Children starting school are physically healthy if:

  • they are rested and nourished
  • their weight and height are within an acceptable range given their genetic history
  • their large muscles and fine motor skills are ready for classroom and playground activities
  • they are as medically healthy as possible
  • they have received appropriate immunization and any medical conditions or physical problems have been identified and addressed. (53)

Their physical health is a product of the nutrition, exercise and care they have received in their home and child care settings. It is also a reflection of the community environment where they live and play. Clean air, clean water, and clean soil contribute to physically healthy children.

In a U.S. survey of 1,339 kindergarten teachers, 75% of the respondents put being physically healthy, well rested and well nourished as the most significant factors in terms of students readiness to learn. (Lewitt, 1995)


Influences on the positive outcome: Physically healthy

Nutrition, exercise, medical care

Protection from injuries


Healthy physical environment

  Adequate financial resources

Note: These influences are also listed in the drop-down list above. Please use this menu to navigate within this page.

Nutrition, exercise, medical care

Nutritious food and lots of exercise are essential for young, growing bodies. Children's early diets not only build their young bodies, but help to establish healthy eating habits. Children need little encouragement to run, jump and climb if they have the space and somebody to play with. They also develop fine motor skills quite naturally if they are given the tools, for example crayons, buttons, and shovels.

Prompt medical attention can usually avoid unnecessary complications from illness or disease and appropriate immunization prevents children from contracting many serious childhood diseases. Fewer deaths and declining rates of hospitalization of young children in the last decade suggest that, in general, Canada’s children have good physical health. (77) However, the rate of hospital admissions due to asthma increased during the 1980s by 27 percent for boys ages one to four and by 18 percent for the same age.


Parents have the primary responsibility to meet their children’s needs for proper nutrition, exercise and medical care. They help ensure their child’s physical health by:

  • providing nutritious meals and helping children to develop healthy eating habits

  • ensuring children have regular opportunities to exercise their large muscles, for example running, climbing, jumping, and swimming

  • providing children with age-appropriate toys and experiences that help them develop fine motor skills, for example holding a crayon, using scissors, and doing up buttons

  • taking children for regular check-ups, immunizations, and the early identification of any problems related to vision, speech, or hearing

  • ensuring children receive prompt medical attention for serious illness.


  • Provide indoor and outdoor places for children to play that are accessible, clean, safe and well maintained.

  • Encourage the formation of preschool play groups where children have regular access to age-appropriate toys. In addition to helping children develop in a positive way, preschool groups provide isolated mothers with companionship and support.

  • Support efforts of low-income families to secure nutritious food through initiatives such as food buying clubs, community gardens and collective kitchens. Food Basket is an example of this type of community initiative.

  • Initiate outreach services to families who may not pay regular visits to a family physician with their children.

  • Reduce or eliminate financial barriers to children’s participation in public recreation programs.
    A coordinated and comprehensive system of tracking the healthy development of preschool children is needed. Given their rapid physical development, young children’s health needs to be monitored regularly to identify any developmental problems as early as possible.

Most communities rely on parents bringing their children to family physicians to monitor their health. However, increasingly professionals see a need for a more comprehensive and coordinated approach to monitoring the healthy development of young children. Such an approach would be built on a simple but comprehensive tracking system for all preschool children with regular screening for healthy physical development as well as for cognitive and socioemotional development. Regular screening ensures early identification and treatment of a range of developmental problems.

Staying on Track is an example of a community-wide early identification, tracking and referral project.


Since governments pay for most health care services, ensuring children’s healthy physical development is a good economic investment.

  • Ensure parents have the economic resources needed for food and shelter for their children.

  • Fund public health systems to monitor population health and design interventions to promote health and prevent injury and disease.

  • Provide medical services to treat children suffering from injury or disease.

Protection from injuries

Children’s experience of the world during the pre-school years is closely linked to physical exploration and experimentation. Yet children are too young to realize the risks they are taking in many situations. Young children need to be taught what is dangerous and told what they are not allowed to do and why. They also require close supervision. In order to avoid being too restrictive, parents need to ensure their home and other environments where children play are as accident proof as possible. Adults must protect and supervise their children in situations where they could be exposed to drowning, burns, poisoning or falls, monitor children in situations around motor vehicles, and ensure children are properly secured when they ride as motor vehicle passengers. (77)

Unintentional injuries are the major cause of death among children and youth over the age of one and a leading cause of hospitalization. In 1995, 1,397 Canadian children and youth (aged 0-19) died as a result of injuries and 47,228 were hospitalized. (335)

  • Supervise your preschool children closely at all times.

  • Child proof your home and ensure dangerous objects such as medicines, poisons, and matches are inaccessible to children.

  • Make sure safety locks are installed on your windows.

  • Lower the temperature of your hot water heater to reduce the danger of scalding.

  • Make sure backyard pools, streams and ponds are not accessible to small children.

  • Teach and enforce rules for behaviour around roads and in driveways and parking lots.

  • Make sure young children always use a car seat.

  • Insist your children use protective helmets when skating or biking.

  • Make sure your children’s toys are age-appropriate and that both toys and clothes are safe and approved by the Canadian Standards Association (CSA).

Communities play a role both in the promotion of safe practices and in the maintenance of safe environments.

  • Ensure parks and playground equipment are as safe as possible by attending to design and maintenance issues.

  • Organize a pro-active campaign to ensure families know about the risk of accidents among pre-school children and what they can do to help prevent them.

