Health Committee on Nov. 9th, 2006

[Rick Dykstra, Conservative, St. Catharines, ON]

Thank you.

I have one really serious question to ask the minister.

My two daughters were very concerned about the issue regarding the Province of Ontario potentially outlawing Hallowe'en. I just want to make sure that I could take home to them tonight that this in fact wouldn't be the case.

[Jim Watson]

No, we had no such intention, Mr. Dykstra, to do that. Although I was teased because when I gave out my Hallowe'en bags, I included toothbrushes and pedometers. My house was egged afterwards.

[Rick Dykstra, Conservative, St. Catharines, ON]

Probably for another reason, but we won't get into that.

One of the points you made I thought was a good one. I appreciate the support with respect to the physical education tax credit, and I thought I would at least extend the opportunity to you as the Minister of Health Promotion in Ontario to see if in fact you might consider or you might recommend to partner with us on that. You commented at the end of your submission on partnership, and I think certainly from a federal perspective 6.1 million children in the country would definitely benefit, a large portion of those being here in the province. Is there some consideration by other provinces on taking on that same credit in a very pragmatic way?

[Jim Watson]

Speaking of credit, I'd like to take credit for inspiring your Prime Minister to bring forward that idea, because a couple of months before he announced it, I floated the idea and the Toronto Star ran a story about it.

I don't think our finance minister was as enthusiastic as I was about the program. I certainly would like to see all of the provinces go down the route, so that it could be matched up and double the impact that the federal tax credit will have. We're not in a financial position to do that at this stage, but those are the kinds of things we should look at when we are in a surplus position in the province of Ontario.

Someone asked whether we use the carrot or the stick approach in our ministry, and I said we use the carrot stick approach. You need a little bit of both. You need some positive reinforcement. I think the tax credit is a positive reinforcement. Some have criticized it by saying it's not enough. I think it's only going to work out to $75. That's $75 more than perhaps parents had in the past, and if we can build on that at the provincial level and double that, that may be another $75. I obviously can't speak for the finance minister, and it's a financial decision that would have to be taken by our cabinet, but it certainly is philosophically something I'm supportive of.

[Rick Dykstra, Conservative, St. Catharines, ON]

Well, I'm impressed that you can have that kind of influence over the Prime Minister and haven't been able to do that with the provincial finance minister. But keep at it. I'm sure you'll get through.

The other question I had related to the importance of the provincial health levy that was applied through your first budget. I don't want to get into the partisanship of whether it was a bad or good idea or what have you, but the fact is it was in the budget and it obviously extended an additional tax to Ontarians. I wonder from a health promotion perspective if any of that funding actually is within the realm of your ministry, so that you can actually use it from a promotional perspective rather than just from a prevention perspective.

[Jim Watson]

It is, in fact. Mine was one of the few ministries that got an increase in our base funding, particularly with our smoke-free Ontario campaign. We brought in a very comprehensive anti-smoking package. It's not just legislation that bans smoking in public work places, but it also provides cessation counselling, advocacy, and so on. We went from about $10 million two years ago or so to $60 million on the smoke-free Ontario package. The $10 million in the healthy eating and active living strategy is new money for a new strategy, and that money has been going out the door as of March 31, April 1, the new fiscal year, as well.

[The Chair, Conservative, Rob Merrifield]

I'm sorry, Mr. Dykstra, your time has gone.

Ms. Priddy, you have five minutes.

[Penny Priddy, NDP, Surrey North, BC]

Thank you, Mr. Chair.

Mr. Minister, I'd like to ask you a couple of questions, and then if I have time, I'd move on.

And I'd really like a copy of people's presentations, because folks had really good stuff to say, so I'd be really glad to have it. I'm from British Columbia, so I'm pleased to see two people here from B.C.

You talk about the infrastructure for leisure activities--pools, rinks, whatever--and you're looking at how infrastructure could be built in Ontario. I talked last week to FCM about DCCs, or development cost charges, and whether the municipalities in their charging--I think they charge DCCs in Ontario; it's a little bit from each development, or if you're growing fast it's a lot from each development--targeted any of those DCCs towards some of the infrastructure you were particularly looking at. I know that there is a real deficit and has been since our last big building bout. I must admit, I'm the kid who grew up swimming in the first covered swimming pool in Toronto with Marilyn Bell as a swimming instructor. That was the bout before that of building infrastructure. Did they help target some of that towards the infrastructure you were looking at?

[Jim Watson]

Just to give you some perspective, after what was supposed to have been a federal-provincial-territorial ministers meeting a couple of months ago in Toronto, which ended up being a provincial-territorial meeting instead, FCM put out a communiqué in support of what we were doing in our call for the federal government and the provincial governments to work together to create a sport and recreation infrastructure fund.

