Making early childhood count

Hertzman, Clyde; Williams, Robin

doi:10.1503/cmaj.080512

Cited by 45 publications

(33 citation statements)

References 3 publications

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“…The CHMS excludes children under 3 years and has limited data on children 3 to 5 years of age (15) . If Canada aims to make 'early childhood count', we will need to identify feasible surveillance approaches (1) . In the current study we present two successful approaches to sentinel site surveillance through paediatric and community-based health-care practitioners: the CPSP (www.cpsp.cps.ca/) and TARGet Kids!…”

Section: Discussionmentioning

confidence: 99%

Severe iron-deficiency anaemia and feeding practices in young children

Parkin

DeGroot²,

Maguire³

et al. 2015

Public Health Nutr.

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Objectives: Fe-deficiency anaemia (IDA) occurs in 1-2 % of infants in developed countries, peaks at 1-3 years of age and is associated with later cognitive deficits. The objectives of the present study were to describe the characteristics of young children with severe IDA and examine modifiable risk factors in a developedcountry setting. Design: Two prospective samples: a national surveillance programme sample and a regional longitudinal study sample. Setting: Canada, 2009-2011. Subjects: Two samples of young children recruited from community-based healthcare practices: a national sample with severe anaemia (Hb < 80 g/l) due to Fe deficiency and a regional sample with non-anaemic Fe sufficiency. Results: Children with severe IDA (n 201, mean Hb 55·1 g/l) experienced substantial morbidity (including developmental delay, heart failure, cerebral thrombosis) and health-care utilization (including a 42 % hospitalization rate). Compared with children with Fe sufficiency (n 597, mean Hb 122·4 g/l), children with severe IDA consumed a larger volume of cow's milk daily (median 1065 ml v. 500 ml, P < 0·001) and were more likely to be using a bottle during the day (78 % v. 43 %, OR = 6·0; 95 % CI 4·0, 8·9) and also in bed (60 % v. 21 %, OR = 6·5; 95 % CI 4·4, 9·5). Conclusions: Severe IDA is associated with substantial morbidity and may be preventable. Three potentially modifiable feeding practices are associated with IDA: (i) cow's milk consumption greater than 500 ml/d; (ii) daytime bottle use beyond 12 months of age; and (iii) bottle use in bed. These feeding practices should be highlighted in future recommendations for public health and primarycare practitioners.

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Section: Discussionmentioning

confidence: 99%

Severe iron-deficiency anaemia and feeding practices in young children

Parkin

DeGroot²,

Maguire³

et al. 2015

Public Health Nutr.

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“…Stakeholders can use geographic information system (GIS) mapping tools to chart patterns of social risk and disease epidemiology across local populations. The broad use of the Early Development Instrument (EDI) to measure and map school readiness across communities Canada and Australia is an excellent prototype of such an approach (Centre for Community Child Health n.d.; Hertzman and Williams 2009). These data can demonstrate the impact of gradients in social risk, and motivate communities to tackle social issues and prioritize prevention and intervention strategies.…”

Section: Raise Public Awareness About Social Determinants Of Healthmentioning

confidence: 92%

“…Because the investments of one sector (e.g., health during the early years) result in benefits to another sector (e.g., lower rates of special education services), it is often difficult to account for and incentivize necessary investments, when little or no financial benefit accrues to the sector making that investment. The discounting of children's needs and their relative invisibility in the realm of public policy is further exacerbated by existing data systems, which are not equipped to produce a picture of the "whole child" nested in the context of the families and communities in which they reside, or to give valid estimates of the longitudinal costs of shortchanging investments in children and their families (Hertzman and Williams 2009). Consequently, the creation of child and family policies remains a low-status occupation, with service sectors competing with each other for marginal resources.…”

Section: Policy Implicationsmentioning

confidence: 99%

Why Social Determinants?

Halfon¹,

Larson²,

Russ³

2010

hcq

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WhyDeterminants Social abstract There is overwhelming evidence that social factors have profound influences on health. Children are particularly sensitive to social determinants, especially in the early years. life course models view health as a developmental process, the product of multiple gene and environment interactions. adverse early social exposures become programmed into biological systems, setting off chains of risk that can result in chronic illness in mid-life and beyond. Positive healthpromoting influences can set in motion a more virtuous and health-affirming cycle, leading to more optimal health trajectories. mounting an effective response to social determinants will involve both direct social policy initiatives designed to eliminate poverty and inequality, and indirect approaches focused on disrupting pathways between social risks and poor health outcomes. To be effective, these indirect strategies will require nothing short of a transformation of existing child health systems. Parents and professionals must work together from the ground up, raising public awareness about social determinants of health and implementing cross-sector place-based initiatives designed to promote positive health in childhood. ? One of the many photos from the archive of Toronto's Board of Education. Circa 1911.

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“…Hertzman and Williams (2009) suggested one approach to gathering such data is through the use of indirect assessments such as populationbased surveys. Such surveys require individual data collection for all children in a given location, but enable aggregation of data to examine development (and factors impacting development) at a community level.…”

Section: Population-based Measures Of Developmentmentioning

confidence: 99%