunized for DPT (diphtheria, pertussis and tetanus), placing Canada 28th out of 29 reporting UNICEF countries The prevalence rate for mental health problems in children and youth is approximately 20%; 15% for “significantly distressing and debilitating mental health problems” among 4 to 17 year-olds

Canadian Health Care Federal Government Fund transfers to provinces and territories First Nations, Inuit, and Metis health Refugee and new Canadians National Public Health initiatives Provincial and Territorial Governments Health care delivery – both clinical and public Public health legislation Education Broad determinants of health

What Canada Does Have National Immunization Strategy –Progress and sustained funding hard to track –No harmonized schedule or national registry –Renewed commitment in the mandate letters Public Health Agency of Canada –Set up largely to react to public health threats Mental Health Commission –Children and youth a priority

What Canada Does Not Have National Education Strategy National Aboriginal Child and Youth Strategy National Injury Prevention Strategy Federal Commissioner for Children and Youth Broad Determinants of Health

What the Federal Government is Promising National Early Years Strategy National Aboriginal Child and Youth Focus –Truth and Reconciliation Commission –Jordan’s principle National Poverty Reduction Strategy –National Housing Strategy Federal Commissioner for Children and Youth –Not immediate priority Ministerial mandate letters

Emerging Federal Issues Physician Assisted Dying Medical Marijuana Recreational Marijuana Climate Change

CPS Philosophy To improve the health and well-being of children and youth by; –Improving clinical care –Providing anticipatory guidance –Changing government policy –Enhancing parent/caregiver health literacy Translate the latest peer reviewed evidence into changes in behaviour

CPS Statements Set standards for both clinicians and government policy Created by the CPS Committees –Specialists and Sub-specialists –Review most recent medical literature, reports, and documents from other organizations and government Reviewed by other appropriate CPS Committees, outside experts Approved by the Board of Directors CPS does not accept industry funding for guidelines

Success of Previous Reports All governments now refer to the report when CPS visits Government send letters when they have passed appropriate legislation of approved funding Used by other groups to advocate for key issues Used by government officials to convince their colleagues that changes are needed

2012 Status Report Disease prevention Health promotion Injury prevention Best interests of children and youth Federal government policies and programs

Disease prevention Publicly-funded immunizations –Although almost all jurisdictions are meeting CPS standard, immunization rates continue to fall –Seeing outbreaks of vaccine preventable diseases Measures to prevent and reduce adolescent smoking –All of Canada is now smoke free in indoor public places –Many jurisdictions have banned smoking in cars –Some have moved to ban smoking in outdoor public places

Health Promotion Child and youth mental health care planning –A real patchwork across the country –Need to improve access to services –Many provinces are seeing this as major issue –Also calling for a National Child and Youth Mental Health Strategy in step with Evergreen Paediatric resource planning –Not one province or territory has a long term human resource plan created in collaboration with local paediatricians

Emerging Issues Newborn hearing screening –Looking for comprehensive programs that have screening and treatment Enhanced 18 month well-baby visit –Developmental screen –Counseling on positive parenting, anticipatory guidance, and literacy promotion –Ensure health professionals are remunerated for extra time

Injury Prevention Bicycle helmet legislation –No progress since 2009 ATV Legislation –Need political will, have seen some provinces go backwards since 2007 Booster seat legislation –Provinces and territories starting to move forward since 2007 –Atlantic provinces lead the country Snowmobile legislation –No change since 2009

Best Interests of Children and Youth Child Poverty –Key determinant of health –More provinces have strategies but are they leading to improvements Jordan’s principle –Few jurisdictions puts the interests of First Nations children and youth first Child and youth advocates –Most provinces have one, but mandates are limited in many instances –Need to be a voice for all children and youth, not just children and youth in care

Child Poverty Poverty reduction legislation In place for at least 3 years Specific plan focusing children and youth Specific reduction targets and goals –Much work needed to convince decision makers that poverty reduction is key to life long health –Have seen some improvement including Ontario

Federal Government National Immunization Strategy has led to much more equitable access to recommended vaccines across the country However, the federal government still has work to do on: –National Injury Prevention Strategy –Child and Youth Commissioner –National Mental Health Strategy –Jordan’s Principle –Child Poverty Strategy –National Early Learning and Child Care Strategy

Central Canada Report Card Issue ManitobaOntarioQuébec Publicly-funded immunization programs FairExcellentGood Measures to prevent and reduce adolescent smoking Excellent Good Newborn Hearing ScreeningPoorExcellentGood Enhanced 18 month visitPoorExcellentPoor Child and youth mental health care planning GoodExcellentGood Pediatric human resources strategy Poor

Issue ManitobaOntarioQuébec Bicycle helmet legislationPoorGoodPoor All-terrain vehicle (ATV) safety legislationFair Good Booster seat legislationFairExcellentGood Snowmobile safety legislationFair Excellent Child povertyGoodExcellent Jordan’s PrincipleFair Poor Child and Youth AdvocateGood Fair

New Issues for 2016 E- cigarettes – should be treated like all other tobacco products Smoking in public places should be banned Children with type 1 diabetes and support in schools Health benefits for refugees Breast feeding friendly policies