Health Committee on Dec. 4th, 2007

[Claude Rocan]

I'll just mention two fora in particular that I think are important in this area. One, as Mr. Ball mentioned, is the Joint Consortium for School Health, which I think is particularly significant, because at the provincial level it brings together the education and the health sectors into the same forum. That's quite unusual. I think it has a lot of potential for us as a platform to work from. Of course we're at that table as well. The issue of healthy eating and physical activity is certainly something that's front and centre in those deliberations.

The other forum that I would mention is the Ministers Responsible for Sport, Physical Activity and Recreation, which reaches out, again, to another group of ministers outside of the health area. We participated in it as the Public Health Agency. It's very focused, of course, on the issue of physical activity and strategies that we can use together at the provincial, federal, and municipal levels in order to increase the level of physical activity.

I would certainly say, based on the discussions I've heard in both fora, that there is an increase in the level of interest and concern about physical activity. I'm hoping that perhaps we've hit bottom, and that we're working our way back up again.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much.

Mr. Regan.

[Geoff Regan, Liberal, Halifax West, NS]

Thank you very much.

Mr. Chairman, as a visitor to this committee, I want to say it's very gratifying to see the tremendous interest you have in the audience here today. If they stay for the next meeting, they may find it almost as interesting as this one, so I hope they will stick around.

Mr. Tilson said he wasn't being critical. I think that was an understatement, if you'll forgive me. I want to urge my colleagues opposite to assist their ministers, not by throwing lob balls and easy questions, but by holding the departments to account.

Having been a minister, I appreciated the work of committees when they uncovered things I didn't know about, when they provided ideas that were useful, and when they held us to account. That's a very useful role for members on all sides of the committee.

What's disturbing about a response you gave earlier, Mr. Ball, was that you looked to the chairman to confirm it was true that the role of the agency in responding to a report from a committee is simply to say, here's what we're currently doing. It seem to me that the work of a committee ought to be as a catalyst. The work of parliamentarians in this regard--listening to witnesses, providing analysis, and providing arguments--ought to be as a catalyst for an agency or a department, to look into what it's doing to look for better ways of doing things.

In this regard, let me turn to recommendation 12, which called upon the agency to “work to facilitate, in collaboration with the Joint Consortium for School Health, appropriate healthy food and physical activity standards and programs in schools”.

This is a consortium that works with deputy ministers. I'd like to know what's happening with it. The answer simply refers to “working collaboratively with the World Health Organization to develop an international school policy framework”, etc. It doesn't really give any answer to suggest there's any effort going into this work across federal-provincial governments.

I'd like to know when the last meeting of this consortium was and what it's doing.

[Jim Ball]

Again, I'll turn to my colleague Mr. Rocan to provide details on the Joint Consortium for School Health and address your question.

[Claude Rocan]

I can't answer your question specifically about when the last meeting was, but I can say that we meet regularly. The consortium meets at different levels. There are working-level committee meetings. There are management-level committees. There are deputy-minister-level committees. So again, I can't give you a specific date.

There is a teleconference that is taking place in fact on Friday in Toronto. You've caught me at a bit of disadvantage; I can't give you the agenda of that meeting off the top. But what I can say is that the meetings very much have been focused on the information sharing side. We don't have programs, because these are different jurisdictions across the country, but we do identify particular issues of interest, look for the best research and evidence in those areas, and share that information with the different members of the consortium, who in turn pass that on to school health coordinators at every provincial or territorial level.

[Geoff Regan, Liberal, Halifax West, NS]

Let me ask whether this is at the deputy minister level. My understanding is that they are the consortium. I take it the conference on Friday is not at the deputy minister level. How often have there been meetings of the consortium, and how many have there been? I know you can't recall the last time, but maybe you can give me an idea of how frequently they're occurring and when deputy ministers have been involved.

[Claude Rocan]

Deputy ministers are involved at least annually, and beyond that, more frequently there are meetings that take place at the management committee level. Those are usually directors, directors general, and sometimes assistant deputy ministers. They will meet--and again, this is a rough guess--I would say on an average of once every two to three months.

[Geoff Regan, Liberal, Halifax West, NS]

Thank you.

Another part of recommendation 12 is to “provide appropriate healthy food and physical activity standards and programs in First Nations schools within federal jurisdiction”. Again, all we see as the response is basically working collaboratively with the World Health Organization. Isn't that a weak response, or a non-response, to that recommendation?

