Ask the expert: How COVID-19 is changing the landscape of children’s health care with Dr. Balfour, pediatrician for Island kids

Throughout the COVID-19 pandemic, Children’s Health Foundation is committed to supporting Island families. This post is part of our Ask the Expert blog series in which our CEO Veronica Carroll interviews experts across Vancouver Island and the surrounding islands on issues affecting children’s health and how families are adapting during these unprecedented times.

Veronica recently connected with pediatrician, Dr. Jennifer Balfour, who shared the recent rise in mental health challenges in Island kids and youth, how COVID-19 is deepening social inequality, and how Children’s Health Foundation can have the most significant impact for families.

Can you tell me about your professional background?

I am a pediatrician based in Victoria. I see children referred to me from family physicians and nurse practitioners, including those with complex developmental needs, autism, and other diverse health challenges. I completed a fellowship year in infectious diseases, which is a particular interest for me.

As a former board member, what inspired you to get involved with Children’s Health Foundation?

I was excited by the opportunity to have a greater impact on system issues. As a large part of my practice is about solving individual problems on a day-to-day basis, I was motivated by impacting the system on a bigger level with a goal to solve gaps for patients.

What are some of the most common heath challenges you see Island children coping with in your practice?

Some of the routine medical issues I address include headaches, growth problems, asthma, and other challenges. It is notable how many children deal with mental health issues, especially anxiety; the number of children struggling with mental health has drastically escalated since the pandemic.

One of our impact areas is youth mental health. Can you tell us more about how your patients have been experiencing an increase in mental health challenges during the pandemic?

While social isolation has caused little ones to struggle due to having their learning stalled, not seeing their friends, and feeling incompetent, there has also been a significant spike in the number of teens engaging in risky behaviours. My colleagues and I are seeing it in our offices, and  we’re also witnessing teenage substance use and overdoses in the hospital. We’ve also seen an unbelievable spike in infants born with addiction issues from mothers who use substances.

You work with a number of children with complex health challenges. Have you seen what they require, by way of support, changing over time?

Absolutely. Twenty years ago, many kids were in the hospital due to serious acute infections, which is now rare because of the great success of immunizations. Thanks to advances in neonatal care, many more infants with complex needs survive compared to a few decades go. Medical professionals think in a more system-wise manner for children than in past years.

What role do you think our Foundation can play in supporting families who have children with complex health needs?

From my perspective, supporting space and services for children’s health care including, speech therapy, physiotherapy, and occupational therapy, is the most impactful way Children’s Health Foundation can have a significant impact in the community. For families with children with complex needs, economic factors can present a barrier to equal access to care. Bridging this gap is an important way to support Island families.

Has COVID-19 impacted pediatric care, and if so, how?

It’s emphasizing the gaps between those with financial security and those without it in society. I worry that the treatment of social distancing may be worse than the disease because kids are suffering so much in isolation; they are not able to practice their social skills, they feel unsteady, and their learning is stalled. It’s been a true loss of security.

For many financially precarious families, children rely on being in school to have a regular daily meal. Often these kids are not visible to society and can fall through the cracks.

As children with complex needs, including those with speech delays and autism, have not been able to access their care teams, interacting through a screen has proven challenging. Additionally, routine medical procedures that truly help kids and are vital to their development have been delayed.

How do you predict COVID-19 will change the landscape of children’s health in the coming months? Do you foresee positive and negative outcomes?

Kids suffer when economies suffer – a fragile economy will mean fragile economics at home. They’re going to have a lack of opportunity, food and home insecurity, and parents who are less stable in respect to their mental and emotional health. Children will certainly feel the impact of that.

Kids are spending more time on their screens and are less engaged in physical activity, of which they already were not getting enough. That may become a worrying yet permanent swerve in society, and we are all watching to see what comes next.

With respect to the positive outcomes, virtual care has undoubtedly been a beneficial development for children’s health care.

What do you see in the long-term future of pediatric care on the Island and surrounding islands?

We live in an area that is rapidly growing. As the referral centre for up-Island families and those from the Gulf islands, I would love to see our cohesive service of pediatrics grow while continuing to work towards an effective system between practitioners.

I would love to see an expansion of mental health supports and specialty services for kids with complex needs. The question is whether we can seek those opportunities because there are many competing priorities between the pandemic, an aging population, and general surgeries being behind. It’s vital to keep kids and youth on the front burner because they’re going to grow up to be our future.

What inspires you most in your work?

I am inspired by families’ determination to help their children have the best lives possible by focusing on one good day after another. I’m also inspired by my colleagues who are incredibly committed to their work; they bring dedication and hard work to new ideas and projects every day.