The health of Canada's children. Part IV: Toward the future.

Canadian children's health is influenced, in large part, by the living circumstances that they experience. These living circumstances - also known as the social determinants of health - are shaped by public policy decisions made by governmental authorities. While public policy should be focused on providing all Canadian children with the living circumstances necessary for health, it appears that Canada is far from achieving this goal. Instead, there are programs directed at Canada's most severely disadvantaged families and children. While vital, these programs appear to achieve less than that which would be achieved if governmental action was designed to strengthen the social determinants of health for all children. Considering the governmental actions that would achieve this goal are well known - with rather little evidence of policy implementation - it is essential to understand the processes by which public policy is made. An important physician role - in addition to providing responsive health care services - is to become forceful advocates for public policy in the service of health. It is in the latter sphere that physician involvement may yield the strongest benefits for promoting children's health.