Good morning.
Thank you, everyone, for this opportunity to appear before you today and to outline our concerns.
As president of the Association des pédiatres du Québec, I represent more than 760 pediatricians in Quebec who are expert practitioners in various fields ranging from neonatology and intensive care to community pediatrics. While challenges vary widely from one pediatric population to another, my members have a common concern for the health of our children, specifically in this post-pandemic context.
Our first concern when discussing children's health is the set of problems associated with their physical health, but there are also problems related to their developmental health. Children are the only population whose development is constantly dynamic. Developmental challenges are extremely important and an integral part of children's health.
We cannot overlook the psychological health of our children, whose lives have been greatly disrupted in the past few years. Then there's what I call “educational” health. Frequent pandemic-related interruptions in classroom instruction have raised significant impediments to continuous learning. The present and future health parameters of these children have been greatly disturbed in recent years.
Despite these concerns, many of these children's health parameters are improving. Survival rates from birth are up; vaccinations, although sub-optimal, are constantly improving; prevention programs across the country are having very positive effects; and our prevention measures have resulted in less severe trauma and other impacts, and we must continue to invest in these areas.
However, many problems are still of major concern. In Quebec, 12% of children 5 years of age and under live in financial insecurity. These are extremely important factors when it comes to monitoring the health of these children. One in 5 children, 20%, enter kindergarten with significant developmental problems, motor, language and social issues.
Quebec's Agir tôt program has been rolled out in recent years. Its purpose is to detect problems in early childhood before they become established, and to ensure that parents and the home environment stimulate children in the initial years of their lives, thus completely altering the path they are on when they arrive at school.
For school-aged children, obesity and overexposure to screens and technologies are problems that result in dependence, which will have a major impact on their health when they reach adulthood.
The health of children and adolescents greatly depends on the physical, financial and even psychological health of their parents. The pandemic obviously left children more vulnerable, and parents experienced more financial insecurity, domestic violence and mental health issues. Unfortunately, few resources are allocated to psychosocial support for those children and their families, and this problem will have to be addressed sooner or later.
In adolescents, we see that problems that began in childhood have become established. Obesity and sedentariness rates have never been this high, and they surged during the pandemic. The pandemic also had a major impact on their developmental trajectory. This population was more affected by the pandemic measures than other groups. We have observed a surge in anxio-depressive and food disorders and an increase in substance abuse. This is a population that will inevitably require attention.
The concern for us at the Association des pédiatres du Québec is to make children a priority again. Under the living conditions that technological developments have afforded us, life has never been easier, and yet the younger generation are facing health problems specific to the 21st century. The pace of life has accelerated, and everything takes place on screens and social media, which is very hard for these patients. On the other hand, technology has also helped optimize the life expectancy of very sick children who previously didn't live past the age of 5, 6 or 7 years. Even if patients are saved in the first years of their lives, there are no resources for them once they leave hospital.
I'm thinking of extremely premature babies and patients who have undergone a gastrostomy or tracheostomy. These children now have greater survival potential, but their parents, the caregivers of those children, have little support to help them carry on.
In future, we hope to provide parents, the children's mothers and fathers, with better tools from the conception of their children in order to optimize the family environment in which those children grow up.
We want to rely more on prevention to limit the impacts on children's health. We also have to ensure that children's environments—child care, early childhood centres and school environments—are stimulating.
We must understand the impact our lifestyles have on the young generation's health. We also need to continue efforts to provide greater access to care.
Lastly, we must bear in mind the situation of chronically ill patients as they mature into adults. As I noted earlier, sick children now have better survival potential, but we have little expertise in supporting adolescents 15, 16, 17 or 18 years old who are diagnosed with serious conditions or who require extensive care.
In speaking with my counterparts from other provinces, I have observed that pediatric populations are similar across the country. The structures in place and the problems experienced vary greatly from province to province, and that fact must be taken into consideration.
Thank you very much.