Item - 2026.HL32.1

The Board of Health:

1. Recognized the importance of preventing adverse childhood experiences and promoting protective experiences, and endorse the Ontario Early Adversity and Resilience Framework, as outlined in the report (April 20, 2026) from the Medical Officer of Health, which seeks to build resilience for children and youth, families, and communities.

2. Requested the Medical Officer of Health, in collaboration with the relevant City divisions, agencies and corporations to advance a coordinated trauma- and violence-informed approach to City services that recognize the impacts of trauma, adversity, racism and violence to foster trust and safety with clients and prevent re-traumatization.

3. Requested the Medical Officer of Health to build on Toronto Public Health's initiatives to mitigate early adversity in alignment with the Ontario Early Adversity and Resilience Framework through continued collaboration with City and external partners, including increasing knowledge and public awareness regarding adverse childhood experiences and resilience, leading to increased capacity of local public health and community partners to support clients and communities impacted by early adversity.

4. Requested the Medical Officer of Health to continue collaborating with school boards to improve the health and well-being of students by leveraging the Ontario Early Adversity and Resilience Framework to strengthen environments that build resilience and foster protective factors, such as healthy relationships and social-emotional skills, for children and youth.

5. Requested the Medical Officer of Health to work with relevant school board and provincial partners to enhance data collection mechanisms related to adverse childhood experiences and resilience indicators.

6. Requested the Medical Officer of Health to report back to the Board of Health in Q2 2028 with a progress update on the implementation of the Ontario Early Adversity and Resilience Framework and opportunities to further improve the health and well-being of children and youth.

7. Requested the Minister of Education to preserve the School Climate Survey and consider its expansion to include issues raised in the Ontario Early Adversity and Resilience Framework.

8. Requested the Toronto District School Board, Toronto Catholic District School Board, Conseil scolaire Viamonde and Conseil scolaire catholique MonAvenir to collect and share school-based equity indices, including the Learning Opportunities Index and the School Climate Survey, with Toronto Public Health on an ongoing basis to inform its program interventions, design and delivery to promote health among children and youth.

The Director and Chief Nursing Officer, Community Health and Well-being, the Acting Deputy Medical Officer of Health, Decision Support, Surveillance, Toronto Public Health gave a presentation on Promoting Positive Childhood Experiences to Improve Health Outcomes Across the Lifespan.

Early experiences have a powerful influence on lifelong health, making it essential to strengthen the conditions that support children and families across Toronto. Adverse childhood experiences are stressful or potentially traumatic events that occur before age 18, including physical, sexual, and emotional abuse, neglect, and household dysfunction such as parental substance use, mental health concerns, incarceration, or witnessing intimate partner violence. Community level experiences such as consistent exposure to community violence including gun violence, and structural forms of trauma including colonialism, racism, poverty, and unstable housing are also significant sources of adversity.

Adverse childhood experiences are common in Toronto, with nearly one-third of adults reporting at least one adverse childhood experience. Due to structural and systemic inequities, certain populations experience a greater burden of early adversity, including Indigenous, Black, racialized, 2SLGBTQIA+ individuals, women, immigrant communities, and people living in low-income households. Exposure to early adversity is associated with negative long-term health and social outcomes, including chronic disease, mental health challenges, substance use, lower levels of physical activity, increased sexual health risk, and housing instability or homelessness.

While there is an association with negative outcomes later in life, adverse childhood experiences do not necessarily lead to negative outcomes. Protective factors, such as safe, stable, nurturing relationships, social-emotional skills for children and families, equitable environments, and social connectedness, can reduce the impacts of early adversity by building resilience. The Ontario Early Adversity and Resilience Framework provides structured approaches for upstream prevention, resilience-building, and equity-informed action across individual, family, community, and structural levels.

Toronto Public Health delivers programs and services across the preconception, prenatal, early parenting, and child development stages to prevent adverse childhood experiences, foster positive experiences, and strengthen resilience. Toronto Public Health also tracks related data to guide programs and inform policy development. Collaboration with City divisions, agencies, and community organizations contribute to the improvement of social, economic, and relational conditions that support safe, stable, and nurturing environments. Preventing adverse childhood experiences and fostering protective experiences improves outcomes for individuals, families, and communities, reduces long-term impact on health and well-being, and advances equity for communities disproportionately affected. As a result, preventing early adversity and strengthening positive childhood experiences through upstream, equity‑informed public health action is a critical strategy to improve health outcomes across the lifespan. The recommendations in this report ask the Board of Health to recognize the importance of early intervention to prevent adverse childhood experiences, endorse the Ontario Early Adversity and Resilience Framework, and collaborate with relevant City and external partners to advance a coordinated trauma- and violence-informed approach to City Services and explore opportunities to prevent early adversity, promote protective experiences, and build resilience for children, families and communities across Toronto.