Early Child Development and Chronic Disease

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I Introduction

Practitioners and policy makers in the field of early child development have long been aware of the importance of early child development on future wellbeing. This focus provides an opportunity to ensure we recognize the connection between early child development and chronic disease and support organizations and practitioners to take action. In Spring 2009 the Best Start Resource Centre will be releasing a report to help raise awareness about the important connection between early childhood and risk factors for adult chronic disease. Development of this report was supported through contributions from key informants and advisors with expertise in early child development and chronic disease.  The report focuses on childhood developmental influences from birth to age six and includes healthy eating, physical activity, obesity, sun exposure, exposure to second-hand smoke and attachment.  It describes how health in early childhood can impact our health as adults and was written to help practitioners move from knowledge to action. The report provides several examples of Canadian best practice programs that have proven to be effective in improving the health of babies and young children and may lower their future risk of chronic disease as well as recommendations for concrete actions.  

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II Link between Chronic Disease and Early Child Development

Chronic diseases are illnesses that have an uncertain outcome and are caused by multiple risk factors. They usually develop slowly, last for a prolonged period of time and can cause premature disability, illness and death. There are many causes for chronic disease which can be grouped in the following categories:

  • background risk factors such as age, sex, and genetic background
  • behavioural risk factors such as smoking, alcohol consumption, lack of physical activity and unhealthy eating habits
  • intermediate risk factors such as blood pressure, cholesterol levels, and obesity.  

It is important to note that some risk factors for chronic disease such as age, sex and genetic make-up simply cannot be changed however we can modify many of our behavioural and intermediate risk factors.  

Until recently, our efforts to prevent chronic disease have focused mainly on conditions that affect adults. We now know that our risk of chronic disease is actually being established much earlier than previously thought. Our experiences and the behaviours we develop in early childhood such as infections, unhealthy eating, lack of physical activity and socioeconomic or psychosocial disadvantage can affect our future risk of chronic disease.

The early years provide the basic foundation for learning, behaviour and lifelong health. This period starts before birth and includes the development of the child up to the age of six.  Research has demonstrated that very early development is affected by a set of inter-related environmental, social and physical factors and if children live in disadvantaged conditions, the odds are they will be less healthy as adults. Taking steps now to ensure that our children receive the best possible start in life is the most important thing we can do to build a healthy society.  

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III Addressing the Social Determinants of Health

Chronic diseases are affected by individual choices as well as factors that we cannot always control. These are called social determinants of health and may include the communities where we live; our social and economic conditions (poverty, employment and family size); and the environment (climate and air pollution). The impact of these factors may be most obvious during the early years. Study after study has confirmed the fact that the first years of life lay the foundation for future development. It is becoming more apparent that the determinants that effect children's health will ultimately have an impact on their future risk of chronic disease.

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IV Recommendations

It is important not only to recognize the link between early child development and chronic disease but to consider ways in which we can address this connection. The Best Start report about the important connection between early childhood and risk factors for adult chronic disease provides suggested recommendations for policy makers, organizations and practitioners who work with young children and families and/or in chronic disease prevention, and provides some key steps that can be taken to lower future risk of chronic disease. These recommendations focus on overall actions that can be implemented by society as a whole and include specific steps that early child development practitioners and organizations can take to promote early child development and chronic disease prevention.  

Recommendations for practitioners: 

  1. Recognize that every step we take to promote healthy child development is actively reducing chronic disease and contributing to the health of the next generation.
  2. Understand the importance of and adopt a comprehensive approach to early child development and chronic disease prevention that is grounded in the social determinants of health.
  3. Take every opportunity possible to actively learn about the links between early child development and chronic disease.
  4. Seek out best practices that can be modified if necessary and used to enhance positive and healthy conditions during childhood.
  5. Establish and promote policies in day care settings, schools, and other venues that ensure children are provided with:
    • good quality, safe, nutritious and culturally appropriate food
    • daily and safe opportunities for physical activity and recreation, indoors and out
    • protection from the sun, especially during the sun's peak hours
    • a safe nurturing environment that encourages attachment and bonding.
  6. Encourage parents to:
    • Breastfeed their babies and provide their children with healthy food choices based on Canada's Food Guide.
    • Nurture and bond with their children.
    • Avoid smoking around their children.
    • Protect their children from the sun.
    • Ensure their children have plenty of opportunity to engage in lifestyles which promote physical activity.
    • Recognize that their children are developing lifelong health behaviours now.
    • Understand their role in preventing chronic disease in their children when they are adults.
  7. Be a positive role model by adopting healthy behaviours both at work and at home such as not smoking, eating healthy foods, getting plenty of physical activity and avoiding the sun.

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V Conclusion

The early years are a critical period in human development. Childhood experiences have a profound impact on future wellbeing including risk of chronic disease. It is clear that scientific evidence exists about the link between early child development and chronic disease. Government policy-makers must be engaged, and the time is right to get the word out and take further action in this area.

Linking early child development and chronic disease is even more important as part of a long-term strategy that can offer a dramatic return on our investment in the health of Canadians. Practitioners in the field of early child development and their colleagues working in chronic disease prevention, community and public health have a key role in and responsibility for advocating for and implementing strategies which address the connection between early child development and chronic disease in order to promote the health of our precious generation, the children of today.  

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VI References

McCain, M., Mustard, F., & Shanker, S (2007).  Early Years Study 2: Putting Science into Action, Council for Early Child Development. Retrieved December 15, 2008 from: http://www.founders.net/fn/news.nsf/24157c30539cee20852566360044448c/5e0d29958d2d7d04852572ab005ad6a6!OpenDocument

Public Health Agency of Canada. Centre for Chronic Disease Prevention and Control  (2006).  What are Chronic and Non-Communicable Diseases? Retrieved November 5, 2008 from http://www.phac-aspc.gc.ca/ccdpc-cpcmc/topics/chronic-disease_e.html

Public Health Agency of Canada (2003).  What Makes Canadians Healthy or Unhealthy?  Retrieved November 6, 2008 from http://www.phac-aspc.gc.ca/ph-sp/determinants/determinants-eng.php#employment

The World Bank (2006). What is Early Child Development? Retrieved November 5, 2008 from: http://web.worldbank.org/WBSITE/EXTERNAL/TOPICS/EXTCY/EXTECD/0,,contentMDK:20260280~menuPK:524346~pagePK:148956~piPK:216618~theSitePK:344939,00.html