Health Committee on Dec. 2nd, 2010

[Jennifer Heatley]

It's difficult to pinpoint exactly why. The most frequent cause of hospitalization of children is falls. We are currently working in the region to develop a falls prevention strategy for children. It is difficult to know why one particular area in the country has a higher rate than another, but there are good cases for various socio-economic factors related to income and education levels. Those are very important factors when it comes to putting individuals at risk for injury.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

You said we know how to do this. I look at your top five reasons for injury. Can you table with the committee the recommendations you would make to reduce each of these? Is that possible?

Yes? Okay.

[The Chair, Conservative, Joy Smith]

Mr. Groff is on the line as well.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

What were the recommendations of the Atlantic report, and what have you done to roll them out across the country?

[Jennifer Heatley]

Do you mean the child and youth Atlantic report?

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Yes.

[Jennifer Heatley]

There were a variety of recommendations based on the various injury issues. We haven't worked to roll them out across the country. It's been more specifically in the Atlantic region. We look a lot to policy and environment changes. Since the report was completed, a significant number of policy changes have happened. Examples include ATV legislation, booster seat legislation, and pieces like that. We will look to evaluate their effects.

For the most part we work closely with Child Safety Link, which is a Maritimes-wide injury prevention program, to address these issues. They have used this report to identify where they need to be focusing their work. Falls came out as being responsible for the majority of hospitalizations. We have partners in all four provinces that we work closely with to determine priorities for injury prevention action.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

Dr. Macpherson, if you could give this committee your wish list, what are the top five things you would like to see implemented immediately to help reduce injury?

[Dr. Alison Macpherson]

The first thing would be a national strategy to get people on board and working together. I would definitely increase research funding. I am the co-principal investigator of one of the CIHR teams on child and youth injury prevention. Our approach to research is very integrated. We work with non-profit organizations--the four national NGOs--to move forward.

On the actual concrete things that I think you're looking at, I would lobby very hard for bicycle helmet laws that cover all ages across the country--so mandatory bicycle helmet legislation. I would insist that playgrounds meet the CSA standards, because falls are really important. One of the places children fall is on playgrounds. If they fall onto a surface that absorbs the shock they're much less likely to get injured.

I would have four-sided pool fencing for all residential pools so that children, especially toddlers, can't toddle out and drown in them. I would make a concerted effort to protect vulnerable road users, like bicyclists and pedestrians, by having designated lanes that can't be impinged upon by cars; and speed limits in residential neighbourhoods, particularly in school zones, that are enforced and that slow traffic down, so that what happened to Tyler doesn't happen.

Is that enough of a wish list? I could go on.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Go on. Put the wish list out there. Please feel free to join the conversation.

[Dr. Alison Macpherson]

Okay.

I would partner very actively with the Assembly of First Nations and Inuit Tapiriit Kanatami to address injuries in those very vulnerable populations and help them to have a strategy for injury prevention that works in first nations and Inuit communities. It's a huge problem there. They do have people working on it, but they could definitely use some support.

If you talked about falls and things like that, it would be the playgrounds and helping people make their homes safer.

One of the bottom lines I would address is poverty and inequity. I mean, that's a fundamental root cause. It's hard for parents to keep their kids safe and to help them get to school safely if they have to work two jobs. It's hard for parents to buy safety equipment, to buy a bicycle helmet if someone gives them a bicycle, if they don't have adequate income to do that.

I would definitely look upstream at the social determinants of health and I would work actively with policy-makers, such as the federal government and the provincial governments, to keep kids safe--in their cars, on the streets, everywhere they go.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

I can't read your name, I'm sorry.

[Rebecca Nesdale-Tucker]

My name is Rebecca Nesdale-Tucker and I'm with ThinkFirst Canada.

I would very much echo what my colleagues have said at the table.

Number one is that we'd like to see strategic action. It has worked on the international scene in other countries. It simply makes sense to figure out what the priorities are and focus our attention there collaboratively.

As Alison said, whatever we're approaching we want to have a three-Es perspective, so consider the education, the enforcement, and the engineering. Absolutely, we want helmets whenever your head is vulnerable. Whether it's sports and recreation, if you're on wheeled activity, have a helmet on. Have enforcement of appropriate rules across injury cause, and make sure the engineering is appropriate as well. That goes to product safety and to regulation.

Almost every type of child injury requires this kind of multi-faceted approach. We have the solutions; we simply need to implement them.

