TORONTO - Canada should have a national strategy to prevent injuries in children and youth, says a report commissioned by Health Minister Tony Clement and released Tuesday.

"Preventable injuries is the No. 1 killer of kids in this country," says Dr. Kellie Leitch, who wrote the report after being asked to review programs, identify gaps and come up with new initiatives to improve the health of children and youth.

"I was astounded with how many parents agreed with me, how many parents knew exactly what needed to be focused on for their kids."

The paper, entitled A Report by the Advisor on Healthy Children and Youth, also calls for improvements in mental-health services and setting targets to reduce the rate of childhood obesity from eight per cent to five per cent by 2015.

Canada isn't doing as well as it could in these areas, the report argues.

Among 29 nations of the Organization for Economic Co-operation and Development, it notes that Canada ranks 22nd when it comes to preventable childhood injuries and deaths, 27th in childhood obesity and 21st in child well-being, including mental health.

In a letter that accompanied her report to the minister, Leitch said Canada is doing "surprisingly poorly" in these areas when compared to other OECD countries.

Leitch is calling for a wait time strategy to make sure children with mental problems are cared for in a timely matter.

"The earlier these children are seen, the higher the likelihood that they'll lead productive normal adult lives," she said in an interview.

In a statement, Clement said he welcomed the report and looked forward to reviewing it.

Leitch was appointed last March, and spent the first part of her mandate travelling across the country and meeting with parents and people in organizations that are related to children and youth health.

She reviewed about 500 documents, and had responses from more than 7,200 parents to an online questionnaire.

"It's really a bringing together of what Canadian parents, children and people in the child health field believe is the direction that the government of Canada should be going," said Leitch, who is a pediatric orthopedic surgeon in London, Ont.

Leitch recommends a longitudinal cohort study to provide data to help understand environmental factors that have an impact on health. This would involve repeated observations of the same children over a period of about 10 years.

The recommendations to counter obesity encourage after-school programs and call for a ban on junk food advertising on programming aimed at children under 12 by 2010.

In the area of incentives and supports for parents, she said the new children's fitness tax credit aimed at parents with kids in certain recreational programs, such as soccer and hockey, is a move in the right direction.

"Well, if we could include helmets as part of the children's fitness tax credit, you know, that might be an opportunity to empower parents to do the right thing," she said.

In addition, she called for the federal government to enact legislation to restrict hazardous substances in products designed for children and youth, such as lead and mercury.

And it should encourage all provinces to make booster seats mandatory for children aged four to eight until they weigh 80 to 100 pounds or until they are 52 to 57 inches in height.

"I think any movement toward a national co-ordinated approach to addressing injury is very much welcomed," said Shawn Feely, program director of IMPACT at Children's Hospital in Winnipeg, a centre that conducts research on injury prevention.

"Injuries definitely do have a pattern, and when you have a pattern these things are predictable. But there's still a lot of things that need investigation to find out exactly what is happening in some of the interventions."

Falls by toddlers are a frequent cause of hospitalizations, and motor vehicle crashes can claim lives. Among older kids and adolescents, there are concerns about suicide, assaults and self-inflicted injuries, Feely said.

Pamela Fuselli, interim executive director of Safe Kids Canada, said she was "thrilled" with the report.

"I think the national strategy certainly is something that we have been asking for for a few years," she said.

In particular, she applauded the recommendation for a tax credit on helmets.

"We know that some of the lower-income families have some struggles as to buying safety equipment or they have, obviously, different priorities," she said. "And so anything that makes access to safety equipment, protective equipment is of benefit."