Veterans Affairs Committee on Jan. 31st, 2008

[The Chair, Conservative, Rob Anders]

Thank you.

Now on to Mr. Stoffer with the New Democratic Party, for five minutes.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you very much, Mr. Chairman, and thank you all very much for your presentation.

Sir, on page 5 of your presentation you put “The good news is...”, and I looked at the fourth paragraph and it says “Seniors are active in their communities and they're working longer”. Now, some seniors like to work longer; some seniors have no choice but to work in their senior years because their pensions don't necessarily qualify for them to maintain a decent life to be with their grandkids or their neighbours. I don't know if that's such good news. So I would caution you on that one, because some seniors I see working at McDonald's or Tim Hortons are there because they have no other choice to put bread on their tables. So I don't necessarily call that good news in that regard, but I thank you for that.

I see in this pamphlet you have that CLSA will be doing a questionnaire with 50,000 men and women aged 45 to 85 in the near future. I see some of these reports that come out and they can be somewhat wordy, somewhat difficult to answer. If you're a person who's elderly, who doesn't have a decent formal education through school--and many veterans left school in order to fight and they never got back--will these forms put it in a manner that is not dumbed down but is clearly understandable for them so they know exactly what they're ticking off when they fill out those forms?

[Dr. Linda Mealing]

I understand those surveys have been piloted.

During the development of the protocol for the study over the last two years they were validating certain tools, making sure the questions were understandable, especially when it came to consent and proxy consent and things like that.

So definitely, the target audience is taken into consideration in developing these questions. I think they've also been working with the CCHS, which has had experience with that at Stats Canada, to make sure the questions are understandable.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

The other concern is regarding first nations and working with that specific group. Are they targeted in the overall picture? Are they specifically looked at? A lot of them live on reserves. A lot of them may have suffered from residential school abuse, or other concerns of that nature. You mentioned diabetes in the native community. Diabetes is running rampant now. Have you incorporated them into the entire picture?

Also, we have many immigrants coming into the country now. Are there differences within populations, say those who are Caucasian, Asian, African, in terms of their diet and culture and mental well-being? What is the information showing in terms of Alzheimer's, their falling, dementia, etc.? Have you broken it down specifically, or have you had the resources to do that?

Thank you.

[Claude Rocan]

In terms of first nations, we involve the first nations and Inuit health part of Health Canada. They're very involved in these issues. You mentioned diabetes. There's an aboriginal diabetes strategy that focuses on the needs of that population. It's their role to focus specifically on that population, whereas the work we do is more geared toward the population of Canada as a whole.

With regard to immigrants, I'm going to ask John to speak to that.

[John Cox]

I would say there are two issues in play. One is actually identifying the sub-populations you're talking about. Immigrants are no less diverse than the population of seniors as a whole. We could be talking about recent immigrants or immigrants who have been established for some time but may not have adapted fully to either the English or French-language cultures in which they live. So there are specific challenges.

In my experience, the whole issue of seniors from external backgrounds is becoming much more of a factor in discussions. They are more of a factor in terms of service providers looking at how they deliver services in a way that a community such as the South Asian community of Vancouver might take advantage of what is known. At the same time, they want to learn from those communities what their first choices are and where they would go for help. Those may be different access points than we would normally see in a traditional non-immigrant community, if I can put it that way.

I think there's distinct attention being paid to them. We've worked through a variety of projects, for example, in looking at groups of older Canadians from a variety of different cultural and ethnic backgrounds to see what they can share with each other and what needs to be adopted. That carries over with a lot of our current work with international partners on a variety of issue areas, to see what we can pick up as well as what we can share.

I would say that the topic and the concern are well recognized, but the challenge remains and we have to keep at it.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you.

[Nancy Milroy-Swainson]

I would like to add one thing. In addition to work we do within the portfolio with integrating concerns for first nations or multicultural requirements, we are also mindful of the need to include a first nations perspective.

For example, the Mental Health Commission of Canada is not formally a part of government, but there is a need to integrate mental health and first nations issues. It's similar to the cancer corporation. Both of those organizations are dealing with concerns of critical importance to seniors, and government is interested in making sure there's an aboriginal lens brought to bear on that work as well.

[The Chair, Conservative, Rob Anders]

Thank you.

