Dear Colleagues,

As health care costs rise and health care delivery becomes increasingly complex, it’s clear that our system must not only work to treat illness; it must also work to prevent it from occurring in the first place. That is why the Royal College is calling for action for early childhood development — and I hope you will join us.

Today is National Child Day in Canada and around the world. Together with our partners, we have issued 15 recommendations to improve the health and wellness of Canada’s children, including calls for increased government funding and enhanced support for parents.

Canada cannot afford to fall behind

As doctors, we know that crucial physical and cognitive advancements take place between birth and age six.

Research suggests that 90% of a child’s brain is developed by age five. At the same time, evidence also shows that the root of many chronic diseases are formed prenatal and in childhood. Children experiencing adverse childhood experiences (ACE) such as abuse, neglect, poverty, spousal abuse, parental addiction, environmental stresses, etc., are far more susceptible to later disease in adulthood.

Canada lags behind other wealthy countries in its support of early childhood development and learning—a reality that could cost us dearly in future. Currently, Canada spends 0.6% of its GDP on early childhood care and learning, trailing France, Sweden and most other OECD countries. This is also significantly below the OECD’s 1% benchmark.

Our country can, and should, be a world leader in supporting its children’s healthy development.

15 recommendations for change

The factors that can influence and shape early childhood development are truly complex, involving many jurisdictions, different levels of government and health practitioners across Canada.

That is why we developed 15 diverse recommendations for how governments and physicians can take action on early childhood health and wellness. These include the federal government committing to increased funding for early childhood development towards a target of 1% of GDP — bringing Canada in line with other OECD countries.

The full 15 recommendations are available online and were created in collaboration with representatives and subject matter experts from the College of Family Physicians of Canada, the Canadian Medical Association, the Canadian Paediatric Society, the Canadian Association of Paediatric Health Centres, and other associations and academic partners.

Recommendations for medicine

Physicians in all specialty areas can also play a role.

The science of early brain development and biology is rapidly and continuously evolving. We must ensure that current and future physicians up-to-date on the latest information.Also, practitioners in all disciplines have numerous opportunities to educate patients about the importance of early childhood intervention.

That is why our recommendations include the following:

  • Make continuing medical education on early brain, biological development and early learning available to all care providers, particularly but not limited to those in primary care.
  • Developing comprehensive resources for primary-care providers to identify community supports and services to facilitate referral for expecting parents, parents, and children.

The Royal College is working with our partners to develop educational modules for Fellows, with a target to deliver in 2015. At the bottom of this message, you’ll also find a few resources recommended by the Working Group.

Let’s start a national conversation about supporting childhood development

We’re publically calling for action. Fellows, you can help educate Canadians about this issue and encourage your government officials to act.

  • Download the Royal College’s position statement or Op-Ed and share it within your network.
  • Read our joint statement or Q-and-A and use this knowledge to lobby your federal and local government representatives.
  • Promote early childhood interventions with your patients and colleagues whenever appropriate.
  • Contact if you want to get involved in future media and advocacy efforts in your area.

We do not have all the answers, and hope to continue refining our recommendations and increasing advocacy efforts in the coming months.

The Royal College’s vision is “Best health for all, Best care for all”, and the health impacts of healthy early childhood development are felt over a lifetime.

We also want your support. Are there other strategies the Royal College can use to raise awareness and spur action? Are there other ways that we can support Fellows’ efforts to approach their federal and local government representatives?

I look forward to hearing from you.


Andrew Padmos, MD, FRCPC, FACP
Chief Executive Officer


Select resources recommended be the Working Group