Health Committee on Feb. 14th, 2007

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Thank you, Chairman.

I'd like to just clarify some points for the witnesses that just spoke. The issue of the Canadian cancer strategy was brought up. I'm pleased to report that it's $260 million over five years, in addition to the $300 million for chronic disease. Certainly, in regard to the investment the federal government is making in the area of child health, there was a suggestion that it's going down, but actually it's going up. If you take the child tax credit for active living, including dance and other cardiovascular activities, that's in the hundreds of millions of dollars, and if you include the universal child care benefit, we're talking billions of dollars.

Over and above that, of course, we have the 6% escalator in the transfers to the provinces year over year, which is $1.1 billion this year, $1.2 billion next year, and so on. That is just for your information.

I was very interested in the presentations. Unfortunately, I find these meetings are too short, because we don't have enough time to get into this in depth. A lot of the areas you've spoken about would fall within provincial responsibility. And as I was listening to the presentations, I was really interested in hearing what the witnesses had to say about the role of parents in the schools. I think it was only Madam McKay who came close, when you mentioned families in your presentation, but the role of a parent or guardian I think would be very important.

The other startling statistic that I heard, I think, was the 57% increase in female obesity. That is startling for all sorts of reasons, not the least of which is the stereotype this committee has been presented with, of the young male playing video games in front of the TV, and that is one of the reasons why obesity rates have increased. Obviously that stereotype, like all other stereotypes, is just a stereotype. I wonder if you could explain why females are becoming less active.

There were three questions there.

[Dr. Heather McKay]

I'd like to first of all address the comment earlier, and I just want to be really clear that this is in no way suggesting a national program, because we're not talking about programs. We're talking about capitalizing on existing initiatives and coming together, as Kelly pointed out, to share what we already know. So it's not duplicating effort.

I don't think anyone here is in any way suggesting that one model will fit this whole country, because it will not.

Parental responsibility.... I think there have to also be initiatives directed towards parents. They're living in the same toxic environment, so parents aren't really given half a chance. Children spend much of their awake time away from their parents within the school environment. So it's again not just the responsibility of parents or the responsibility of schools or the responsibility of community, but a collective responsibility that has to be acknowledged. And parents have very little to say. I think you'll be surprised that they know very little about what their children are eating at school so they don't eat the lunches that are sent with them. They often don't eat meals together. It is in some ways out of their hands.

So I believe there is a role for schools, and I'll address those two and let someone else take the others, if they so wish.

[The Chair, Conservative, Rob Merrifield]

Thank you.

Ms. Lamarche, go ahead.

[Marie-France Lamarche, Director, Chronic Disease Prevention, Community Programs Directorate, First Nations and Inuit Health Branch, Department of Health]

I'm going to speak to Ms. Gagnon more particularly.

In the case of the First Nations reserves, we're talking about a federal responsibility. So I think a multisectoral approach is necessary with regard to the measures that must be taken in the schools to fight obesity. We're not just talking about education or health; we're also talking about Transport Canada, among other things.

On the reserves, police officers become the best coaches in training teams of all kinds. There's really a range of workers on the spot. We're talking about obesity, and that's curiously very much related to food insecurity. Many economic factors come into play. Here I'm talking specifically about Aboriginal people. It's important to have a place where people can talk, do research, evaluate and monitor. The figures that Statistics Canada provides us are invaluable in developing our programs.

When we talk about an integrated strategy, in my view, that means the provinces, the federal government, universities and non-governmental organizations, rather than federal and provincial jurisdictions.

[The Chair, Conservative, Rob Merrifield]

I appreciate that.

I'll add a little time for Mr. Fletcher if anyone would like to address his questions.

[Farida Gabbani]

I'd like to address the question around families.

I know in Nova Scotia for sure we have looked at who we should be targeting as far as social marketing is concerned. We had research done and we came to the conclusion that we should be targeting the parents of children from zero to twelve because the parents make the decisions as to what they participate in and what they eat and how they eat, the kinds of lives they lead. We have a website up called momsanddads.ca, and it's specifically for parents to go to to ask questions, to pose questions, to get information on the areas of physical activity, healthy eating, and obesity.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Can someone answer the question about the female activity level?

[Dr. Heather McKay]

I think we've known for a really long time that all children become less active as they get older. We also saw a plummet in positive psychosocial health indicators as children approach adolescence. So there's no difference, really, and we have known that for a long time. Those figures are just being exaggerated now in terms of physical inactivity.

I don't think that girls are any less active. The problem is no less of a problem in girls than it is in boys, in our data anyway, in terms of why children are generally becoming less active.

[Steven Fletcher, Conservative, Charleswood—St. James—Assiniboia, MB]

Well, I heard something like 57%--

[Dr. Heather McKay]

Yes, that came from Andrea.