Now we go over to the Conservative Party. Mrs. Hinton, for seven minutes.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you very much.

I'm going to begin with some observations, if you don't mind. When you sit and listen to a number of other members speak, things start up in your mind and you might want to mention some of them.

I was very pleased, by the way, to hear you say that the departments within government are actually speaking to each other. I think that's a bonus right there, that intergovernmental conversations are taking place. I think it's wonderful.

I'm also very pleased, and I'm sure you must be very well aware of this, that for the first time in Canadian history this government has put a minister in place strictly for seniors. That's the Honourable Marjory LeBreton. I'm sure she would be delighted with all of the comments that have come out here. This is wonderful information.

I share the concern that my colleague Mr. Perron expressed earlier with regard to the number of doctors. We've had this conversation come up a few times, both personally and at committee. Speaking from personal experience I can tell you without hesitation that it takes a minimum of ten years to produce a doctor. I speak from experience, because I happen to be the parent of a doctor. If they specialize, it will take even longer.

So we have a little catch-up to happen here before we actually have enough physicians for our own country. But it is a worldwide problem. I was pleased to hear you say that as well. I didn't want to think that was my own opinion, that we have this problem worldwide.

In terms of aging, I have to tell you, you shocked me with the content of what you said. I'll go back to page 6, where it says that a large majority of seniors--85% of those aged 65 to 79--have at least one chronic disease or condition such as asthma, arthritis, rheumatism, high blood pressure, emphysema, chronic obstructive pulmonary disease, diabetes, heart disease, cancer, schizophrenia, mood or anxiety disorder, and obesity.

On page 9 you said that health promotion efforts are important to disease prevention and that up to 70% of cancers, 90% of type 2 diabetes cases, and 50% to 70% of strokes are preventable.

First you scared me on page 6, and then you gave me hope on page 9.

I'm going to give you an opportunity to elaborate. There could very well be many seniors listening to this broadcast. So could you tell us, in short form, what you think can actually happen to prevent these diseases? If you can prevent 70% of the cancers, 90% of type 2 diabetes, and 50% to 70% of the strokes, I think that's worth talking about.

[Claude Rocan]

Thanks for the opportunity.

There are some common risk factors that apply to a full range of chronic diseases, most of which have been mentioned here. They relate to physical activity, healthy eating, and smoking cessation, and of course healthy weight, which is related very often to physical activity and healthy eating.

Those are huge issues, and we certainly work very hard on those issues generally, as well as having a lens specifically in terms of the senior population. We do have a physical activity guide for older adults. In fact, we have four guides--for children, adolescents, adults, and older adults. There is very useful evidence-based information in those guides to help people make decisions about becoming physically active.

With regard to healthy eating, of course there's Canada's Food Guide, which has just been released in revised form. I think it was last year. Again, there is some specific information there for seniors, including advice in terms of taking vitamin D, which is very important to the senior population. There is also an aboriginal food guide that has been developed for aboriginal people. Of course, in terms of smoking cessation, there is very robust programming within the health portfolio to give people advice on how to stop smoking.

Those areas in and of themselves can make a huge difference in people's health status. We do work quite diligently in the area of health promotion to try to get those messages across and to work on the environmental factors that will make it easier for people to make the healthier choices as they relate to their own health.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you very much.

We heard from the last witnesses on Tuesday about falls by seniors, which you touched on again today. One of the conclusions I drew from the last witnesses was that it was really important to have the physicians we have in this country treating patients on a daily basis, and to make them aware of some of the options they have.

You were talking about education once again, or that's my take on what you just said. I was hoping there was some magic bullet you were going to tell me about, but you were talking about educating people to eat better and about the benefits of exercise. That's basically where you're going—which would also prevent a lot of falls.

[Claude Rocan]

Yes, but I think it goes beyond that as well.

I think it's education. I think it's knowledge about best practices: what sorts of interventions have been tried that have proven to be successful; learning from the experiences of other countries and jurisdictions; looking for partnerships to try to transmit that information at the community level; looking for ways of playing a catalyzing role, so that specific interventions can be conducted at the community level.

So I think there are a range of interventions, as well the more environmental types of activities I mentioned, for affecting how people live so they can make healthier choices more easily.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

I have another observation.