Similarly with road safety crashes, we want kids in the appropriate child restraints, in the car seat, in the booster seat. We want to lower speeds. That helps pedestrians, helps all different types of vulnerable road users. Then again, the education piece: educate adults, but I also think we first favour educating kids from a young age so they're self--

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Nesdale-Tucker.

I know we always get some very interesting answers, because we regularly get Dr. Duncan's ask for a wish list from our delegations. It's really interesting, because there's a thread that goes through all of these.

Mr. Malo.

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

Thank you, Madam Chair.

[The Chair, Conservative, Joy Smith]

Yes, it's your turn.

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

I would also like to thank the witnesses who are here today.

First of all, allow me to quote certain passages from the document entitled: The Economic Burden of Injury in Canada presented to us by the SMARTRISK group. This document describes the situation in each of the provinces. Madam Chair, may I be allowed to read what is being said about Quebec. This is at page 103 of the French translation, and at page 99 of the English version. The document states:

In Quebec, the network of public health organizations has been consistently active within the area of injury prevention for the last 20 years. The injury prevention initiatives in the province are an expression of the Loi sur la santé publique (The Public Health Act) and the Programme national de santé publique 2003-12 (The Provincial Public Health Program 2003-12). The latter document identifies the priorities to be addressed by the public health and social services networks throughout the province.

I will skip a few lines and go to the second paragraph that I will quote in its entirety:

The initiatives that have been implemented so far have yielded successful results in decreasing the number of injuries and deaths on the road, at home, and in sports and recreation. Successful initiatives have been those that have targeted individual behaviour, produced safer environments, or enforced safety regulations. As it was mentioned above, success has been dependent on collaborative efforts among a wide range of related stakeholders.

And finally, I will read the last paragraph in its entirety:

To a group of leading organizations in the field of injury prevention in the province, the WHO has offered the designation of “Centre collaborateur OMS du Québec pour la promotion de la sécurité et la prévention des traumatismes (Quebec WHO collaborating Centre for Safety Promotion and Injury Prevention)”. The Centre operates under the supervision of l’Institut national de santé publique du Québec, and works closely with the World Health Organization and the Pan-American Health Organization. The Centre addresses the safety and injury prevention needs of the international community as well as those of the international network of French-speaking safety and injury prevention organizations.

Madam Chair, I have finished reading the portion of the report pertaining to Quebec.

[The Chair, Conservative, Joy Smith]

Before you ask your question, I'll just remind you that we do have Dr. Groff here, who actually is part of SMARTRISK.

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

Mr. Luc Malo: Thank you very much, Madam Chair.

In fact, my question goes to Mr. Groff. But beforehand, please allow me to conclude that in view of all of the above, it seems clear that a pan-Canadian strategy is not the best solution for Quebec. In fact, as I mentioned at the very beginning of my presentation, a good number of mechanisms have been put in place over the past 20 years. This is not to say that we should remain static. Because of its effect on an individual, as Tyler so aptly described it in his statement before us, one injury remains one too many.

However, my question to Mr. Groff is linked to what Ms. Macpherson has said concerning aboriginal peoples as well as to certain other statements that were made earlier this week. It was during our first meeting on the subject and it was on the fact that this type of injury occurs more frequently in aboriginal communities than in non-aboriginal populations.

Mr. Groff, has this data collection exercise also been done for aboriginal populations?

Madam Macpherson, what kind of collaborative measures with aboriginal communities do you foresee in order to come up with an efficient strategy?

[The Chair, Conservative, Joy Smith]

Who would like to respond?

[Dr. Alison Macpherson]

I will also answer.

[The Chair, Conservative, Joy Smith]

Dr. Macpherson, go ahead.

[Dr. Alison Macpherson]

I will answer in English, if that is convenient.

If we're speaking specifically about the first nations and Inuit population, there have been some strides made. On the question of the statistics for them, the health statistics are not as comprehensive as they are generally for the mainstream population, but the Assembly of First Nations launched the aboriginal longitudinal regional health survey, the second round of which has just been finished, and as researchers we are working actively with them to get some accurate statistics on all types of injury in first nations communities.

Similarly, Inuit Tapiriit Kanatami is working to try to get a really good handle on injuries in Inuit communities, which are mostly in the far north, as you know.

So there is definitely a lack of information, but the key lobby organizations are keenly interested in getting more information, to find out what the statistics are, and to move forward with appropriate steps.

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

The communities—

[The Chair, Conservative, Joy Smith]

Monsieur Malo, did you want Dr. Groff to make some comments?