Evidence of meeting #42 for Health in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was million.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Glenda Yeates  Deputy Minister, Department of Health
David Butler-Jones  Chief Public Health Officer, Public Health Agency of Canada
Philip Groff  President and Chief Executive Officer, SMARTRISK
Jennifer Heatley  Executive Director, Atlantic Collaborative on Injury Prevention
Rebecca Nesdale-Tucker  Executive Director, ThinkFirst Canada
Alison Macpherson  Board Member, ThinkFirst Canada
Tyler Lisacek  Community Volunteer, ThinkFirst Canada

12:10 p.m.

Jennifer Heatley Executive Director, Atlantic Collaborative on Injury Prevention

Thank you, Madam Chairperson.

Thank you for having me here today. My name is Jennifer Heatley and I'm the executive director of the Atlantic Collaborative on Injury Prevention, or ACIP as we call it for short. ACIP is an NGO based out of Halifax and works to reduce the burden of injury in the four Atlantic Canadian provinces.

After several years of working in the area of injury prevention, I continue to be surprised at its contradictory profile as a public health issue. On any given day, the media often leads with stories of injury in all its forms, but despite the high profile of individual incidents, there is a striking difference between injury and the other leading killers of Canadians.

Research dollars, surveillance systems, and strategies are pale compared to those of other major diseases such as cancer and heart disease. The public's concern about injury, although sincere, has not translated into "movembers" or "walks for the cure". Injuries are still considered bad luck or fate.

What we do know is that preventable injuries, both those that are intentional and unintentional, present a significant social and economic burden in Atlantic Canada and across the country. Over 1,000 Atlantic Canadians die annually as a result of injuries and another 16,000 are injured severely enough that they need to be hospitalized. Overall, this costs Atlantic Canada over $1 billion per year in direct and indirect costs.

Furthermore, injury is an issue that highly impacts our youth. Although injury is the leading cause of death across all ages, up to the age of 44 it is the number one cause of death. For children and teenagers, it is responsible for more deaths than all other causes combined.

Injuries that kill and disable so many Canadians are preventable through healthy public policy and evidence-based strategies. The issue of injury would benefit from a coordinated national injury prevention strategy. National strategies and coordinated efforts have been integral to other high-profile health issues. We need to move beyond attempting to change individual behaviours and work to create safer environments through broader social change.

There is a need for federal leadership to coordinate across sectors, so that injury prevention efforts are comprehensive and take into account the many factors that put individuals at risk for injury. Continuing to create divisions between issue areas or between intentional and unintentional injury is artificial and unnecessary, as the root causes are the same for all.

Although the federal government has recently indicated a planned focus on injury prevention for children, ACIP would encourage an approach that will address injury across ages, population groups, and injury issues. The socio-economic conditions that increase injury risk for children are the same as those that increase risk for other populations and age groups at higher risk, such as seniors and aboriginals. Furthermore, children are heavily influenced by the adults in their lives and their surrounding environments. Safe and healthy children cannot exist without safe and healthy adults, and communities.

Our communities won't be safe until they're equitable. Canada has the capacity to be as healthy and safe as other countries who are leaders in the health field, but we need to make some big changes. We know what the cure for this disease is. If we can come together as a country on a coordinated injury prevention strategy and a series of healthy public policies that address the role that poverty plays in injury, we can address billions of dollars in avoidable health care costs, and, more importantly, an enormous personal burden to millions of Canadians.

Thank you.

12:15 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you very much.

Now we'll have a presentation via teleconference from SMARTRISK, with Philip Groff, president and chief executive officer.

Would you share with us some of your insights into this area, please?

12:15 p.m.

President and Chief Executive Officer, SMARTRISK

Dr. Philip Groff

Thank you, Madam Chairperson, and thank you to the rest of the committee.

My name is Philip Groff, and I thank you all for the opportunity to speak with you today and to share some information on injury and its prevention.

I'm here today representing SMARTRISK, a national charitable organization dedicated to preventing injury and saving lives. Our mission is to empower you through education, programming, and policy change to recognize and manage the risks of injury in the smartest way possible. We focus most of our programming efforts on young people, as they are at peak risk for injury and are prone to take risks without thinking them through. We believe if we can reach young people, traditionally a tough group to get through to with safety messaging, we could help make them smart risk-takers for life.

