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									Commentary on child health and well-being … the policy-research
Nancy Reynolds

Key words
I   Children and youth      I   Child health policy          I   Evidence-based practice

       olicy issues related to human health and development                        the evidence. Academic and clinical occupational therapy

P      are increasingly complex. The simple questions have
       generally been answered. There is often no simple
cause and effect relationship on which to focus the pursuit of
                                                                                   researchers will need to consider the alignment of future
                                                                                   research pursuits with policy-relevant issues and questions.

                                                                                               Recent developments in
evidence to inform policy. This statement is particularly true
when considering the opportunities and needs for evidence                                        child health policy
related to child health and well-being.                                            The focus on child health policy at provincial and national
     Since I first began to think about writing this                               levels has been building strength in Canada over the past
commentary, the current global economic crisis has started                         decade. There has been a progressive emergence and
to influence national and provincial child health policy and                       convergence of many key policy agendas. As recently as 2007,
research environments. The majority of child health policy                         Canada still only ranked 12th out of 21 wealthy countries in
that has emerged over the decade has targeted long term                            the United Nations’ rankings of child well-being (UNICEF
population health outcomes. With fewer resources and the                           Innocenti Research Centre, 2007). Results like the UN
urgent need to contain the increasing percentage of the GDP                        ranking have helped to sustain the focus on policy to support
spent on health care, health policy agendas in some provinces                      better outcomes for children. Early in the new millennium the
are tightening their focus and targeting shorter term                              Federal/Provincial/Territorial Early Childhood Development
outcomes such as increasing the efficiency and effectiveness                       Agreement (2001) emerged in Canada. Provinces developed
of health care services. In the research community, many                           their own policy initiatives in alignment with the national
organisations are anticipating reductions or in some cases                         framework. In 2005, national health goals were developed,
even an elimination of their funding from federal and                              again through a federal/provincial/territorial process. The
provincial governments in the 2009/10 fiscal year. Other                           first stated goal is “Canada is a country where: Our children
research organisations funded through endowments have                              reach their full potential, growing up happy, healthy, confident
seen a significant reduction in their investment income. Our                       and secure” (Health Goals for Canada, 2005).
collective challenge over the next several years will be to                              In May of 2006, the final report of the Standing Senate
ensure the momentum that has been building in Canada                               Committee on Social Affairs, Science and Technology, Out of
related to child health policy and research is sustained.                          the Shadows at Last; Transforming Mental Health, Mental
     Systemic action and shared responsibility are necessary                       Illness and Addiction Services in Canada (2006) was published.
foundations on which to develop effective policies that                            Chapter Six of the report is titled “Children and Youth.” This
support optimal child health and well-being. Over the last                         report resulted in the establishment of the Mental Health
decade, the policies that have been emerging in Canada to                          Commission of Canada. One of the key priorities for the
support the agenda acknowledge the requirement for cross                           Commission is child and youth mental health.
ministry and cross-sectoral systemic action. When funding is                             In 2007, Dr. Kelly Leitch was appointed as an Advisor on
tight, support for this highly collaborative activity is often                     Healthy Children and Youth to the Federal Minister of
impeded by the competing funding priorities that are the sole                      Health. Dr. Leitch consulted broadly across the country and
responsibility of a particular ministry or child-serving sector,                   developed her report titled Reaching for the Top (2007). In
both at the policy and service delivery levels.                                    that report, she identified five key items for particular
     Timely and relevant research evidence will be required                        attention injury prevention, childhood obesity, mental health
to inform decisions and future policy investments. However,                        services, longitudinal data to help understand environmental
funding to support child health research will be more                
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