Health Committee on Oct. 26th, 2006

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Would you have any indication from your own research?

[Lisa Oliver]

I haven't looked at any research on dietary intake yet to comment on what type of dietary advice parents in low-income families are giving their children.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

On page 11 of your presentation, you speak about a variety of different recommendations in terms of reducing barriers to participation in organized sport. What do you think the number one factor is for these children not to be able to participate in organized sport in some of those lower socio-economic brackets?

[Lisa Oliver]

In some low-income neighbourhoods, there may be no programs for children to enrol in. There hasn't been a systematic study, but especially in low-income parts of cities and in rural communities, you may have few opportunities. You may have parents working long hours, not having the time to organize groups to organize these programs, so that could be one problem. Second, with parents working long hours, it could also be transportation or not having extra money to get their children to these sports. This is another barrier aside from being able to pay for these activities.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

To Valerie or Lisa, we know that the government today--I think just a few hours ago--issued a report on its tax credit promise to encourage children...and lower obesity and overweight demographically within the children's environment. What are your thoughts in terms of the $500 tax credit? From reading it, it adds up to about $76 per family per child. Do you think that type of initiative is going to encourage children across the country and encourage families to participate in organized sport, especially among these lower socio-economic demographics, which have a very high rate of obesity and overweight children?

[Lisa Oliver]

I think it will encourage some families to enrol their children in these activities, knowing they'll get a tax credit. If we look across the socio-economic gradient and we think, who is going to benefit the most, if you're living in a neighbourhood with activities to begin with, you might be more likely to enrol your children in these activities because they're there. If there are no activities, you might not even be able to spend this money, or if you don't have the $500 up front to put your children in these activities.... It will definitely increase physical activity, but there could be some situations--if we look at the graph on page 8, if it's being used more in high-income neighbourhoods and less in the low, we could even increase our disparity; we could increase the gradient if it's being used differently among higher-income families and in higher-income neighbourhoods. We could even see a widening.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Valerie.

[Dr. Valerie Tarasuk]

I didn't hear the announcement, but you're saying $500 a year per child or per family?

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

A tax credit, per family.

[A voice]

Per child.

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Per child.

[Dr. Valerie Tarasuk]

Per child, and the question is what impact would that have on low-income families?

[Ruby Dhalla, Liberal, Brampton—Springdale, ON]

Just before you answer, the reason I touched on that question is that throughout your presentation you talked about how our social policy has not provided economic security for families, and at the end of the day, this has resulted in an increase in obesity. This committee is looking at different recommendations to address the issue of childhood obesity. We as a committee need to hear the right solution or recommendation. The Conservatives have put forward the tax credit. Is that a step in the right direction?

[Dr. Valerie Tarasuk]

In the face of abject poverty, any money is welcome, but what is sorely lacking from so many policy initiatives that happen as tax credits is any intelligent analysis of how much money is needed. When you look at the comparisons between people's incomes and their actual living costs, what we desperately need are programs that fill those gaps. The arbitrary dropping of amounts of money that are computed through some other calculation that isn't targeted toward the needs of those groups...all money is helpful for someone who doesn't have any or has very little, but the idea that we could see a measurable effect of something that's small...those things invariably end up looking like drops in the bucket. There needs to be a point when the pendulum swings and we start to see tax credits or redistribution schemes, when the dollar amounts are calculated based on some evidence of need. In that case, we'd probably figure out that somebody needed way more than $500 a month. Certainly the people we study do. Others probably don't need any money, and if they got an extra $500, the most we could expect is what Lisa suggested, maybe some exacerbation of inequities.

[The Chair, Conservative, Rob Merrifield]

Thank you very much.

Madame Gagnon.

Just a second. There are a couple of minutes left, and I thought she was done. We'll have Mr. Temelkovski.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

First and foremost, thank you to all of you for your presentations.

Dr. Grover, you mentioned that this is very important and may be distinctly different from one community group to another. You mentioned Southeast Asians. Is there data that shows the difference among groups within Canada?

[Dr. Arvi Grover]

The data I was speaking of had to do with two parameters, two variables. One was the prevalence of obesity and the second was the prevalence of hyperinsulinemia. That is the pre-diabetic state I was alluding to. Those are the two parameters that have really stood out.

Most of the data I mentioned came out of Britain. They haven't looked at this enough within the Canadian population for me to have accumulated any data on it. We--including me--have looked at it in the adult population, and we know from this that there are certain parameters we need to also follow in children. But it hasn't been prospectively studied in Canada.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Would you say, following that logic then, that we will need an educational program that would specifically target different groups?