  • Ensure safety and supervisory standards are met at all public and private pools.

  • Monitor compliance with seat belt legislation.

Governments pass legislation, develop regulations and monitor compliance in many areas related to public safety including child safety.

  • Mandate the use of devices that increase child safety, for example car seats and bicycle helmets.

  • Enforce municipal by-laws for building and property safety standards, for example the use of smoke detectors and fences around private pools.

Healthy physical environment

The food children eat, the air they breathe, and the water they drink all contribute to their healthy development. Children are not simply "little adults" in terms of their experience of environmental contaminants.

  • Children behave differently than adults.
  • Children are physiologically different from adults.
  • Children's organs are still developing.

This means that children’s experiences of their environment and its impact on their bodies cannot be judged by adult standards.

Children, particularly young children, breathe closer to the ground which has a higher concentration of small particles of dust, mist and heavy gases. They eat up to eight times as much as adults in proportion to their body weight which may mean greater exposure to food related toxins. Also, children's organs are still developing. Small levels of particular compounds at sensitive developmental stages may have lifelong effects. (151)

Various studies suggest a need to be concerned about the impact of environmental contaminants on children.

  • Hospital admission records found that admissions of children for respiratory diseases increases in periods of high air pollution.

  • Asthma is now the most frequent chronic illness of childhood. Indoor and outdoor contaminants may contribute to the development of asthma and can aggravate asthmatic symptoms.

  • Studies on young animals have shown their developing neural systems are more sensitive to certain toxins because of their immature metabolism. There is concern that the human nervous system may also be vulnerable to exposure to certain toxins during its development stage. (229)

  • Poor children are more likely to be exposed to multiple contaminants, including living in substandard housing and in neighbourhoods adjacent to transportation corridors and polluting industries. (324)

The effects of environmental tobacco smoke (ETS) on fetuses and young children can include complications of pregnancy and low birthweight, increased risk of sudden infant death syndrome and ear infections, reduced lung development, and increased severity of asthma and other respiratory illnesses. In 1995, at least 1.4 million Canadian children were exposed to ETS in their homes. The majority of these children lived with parents aged 25 to 44 – the age group that smokes the greatest number of cigarettes daily. (325)

In recent years, the idea that chemicals may pose a threat to the developing reproductive systems of the fetus and young child has been identified as a major concern requiring further study. There is also growing scientific evidence that a variety of contaminants called "endocrine-disrupting chemicals" can exert health effects including reproductive disorders, cancer, neurological damage and behaviour and immune dysfunction, by their ability to alter the functions of hormones within the body. (326)

The 1997 Declaration of the Environment Leaders of the Eight on Children’s Environmental Health identified seven areas of concern that require further study and information sharing in terms of policy and program solutions:

  • increasing our understanding of the particular exposures and sensitivities of infants and children to environmental standards and exchanging information on relevant regulatory decisions
    further reducing maternal and child exposure to lead

  • ensuring microbiological safe drinking water for all Canadian families
  • reducing air quality threats
  • reducing the exposure of pregnant women, children and youth to environmental tobacco smoke
  • reducing threats to children’s health from endocrine-disrupting chemicals
  • reducing the impact of global climate change on children’s health. (327)

It is beyond the scope of this guide to deal with the many questions and volume of research in this area. However, there is increasing concern about the vulnerability of growing bodies to environmental contaminants. We know that healthy food, water and air are essential for healthy children.

Parents control many aspects of their home environment and also exercise some control over where their children spend time away from home.

  • Make your home and car smoke-free.

  • Remove things that can trigger asthma if your children have respiratory problems, for example carpets and pets.

  • Keep your children away from environmental pollutants as much as possible, for example pesticides and contaminated land-fill sites.

  • Join other parents and groups that advocate healthier environments.

Community groups often provide leadership in promoting public awareness about environmental threats to children and advocating change. They also promote awareness of healthy public policy and practice.

  • Form groups to persuade local governments to not use pesticides in children's parks.
  • Form groups to provide public education and support healthy public policies around child-friendly standards related to issues such as smoking indoors.
  • Form groups to demand action to deal with local environmental threats to their children’s health.

Governments are in the strongest position to ensure healthy environments for growing children, although their willingness to act on many issues can be a function of public pressure. Through research, public education, regulations and legislation, governments promote knowledge, education and action related to healthy physical environments for children.

The Great Lakes Health Effects Program is an example of a program aimed at protecting mothers, infants and children from exposure to environmental contaminants.

Adequate financial resources

Financial resources are essential to purchase the food, shelter, clothing and other goods or services needed for healthy physical development. Families with stable, adequate financial resources can afford good food, can choose to live in healthy neighborhoods, and can afford to pay for recreational activities that contribute to the healthy physical development of their children.

In 1995, 25% of children in Canada lived below the "low income cut-offs" – a widely accepted measure of poverty. Because their parents are younger and less established in their careers, there are more low-income families with young children than with older children. Children living in single parent, female-led families are the most likely to be poor. (332)

In 1998, more than 250,000 children received food from food banks. (321)

Employment that provides an adequate income is the most desired option of all families for supporting their children. However, some families have no wage earner. Others, have employment that is inadequate to meet their basic needs. Government policies play a major role in ensuring all families have an income that ensures they can meet the basic needs of their children. Policies in the following areas have a direct effect on family incomes and their ability to provide basic necessities for their children:

  • taxation policies
  • income support policies
  • unemployment insurance benefits
  • parental leave policies.

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