Climate change health impacts on children in Canada: a systematic review.

BACKGROUND: Climate change is accelerating; however, effects on child health remain poorly understood. Countries need context-specific evidence to translate global knowledge into adaptation. Canada is warming faster than the global average and provides an informative case of paediatric climate risks. METHODS: We conducted a systematic review with narrative synthesis of the impacts of climate change on child health in Canada. Eligible studies explicitly attributed a change in a child health risk factor or exposure to climate change. Findings were narratively synthesised and study quality was appraised using design-appropriate tools. RESULTS: Of 3614 records identified, 54 original articles and 17 reviews were included. A Canada-specific framework linked rising temperatures, changes in precipitation, increased wildfires, alterations to ecosystems and the spread of vector-borne diseases with child health. These impacts appear to follow existing health inequities. Quality appraisal identified frequent concerns about representativeness and control of confounding in quantitative studies, while most reviews were judged at high risk of bias. CONCLUSIONS: Evidence increasingly demonstrates climate change impacts on child health in Canada, but knowledge gaps remain. The findings demonstrate that children remain vulnerable even in a high-income country when climate hazards interact with developmental needs, inequity, infrastructure and relationships to land. The framework offers a transferable approach for countries to identify locally important hazards, vulnerable groups and intervention points. Strengthened efforts are urgently needed to implement these interventions in order to protect the health of current and future generations of Canadian children.