Thank you. Good afternoon.
Bonjour à tous et à toutes.
Thank you for the invitation to present today.
In the interest of time here, I will start by saying that we agree very much with our previous colleagues on the urgent need to address the social determinants of health. I'll just preface this by saying that there really are two areas we want to discuss. We want to discuss, first of all, the role of the public health system and public health professionals in creating those opportunities for health. Secondly, we want to talk about the fact that any disease prevention or health promotion initiatives have to be grounded in that comprehensive approach to the social determinants of health.
I have a very quick thing to note. In the spirit of the season, I have brought you a gift. You'll see that we have a poster commemorating the 12 great achievements of public health. The reason we did so is that it's almost a colourful mini-primer on what disease prevention and health promotion are, and what we are talking about when we say that.
What is really critical for us right now is that we're at a pivotal time. We know there is going to be a new health transfer agreement. There was mention of health promotion and disease prevention in the last transfer agreement, but it was minimal. We have an opportunity now to make sure it is prominently profiled in any new agreement. We're urging you in your roles to help make that happen with your colleagues at the provincial and territorial levels.
Quite frankly, as a society we have tended to focus more on personal responsibility, and that is okay. You know, there are thoughts of “I need to exercise; I need to eat properly.” But if I don't have clean drinking water, nor the level of income that I need, nor a good education, then we know that ultimately my health is going to be affected. So in terms of personal responsibility, it is a limited strategy unless we address those upstream factors.
Health Promotion 101 says an apple a day keeps the doctor away. In neighbourhoods like Toronto's Flemingdon Park, which has been recognized as a food “desert”, you can't get that apple; there isn't a way to access it. You're probably working two or three jobs and you probably can't afford to put your child in day care. That's where health is created and lost.
So what can we do? Public health professionals have a unique role to play here. They're actually the people on the ground level who are helping with that intersectoral collaboration we just heard about. They actually engage communities. They engage the municipality, and they support the development of public health policy.
I will say, it mystifies me at times. Why are we spending 5% on disease prevention and health promotion and 95% on acute care, and then we're mystified by that? We should know we need to invest more, and we need to actually take those words and bring them to life with strategic investments. We have a lot of recommendations, but I'm just going to condense them into a few that you will hopefully remember.
Let's shift the conversation from health care to health equity. You've just heard my colleagues say that much more eloquently than I can, but that's where we need to focus. We need to better coordinate between the Canada health transfer and the Canada social transfer to approach those determinants of health that aren't within the health sector.
Lastly, I make a plea that we have to finally increase the investments in public health. Every time there is some sort of a public health crisis, I'm called here. And that's okay; I'm grateful for the opportunity. But we talk about H1N1; we talk about SARS; we talk about listeriosis. The media calls me a lot, for about a week—and then it just ends, I must say. Then I'm no one's favourite cousin any more. We go back to the status quo and the current funding levels; in fact, we look at potential reductions.
So we really must have a meaningful, sustained investment in public health, both in infrastructure and human resources. I truly believe the federal government has a unique role to play in that, and that all of the answers are already here.
Whenever we pull together our briefs, I always say it seems that we don't have a clear ask, because we're asking for everything. I realize that. That is the limitation of saying we need a shift in conversation, in dialogue, in the system overall. But this isn't a quick fix. I know all of you come from different parties, and that's a good part of our democratic system, but I truly believe this will require long-standing political will from all of the political parties, working together over many different electoral periods, if we're going to make any kind of difference and if you're going to have a legacy.
So if you asked me where we need to start, don't look too far. You have already heard from CACHCA. They stole my speech, thank you—