Mitigating child health inequalities through equity, diversity, inclusion, and accessibility school practices in Canada.

Unhealthy lifestyle behaviours and mental disorders disproportionately affect children living in deprived neighbourhoods. In Canada, schools are encouraged to adopt equity, diversity, inclusion, and accessibility (EDIA) practices to tackle these inequalities. We examined whether integrating EDIA school practices into curriculum and programming mitigates the impact of neighbourhood deprivation on children's lifestyle behaviours and mental health. In 2023/2024, we surveyed 1970 students in grades 4-6 (aged 9-12) from 28 elementary schools in Alberta. Students self-reported diet, physical activity, screen time, and mental health and wellbeing. School principals reported on the extent (full vs. partial) of integrating EDIA school practices into curriculum and programming. The Canadian Index of Multiple Deprivation (i.e. residential instability, economic dependency, ethno-cultural composition, situational vulnerability) was used to capture neighbourhood deprivation. Over half (54%) of schools had fully integrated EDIA school practices into curriculum and programming, and were located primarily in areas with greater residential instability (50%), ethno-cultural diversity (57%), economic dependency and situational vulnerability (46%). In highly deprived neighbourhoods, students attending schools with fully integrated EDIA practices were less likely to have poor diets (0.9 vs. 1.6) and consume excessive intake of free sugar (1.3 vs. 1.8) and saturated fat (0.6 vs. 0.8). EDIA school practices did not appear to moderate the relationship of neighbourhood deprivation with physical activity, screen time, or mental health and wellbeing. These findings suggest that integrating EDIA school practices into curriculum and programming may help buffer some adverse effects of neighbourhood deprivation on children's health and diets in particular.