1. PUBLIC HEALTH AND BEST START AND CHILD AND FAMILY CENTRES alPHa Winter Symposium Feb. 11, 2011 INTRODUCTORY REMARKS

2. Early Learning Visioning Day FEB 9, 2011

3. Dr. Paul Roumeliotis, MD.CM, MPH, FRCP ( C), FAAP Medical Officer of Health, Eastern Ontario Health Unit Chair, Council of Ontario Medical Officers of Health (COMOH) Adjunct Professor of Pediatrics, McGill University The Early Years Are The Most Influential The Most Influential LIFE-COURSE PERSPECTIVE ON HEALTH

5. Neal Halfon 04-212 Sound Vision Smell Touch Proprioception Taste 5

6. 03-079 Eye cataracts at birth prevent normal development of vision neurons in the occipital cortex (Hubel and Wiesel) Cochlear defects at birth impair hearing development (Rauschecker and O’Donoghue) Vision and Hearing Critical Period

9. LIFE COURSE PERSPECTIVE physical, social, medical insult

10. EARLY DEVELOPMENT INSTRUMENT(2005-06 LONG TERM Biological mechanisms which are activated by the circumstances of disadvantage are the immediate causes of the mis-development of brains and of the modification of the genome's expression in children. There is link between these events and illness and poor all round functioning of the later adult.

11. Epigenetics (heritable without changes in DNA sequence) Methylation of DNA (cytosine) Histone acetylation 07-170

12. Examples: SGA-IUGR children have higher rates of metabolic syndrome(diabetes, hypertension high blood pressure as adults. People abused as children have higher rates of heart disease as adults

15. Normal Child Health and Development Normal Child Health and Development Is the Key to a Lifespan of health and success! Harmonized-all government approach with a “child health promotion lens” on all policies, planning and programs o LIFE-COURSE PERSPECTIVE ON HEALTH

16. Public Health is what we, as a society, do collectively to assure conditions for people to be healthy -Institute of Medicine o

17. "This is a key policy window that we cannot afford to miss. The ship is sailing and we need to get on board to help steer it."

18. Challenges in Defining Public Health’s Role in Early Learning Funding and resources Convincing decision-makers higher upfront costs returns are medium to long-term Defining “core” evidence-informed services balancing consistency with meeting local needs Need for new data, data linkages and outcome/evaluation measures Helping partners understand the PH role*

19. Opportunities for Public Health Be active and be a partner/leader/broker critical need for linkages between child care, primary care, public health and other essential services sectors Build on our strengths population health approach and systems thinking evidence-based long-term perspective collaboration knowing our communities……STABILITY HPPA Catalyst for deeper integration Improve our reaching in supporting families through multiple pathways Improve surveillance and address lack of data Contribute to the development of provincial policy

20. Elements of a Vision for Public Health’s Role Every child and family has the support needed to reach full potential Society cares about children and provides stability through the social determinants of health The child and family drive the services, and are central to seamless and accessible services. Clearly defined outcomes feeding into population health assessment and ongoing surveillance view with a life-trajectory view......LONG TERM THINKING LENS Public health is integrated within the community and has the capacity to impact families across the spectrum Putting children first, politicians, voters and all communities believe in supporting and empowering families

22. Wrap up: practical steps toward a vision and position statement AND ACTION AND ACTION