Canadians have long measured national success by what we build: our railways and highways, ports and pipelines, industries and exports, and our gross domestic product. These things matter. They have helped shape our prosperity and define our place in the world. But they are not, ultimately, what determines whether a nation thrives. Nations succeed because their people succeed.

As physicians, we are trained to think across decades, not election cycles. We encourage healthy eating, physical activity, vaccination, smoking cessation, mental wellness and early intervention because we know the greatest returns come from preventing illness before it begins. We do not wait for diabetes before discussing nutrition or for heart attacks before addressing cardiovascular risk. We vaccinate children to prevent illnesses that might otherwise occur decades later. The same principle should guide how we build our country.

Too often, governments make decisions based on short-term fiscal pressures and election cycles rather than the long-term wellbeing of people and the planet. The result is predictable: we underinvest in prevention, allow avoidable illness to develop, and spend ever more treating preventable disease. This approach strains our healthcare system while diminishing the productivity, resilience and quality of life of Canadians.

What if Canada measured success differently by considering the wellness of our future generations?

Building resilience instead of responding to crises

Canada is entering an era defined by continuous disruption. Climate change, emerging infectious diseases, geopolitical instability, trade uncertainty, artificial intelligence and demographic change are reshaping every aspect of society.

These challenges are interconnected. If our strategy is simply to respond to each crisis as it arises, we should expect to spend our future moving from one emergency to the next.

Around the world, governments are beginning to recognize that resilience cannot be built through crisis management alone. An increasing number are aligning public policy around a broader objective: maximizing the wellbeing of current and future generations.

Perhaps the best-known example is Wales’ Well-being of Future Generations Act, which recently marked its tenth anniversary. The legislation requires public bodies to consider the long-term consequences of decisions across sectors, from housing and transportation to education, climate and health. A Future Generations Commissioner helps ensure those principles remain central to government decision-making. Progress has included advancing a real living wage, strengthening local food resilience and embedding prevention into public policy.

Although Indigenous cultures are diverse and distinct, many Indigenous knowledge systems have long embraced this perspective. The Haudenosaunee principle of considering the impact of decisions on the Seventh Generation reminds us that responsible stewardship has long been measured across lifetimes rather than election cycles.

Canada would benefit from adopting the same long-term perspective.

Health is economic infrastructure

Too often, health is discussed primarily as a government expenditure. This fundamentally misunderstands its role.

Health is not simply a cost of running Canadian society. It is one of the primary drivers of economic prosperity.

The United Nations has encouraged countries to move Beyond Gross Domestic Product as the principal measure of national success by accounting for human, social, ecological and institutional capital alongside financial wealth. Healthy populations are foundational to each of these forms of capital.

Healthy people learn more effectively. They innovate, start businesses, participate in the workforce longer, care for families and strengthen communities. Poor health reduces labour force participation, increases disability, widens inequities and generates costs that ripple across every sector of society.

Health does not compete with economic growth. It creates it. Just as roads move goods and digital networks connect economies, healthy populations power nations. Health is infrastructure.

Opening Canada’s economy to health innovation—including medical technology, clinical trials and pharmaceutical research—could further strengthen this foundation by attracting investment, supporting scientific excellence and creating high-value employment. Retaining more of Canada’s remarkable scientific talent would position health not only as a public good but as a major economic engine.

Investing where returns are greatest

If health is infrastructure, then children represent its highest-return investment.

As physicians, we have cared for children throughout their development. It is impossible to separate future educational achievement, workforce participation and economic productivity from childhood health.

Children who are well nourished, emotionally supported, physically active and able to access timely healthcare are better positioned to learn and thrive. Conversely, adverse childhood experiences, untreated mental illness, poverty and unstable housing create barriers that can persist throughout life.

Every child whose potential is diminished by preventable illness or inequity represents more than an individual tragedy. It represents lost human capability for Canada. Investments in early childhood, education, housing, prevention and primary care are not competing priorities. Together, they build the resilient, productive population upon which our future prosperity depends.

Health is national security

Traditionally, national security has focused on military readiness and geopolitical threats. Recent years have broadened that definition.

COVID-19 demonstrated the importance of trusted public institutions, domestic research capacity and strong public health systems. Wildfires, extreme heat and other climate- related disasters showed that healthier communities recover more quickly from crisis, while those already experiencing inequities fare disproportionately worse.

Health security is not separate from national security. It is one of its foundations.

Keeping Canadian health data securely within Canada and enabling its responsible secondary use for the public good would allow us to better understand which policies improve health, where inequities persist and which investments generate the greatest long-term returns. Better evidence leads to better policy.

Every ministry shapes health

Across our practices, we see daily that the conditions in which people are born, grow, learn, work and age often have a greater influence on health than any treatment we prescribe.

Housing policy influences mental health and childhood development. Education policy shapes lifelong opportunity.

Transportation and environmental policies affect injuries, physical activity and respiratory health.

Economic policy influences food security, stress and social connection.

Health is created far more often in homes, schools, workplaces and communities than in hospitals.

That means health cannot be the responsibility of a single ministry. It must become a shared objective across government. and align policy accordingly.

A future-generations approach encourages governments to recognize these connections

Measuring what matters

Canada has traditionally measured success through indicators that capture production but not preparedness.

GDP tells us how much we produce. It does not tell us whether our children are thriving, whether our communities are resilient or whether future generations will inherit a healthier, more prosperous country than the one we enjoy today.

What gets measured shapes what gets prioritized. If Canada measured success through the wellness of its people—not only today but decades into the future—it would fundamentally change how we evaluate public policy.

Prevention would become an investment rather than an expense. Health, education, housing, climate resilience and scientific innovation would be recognized as mutually reinforcing contributors to national prosperity.

A new model of nation building

Every generation inherits the consequences of decisions made by those who came before.

The question facing Canada is whether we will continue to evaluate success primarily through short-term economic indicators or embrace a broader definition of prosperity—one rooted in the health, resilience and capability of our people.

As physicians, we know that health is more than the absence of disease. It is the presence of the conditions that allow people and communities to flourish.

The same principle applies to countries.

Health is not simply another line item in a government budget. It is an economic asset, a source of social cohesion, a driver of productivity, a foundation for educational excellence and a pillar of national resilience.

Canada’s greatest natural resource is not found beneath our soil or off our shores.

It walks into classrooms every September. It goes to work each morning. It cares for families, volunteers in communities, discovers new ideas and strengthens our democracy.

If we truly want a stronger economy, a more secure nation and a better future for generations yet to come, we should judge our success not simply by what our economy produces, but by the wellness of our people.The health of Canadians is not merely an outcome of good policy; it is the measure of whether our policies are good.

Future generations are counting on today’s leaders to think beyond the next budget cycle.