Children are the most vulnerable members of society. They are also the most valuable.
They are the future.
Yet, children are voiceless. They have no political power. No protector and champion.
Sure, our political leaders and policy makers utter bons mots about kiddies from time to time, and they like to trot out smiling children for photo ops.
But despite living in one of the wealthiest and most blessed countries on Earth, we have been horribly neglectful of the health and welfare of our children.
This sad reality emerges clearly in a new report from Khristinn Kellie Leitch, the national adviser on healthy children and youth.
Her 219-page report, entitled Reaching for the Top, paints the portrait of a country that, when it comes to creating a healthy environment for its children, is a bottom-dweller.
Consider that, among the 29 countries of the Organization for Economic Co-operation and Development, Canada ranks:
22nd when it comes to preventable childhood injuries and deaths;
27th in childhood obesity;
21st in child well-being and mental health;
22nd in child poverty;
22nd in youth suicide.
These are abysmal numbers.
"We can and we must do better," Dr. Leitch said.
If there is one shortcoming of the report, it is that it does not stress nearly enough the importance of the socioeconomic determinants of health.
Canada has too many children living in poverty; too many youngsters who are precariously housed; too many children whose education is not up to snuff; too many exposed to environmental contaminants. We also have a generation of aboriginal children suffering genocide by benign neglect.
Still, to her credit, Dr. Leitch made some clear recommendations on how we can do better. These include:
A national injury-prevention strategy: More Canadian children die of unintentional injuries (those suffered in motor vehicle crashes, falls, poisonings) than all other causes combined. Many of those deaths can be prevented by enforcing traffic laws, making booster seats mandatory, promoting helmet use for a broad range of activities, establishing standards for playground equipment, eliminating toxic toys and so on.
Tackling obesity: Set a target to reduce the childhood obesity rate to 5 per cent by 2015 from the current 8 per cent. This can be done, in part, by promoting physical activity (in daily life, not just at school) and sound nutrition, along with cities built to facilitate active living (sidewalks, bike paths, public transit and high-density areas) instead of cities designed to facilitate the rapid movement of motor vehicles.
Improving mental health services to children and youth: The number of young people with mental health problems
is expected to grow 50 per
cent by 2020, posing a major challenge to our education
and health systems. Pediatric mental health services need
to be there, and eternal wait times need to be addressed as
a priority.
Research: Specifically, funding a massive study of Canadian children, from newborns to age 8, to monitor their health status over the long term.
Create a national office of child and youth health with a permanent adviser.
The recommendations consistently stress something very important: that we must set concrete public health goals, then measure to ensure we meet them. Platitudes and guesstimates won't do.
Dr. Leitch is also correct that there is currently "no prism to examine the impact legislative issues, policies or programs are having on the health and wellness of children and youth."
Children desperately need an advocate. And nothing demonstrates this point more clearly than the government's tepid response, with Health Minister Tony Clement rushing the report to the many gather-some-dust shelves in Ottawa.
If anything, Dr. Leitch's recommendations do not go far enough. As good as her efforts were, should we content ourselves with an adviser who reports to the Minister of Health?
Virtually every group that advocates for children in this country has called for the creation of an independent child commissioner, as exists in other countries.
"The badge of honour of a civilized nation is to protect its most vulnerable," says Sir Albert Aynsley-Green, the child commissioner for Britain. "The views, needs and interests of children and young people need to be taken seriously."
Sir Albert has certainly done so, repeatedly holding the government's feet to the fire.
The position was created after a Unicef report showed that Britain was dead last in a ranking of child health in 21 wealthy countries.
Canada can hardly take pride in being only slightly better.
Ruth Collins-Nakai, chair of the Child Health Initiative, a coalition of physicians pushing to improve health outcomes, said that wallowing in mediocrity is simply unacceptable, and we should demand far more for our children.
She believes that Canada should set a bold goal: To be in the top five in all indicators of child health - from childhood poverty to injury prevention - within five years.
One would be hard pressed to argue why we should expect any less for our children, for our future.
apicard@globeandmail.com
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