A holiday wish list for Canada’s Early Years System

Abstract

The evidence is clear that early childhood interventions and supports have long-term health and social benefits – coordinated action is required to ensure that every Canadian child benefits. While many advances have been made to improve the chances for Canadian children to have a healthy opportunity for early childhood development, there is much to be done to ensure that they have the best opportunities possible. To ensure every child is able to reach their full potential, the following wishes are identified for Canadian children: a fairer share of the GDP for Canadian children; the development of a strong early years system; designation of a national lead on behalf of children and youth; a focus on prevention; and development of systems to monitor success and failure.

Please Sir, may I have some more?

– Charles Dickens (1)

As we prepare for the holiday season, a wish list for Canada’s youngest children and families is definitely in order – and ‘having some more’ is indeed part of it.

In Charles Dickens A Christmas Carol(2), Scrooge uttered “Bah, Humbug”, a response that may characterize the initial reaction to our wish list. However, we hope that the “Ghost of Christmas Yet To Come” will prevail here in Canada and that our story, too, may eventually end in a renewal of the joy and caring for all children.

Over the past decades, we have acquired a much better understanding of the integration of developmental neurobiological messages from the study of the brain across many different branches of science. The importance of early child development has been appreciated not only by professionals (including physicians), but also by parents, broader society and our political leaders – at least in their words, if not always in their actions. In short, we agree that early experiences shape brain architecture and these early experiences ‘get under our skin’ (3,4). The science is undeniable.

The sharing and the acceptance of this science across many developed and developing societies has led to increased investments by some in early years programs, and better organization of societal efforts to improve the support to young children and families. There are considerable international efforts to more closely monitor these investments and the outcomes of such programs (5). Governments have commissioned many reviews and reports on priorities and policies related to the health and well-being of children in efforts to enable children and families to be the best that they can be. Unfortunately, we continue to see too many of these reports sitting on shelves gathering dust.

Dicken’s “Ghost of Christmas Past” would point to Canada’s sad history of child labour laws, residential schools and Aboriginal and immigrant child treatment. He might catalogue our slow public evolution of social systems for health, education and child welfare. The “Ghost of Christmas Present” might quietly celebrate our current progress across the country as we work toward a strong coherent policy framework for the development of an early child development system. Such a system would include integrated governance, improvements in funding, access to programming, learning environments and accountability (6). However, much work remains to be completed.

We believe the “Ghost of Christmas Yet to Come” shares our vision and our wish list:

1. We wish for a fairer share of the GDP pie for all Canadian children and young families

With a population of more than 33 million, of whom 20.8% are younger than 17 years of age, and a GDP per capita of $50,345 (7), Canada is one of the wealthier developed countries and, yet, we score poorly on the number of our children and families that live in relative poverty. When developed countries are examined against a poverty threshold set at one-half the median income, they fall between 5% (Iceland) and 25% (Romania). All of the Nordic countries as well as Germany, France, Switzerland and Austria have relatively low child poverty rates (under 10%). Canada falls in the intermediate category (10% to 15%) at 13.3%, along with 11 other Organisation for Economic Co-operation and Development countries. More troubling, however, is the fact that our Canadian child poverty rate is higher than our overall population poverty rate. Furthermore, fewer Canadian pensioners older than 65 years of age live in poverty compared with our Canadian children (8). Children are disproportionately affected by the inequities in income distribution that exist in Canada. Is this a fair and just distribution of our country’s resources, or is there a course correction that is required for Canada’s children?

2. We wish for the development of a strong Early Years System

As countries have struggled to match investments in early childhood to outcomes in their own circumstances, no template for a perfect service system has emerged. Many specific approaches and programs have shown merit and there are some commonly accepted principles of governing, programming and investments. Centering substantive supports around the health and well-being of pregnant women and their families is the accepted approach, with good prenatal, intrapartum and postpartum services, sound supports for initiating and sustaining breastfeeding, parenting supports, quality affordable and accessible childcare, affordable accessible health care and early child development services (3,4). But determining the form of programs and the models of delivery continues to be a challenge.

