The Canadian Institute of Child Health recognizes the need to link data to action, if we are to help our society move towards a healthier future. Our guiding principles for the Profile connect us continuously to this objective. They remind us that any interventions for healthy development of the child, if they are to succeed, must reflect the complexity of the lives of children, recognizing that they are embedded in family, school, community and the social structures that shape society. The guiding principles reflect the wisdom we have acquired over the years in our efforts on behalf of children and youth:
• Ground the document in child development, while maintaining a holistic approach to the child.
It is important to maintain a holistic approach to child development because the process is interactive and comprehensive. Children are not small adults, and the determinants of health that impact their lives can only be understood within a child development framework.
• Recognize sensitive points in the development of a child.
There are sensitive points in the development of a child where risks may arise, opportunities may appear, or interventions may be particularly effective. These risks, opportunities and interventions will help or hinder children and youth, both in the present and in the future. The sensitive points and pathways to healthy development may differ for girls and boys, and there may be cultural variation in the ways that developmental transitions are interpreted.
• Acknowledge that children are important as children.
Children are important not just as the next generation of adults; they play a role in shaping their own lives and they contribute to their families, their schools, and their communities. Strategies must target improving children’s lives now just as much as they aim to improve their futures. Strategies must recognize children’s rights as articulated in the UN Convention on the Rights of a Child.
• Adopt a population-based approach that clearly recognizes the complexity and diversity of children’s lives.
A population-based approach includes everyone. It has the potential to reach all children, youth and families, and still direct attention to the most vulnerable, the most at-risk. A population-based approach can be used to develop a detailed picture of children and youth that recognizes their multifaceted, multidimensional lives.
• Define health broadly to include wellness issues.
The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. In building a well-rounded understanding of the health of children and youth, both negative and positive outcomes will be included. As examples, negative outcomes could include how many children are injured every year and positive outcomes could include how many children aged 5-6 years are ready to learn.
• Focus on critical issues.
Critical issues drive policy development. A focus on critical issues ensures that the information has the greatest possible impact, and requires that adequate attention be given to the most vulnerable children.
• Build on and foster awareness of Canada’s regional, ethnic, linguistic, cultural and religious diversity.
The population of Canada is increasingly diverse. Strategies to improve and promote health and well-being of children and youth must be flexible and responsive to community-level needs.
• Focus on prevention and health promotion.
Primary prevention seeks to avoid the onset of disease by eliminating or, at least, minimizing environmental factors and unhealthy behaviours that increase the risk of death, illness, and injuries. Health promotion creates the environment whereby individuals are able to reach their highest potential for health. Strategies must include how one would like things to be in the future, reducing disease and setting goals for the promotion of health.
• Recognize the major changes that have occurred in the health care system.
The restructuring of the health care system has changed the way that care is provided. Statistics on hospitalization must be interpreted in light of these changes and strategies must be revisited and revised.
• Identify important issues in the Profile even where available data are incomplete at this time.
The Precautionary Principle urges action in the best interests of children based on the information available at a given point in time. In regard to widely distributed environmental toxicants, to wait for absolute and conclusive research can potentially put a generation of children at unnecessary risk.
• Recognize the disparities that exist for children and youth in Canada.
Data needs to be presented in such a way that the disparities within Canada are made visible. Disparities may be regional or economic or they may be related to ethnicity, disability status or gender.
• Address present life quality and determine the desired future state.
Recognize that the determinants of health and children’s circumstance influence the life/developmental trajectory they experience. Strategies must include how one would like things to be at some future time, addressing not only disease reduction but also setting goals for the promotion of health. Address the important considerations related to transition to adulthood.