Our organization began 19 years ago when our founder, Dr. Robert Conn, a pediatric heart surgeon, became interested in precisely where the donor hearts he was harvesting as a member of a transplant team were coming from. He did some research and discovered they were coming from people like you and me, like our children, our nieces and nephews, people who were healthy and happy one moment, but then due to a bad decision on someone's part, or a poorly engineered piece of the environment, or a moment of inattention were fatally injured and eligible to donate their organs. Dr. Conn realized he could save many more lives by preventing injuries before they happen, rather than trying to repair them in the operating room afterwards. He left surgery and founded SMARTRISK.

Since that initial research of Dr. Conn, the data has not lost its impact. In 2009 SMARTRISK released our second national report on the economic burden of injury in Canada, a report that we have tabled with the clerk of this committee. You will see that in any given year, injury claims more than 13,000 Canadian lives and necessitates more than three million emergency department visits and more than 200,000 overnight hospital stays. It leaves more than 60,000 citizens with some form of personal disability and another 5,000 permanently and totally disabled. The annual cost to all Canadians is more than $19.8 billion, all for events that the research literature indicates are largely predictable and preventable.

At SMARTRISK we've spent the majority of our efforts in trying to protect the youth of this country from death and serious injury. As you've already heard, injury is the leading cause of death from ages one to 44, and between the ages of 10 and 35 a Canadian is more likely to die from a predictable and preventable injury than from all other causes of death combined. Getting youth to manage their risk of injury is not impossible, but neither is it easy. We've invested a great deal of time and research investigating what works and what doesn't when trying to persuade teens to make smarter choices. We've learned through research and talking to teens to avoid negative messages, with an emphasis on consequences that push our audience into denial that these events could ever affect them. We've learned to emphasize the positive benefits of making healthier choices rather than trying to scare teens straight, and we've learned to harness the enormous power of positive peer influence so that life-saving messages are spoken in a language that is native to our young listeners, which no adult remembers fully how to speak. We've also learned the importance of building supportive environments so that the healthy choices are also the easy, popular, and fun choices.

We and our partners at the other national injury organizations have learned a lot about how to prevent injuries and save lives. We have the vaccine; what we lack is the infrastructure and supports to deliver it as widely as necessary.

A number of years ago we facilitated a national consultation with stakeholders representing the domains of surveillance, research, knowledge translation, and community programming to develop a draft framework for a national injury prevention strategy. The resulting document, Ending Canada's Invisible Epidemic, called for a pan-Canadian strategy based on six pillars: national leadership and coordination, an effective surveillance system, research, community supports and resources, policy analysis and development, and public information and education.

There has been some development of each of these pillars in the subsequent years, most vividly the leadership shown by CIHR in the development and launching of the strategic teams in applied injury research grants last year, a landmark achievement, as it represents the first time that many researchers in this country will be able to devote themselves to injury prevention research as their primary vocation rather than as a sideline they pursued with passion but little support or recognition.

However, much of the development that has occurred in these areas has been led from outside government, through the dedication of various NGOs. We are still looking for national leadership and coordination on this issue and a commitment to address this epidemic that is commensurate with the magnitude of the burden.

On March 3, 2010, in the Speech from the Throne, then Governor General Michaëlle Jean read the following statement: “To prevent accidents that harm our children and youth, our Government will also work in partnership with non-governmental organizations to launch a national strategy on childhood injury prevention.”

SMARTRISK, along with the other national injury prevention organizations--Safe Communities Canada, Safe Kids Canada, and ThinkFirst Canada--stands ready to partner with the government on this national strategy.

Thank you again for the opportunity to speak today. I'd be happy to answer any questions.

12:20 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Dr. Groff.

We will go to the questions and answers as soon as all our presenters give us their information.

We'll go now to ThinkFirst Canada. We have two speakers here. Rebecca Nesdale-Tucker, the executive director, will be doing the meat of the presentation, and Tyler will be adding a few words.

Rebecca.

