TORONTO - Canada's federal, provincial and territorial governments should be doing more to promote the health and safety of children and youth, says the Canadian Paediatric Society in its latest biennial report card.
The report card, the fourth since 2005, ranks how well the provinces and territories use legislation and programs to address 13 specific issues under four broad areas, including injury prevention and health promotion.
"Since we last published our report in 2009, there have been too few improvements across all provinces and territories," said CPS vice-president Dr. Andrew Lynk. "There continues to be a piecemeal approach to keeping children and youth healthy and safe in Canada, and it's putting kids at risk."
For instance, legislation requiring the use of booster seats in vehicles for children age three to nine varies across the country, even though their use has been shown to save lives and prevent catastrophic injury in traffic accidents.
While the CPS gives British Columbia and Ontario a mark of "excellent" for their booster-seat legislation, "the prairie provinces in-between" aren't making the grade, said Lynk, noting that Alberta and Saskatchewan scored a "poor" for having no law and Manitoba is "fair" because its legislation needs to be bolstered.
The territories also received a poor or fair grade, Quebec was awarded a mark of "good," while the Atlantic provinces were all rated as excellent.
Young children can suffer paralysis, serious abdominal injury or even death from standard lap- and shoulder-belts due to their small size. Raising them up with a booster seat allows the belt to safely cross their collar bone, Lynk said Monday from Sydney, N.S., where he practises pediatrics.
"So that's a real head-scratcher," he said of jurisdictions that don't mandate booster-seat use, "because you would think in terms of saving lives and serious injury that that would just be a no-brainer."
Alberta, for instance, has no immediate plans to legislate booster seats for children. However, Alberta Transportation spokesman Martin Dupuis said the province strongly recommends booster seats and relies on educational programs and regional safety consultants to teach parents how to use them safely and effectively.
The CPS report also shows many of the provinces need to boost their childhood immunization programs, including adding a second dose of chickenpox vaccine before a child begins school.
With the exception of Ontario, none of the provinces or territories has instituted an enhanced 18-month well-baby visit, recommended by the CPS to pick up developmental or behavioural problems in children who could benefit from early intervention.
That more detailed check-up is also designed to identify difficulties facing parents that may affect a child's health, said Lynk. "Because if parents are struggling or depressed or addicted or abused, that's also high risk and they need help, too."
The report also suggests the federal government should be investing more in programs to promote the health and education of the country's youngest citizens.
"Canada lags far behind most wealthy western nations and is ranked last in terms of support for family policy and early child development," said CPS president Dr. Jean-Yves Frappier, citing an OECD ranking of 37 countries.
The CPS says Ottawa, along with the provincial and territorial governments, needs to implement programs aimed at reducing the economic disparities in Canada, where 700,000 of the country's five million children live in poverty.
"And we really believe that child poverty rates should be as important an economic indicator as interest rates, inflation rates and unemployment rates," said Lynk. "Because a lot of those kids, if we don't help them, they're going to be destined as adults to living on the margins as well. And that doesn't help the economy.
"We know if you invest in those early years, it pays huge dividends in productivity, less health costs, less problems with the criminal justice system."
The CPS is also calling on the federal government to implement a high-quality national day-care program and to appoint an independent commissioner of child and youth health, who would report directly to Parliament as the auditor-general does.
Federal Health Minister Leona Aglukkaq was unavailable to comment. But spokesman Steve Outhouse, noting the government had recently allocated more than $5 million for injury prevention among children and youth, said the report would be reviewed.
The CPS said that while governments have made improvements during the intervals between its reports, much remains to be accomplished.
"Some are doing excellent in some areas and poor in others, so it's kind of a scatterbag," said Lynk. "We hope that each province will look at its own report card and compare it to their peers and try to pull their bootstraps up where they can.
"It's a big motivating factor because who wants to be the health minister and know that your province isn't doing as well as your neighbour next door in something as important as child and youth health."