Development charges in the province of Ontario are levied by the municipality. They go into the general consolidated revenue, and they are actually available for sport and recreation infrastructure. In new developments in particular, recreation centres and so on are built with that money and other moneys.

What we're calling for, and the provincial ministers have been very insistent on this, in ensuring that we let people know this is our number one priority.... There was such a backlog of existing facilities, which tend to be in older neighbourhoods and not in growth areas where development is taking place. Thus you don't have those development charges.

To put this in some perspective, I mentioned the statistics earlier: 80% of Ontario's single-pad arenas are over 25 years of age, and 13% are over 50 years of age. Arenas and pools, because of the equipment and the plant that goes with them, are very expensive to build and operate.

That is one of the reasons you see very few private sector arenas. The private sector cannot make money on arenas, so you have to have either a partnership or the government involved in the construction of these facilities.

[Penny Priddy, NDP, Surrey North, BC]

Thank you.

[The Chair, Conservative, Rob Merrifield]

I want to honour our time commitment. We want to thank you for giving us the extra five minutes. We appreciate your presentation to the committee. It was very interesting.

We'll make sure that your presentation is translated appropriately and passed out to all of the committee.

Thank you.

[Jim Watson]

I regret, Mr. Chair, I forgot to introduce my colleagues, Colleen Kiel and Jeffery Pearce, from the Ministry of Health Promotion. I apologize to them.

I thank you very much, Mr. Chair and members of the committee, for the opportunity to talk about some of the exciting things we're doing in health promotion

If I may, I'll conclude with one brief comment. Ultimately, the work that you're doing, and what we're trying to do at the provincial level, is going to help save the publicly funded health care system, because if we put more emphasis and resources on the front end—preventing illness and promoting wellness—we're not going to have what I've called the perfect storm with an aging population, with baby boomers becoming senior citizens.

Unless you've found the fountain of youth, and maybe it is in Jasper, we're not going to curb the aging issue, but we can help curb the wellness and physical inactivity portion of the equation.

I look forward to working with the federal government for the betterment and the better health of all Canadians.

Merci.

[The Chair, Conservative, Rob Merrifield]

Thank you very much. We look forward to that as well.

Now we have Mr. Adam Ostry. We don't want to leave you there, without introducing you and without giving you the opportunity to give a presentation to the committee. We want to thank you for coming.

I understood your time was a bit late from Infrastructure Canada, so the floor is yours for a quick presentation, and then we'll continue with questioning.

[Adam Ostry, Director General, Policy Directorate, Cities and Communities Branch, Infrastructure Canada]

Thank you very much, Mr. Chairman.

Ladies and gentlemen, I am very pleased to be here, at the invitation of the Standing Committee on Health, to contribute to its study on childhood obesity and factors affecting the health of Canadians.

I represent the branch within Infrastructure Canada that is responsible for policy development as it relates to cities and communities, which is a key component of the new Transportation, Infrastructure, and Communities portfolio now under the responsibility of the Honourable Lawrence Cannon.

Although Infrastructure Canada has not commissioned any research in this area, we are following with some interest the research being carried out in other departments and the academic community, when it relates to our specific interest in built infrastructure, and the sustainability and competitiveness of our communities.

My comments will cover a few of the programs and initiatives of the transport, infrastructure, and communities portfolio. First I will highlight some statistics that emerged from a series of reports prepared by Statistics Canada, in collaboration with Infrastructure Canada, part of which relates to the link between health and investment in infrastructure. Second, I will discuss the Government of Canada's investment in infrastructure, including sports and recreational infrastructure, that provides opportunities for physical activity in communities throughout the country. Third, I will follow with investments in urban and active transportation. Finally, I will talk about the role of some crown corporations in the development and rehabilitation of healthy urban centres.

First I will detail a few statistics. In 2005 Infrastructure Canada and Statistics Canada jointly prepared a series of reports on trends and conditions in census metropolitan areas, CMAs, which are cities with 100,000 or more people, in order to better understand spatial differences in our urban communities. One of these reports, which analyzes health in CMAs, reveals that geographic differences are indeed important to consider when discussing the well-being of Canadians.

For example, according to data for 2000-2001, the highest proportion of people between the ages of 20 and 64 who are obese is in Thunder Bay, Ontario, where they represent 20% of the population, the lowest proportion being in Victoria, where they represent only 9.8% of the population. The cities of Vancouver and Victoria have the lowest rates of physical inactivity of the census metropolitan areas in terms of periods of recreation, with 40% of respondents over the age of 12 saying they are inactive, compared to 50% elsewhere in Canada. On average, 15% of Canadians aged from 20 to 64 were considered obese, whereas rates in Vancouver and Victoria were as low as 10%. However, gaps in the data available for communities remain a significant challenge.

