Child Outcomes

Physical Health & Development

Children are born healthy, and reach their optimal physical health and development.

Defining health

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [1]. The Ottawa Charter for Health Promotion states that, in order to be healthy, “an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment” [2]. In this way, health is seen as a resource or an asset that helps us lead our everyday lives.

Healthy births

A healthy birth for every child in Toronto is an important goal because a healthy birth is a significant predictor of future health, development and overall well-being [3]. A healthy birth is closely linked to the health of the mother (starting from before conception), which is affected by many social and material factors [4].

Physical health and development

Physical health and development, mental health, and social and emotional development are all intrinsically linked [5] [6] [7]. The exercise of breaking well-being into separate outcomes poses inherent challenges because all aspects of well-being are so connected. Separating the Physical Health & Development Outcome from the Mental Health & Social Development Outcome ensures that each outcome can be measured in a manageable and appropriate way.


Mental Health & Social Development

Children have the social, emotional, mental and spiritual well-being to reach their potential.

The positive aspects of mental health

Mental health is not merely the absence of mental illness: it also includes the positive aspects of mental health, which are inherently tied to other aspects of well-being, particularly social and emotional development [1]. The Canadian Mental Health Association suggests that the following factors are key characteristics of positive mental health: the ability to enjoy life, to be resilient and bounce back from hard times, balance, self-actualization, and the ability to be flexible and adapt to change [2].

Childhood as an important life stage in itself

Many approaches to child well-being take a developmental approach that focuses on children as future adults. However, conceptions of child well-being should consider childhood as an important life stage in itself and not merely a stage towards adulthood. As such, measuring child well-being requires hearing from children themselves about their own experiences [3].

Spiritual well-being

While not the case for everyone, many people place personal value on spiritual well-being as an important aspect of overall well-being. Approximately 79% of residents in the Greater Toronto Area identified with some sort of religious association or spiritual tradition [4]. In our consultations, we heard from the Aboriginal community that this was an important aspect of well-being for their community. In this outcome, spiritual well-being is meant to remain broad, and is not limited to religion.


Learning & Education

Children are engaged and curious learners, gain knowledge and skills, and have educational success.

Early learning and the transition to school

All children are born ready to learn, meaning their brains are programmed to develop new skills [1]. The foundations set in the early years, even before children enter school, lay the course for later education and learning outcomes [2]. Furthermore, children enter school having had different early experiences and care arrangements. The school system must be ready to meet the different needs and circumstances of all children.

Educational success

Research supports the correlation between education and well-being [3]. However, each child and family defines educational success differently, based on their values. These differences should be taken into account when measuring educational success. Education gives children the tools and skills to meet their own goals [4]. Furthermore, the degree to which children can reach those educational goals is often affected by other social and economic conditions.

Attitudes toward learning

One important aspect of education is the content learned: another is the attitude that a person has towards learning, which is often more difficult to define and measure. While attitudes toward learning may or may not correlate directly to educational success [5], they tend to differ based on socio-economic status [6]. Ideally, children are engaged and curious learners because they enjoy learning, and it is relevant to their values and goals.


Rights & Opportunities

Children’s rights are fulfilled: they have opportunities for personal development and participate in decisions about their lives.

Children’s rights are fundamental

Canada is a signatory to the United Nations (UN) Convention on the Rights of the Child, a legally binding international treaty that recognizes children’s rights as fundamental [1]. The City of Toronto also adopted a Children’s Charter, which reflects the provisions of the UN Convention in a local context [2]. Children’s rights apply not only to basic needs, and protection from neglect and abuse, but also to developing their potential.

Opportunity requires access

Developing one’s potential requires opportunities to make it possible [3]. However, it is not enough for opportunities to be available: they must also be accessible. Therefore, barriers that prevent access to opportunities such as cost, transit, language, and cultural appropriateness, must be considered when measuring opportunity.


Participation is a key component of the Convention on the Rights of the Child [4]. On matters that directly impact their lives, children have the right to say what they think should happen and have their opinions taken into account. Furthermore, children have the right to participate in society, and have a say on matters affecting their social, cultural, religious, economic and political life [5].


Nurture & Care

Children have safe, nurturing and positive environments that encourage learning and development.

Healthy child development requires nurturing

Child well-being is strongly influenced by the many environments in which children grow, live, and learn, particularly by the nurturing qualities of those environments [1] [2]. Nurturing refers to caring for and encouraging one’s development [3] [4].

Positive environments

Parents and caregivers are not solely responsible for providing nurturing environments for children because the home is not the only environment in which children grow up – school, child care, the neighbourhood, the broader community and other environments also influence child well-being. Even within the home environment, how well caregivers are supported by governments and civil society must be considered, as well as the resources that are available to them in order to provide nurturing environments for children [5].

Safety and protection

Despite an important focus on the positive aspects of child well-being like nurturing and development, there are still many children that face abuse, neglect, poor housing conditions, hunger, or that are taken into the child welfare system. Children in the welfare system are more likely to be diagnosed with a special need, and are less likely to graduate from high school [6]. Policies directed towards protection and basic needs can take many forms, for example: quality standards of care, family support, as well as addressing poverty and inequality.



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