Canadian Pediatric Populations and Specific Challenges

Canada comprises 10 provinces and 3 territories covering a landmass of 9.985 million square kilometers. Population density for the most part is in the south part of Canada along the border with the United States. However, there are many smaller rural and/or remote communities, especially in northern Canada. Environmental factors such as weather and long distances between patient and provider and transport issues such as no road access to communities can isolate populations and inhibit recruitment and retention of health-care staff. Such difficulties limit access to acute and specialist health-care infrastructure and resources (Auditor General of British Columbia, 2018). Health-care delivery across Canada is impacted by provincial and territorial government in organizing and resourcing health care. Federal government cofinances some health programs and has informed various funding models, i.e., nonprofit hospitals, fee-for-service, and medication payment policies (Government of Canada, 2018). While approximately 37 million people live in Canada, over the last 40 years (1971–2010), the proportion of those less than 24 years of age has declined by 18.2% (Statistics Canada, 2010). While children account for approximately 16.5% of the population (Statistics Canada, 2010), little variation exists across age groups: 1.9 million (0–4 years), 2 million (5–9 years), 2 million (10–14 years), and 2.1 million (15–19 years) (Statistics Canada, 2017). For indigenous children and youth living in Canada, there is a legacy of colonization, residential schools, and the impact this holds for families and caregivers, community, and nursing (Unicef, 2009). The importance of cultural competence, trauma-informed care, and indigenous knowing are critical when working with all children and their families. When delivering culturally appropriate care to First Nation,Métis, and Inuit people, children’s nurses (or care providers)must also consider Jordan’s Principle (Government of Canada, 2019). The Canadian Human Rights Tribunal (2016) ruled that approaches to health, social care, and community services for First Nations children were discriminatory, resulting in legislation changes outlined in Jordan’s Principle.