[The Chair, Conservative, Rob Merrifield]

Just quickly on that and then we'll move on.

[Andrea Grantham]

The trends show within school environments that when physical education becomes optional, fewer girls choose to continue to be engaged in physical education, and that's part of the trend of the drop-off rates.

We have developed resources around gender equity in trying to increase more positive environments to encourage more participation. Unfortunately, that's just the....

[The Chair, Conservative, Rob Merrifield]

Okay, thank you.

Ms. Priddy, you're next. I'd like to give you five minutes on the floor. You presented this to the committee, so if you want to give a quick explanation as to where that came from....

[Penny Priddy, NDP, Surrey North, BC]

No.

[The Chair, Conservative, Rob Merrifield]

You wouldn't like to?

[Penny Priddy, NDP, Surrey North, BC]

I don't want to use my question time to do that.

[The Chair, Conservative, Rob Merrifield]

I'll give you a little extra time if you want to explain very quickly what this is, so the committee is aware of what you're trying to do.

[Penny Priddy, NDP, Surrey North, BC]

All right, if somebody would give me a copy, I'd be thrilled to, because I haven't seen it.

[The Chair, Conservative, Rob Merrifield]

So carry on, and at the end of your five minutes I'll....

[Penny Priddy, NDP, Surrey North, BC]

I have a comment and a couple of questions I'd like to ask.

We looked at a motion we passed on establishing a national database for all the different ways health facilities are reducing wait times within the public system. There are all kinds of different ways, but it was to be a national database that people can look at.

In a way, this sounds to me, perhaps in a more coordinated way, not to be so much a plan, but a place I can go if I teach in Hall's Prairie Elementary School and want to find out what I can do in my school. I can call up one of the 17 assistant superintendents Surrey school district has, but I want to go on the website. I want to know what's happening across the country in schools to make kids healthier and more active--so a database of information. That seems to be an ideal way for the federal government to take leadership, because it's a perfect place to gather that and then to make sure it goes back out to people.

I would hope it would be a database that would meet the same criteria Dr. Bennett asked about that you could put on the same thing that as a mum.... I wrote down my grandson's school's name because it reminds me that I'm going to go now and find out. So I want to go somewhere where it says to me as a grandmother or to my daughter as his mum, who obviously would be more responsible to do that--I try not to take over--what his school should look like to be healthy, right? It may even be around the physical environment as well, but what's the healthy school? It's a place where I can go as a mum or a dad or a caregiver to look at what that is.

A lot of initiatives that happen in schools in this country have been started by parents or it's the parent who's going to lobby for money to help continue to do these things. I couldn't do that as a mum unless I had evidence and information to do it with, other than just thinking and believing, which doesn't work. So it's a place where both professionals--whatever that means--and parents could go. I don't even think it necessarily has to be a separate.... Maybe it's a link site or something that gathers information.

I wanted to ask a question. I read somewhere in one of the handouts--and Heather referred to this as well--that what you've recognized is that it goes beyond the school. So I'm wondering if you could speak to, other than philosophically, where does this go? What does that mean, goes beyond the school--to where, other than esoterically?

[Dr. Heather McKay]

Sure. What I'm referring to there is what in the parlance is called the socio-ecological model. It means there has to be horizontal and vertical integration. Vertical integration means it's bottom up and top down. It's the ministry...it's our larger environment, it's the built community, and you heard about that.

It's about that doorstep decision-making so when children are stepping out the door to get to school, the easiest choice is the walking school bus, for example. Communities have to be safe to allow them to do that. So that's the larger environment, and you can change the built environment in a number of ways. It includes the family and home environment. It includes the recreation and parks association. It includes the schools and down it goes.

So it is about messaging that is consistent and opportunities that are consistent across this vertical integration and then horizontally as well.

[Penny Priddy, NDP, Surrey North, BC]

Because for three months of the year, kids aren't in school. Actually, I think they should be, but that's a whole different story. That's why I'm concerned about the community component of that piece. So I thank you for the answer to that.

[Andrea Grantham]

If I could, I'll answer the question on information on what's happening across the country.

The CAHPERD website has an actual map of Canada on which you can click on any province to find out what is happening in terms of physical education and physical activity within that province. They also have an interactive report card that parents can use to actually grade what is happening within a school's physical education program.

A program we are looking to do now, actually, which we included in our funding support for physical activity, was an online interactive assessment of both physical education and comprehensive school health environments. You can actually go through the assessment and it will direct the user to programs that are taking place and the resources that are available to support improvements within those areas.

[Penny Priddy, NDP, Surrey North, BC]

Thank you very much.

Did you want me to do this now or later?

[The Chair, Conservative, Rob Merrifield]

I don't think there's anything more to add, other than that it comes from you and you're sending it around.