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Paediatr Child Health. 2009 May-Jun; 14(5): 281–282.
PMCID: PMC2706623

Where is the stimulus package for our children?

Joanne Embree, MD FRCPC

Bailouts, stimulus packages, economic recovery – these words have become part of our collective vocabulary, defining a new reality for North Americans. Dealing with economic woes has been at the top of the public agenda since last fall, yet spending for children’s programs has not been part of the conversation. The auto industry is in a crisis; out-of-work Canadians need retraining and job support; and housing construction needs a kickstart. Airlines, tourism and even the hog industry are taking an economic hit over the H1N1 influenza (‘swine flu’) outbreak. Is this really a good time to be advocating for investments in early childhood? There is perhaps no better time.

In the talk about economic recovery, the view is primarily short-range – supporting those who are out of work right now and minimizing further losses. But this must be coupled with a long-term plan for economic stability, which requires policies and programs that ensure a competent and energetic future workforce. That plan needs to include a focus on the well-being of children – their health, their educational opportunities, their care and their families.

Paediatricians and other advocates for children and youth have been arguing this for decades. However, in recent years, a growing chorus of economists, academics and business leaders have taken up the refrain. Importantly, they have the evidence and data to support this advocacy effort.

In the United States, the Partnership for America’s Economic Success – created in 2006 by a group of business leaders, economists, advocates and sponsors to document the economic impact of investments in children from before birth to age five years – is leading the way. This high-profile partnership has commissioned research and produced a series of papers by leading academics on the evidence for policies and programs that support children’s health, education, and early childhood development.

The difference between this movement and the arguments of the past is the clear link between investments in children and future economic success. It’s not just about “doing what’s right for children”, it’s also about doing what makes fiscal sense for a nation: “[E]arly improvements in child health, academic achievement, and behavior as well as improved parenting can yield sizable economic benefits for adult earnings”, concludes one recent paper (1). Another says that “health problems in early childhood may be significant determinants of adult socioeconomic status” (2).

Studies find that confronting the major threats to child health early on – including exposure to tobacco smoke, unintentional injury, poor mental health and obesity – could yield significant long-term economic benefits. Still, “society has failed to take an investment approach to the health of young children, despite the logic of doing so and despite the evidence available that these investments are beneficial” (3).

Neuroscience has taught us just how critical the experiences of the early years are to future health, learning and behaviour. What happens to children during this time can set them on a lifelong course – for better or for worse. We owe it to children to get it right.

According to Nobel Prize-winning economist James Heckman, the earlier the better. Heckman argues that early learning begets later learning, and that even waiting until children reach school age to intervene may be too late for some. “The real question is how to use the available funds wisely”, writes Heckman. “The best evidence supports the policy prescription: invest in the very young and improve basic learning and socialization skills” (4).

In Canada, despite a strong public education system and universal health care, very young children are sorely neglected on the public policy front. Our standing among the world’s richest countries lays bare these failures: Canada has not fared well in international comparisons of child health and well-being. In a recent report (5) on child care, for example, the United Nations International Children’s Emergency Fund developed a set of minimum standards for protecting children in their vulnerable and formative years. Only six of the 25 Organisation for Economic Co-operation and Development countries met at least eight of the 10 benchmarks. Canada ranked last, meeting only one.

Investments in quality early childhood care and education have the potential for massive returns down the road (6). Still, there has been no movement toward a national child care strategy in Canada. Judith Maxwell, the former head of the Economic Council of Canada, says the federal government should extend parental leave to two years, increase benefits payable through the National Child Benefit, create a national system for monitoring progress in educating children younger than six years of age, and for all provinces to extend the public education system for four- and five-year-old children (7).

What is the policy solution? First, we need a clear commitment from the federal government to make a sustained investment in young children. This is critical. Without it, organizations and practitioners working with and for children will continue to operate in a public policy vacuum, lacking both the resources and the political will to do what they know is both necessary and right.


1. Brooks-Gunn J, Magnuson K, Waldfogel J. Long-run economic effects of early childhood programs on adult earnings (Executive summary) Partnership for America’s Economic Success. 2009. <> (Version current at April 19, 2009).
2. Currie J, Stabile M, Manivong P, Roos LL. Child health and young adult outcomes. Partnership for America’s Economic Success. 2009. <> (Version current at April 19, 2009).
3. Partnership for America’s Economic Success Early childhood health problems and prevention strategies: Costs and benefits. 2008. Issue Brief #3. <> (Version current at April 19, 2009).
4. Heckman J. Invest in the very young Chicago: Ounce of Prevention Fund and the University of Chicago Harris School of Public Policy Studies. 2002.
5. UNICEF . Florence: UNICEF Innocenti Research Centre; 2008. The child care transition, Innocenti Report Card 8.
6. Grenier D, Leduc D. Let’s put a national child care strategy back on the agenda. Paediatr Child Health. 2008;13:837–8. [PMC free article] [PubMed]
7. Maxwell J. Economic downturn increases urgency to invest in children. The Globe and Mail. 2008.

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