What’s the matter with Canada?

By David H. Kirkwood

People who know me probably wonder why I would ask such a tendentious question. After all, my father, who was born and raised in Ontario, remained a Canadian for most of my childhood years. And, except for my mother and brother, all my Kirkwood relatives still live on the northern side of the border. I also have fond memories of family visits to Toronto, Montreal, and the Gaspé Peninsula.

Professionally, I’ve also had great experiences with Canada and its people. As an editor, I have observed consistently that manuscripts submitted by Canadian audiologists and hearing instrument specialists are especially well written. I don’t know if that’s true of Canadians across the board or just among those who go into the hearing care field. In any case, I appreciate it. I should also note that two of our blog’s outstanding editors are from Ontario—Marshall Chasin and Gael Hannan.

I’m far from alone in my appreciation of Canadians. It’s often said that Canada is the one country in the world that no one hates. That’s why when you go abroad, you’ll see so many travelers sporting a maple leaf on their backpack or suitcase. Talk to some of them, and you’ll probably hear some suspiciously American-sounding accents from people trying to pass.

A HEALTHCARE ISSUE

So, what’s my beef with the world’s second largest nation? Well, it has to do with healthcare. No, I’m not talking about its vaunted publicly funded healthcare system, which, despite its detractors in the U.S., even conservative Canadians have grown to cherish during the nearly 30 years it has been in effect.

Canada also has a pretty good record of taking care of citizens with hearing loss. In several provinces, the government covers at least part of the cost of hearing aids for adults as well as children.

The country also does an excellent job of educating hearing instrument specialists. It has several two-year program for that purpose, putting it well ahead of the U.S. in that respect.

That’s why it is so shocking that of the ten Canadian provinces, only Ontario and British Columbia require universal newborn hearing screening (UNHS). Quebec is on its way. It passed a law mandating UNHS, but it is not scheduled to be fully implemented until the end of 2013.

Other provinces tend to test only babies at high risk of hearing loss, such as preemies and those suffering serious infections like meningitis.

Contrast that with In the U.S., where the UNHS movement took off in the 1990s. Now, 95% of babies born here are screened.

THE CASE IS CLEAR

One reason that universal newborn screening is such a no-brainer is its cost effectiveness. True, when you add up the hundreds of screenings, at about $35 a pop, that it takes to identify a single newborn with hearing loss, the price may seem high. But then consider the value of early identification and intervention. It is well established that the earlier a child’s disability is addressed, the more likely that child is to learn as well as his or her normal-hearing classmates and to become a successful, productive adult.

Children whose hearing loss is discovered and treated at age 1 or 2 or older are likely to need special education that will cost society far more than the cost of detecting and addressing it early. What’s worse is that that these children will be far less likely to achieve their full potential. Their lost opportunities are a tragedy both for the children and their families and for society as a whole.

A lot of Canadians are working hard to introduce UNHS in every province and territory of the country. The Canadian Association of Speech-Language Pathologists and Audiologists has adopted position papers to that effect, most recently in 2010. And last January, CASLPA recommended that the national budget provide for universal access to newborn hearing screening throughout Canada.

In 2011, the Canadian Paediatric Society issued a statement calling on all provinces to implement universal newborn hearing screening. One of the leading champions for UNHS in Canada is Hema Patel, MD. A staff pediatrician at Montreal Children’s Hospital, she is lead author of the Paediatric Society’s position statement.

In an interview with the Globe & Mail, a Toronto newspaper, Patel said, “Virtually every developed country has a screening program. It’s shameful that Canada doesn’t.”

She also pointed out to a Montreal television station, CTV, that each day a child unnecessarily lives in silence can result in permanent and possibly irreparable loss of development. She explained, “Hearing is actually not about the ears. Hearing is about the brain and the longer that the child is deprived of that auditory input and the sound that is all around us, the more that it shuts down that development.”

The Canadian Hearing Society, which provides services to people with hearing loss, also supports universal newborn hearing screening.

According to the Calgary (Alberta) Herald, advocates for UNHS in Alberta are petitioning their province to get with the program. Twice before, the government in Edmonton has considered and rejected the idea. But this time, there seems to be growing support for this eminently sensible health policy.

It is shocking that in a country that is generally so progressive universal newborn hearing screening is more the exception than the rule. It is high time that Canadians who share our blog’s credo that Hearing Health Matters take steps to remedy one of the few things about Canada that need fixing.