CHILDHOOD
The quality of individuals’ childhood and the transition to adulthood is crucial in shaping their health throughout the lifecourse. Early social and environmental conditions can affect the way a child interacts with the world as they grow older. Childhood is the time in which people build a foundation for success, and the consequences of an unhealthy childhood can be as severe as decreasing life expectancy. Thus, addressing childhood as a social determinant of health is and must continue to be a public health priority, given the various cumulative, pathway, and latent effects of childhood experiences.
Childhood experiences significantly shape health through three primary mechanisms. These are cumulative, pathway, and latent effects. Cumulative effects occur when repeated or sustained exposures to risks or benefits accumulate over time, amplifying their impacts on health outcomes. A negative cumulative effect of persistent poverty during childhood leads to poor outcomes in the lifecourse, such as poor educational and professional prospects, chronic stress, as well as increased risk for chronic diseases like diabetes and cardiovascular disorders in later life. Conversely, a positive cumulative effect is when positive childhood experiences, such as high levels of developmental support from parents or experiences in early childhood education, lead to favourable outcomes in the lifecourse, such as greater job prospects and decreased risk for mental disorders. Pathway effects are when early childhood conditions shape developmental trajectories. These pathways indirectly influence health as they shape a person’s access to resources and opportunities, which then creates a pathway that eventually leads to poor health. For example, poor nutrition in early childhood can delay cognitive development, reduce academic performance, limit career opportunities, and ultimately contribute to health problems in adulthood. Latent effects are the long-term consequences of events during critical developmental periods from prenatal to early childhood to teenage stages of the lifecourse, which may not become apparent until adulthood.
Given all of the above mechanisms that determine the health of individuals throughout the lifecourse, it is important to recognize childhood as a pivotal determinant of health, which thus necessitates proactive public policy interventions. I advocate for Investments in high-quality early childhood education and social programs that have been demonstrated to lead to substantial positive impacts on long-term outcomes. For example, participants in the Perry Preschool Project have significantly greater educational achievements and employment rates, as well as reduced criminal behaviours than children without any early childhood education.
The failure to create childhood experiences that are conducive to future success in the life course is an injustice that must be rectified by society. All children should be able to thrive in later life by receiving the highest level of care during their developmental years. Early Canadian society failed Indigenous children when they acted to strip children of their childhood by ripping them away from their families and their homes and erasing As such, Indigenous children who later grew up faced tragedies, crises and traumas that resulted from the government’s genocidal practices. Indigenous communities continue to face intergenerational trauma, given the cumulative effects of mistreatment in childhood. This is a cycle that was engineered by early Canadian governments as they targeted children to eliminate the Indigenous population in Canada. Indigenous communities continue to suffer from adverse outcomes. Suicide rates are high, and employment rates are low. Indigenous communities are prevented from succeeding in life because of the legacy of residential schools that are felt by survivors, the survivors’ children and their children.
Recognizing the importance of childhood experiences emphasizes the urgent need for equitable, proactive, and sustained public policies, especially to improve health outcomes for Indigenous peoples. For Indigenous communities in Canada, addressing childhood determinants requires culturally appropriate interventions that genuinely respond to community needs, acknowledge past harms, and dismantle ongoing systemic barriers. Reconciliation can only be achieved once all Indigenous children can be seen thriving. Part of the path to achieve this is by fulfilling the TRC’s calls to action, with an emphasis on child welfare and education.
By prioritizing investment in early childhood, actively promoting reconciliation, and fostering culturally responsive care, society can help mitigate adverse childhood effects and contribute meaningfully to health justice and equity across generations.