Through its research and statistical capability, the Government of Canada can provide cities and communities with a better basis for long-term planning.

This is also the philosophy behind the integrated community sustainability plan, a key component of the government's gas tax agreements with the provinces and territories, some of which, as you know, include municipalities or municipal associations as signatories for the sharing of revenues from the federal excise tax on gasoline for the purpose of investing in environmentally sustainable municipal infrastructure.

The agreements stipulate that a municipality must develop an integrated community sustainability plan, an ICSP, that sets out the guidelines for allowing it to achieve environmental, cultural, social, and economic sustainability outcomes. Ideally, a community's health objectives are best achieved when they are linked and embedded within urban development and land use planning that relates to urban densification, transportation, green space, and community services.

Very few people are unaware of the direct relationship between physical inactivity, participation in sports and healthy communities. The responsibility for providing these services falls to our cities and communities, whose institutions are a provincial responsibility, as you know. The Government of Canada is working in partnership with these two levels of government to support Canadians' quality of life, while respecting each level of government's jurisdiction.

The physical design of our cities and communities, delivery of sports and recreational services, either through educational systems or municipal recreational infrastructure, as well as the provision of active transportation structures, are provincial and municipal responsibilities. Access to community infrastructure, such as arenas, pools, parks or pedestrian paths, can play an important role in Canadians' desire to become more active, particularly when we see that every year, more than two thirds of deaths in Canada are caused by chronic illnesses in four different groups — mainly cardiovascular diseases, cancer, type 2 diabetes and respiratory illnesses.

Some sport and recreational infrastructure has received funding through the Canada Strategic Infrastructure Fund, CSIF--in particular, large-scale facilities for major amateur sport and athletic events--and through the Municipal Rural Infrastructure Fund, the MRIF, which is primarily designed to meet the needs of smaller Canadian communities.

For example, funding through CSIF will enable the Summerside Wellness Centre in P.E.I. to build a sports centre for large-scale amateur sporting events that will support the 2009 Canada Summer Games to be held there. With funding from MRIF, the Buhler Recreation Park project, in Transcona, in east Winnipeg, will provide a new recreational and exhibition space for citizens and users. The park's year-round accessibility will improve access to the community's other existing facilities, which are currently overcrowded and represent safety risks for users and spectators alike.

Quality of life, beyond the obvious benefits of physical activity in terms of improving Canadians' health status, is also measured by the air that we breath, particularly in large urban centres where smog too often obscures the sky.

In its gas tax agreements with the provinces and territories, the Government of Canada has included the funding of active transportation infrastructure as an eligible funding category. These green community projects include bike and pedestrian paths and their related infrastructure. They are often tied in with existing public transit, and we want them to be as widespread as possible for Canadians, so they can use them to get to work and elsewhere.

A couple of examples of the way municipalities have used the federal gas tax funds are the pedestrian and the bike paths in Halifax and the bike paths in Markham.

Personally, I've had the opportunity to participate in this process as lead negotiator on the agreements with the three territorial governments. I can tell you that I found the experience extremely enriching, in terms of the green initiatives put forward. The snowshoe trail in the Yukon and the cross-country skiing trails in downtown Yellowknife are good examples that illustrate what I've been saying.

Investments in public transit are also linked to active transportation. Indeed, the levels of walking, cycling, and transit use in Canadian communities tend to rise or fall together. Transit and walking have a strong relationship, and maximum desirable distances are used to help define transit service patterns in many cities. Research shows that the willingness of passengers to walk to transit increases with higher-quality transit service and better pedestrian environments.

In addition, programs that make it easier for cyclists to go to transit services and then store or bring along their bicycles—as is the case on several OC Transpo routes here in Ottawa—can boost transit ridership, reduce the cost of parking provisions at stations, and reduce congestion and pollution.

Indeed, Transport Canada has implemented the Urban Transit Demonstration Program with a view to supporting the development and integration of strategies, planning tools and best practices in the area of transportation, such as those intended to reduce greenhouse gas emissions. This initiative will allow Canadian cities to implement demonstration projects aimed at promoting innovative approaches in this area.

For example, the City of Whitehorse is investing in its transit infrastructure, including active transport. By redesigning the layout of Main Street to reduce bus waiting times, the City of Vancouver is improving pedestrian safety and revitalizing this major artery — another example of good practices that result in healthier living.

In terms of Crown corporations, the Canada Lands Company, or CLC, is responsible for managing, redeveloping and selling the Government of Canada's strategic real property. It does this using innovative approaches that obviously provide a financial return to the government, while at the same time revitalizing Canadian communities. The site development plan for Benny Farm in Montreal is an excellent example of what CLC is doing to improve the community's quality of life, with its recreational centre comprising both sports facilities and community halls.