12:20 p.m.

Rebecca Nesdale-Tucker Executive Director, ThinkFirst Canada

Thank you.

I'm Rebecca Nesdale-Tucker, executive director of ThinkFirst Canada. We're grateful for the invitation to present to you today on this important health issue.

Preventable injury is the leading cause of death for young Canadians age one to 44, and it's a leading cause of death and disability for all ages. Though often considered accidents or acts of fate, most injuries are in fact preventable.

Canada can and must do a better job of keeping Canadian children, our most precious resource, safe. That's why ThinkFirst Canada exists. It was founded in 1992 by renowned brain surgeon Dr. Charles Tator and other committed individuals who understood then and now that—

12:20 p.m.

Conservative

The Chair Conservative Joy Smith

Excuse me. Could I just interrupt you and ask you to slow down for our translators?

12:20 p.m.

Executive Director, ThinkFirst Canada

12:20 p.m.

Conservative

The Chair Conservative Joy Smith

They're good, but they're not that good.

12:20 p.m.

Executive Director, ThinkFirst Canada

Rebecca Nesdale-Tucker

I was trying to jam all I could into the five minutes.

12:20 p.m.

Conservative

The Chair Conservative Joy Smith

Just relax. I am generous with the time—

12:20 p.m.

Executive Director, ThinkFirst Canada

12:20 p.m.

Conservative

The Chair Conservative Joy Smith

—but I try to keep it within limits so everyone can be heard.

12:20 p.m.

Executive Director, ThinkFirst Canada

Rebecca Nesdale-Tucker

Dr. Charles Tator, our founder, and his committed colleagues, understood then and now that prevention is the only cure for serious brain and spinal cord injuries in this country.

ThinkFirst Canada is a national organization, and we have chapters in every province. We work with our chapters and partners to increase literacy and safety promotion through schools, sports and recreation-based programming, concussion education awareness, and helmet promotion. We develop our programming with an evidence base and with multi-disciplinary committees, and we deliver our message with VIPs, voices of injury prevention, who are injury survivors.

I am delighted and honoured to have Tyler here with me today. He is a VIP with ThinkFirst Ottawa, our chapter here. Tyler is one of our local heroes. He just this week was awarded for being a child activist in the region, and he has spoken to over 8,000 people in the past two years, sharing his story and his life-saving message.

I'm also delighted to have here with me today Dr. Alison Macpherson, who is a leader in the injury research sector in Canada, and a professor at York University. She will share with us some information about the status of injury in Canada.

12:20 p.m.

Dr. Alison Macpherson Board Member, ThinkFirst Canada

Thank you very much.

It is an honour to be here on behalf of the ThinkFirst Foundation of Canada.

Injury affects all of us. It affects the injured person; it affects the person's family; it affects our health care system profoundly. Injury is a huge public health issue in this country. On average in Canada, 500 children a year die from injuries. That's more than one child a day. These are your children, your grandchildren, your nieces, your nephews. We're all affected.

Every 30 seconds in Ontario, somebody walks into an emergency department for treatment resulting from an injury, so it's really important. It affects our wait times, our hospitalizations, everything.

The impact of injury is lifelong. Having a spinal cord injury can result in paraplegia, decreased mobility for the rest of your life. Having a brain injury, as I'm sure Tyler will share with us, can change your life forever.

The leading causes of injury include drowning, motor vehicle and pedestrian injuries, and falls. All of these have evidence-based strategies that can reduce their incidence or their causes in our population. If we just did what we know works, we'd already make a huge impact. Things like bicycle helmet laws, four-sided pool fencing, playground standards that meet the CSA standards developed here in Canada, rule changes in sports, can all lead to healthier and safer kids in Canada. We know that some populations are particularly vulnerable. Poor children are at increased risk. Our first nations and Inuit children are much more likely to die of injury than our other Canadian children. Children who live in rural and remote areas on places such as farms are also at increased risk.

We rank 32nd among OECD countries in injury prevention, and for a country like Canada, that is not good enough. We can and must do better for our children and for our communities in injury prevention.

Rebecca's going to talk a bit about some suggestions for strategies, which I think are similar to what the other speakers have mentioned.

