Health Canada
Brooke Claxton Building, Tunney's Pasture
Postal Locator: 0906C
Ottawa, Ontario
K1A 0K9
RE: Support needed for continuation of the Canadian Healthy Infant Longitudinal Development (CHILD) Study
Dear Honorable Minister,
On behalf of The Sandbox Project, we wish to draw your attention to, and encourage your support for, the continuation of the Canadian Healthy Infant Longitudinal Development (CHILD) Study, an internationally recognized, longitudinal population-based birth cohort investigating the origins of chronic childhood illnesses. The CHILD Study represents a key tool for understanding the impact of the environment on children’s health, and the epidemic of asthma, allergy and many other chronic diseases of later childhood and adulthood in Canada. The mission of The Sandbox Project is to make Canada the healthiest place on earth for kids to grow up – what can be learned from the CHILD Study is critical if we hope to succeed.
Minister, as you know The Sandbox Project was created in response to the 2008 “Reaching for the Top” report to the Minister of Health for the Government of Canada by Dr. Kellie Leitch, and her finding that Canada is slipping further behind its peer countries when it comes to key health indicators for children and youth. The Sandbox Project provides leadership to act as a catalyst for change in Canada. It works directly with parents, business, health industry leaders, governments and non-governmental organizations to raise awareness, to pursue research and to collaborate to develop solutions and better public policy. Thank you again for your participation in our awareness raising campaign with the giant sandbox on Sparks Street mall this past summer. On November 6-7, 2012, the Environment Working Group of The Sandbox Project, held a workshop in Kitchener, Ontario, supported by CIHR, and obtained input from representatives from 41 of Canada’s leading children’s environment and health experts working in the areas of research, advocacy and policy, who came together to identify and prioritize needs to improve children’s environmental health in the coming 5 years. Advocating for support of the CHILD Study was identified as a high priority activity endorsed by all attendees. CHILD was recognized as a critical research activity in Canada for enabling progress in improving children’s health.
A key recommendation by Dr. Leitch, in her “Reaching for the Top” Report, was for a federally funded large longitudinal birth cohort study in which multiple environmental and other exposures are rigorously assessed and health status carefully monitored throughout childhood. Canada and other high income countries are in the forefront of an epidemic of chronic non-communicable diseases (NCD). One in three children now develop breathing difficulties in the first few years of life and 20% of children are diagnosed with asthma before the age of 12. The causes of the epidemic of asthma and allergy over the last few decades are not understood, but the impact of our changing environment (broadly both indoors and outdoors, our nutrition, chemical exposures and stress) is strongly suspected.
In 2011 the World Health Organization stated: “Noncommunicable diseases – or NCDs – like heart attacks and strokes, cancers, diabetes and chronic respiratory disease account for over 63% of deaths in the world today. Every year, NCDs kill 9 million people under 60. The socio-economic impact is staggering.” In 2011, for only the second time in the history of the United Nations, the General Assembly met on a health issue (the only previous issue was AIDS). The aim was for countries to adopt a concise, action-oriented outcome document to shape the global agendas for generations to come. There is increasing evidence that there is a strong relationship between the epidemic of obesity and many NCDs, including respiratory and cardiovascular diseases and diabetes. Importantly, obesity and these diseases begin early in childhood. The principal aim of the CHILD study is to investigate the origins of these and other chronic, non-communicable diseases and to develop strategies aimed at their prevention.
The CHILD Study was developed in partnership with the Canadian Institutes of Health Research (CIHR) and the Allergy, Genes and Environment (AllerGen) Network of Centres of Excellence to investigate environmental factors which may be responsible for these major health problems. The CHILD Study is the largest longitudinal hands-on population-based birth cohort in Canada investigating the origins of chronic childhood illnesses. It is recognized internationally as having the potential to be one of the most informative studies of its kind, involving world class research teams in over 20 interrelated scientific disciplines. Over 3,600 pregnant women from multiple centres across Canada have been recruited and the children are being followed from before birth to the age of 5 years. With sustained funding, researchers will follow this cohort into later childhood and even adulthood. The focus of the study is on environmental factors related to the development of allergy and asthma, and risk factors for obesity, metabolic diseases such as diabetes, and cardiovascular disease. The CHILD Study has become a major research platform which will enable numerous health related investigations to be undertaken in the Canadian population.
We urge you, as a matter of high priority, to support and directly fund the continuation of the CHILD Study, to enable careful follow-up of the health and development of these children for the benefit of generations to follow. This will ensure that the government investment will be returned in major saving to health care and increased productivity overall. The study will provide invaluable scientific information which will position Canada among the global leaders in research relating to the impact of the environment on children’s health, and the development of chronic diseases of later childhood and adulthood. The study by its longitudinal nature and direct involvement of the nearly 10,000 participants (children and parents) will greatly extend information obtained through other government supported studies such as the Maternal Infant Research on Environmental Chemicals (MIREC) study and the Canadian Health Measures Survey.
The resources needed to maintain this study long-term (on average, $3 million per annum) are outside the scope of CIHR, although applications have and are being made to CIHR to fund specific components of the study. To secure the long term future of the study for its benefits to all Canadians, CHILD must be supported and funded by the Federal government. Without government support starting in 2014, the CHILD Study will be limited in scope and duration, and many of the potential benefits from understanding health risks will be in jeopardy. Lack of funding will seriously impede the development of preventive measures which are key to reducing health care costs and improving future Canadian quality of life and competitiveness.
This “made in Canada” longitudinal cohort study will provide critical new data on the health of Canadian children and youth and the impact of environmental factors. Application of this knowledge will reduce the impact of chronic diseases, and their economic and social burden, in our society.
Minister, we respectfully ask for an opportunity to meet with you to discuss this request for continuing substantial support for what we know you will recognize to be an important and much needed study.
Dr. Eric Crighton
Co-Chair, Environment Working Group, The Sandbox Project
Associate Professor, University of Ottawa
Dr. Christine Hampson
President and CEO
The Sandbox Project
Supporting members of The Sandbox Project Environment Working Group and Committee:
Peel Public Health
Toronto Public Health
South Riverdale CHC
Oshawa Community Health Centre
Sick Kids
Clean Air Champions
Dalhousie University
University of Toronto
United Nations University
McMaster University
University of Western Ontario
Asthma Society of Canada
Anaphylaxis Canada
Canadian Partnership for Children's Health and Environment
Canadian Environmental Law Association
University of Saskatchewan
University of Waterloo