The Garrison Woods urban revitalization project in Calgary, likewise under the CLC auspices, is working to find better ways of dealing with public health issues, such as street lighting on sidewalks and safer street lay-outs.

The Downsview Park corporation on a former military base in Toronto has been busy since 1996 transforming the site into a unique urban green space with a recreational focus, highlighting children's sports and offering them summer camps and environmental learning programs year round. It is a fine example of how urban land can be rehabilitated.

I could share many more success stories with you, but I know that time is short. So I will conclude my opening comments.

Mr. Chairman, the Transport, Infrastructure and Communities portfolio aims to implement the necessary measures to improve the quality of life of Canadians living in cities and communities across the country, one of the effects of which will be to combat obesity.

Thank you very much for giving me this opportunity to share with you some of the practical examples of the way in which the portfolio I represent is helping to improve the health of Canadians. Thank you.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Now we'll continue with our questioning. We have Ms. Davidson for five minutes.

[Patricia Davidson, Conservative, Sarnia—Lambton, ON]

I'd like to thank all the presenters.

Certainly we've heard a lot of information again here today. It's been very interesting.

My first question is going to be Ms. Mongeau, please. I was certainly interested in what you had to say when you described childhood obesity and the whole issue as not only a public health problem, but also as a societal problem. I think that's so very true. We've got a whole society where kids hardly walk to school any more. They get bussed from a very young age. Parents are afraid to let their children outside to play; there are safety issues. There are a lot of issues in communities, whether they're large or small, that make it difficult for children to be out on their own.

We've got parents working, both parents or single-parent families, and the parent comes home from work tired. Something quick and easy is often what happens. As the minister has said, Home Ec is not taught in schools any more, at least in Ontario. I don't know if it is in the other provinces. So we lead very harried lifestyles.

How do we effect societal changes that can address some of these issues?

[Lyne Mongeau]

I am going to answer in French.

Some authors say that this obesity crisis requires the development of a whole new social movement. We are clearly seeing that this affects every sector of society. I think the first step is for there to be a broadly shared understanding within society of the issues that you and I have identified.

If we adopt a vision that focuses on nutrition and physical activity, we will achieve meaningful results, but that won't be enough. Indeed, some aspects of the issue really require us to get to the root of the problem. We obviously can't change the universe or return to the kind of lifestyle that existed long ago. Nor is that what we want. However, it is important to be conscious of the fact that social transformation is occurring, and that we did not foresee any of the consequences of that transformation. One example might be that even though parents work, many primary schools don't have the necessary infrastructure for children to be able to have lunch on site. Provision could have been made for that sort of thing. It is difficult to find solutions when there is a lack of infrastructure. Furthermore, it becomes very costly.

So, we are going to have to be very creative and focus instead on a social movement. We will also have to think very deeply about issues related to commercialization, including the role of advertising, particularly when it's directed at children. They have not developed enough of a critical mind to be able to deal with advertising.

Furthermore, social norms are a new concept that is a subject of research and one that is increasing being explored. They allow people to have a different concept of life. That is very powerful from a social standpoint. Implementing such an approach would have a more meaningful impact than current measures, which attempt only to change individual behaviours. The fact is that individuals are part and parcel of those social norms.

If it is deemed to be normal for children to walk over to their friends' house, that is what they will do. Public awareness campaigns can help to transform social norms, but as regards certain behaviours, they have to be shown to be abnormal. If drinking soda pop is considered to be normal behaviour, for example, children will drink soda pop and advertising will continue to reinforce that lifestyle choice. Everyone will find that normal.

But creating a social movement and changing certain aspects of our society is a major challenge. We all feel rather overwhelmed; there is no doubt about that.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

We will move on to Ms. Keeper. You have five minutes.

[Tina Keeper, Liberal, Churchill, MB]

Thank you very much.

I would like to thank everybody for their presentations.

I would like to ask two questions. One is to Ms. Panagiotopoulos.

One of the recommendations you made was about the Canadian Institute for Health Research. It was to include additional funding on an evaluation component for the treatment program. Could you just elaborate on that a bit, please? Are you saying there are currently treatment programs in existence?

[Christina Panagiotopoulos]

There's only one at the moment, in Vancouver.

[Tina Keeper, Liberal, Churchill, MB]

Okay.

[Christina Panagiotopoulos]

Within that, we need an evaluation component to see if it's the right program to begin with.

[Tina Keeper, Liberal, Churchill, MB]

Right.

[Christina Panagiotopoulos]

It's the Shapedown program. It's taken from a California model. It is effective. We know it's effective, but is it the best? I'm not sure.

Also, we need to find the best practices overall. A Canadian initiative would help bring all the best practices from each of the centres across Canada, if there are similar ones.

[Tina Keeper, Liberal, Churchill, MB]

You said this is the only one you're aware of. Would that be in B.C. or in Canada?