When a crow went down with West Nile virus somewhere in Ontario, my phone would ring. Practising as an infectious disease specialist at the time, I was alerted to early warnings about threats to the public's health from infectious agents. Immediate response was expected – and provided – by our strong public health infrastructure.
But here at the children's hospital where I now work, a group of us meet regularly, if informally, about another pressing public health threat – hunger.
We live in one of the wealthiest countries in the world. But hunger is something that we at the hospital increasingly see among the families that bring their children to us for medical attention.
For 10 days beginning May 6, which marked the start of Hunger Awareness Week in Canada, the United Nations Special Rapporteur on the Right to Food is making a formal country mission visit to Canada. It's the first-ever visit to a developed nation by Olivier de Schutter, a Belgian law professor who became special rapporteur in 2008.
As a signatory to both the Universal Declaration of Human Rights (1948) and the International Covenant on Economic, Social and Cultural Rights (1976), Canada has a legal obligation to "respect, protect and fulfill the right to food."
It's my hope that this visit – and the recommendations in the report that Prof. de Schutter will subsequently produce – will throw a spotlight on the disturbing truth that far too many Canadian children are hungry because their families lack access to adequate and nutritious food.
Food Secure Canada estimates that almost 2.5 million Canadians live without secure access to food.
An infectious agent like West Nile poses an immediate threat as well as long-term health consequences (if almost exclusively in adults). Unquestionably, the consequences of hunger and food insecurity in childhood are similar.
Why are we concerned here? Many pediatricians with community practices tell us that finding the money to feed their children is the top problem faced by many parents they meet.
We see children whose parents struggle with poverty. We admit proportionately more children from high poverty neighbourhoods to hospital than from other neighbourhoods, and the children from poorer neighbourhoods stay longer at the hospital.
We know that childhood hunger – which of course is linked to poverty – has long-term impacts on physical and mental health.
For healthy growth and development, children need sufficient nutrients. Deficiencies of even small amounts during this important period can have long-term health consequences.
One thing we're seeing in recent years is an upswing in cases of rickets, a condition still prevalent in developing countries but one that I thought would be corrected in Canada through the 1970s, when I trained in Montreal.
Rickets is preventable. It is primarily caused by a lack of sunlight and vitamin D, (including vitamin D supplementation with breast feeding), although a lack of calcium can also contribute to the condition, which causes bones to soften and become prone to deformity. Foods that contain vitamin D include fortified milk, as well as eggs, fish oils, margarine and some other foods.
The children we see who have developed rickets are quite simply not getting adequate amounts of sunlight and nutritious food, including vitamin D supplementation with breast feeding.
As a recent report from Toronto's medical officer of health states: "Children who live in food-insecure households are more likely to have growth and developmental problems, be susceptible to illness and perform poorly in school, compared to children who are food-secure."
Adequate nutrition is also a key issue when it comes to mental health among youth. Psychiatrists speaking at the request of community youth in one of our priority neighbourhoods advised that the first two mental-health questions that should be asked of young people are: "How did you sleep last night?" and "Have you eaten today?"
We know that in the Greater Toronto Area, the use of food banks is increasing rapidly. A key reason is that housing costs are eating up a growing proportion of family income. Initiatives are under way to help physicians and other health care providers better link families to resources such as food banks and government services.
But while there is a perception that food banks – as well as programs like school and community meal programs, community gardens and kitchens – are providing the needed response to food needs, Canadian research challenges this notion.
The UN Special Rapporteur will present his preliminary findings on food security in Canada on May 16 in Ottawa. It's my hope that this will put child hunger squarely on the political agenda in Canada – and galvanize action to eliminate it.
Specializing in social pediatrics, Dr. Elizabeth Lee Ford-Jones is an expert adviser with EvidenceNetwork.ca, project investigator at the Hospital for Sick Children and a professor in the department of pediatrics at the University of Toronto.