[Jim Ball]

We are working through the first nations and Inuit health branch. The response to earlier questions demonstrates the kinds of programs we are putting forward to support physical activity and healthy eating on reserve.

For further details on your question, I'll turn to Kathy Langlois, from the first nations and Inuit health branch.

[Kathy Langlois]

Thank you.

As I had indicated a few moments ago, we do realize that partnerships are required in this area. I did acknowledge that the Department of Indian and Northern Affairs is responsible for infrastructure. If you look at the actual government response to that specific recommendation, it does talk about Indian and Northern Affairs programming related to their education program and a program called New Paths for Education.

[Geoff Regan, Liberal, Halifax West, NS]

We'll be sitting on Thursday, I guess, so we'll have a chance to talk to them—the committee will, at least--then.

If you don't mind, let me ask you about recommendation 3, which says, “Implement a mandatory, standardized, simple, front-of-package labelling requirement on pre-packaged foods for easy identification of nutritional value”. The response indicates that public consultation on health claims for foods, including front-of-package labelling, was to have been launched this summer. Public consultation was announced in November, just last month, but doesn't appear to include the labelling component. Why not?

[Jim Ball]

As I mentioned in my remarks, the public consultation will now include the issue of front-of-package labelling.

To give you further specifics on those consultations and how they will occur, I'll turn to my colleague Mary L'Abbé.

[Dr. Mary L'Abbé]

Thank you very much.

You are absolutely correct. We are into consultation right now on the whole question of front-of-package labelling. There are a number of products on the market with a variety of logos and symbols on food packaging that mean a variety of things, and that is actually part of the problem. Some of them are industry-led programs, and some of them are third-party programs. In the current situation in Canada, we have no standardized criteria to aid the consumer in evaluating those logos.

So that is actually part of the issue of why we're consulting on it, to develop some recommendations, potentially, for some standards to ensure that consumers have information that's not misleading, that it actually does give factual, truthful information about the foods they're consuming, highlighting presumably the healthy aspects of those foods.

[Geoff Regan, Liberal, Halifax West, NS]

As a related issue—

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you very much, Mr. Regan.

Mrs. Davidson.

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

Thank you, Mr. Chair.

I'd like to thank the presenters today. Certainly we thank you very much for coming out and going through the government response.

When we went through this study, it became very evident that it was a huge issue. It was more or less all-encompassing. It was a societal issue as well as a many-tiered issue as far as jurisdiction went. We've referred quite a bit to that partnership and working together to try to come to some consensus.

One of the other issues that I think came forward loud and clear was the fact that there was a lack of data, particularly when we were talking about first nations, Inuit, and Métis. Oftentimes people who were presenting to us knew that something was happening, but they didn't have the data to back it up.

One of the things we talked about at great length at the committee was the fact that we needed to get some processes put in place that were going to provide that data so we would know when we came forward with some responses and solutions that we could approach it in a scientific manner and know what we were talking about.

Ms. Langlois or Mr. Ball, would you like to comment on the data collection process as it refers to first nations, Inuit, and Métis, please?

[The Vice-Chair, Liberal, Lui Temelkovski]

How about Madame Finegood? She was nodding her head. I think she might wish to comment—if you don't mind, Mr. Ball.

[Dr. Diane T. Finegood, Scientific Director, Institute of Nutrition, Metabolism and Diabetes, Canadian Institutes of Health Research]

I guess data's my business.

Yes, absolutely, and I think the members have articulated very clearly the data gap or the knowledge gap. Sometimes we have knowledge about what the problem is, but we don't actually have knowledge about what works and what the solutions are.

In reference to the previous comments about front-of-pack labelling, we have very little information about what kind of front-of-pack labelling would actually stimulate consumers to make the healthy choice. In fact, CIHR has funded a researcher here at Carleton who has done some very interesting work looking at packaging for children's foods and has also done focus groups with kids to find out what they think when they see front-of-pack labels that talk about goodness for this reason or that reason.

Most kids don't take those seriously. When they see fun foods, which is the way most food is marketed to kids, then they think it's fun and not good for you, but that's what they want. When it looks serious, then they don't want it. So we're beginning to uncover what those relationships are.

In terms of aboriginal health and aboriginal health issues, this is a really critical area where there's a data gap. And there are different kinds of data: there's data about how big the problem is, but more importantly there's data about what would work and what the solutions are.

I wanted to make the comment that community-based research, wherein you work with the community to understand the changes that they want to put in place, tends to lead to a more effective solution orientation. We are partnered with first nations and Inuit health branch on our new program, which allows us to try to understand what works, for whom, and under what circumstances.

