By Stephanie Dunn
and Jennifer Zwicker
University of Calgary
“The true measure of a nation’s standing is how well it attends to its children, including their health, safety, material security, education and socialization, and their sense of being loved, valued and included in the families and societies into which they are born,” according to UNICEF. Yet how can we measure our nation’s standing when we’ve stopped measuring the health and well-being of children in Canada, particularly those with disability?
National population data is out-of-date, with the most recent on Canadian children with disabilities almost a decade old. Three of the four population-based disability surveys for children are no longer active, meaning we lack critical information on the diverse and often unmet needs of this group, as well as the out-of-pocket costs paid by families.
In this dearth of information, how can we design effective policies and programs that improve the social, health, employment and economic outcomes for children with disability and their caregivers?
Let’s take developmental disability as an example. As many as 850,000 children in Canada live with a brain-based developmental disability. This group faces lifelong challenges with mobility, language, learning, socialization and/or self-care. All of these impact their quality of life and create special challenges for their families. These children also typically have poorer health, lower educational achievement, fewer economic opportunities and higher rates of poverty than children without disabilities.
These are (unfortunately) some of the only unifying features of this heterogeneous group. The nature and needs of children with disability are diverse, varying from child to child, requiring unique combinations of targeted supports. Yet the lack of data means we know very little about how adequately existing services and supports meet the diverse needs of these children.
As Margaret Chan, former director-general of the World Health Organization, has said repeatedly: “What gets measured gets done.” A first step is to better understand the needs of this underserved population. Better information on the nature and needs of children and youth with disability is essential for policy-makers at all levels of government to predict and plan for improved provision of efficient, equitable and inclusive services and supports.
Better data will also allow for a deeper understanding of the education and employment requirements, and how these influence important outcomes such as income, as well as challenges in accessing services for those with disability.
A few provinces are leading the way to help researchers and policy-makers better understand the nature and needs of children with disability. For example, Alberta established a child and youth data lab dedicated to understanding the impacts and policy needs that will optimize the well-being and future potential of its youngest citizens. And the Manitoba Population Research Data Repository is a comprehensive collection of administrative, registry, survey and other data relating to Manitobans. This information helps identify health and social policy tools that can be developed to address needs.
Yet these initiatives only partially address the problem. They don’t describe the current or changing prevalence of disability across Canada. Nor do they provide much-needed longitudinal data to determine the well-being of children in different provinces. They also are less helpful in designing and evaluating policies and services in other provinces or territories.
How do we resolve these important issues?
In the short term, increased co-ordination of existing repositories of data on this population is needed, as well as better access for researchers and analysts. Linking provincial-level administrative data is another promising possibility to improve our understanding of the economic and social impacts that children and their families experience.
In the longer term, we need federal investment in national longitudinal data on children and youth with disabilities. With needs identified, they can be addressed.
Fortunately, Canada has a world-class network of interdisciplinary clinicians, researchers, patients and family stakeholders with the CHILD-BRIGHT network and Kids Brain Health Network. And they recently met in Toronto for a conference with the goal of doing just that. These networks play an important role in translating measurement from population data and scientific evidence into better care, to create meaningful change in the lives of children and families.
But this can’t happen in the current paucity of information. Failure to act now will inevitably leave some Canadian children behind and have long-lasting ramifications on the lives of our children and the broader society.
It’s time for Canada to measure up.
Dr. Jennifer Zwicker is a director of health policy at The School of Public Policy and assistant professor in the Department of Kinesiology at the University of Calgary. Her research focuses on the socio-economic impact of health research, developmental disability programs and interventions as a means for informing evidence-based policy development. Stephanie Dunn is a research associate in the health policy division at The School of Public Policy at the University of Calgary. Her research interests include disability, social policy and public health.