A recent United Kingdom report (9) called for cross-party cooperation and acceptance of the objective of early intervention to provide the “social and emotional bedrock” for the current and future generations of babies, children and young people. Central to this proposal is the emphasis on pulling together the proven and effective early intervention programs for coordinated delivery, as well as focussing on investments in the pioneering of new strategies (10). In Canada, we also need to develop an early years strategy that can be embraced by all – all segments of society, all levels of government and all parents.

Globally, many jurisdictions with far less resources than Canada have made focused efforts in the early years to ensure optimal health and social outcomes. If they can do it, why can’t we?

3. We wish for a national lead, a kind of ‘Chef de Mission’ on behalf of Canadian children and youth

Parents need to be front and centre in their children’s lives, but they do not control many of the factors that lead to success in the communities where they live and raise their children. For more than 20 years, there have been calls in Canada for a National Commissioner for children and youth from various professional and nongovernmental agencies and, as recently as this spring, once again a private member’s bill outlined the need and the role. The Honourable Marc Garneau, when introducing the bill to parliament said, “The true measure of a nation’s standing is how well it attends to its children, including their health, safety, material security, education and socialization” (11).

Without an ability to clearly focus on successful outcomes for children at the federal level, we may never recognize the problems and mobilize the resources and solutions needed to improve the developmental trajectories for our youngest citizens (12).

Creating such a position is particularly challenging for Canada because many of the necessary services fall within provincial/territorial jurisdiction (13). This requires leadership from the federal government. Even if it is argued that health and education fall in the jurisdiction of the provinces, there are many constitutional areas in the federal domain that are clearly related to the broad social determinants of health, not to mention that one of the most significant drivers is tax policy. If the federal government does not step up to provide this leadership, then perhaps the Premiers, through the Council of the Federation could take this on, similar to the leadership they have proposed to take in other health areas.

4. We wish for a focus on prevention rather than late intervention

The random violence experienced in Toronto (Ontario) (14) and Colorado (USA) (15) this past summer once again stimulated much public discourse and reflection as to the society in which we find ourselves and the root causes for these frightening behaviours. Somehow the chronology of a young offender appears to be predictable: the result of the failure of families, social services, education, health systems and, in fact, all of society. While we can often easily identify the failure points, it is much more difficult to identify and explain the complex factors that lead to a successful early childhood and life.

Work in England (16) explored an individual’s propensity to be violent and the societal factors or triggers that, in combination, result in violence. Against this framework, the authors evaluated the upstream effective intervention programs beginning in the early years and identified 47 candidate practices for policy consideration. These were collected from community (health and early parenting), school related (preschool, school and after school), and social and family welfare system examples from across the world literature (17).

Although we choose to build more jails, spending more than $630 million on 30 projects across Canada to create 2700 new cells (18) and enhance the prison system, we need instead to focus on the core enablers, grounded in the early years, for a successful life. The development of contributing, nonviolent, responsible citizens begins in early childhood. We can invest upstream and improve child development, or focus downstream and pay far more later for police officers and jails!

5. Finally, we wish for systems that allow us to honestly monitor both our successes and our failures

The information systems involved in early childhood development in Canada are fragmented. While progress has been made in many provinces, there are no clear national standards regarding items to be collected, and inconsistent methods are used for data collection. And when data are collected, they are often not easily accessible for monitoring, evaluation and research. A national platform for setting standards, and collecting and disseminating data is essential if we are to be able to identify and measure progress on this agenda.

Although it might appear that we have come a long way from the days of Charles Dickens and his descriptions of the lives of poor children in the London workhouses of the 1830s, there is so much more for us all to do. We lack a clear and singular focus of Canadian leadership that is accountable to tackle this holiday wish list for children. How do we get the message across that our kids are worth it, that it makes economic sense and that it is the right thing to do? Leaving it up to the “Ghost of Christmas Yet to Come” is not an option.