The issue of ParticipACTION was brought up. The government funded ParticipACTION because brand recognition was high. Unfortunately, for the last time that ParticipACTION was funded, we don't really know whether it had an impact on health. CIHR put in place a program and funded two research groups to help us understand what the impacts are this time of ParticipACTION.

A critical component of it is that we're responsive in a very timely fashion to fund those projects. Our system wasn't set up that way. We've now changed it to create a program that is responsive, and the two research groups that are working on ParticipACTION were actually in the field before ParticipACTION was launched this fall.

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

Do you have any timeframes on these studies?

[Dr. Diane T. Finegood]

Those studies were both funded for a year, so by the middle of next year we should have the beginning knowledge of the impacts of the initial advertising campaigns or social marketing campaigns, for ParticipACTION and for several other programs that are what we would call natural experiments. They are policies, programs, interventions.

We've heard a lot of good ideas around the table, but not a lot about what works. We're trying to be responsive to that by funding researchers in the community to actually understand the answers to those questions and fill the data gaps we have.

[Jim Ball]

I think another important part of responding to your question is the new first nations regional health survey that I mentioned in my opening remarks. This is specifically designed to collect the kind of data we were previously lacking, in order to address the issue of childhood obesity and other health issues among aboriginal populations.

Kathy, you could speak to that further. It would be appreciated.

[Kathy Langlois]

Sure, I'd be happy to.

The First Nations Regional Longitudinal Health Survey will be out in the field in early 2008. With regard to areas related to childhood obesity, it is going to do some height and weight measurement of first nations kids and is going to be asking specific questions about physical activity and nutrition as well. That will be adding to the data. This will be the third time, so we're hoping and attempting to build longitudinal data over time with it.

With regard to the Inuit as well—just in reference to my colleague Dr. Finegood, who talked about community-based research and the need to actually get to people in the communities—some work is going to go on with the Inuit as well, repeating a survey that was done in 2004, which saw the ship CCGS Amundsen travel to 14 communities along the coast of northern Quebec, from Hudson Bay to Ungava Bay. It will also be taking body measurements and asking general health questions in relation to physical activity and nutrition, among a whole suite of questions. That's supposed to begin in 2008. We expect a wide range of data that will be helpful to us from that as well.

[The Vice-Chair, Liberal, Lui Temelkovski]

Thank you.

Thank you, Mrs. Davidson. Your time has expired.

Monsieur Malo.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Earlier, in your answers to my questions, you named a number of existing programs on which you're relying to reduce the problem of childhood obesity. However, despite these programs which, unless I'm mistaken, were not extensively monitored at the time by means of specific data, we see that childhood obesity has increased in recent years in a quite substantial and dramatic manner.

I simply wonder why we have waited so long to develop new strategies that, according to your answer, will arrive somewhere in 2008 in an attempt to put a stop to the problem.

On this point, earlier we took another look at labelling. On the basis of your answer, I still wonder whether you consider a single box on the front of packages appropriate or not. Perhaps we should go a little further on this subject.

I would also like you to answer my previous question: why have we waited so long to learn about the entire scope of the program?

In addition, how are you going to group around a single table the stakeholders in the various sectors of health, marketing ethics, the food industry and agriculture, and ensure that each of those stakeholders sets aside its own interests and finds innovative and effective solutions to reducing obesity among youth?

[Jim Ball]

Thank you very much for your comments. There are a number of questions within those.

Clearly, I don't think it's a question of why have we waited so long; I think it's a question of dealing with a very complex issue where we need to understand the measures that will be most effective at addressing this complex set of underlying factors driving the dramatic gain in weight, not only among children but also among the Canadian population in general. We are attempting to do the right thing—not just things. We therefore need to do the appropriate research work that CIHR has put an increased focus on. We are doing the appropriate analyses.

With respect to your comment on front-of-package labelling, we need to make sure that what we do there, if anything, is in fact going to be effective and of assistance to Canadians. So it is a case of ensuring we are taking a thoughtful, analytical, and evidence-based approach to addressing this issue. So we are engaged in considerable work to look at those underlying factors and what we can do about them to result in successful change.

As I said in my opening remarks, we have a number of new initiatives we've put in place to in fact do this. We are going to be measuring those new initiatives in terms of their impact and, based on that, either modify them or encourage their implementation with our partners on a much broader scale.

If you'd like us to go into further detail on your point about front-of-package labelling, I'll refer your question to Mary L'Abbé.