[Dr. Arvi Grover]

I think the educational program not only needs to target different groups; it needs to target different tiers within each group. By that I mean we need to first educate ourselves on the need to become aware that this is an epidemic, a disease state.

You must understand that for the longest of times, everyone, including the medical community, looked at obesity as a cosmetic state, as a physical thing—we're out of shape; it doesn't necessarily indicate that we're going to die. We now know that, independently, it is associated with sudden cardiac death. This information is relatively recent and has only become disseminated into the medical community. It has not had the same impact in the community just yet. So we need to educate not just different communities in a different way, but within the community we need to educate the physicians. We need to educate the teachers, the urban developers, the planners so that they can plan more playgrounds and more parks.

All of this is a multi-tiered answer to what you're really asking for, but in general, yes, we need to be specific and sensitive to each community. For example, people in the Japanese community eat a lot more fish. We know that consumption of omega-3, for example—and the American Heart Association and the ACC have also documented this—is associated with fewer events. They may not be as likely to have cardiovascular deaths as, say, those individuals who don't consume such products.

So there are certain unique needs among the communities, yes.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Maybe I could ask—

[The Chair, Conservative, Rob Merrifield]

No. Thank you very much.

Madame Gagnon, you have five minutes.

[Christiane Gagnon, Bloc, Québec, QC]

Good afternoon. Thank you for being with us today.

You made interesting presentations today and spoke about several factors that can have an impact on obesity.

I would like to address my question to you, Ms. Tarasuk, because you are among those who see a correlation between socioeconomic factors and obesity. You mentioned that people need helped so they can have a higher income.

As parliamentarians, what measures could we recommend to the government? Are you in favour of more concrete measures, for example giving money to parents who could then decide where to spend it, whether on sports or on buying better quality food? How could we be more proactive in reducing the incidence of obesity?

[Dr. Valerie Tarasuk]

If I understand your question correctly, you're asking about the idea of allocating money directly to families, as opposed to programs where you're effectively pulling children out of the family and enriching their environment elsewhere.

I think it's very, very important that we target families, not individuals within families. We have a lot of programs now that are isolating a member of the household. The Canada prenatal nutrition program is a prime example of that. We also have other kinds of programs, such as CAPC, where we're identifying vulnerable groups but then enriching the life of one member of the household--the child, a pregnant woman, an infant up to the age of six months or something like that. I think those programs have very little potential to ameliorate the problems of poverty within the family as a whole and therefore with the individual who is being targeted. So I think it's very important that money go to the families.

One thing we've noticed in our research in Toronto, which is very worrisome, is that when a family is struggling to put food on the table, that's only one of a multitude of problems they're facing. Sure we find people in severe situations using food banks, and we also find the odd person whose children are attending some kind of school feeding program, but at the same time, those people are delaying payments of bills and they're having utilities or services, like telephones, turned off. There are other kinds of compromises happening within the household.

When you give money to the family to take them to a higher level of living, our analysis tells us that everything rises. We can expect to see more participation in physical activities. We can expect less stress in that household, so a more nurturing environment for those children. We can also expect to see better food on the table.

But for us on the outside to try to micromanage that circumstance by saying put the money towards foods or physical activity is very inefficient compared to what we can do if we say that we're going to provide enough income to meet their basic needs and then we'll provide supports to help with other issues in their household.

[Christiane Gagnon, Bloc, Québec, QC]

House prices have been skyrocketing and owners have been increasing rents.

Could a social housing construction program have a positive impact on people's quality of life by leaving them more money to buy food?

[Dr. Valerie Tarasuk]

I couldn't agree more. However, I should flag something for you. We have work that's now under review for publication and the work we're doing with families in Toronto. Both of those pieces of work, one looking at the survey of household spending and the other working directly with low-income families, raise serious questions about our notion of affordable housing.

There is no question that the amount people spend on housing has a direct impact on what's left for food. As income deteriorates, that has a major implication. Conventionally, in Canada, as in many western countries, we've defined affordable housing as 30% of income going to housing. For people who are living in subsidized housing, it is structured in such a way that they are paying 30% of their income for housing. If their income is very low, 30% is too much. If those families are also on welfare, that's why we find high levels of food insecurity among families living in subsidized housing.

While subsidized housing is an incredibly important way to mitigate the ravages of low income, to enable low-income families to achieve basic nutrition needs, it is important that we do the math. We need to take a look at exactly how much money is left for food and whether that is enough. In some cases, incomes have fallen to such a point that 30% of income for housing is too much to enable people to still put food on the table.