12:25 p.m.

Executive Director, ThinkFirst Canada

Rebecca Nesdale-Tucker

As Dr. Groff and Ms. Heatley said, an all-ages injury prevention strategy has been called for by ThinkFirst Canada and its partners for many years. It was a welcome announcement, then, when the federal Speech from the Throne called for such a strategy for children and youth. The funding of strategic teams and research was also a welcome announcement, and we're also very much looking forward to the renewal and enforcement of Canada's product safety legislation.

We have great opportunities in Canada to lower the incidence of preventable injury. We look forward to opportunities, with increased resources and partnerships, to support greater injury prevention efforts. This can be better achieved with funding at a level more commensurate with the health burden that injury has on our society and in keeping with the resources dedicated to other comparable health issues.

What we would really like to see is resources to sustain a home to lead evidence-informed pan-Canadian action on injury. So we'd like to see that comprehensive approach that Alison referred to. We'd like to see it streamlined with a healthy living strategy. We'd like to see health literacy, including injury prevention, in all Canadian schools. We'd like to see safer sports and recreation so that our kids are healthy, active, and safe, so at the same time as combating obesity we're also addressing injury issues.

In public policy for a safer Canada, we have a lot of opportunities there. Of course, we'd also like to see continued injury prevention research and evaluation.

12:25 p.m.

Conservative

The Chair Conservative Joy Smith

You'll certainly get a chance to add a lot of things as you hear the questions.

Tyler, I think you had a couple of things you wanted to say. Please go ahead.

December 2nd, 2010 / 12:25 p.m.

Tyler Lisacek Community Volunteer, ThinkFirst Canada

Could you please repeat the question?

12:25 p.m.

Conservative

The Chair Conservative Joy Smith

Tyler, I just said that if you wanted to say a few things that would give our committee some good insight into what you think we should do for injury prevention, we'd be very happy to hear from you.

12:25 p.m.

Community Volunteer, ThinkFirst Canada

Tyler Lisacek

Giving ThinkFirst or the brain injury prevention associations money so we can reach out to help more public schools and schools in general would be great.

When I got hit, I was one kilometre away from home. I was on my bicycle. I was hit from behind by an SUV going 98 kilometres an hour. That pretty much caused my head to go right into the windshield. I ended up in CHEO with traumatic brain injury and all those other fun things.

Ever since then, with the side effects, the effects of it, the accident's changed everything. Since I got hit, all my friends, since we live out in the countryside, where everyone does aggressive four-wheeling, they don't want me to hang around. If I get hit, it's on them, so they say, “It's better just to take him out of the equation”, so nothing like that. I'm basically not allowed to do anything, anyway, because if I do get hit in the head again I could wind up back in a coma or in the hospital with worse.

It has caused me to do therapies for the past five and a half years. I'm still doing them. I'm on medications. I'm always doing neurology tests. I did some in October for a couple of days every two weeks.

12:30 p.m.

Conservative

The Chair Conservative Joy Smith

Tyler, I'm sure that some of the panel will be asking you some questions. I have to say that your being here makes a big difference to a lot of people.

12:30 p.m.

Community Volunteer, ThinkFirst Canada

Tyler Lisacek

Thank you.

12:30 p.m.

Conservative

The Chair Conservative Joy Smith

I think you are doing really, really well. Wow. You're just a modern-day hero, so thank you for being here.

We'll just wait and see what the rest of the panel has to say. Is that okay with you, Tyler?

12:30 p.m.

Community Volunteer, ThinkFirst Canada

Tyler Lisacek

Yes. I'm better at questions.

12:30 p.m.

Conservative

The Chair Conservative Joy Smith

Well, I think you were very good at the presentation. Thank you so much.

We'll now go into our Qs and As. We will begin with Dr. Duncan.

12:30 p.m.

Liberal

Kirsty Duncan Liberal Etobicoke North, ON

Thanks, Madam Chair.

Thanks to all of you for coming.

Tyler, congratulations on your recent awards. Thank you for having the courage to come. You make a real difference.

Why does Atlantic Canada have a higher rate of hospitalization of children due to unintentional injury?