Having served as a school trustee for three terms in another life, I think we need to start a lot earlier with seniors on this exercise and healthy eating issue, because if we did that when children were in school and put the emphasis there then, we probably wouldn't be dealing with these problems later in life. One of the observations I made as a school trustee is that we encourage physical education in our school system—we build multi-million-dollar gymnasiums, and then we bus the children to school. It defeats the whole purpose. If children are in the position to be able to walk to school, there's free exercise right there. I guess it's just a matter of our thinking.

If I have any time left over, I will pass it to my colleague, Mr. Shipley.

[The Chair, Conservative, Rob Anders]

You're 33 seconds over your time, actually.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

Oh, never mind.

Sorry, Bev.

[The Chair, Conservative, Rob Anders]

Mr. Shipley will have ample opportunity.

Are there any responses by the witnesses?

[Claude Rocan]

I just want to mention briefly that I agree with your point entirely. In fact, we are engaged in what we call a joint consortium on school health, dealing with the whole range of health behaviours in schools, including the issue of physical activity.

Of course, from a federal government perspective, we don't have responsibility for what goes on in the schools, but we certainly participate in that forum, and use it as an opportunity to provide some information and some of the research results we have, and just try to play a helpful role in trying to encourage that sort of thinking, so we can make some connections.

I'll just mention briefly one example that I find very exciting, called the walking school bus idea, where seniors help children walk to school. The children are provided with an escort to the school, which deals with the safety and security issue, and it also deals with the physical activity needs of both the senior citizens and the children. So it has benefits from a number of different perspectives.

There are ideas like that, which some communities have tried, and we think it's very important to evaluate the impact of those interventions and, once we have a better handle on how they work, to share that knowledge and information with others who might be interested in trying something like that in their communities.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

A wonderful common-sense idea--really great.

[The Chair, Conservative, Rob Anders]

Yes, it sounds really good.

I had a comment I wanted to make, but I won't, because it would be inappropriate.

[Some hon. members]

Oh, oh!

[The Chair, Conservative, Rob Anders]

It was about a side conversation I had with Mr. St-Denis, but I'll just leave it at that.

Now over to the Liberal Party, and Mr. Valley, for five minutes.

[Roger Valley, Liberal, Kenora, ON]

Ah, you're making up.

Thank you very much for coming. I apologize profusely. You've made the effort to get here, and I was a little late. I apologize. Generally, it's constituents who keep us that way, but I wanted to apologize.

I always learn from these presentations and I'm always writing notes and trying to figure out what words to use. Healthy aging and active aging are all important things for understanding how we're going to help everyone enjoy later life.

You go on, Claude, to say: “This approach encourages us to focus our efforts 'upstream'.”

On Tuesday we had a presenter here talking about falls and how important falls are. Later in your document you mention that. And we hear from veterans all the time—and I mentioned this to you today—that part of their problem is they're very hard of hearing: for one reason, because they're elderly; the second reason, we believe, is that simply every veteran we see has pretty well the same issue as a result of their service. They believe a lot of it is involved in their service.

I'll make a comment, and maybe some of you could give your opinion. If we're talking about going “upstream” or about keeping people healthy and active, and if we don't want them to fall, we should be much more prepared to listen to veterans when they need hearing assistance. That alone keeps them from falling, I believe; all of this has been more or less documented.

Is that what you mean by “upstream”: doing something to prevent anything that can happen in the future?

[Claude Rocan]

Yes, and it's trying to work, as I mentioned, on the environmental conditions that people live in so that they can avoid crises later on. The preventive agenda is core to the work we do in the public health area. So it's exactly along those lines.

[Roger Valley, Liberal, Kenora, ON]

It seems we spend an awful lot of effort. When we have senior citizens who are veterans sitting in front of us who we know need hearing assistance, they can't get it for a couple of reasons. One reason is that the department doesn't always put enough value into their statements that it was involved with their service; another, that they simply can't afford it. So they end up facing issues such as a fall, which only makes it worse.

You also mention a couple of things about involvement and working guidelines for cities and small communities. You mention quite a few provinces, some that are active and some that are becoming more active. In the world....

The reason I ask this question is that I see later on in the document you talk about presenting to the UN. I think it's probably next month, is it, in February?