Madame la présidente and committee members, my name is Scott Haldane, and I am the president and CEO of YMCA Canada.
On behalf of the YMCA and its 53 member associations in Canada, thank you for giving us the opportunity to discuss priorities in the area of health promotion and disease prevention.
The YMCA has a history of over 160 years working on the front lines of health promotion and disease prevention with Canadians of all ages. Our membership now exceeds 2.13 million Canadians, and in 2012 our network of health, fitness, and recreation facilities across Canada will top 120 centres.
The YMCA is the largest non-profit organization in the country that offers services for children. It is a major provider of after-school programs, summer camps, youth exchanges and youth leadership programs. We offer a wide range of employability training programs for people of all ages. We also provide services to newcomers and many other social services in our communities.
As associations, we're committed to strengthening the foundations of communities; nurturing the potential of children, teens, and young adults; promoting healthy living; fostering a sense of social responsibility; and delivering lasting social and personal change.
The YMCA endeavours to find solutions to these issues nationally and internationally.
In March 2011 we hosted the launch of the federal government's healthy weights initiative, “Our Health Our Future: A National Dialogue on Healthy Weights”. This year I've had the privilege of chairing the national panel on elementary and secondary-level first nations education for students on reserve. We've just finished our engagement process, and we are in the process of writing our final report for the Minister of Aboriginal Affairs and for the national chief, Shawn Atleo.
Ida Thomas, the vice-president for children, teens, and young adults at YMCA Canada, is serving as the chair of the Chronic Disease Prevention Alliance. This year she represented them at the UN summit on non-communicable diseases with the Minister of Health.
Recently, we organized a series of workshops for the Canadian Nurses Association on the future of health care in the country. We participated in the annual general meeting of the Canadian Medical Association. We were recently quoted in The Globe and Mail supplement on health determinants.
We know from research and practice that the major determinants of health we must work together as a country to address include education, employment, healthy child development, income levels, personal health practices, the social environment, and social support networks. These health determinants interact in complex ways, a fact that policy interventions often fail to address.
In light of studies on the economic and social determinants of health, we are increasingly concerned by recent trends affecting the health of Canadians, trends whose economic and social consequences have a high cost for Canada and its citizens. Chronic diseases constitute a heavy burden. They cost the Canadian economy nearly $93 billion every year.
Childhood obesity rates have nearly quadrupled in the past three decades. One factor among others is the fact that children and teens are spending only 14 minutes in the after-school hours in active physical activity, according to recent Statistics Canada data.
The number of children with chronic disease is nearly four times the rate it was a generation ago. A flood of chronically ill young adults with weight-related illnesses, such as diabetes and heart disease, is foreseeable. Yet the World Health Organization argues that 90% of type 2 diabetes, 80% of coronary heart diseases, and one third of cancers can be avoided by healthy eating, regular exercise, and non-smoking.
Vulnerable populations--and this is where the determinants of health really come in--are at even greater risk. The Ontario Association of Food Banks pegged the poverty-induced costs related to health care at $2.9 billion in that province alone.
The educational achievement gaps for first nations youth--something I've learned about as chair of the national panel--sets up an ongoing cycle of poverty, disease, and other social issues within those communities, with impacts that multiply at the family and societal level. It has been estimated that closing the education gap could add $179 billion over 25 years to Canada's GDP.
On the economic and employment side, personal bankruptcies are on the rise, and unemployment, including youth unemployment, is increasing. We are increasingly at risk of a whole generation of young people suffering underemployment, with all the concomitant implications for long-term health outcomes.
Canadians are living longer but not better. While life expectancy has steadily increased, the number of years lived in good health peaked in 1996 and has declined every year since.
Some of these statistics might seem surprising, but when you look at it from the perspective of the social determinants of health, you see that they have a significant impact on health outcomes.
TD Economics warns that unless something drastic changes in our approach to health care, it will comprise 80% of total program spending at the provincial level by 2030.
Governments have a crucial role to play in health.
They must propose new solutions and make those that exist even more accessible and affordable. They must be leaders to ensure that health promotion and disease prevention policies take into account the main health determinants, determinants that are interconnected. They must also set targets and assess the results of their actions on health.
I want to make sure that I go to my recommendations, so I'm going to go ahead a couple of pages; it will be in the document.
Our first recommendation from the YMCA is related to the early years strategy. A substantial body of evidence already exists on the impact that early years investments have on later health determinants, particularly through improved learning outcomes and as a predictor for school attachment. For example, YMCA's associations across the country are collaborating with Dr. Paul Kershaw of the College for Interdisciplinary Studies at UBC's Human Early Learning Partnership, a part of the global knowledge hub for social determinants of early development.
As the provinces struggle in this area, there is a strong need for renewed federal leadership, so we recommend that the federal government should immediately re-engage with provincial and territorial counterparts in discussing an early years strategy for Canada in advance of the upcoming health accord renewal.
We also recommend that Health Canada should consider funding an expansion of the aboriginal head start program that currently exists in only 20% of first nations communities, something that would make a significant difference in giving kids a chance to learn when they enter school and a very important investment in first nations health.
Second in our recommendations are opportunities for accelerated support for health prevention. In our 2011 pre-budget submission to the government, the Canadian YMCA asked the government to make the children's fitness tax credit a refundable tax credit and to embark upon a multi-sector strategy to raise awareness of the credit's existence and benefits. This policy was included within the Conservative platform “Here for Canada”, as was doubling the credit's value to $1,000 for eligible activities. Also included was the creation of an adult fitness tax credit covering $500 of registration fees for adults, to be enacted once the budget is balanced around 2015, if all goes well.
But the payback on encouraging physical activities for all ages is clear. We know that extending the program to adults offers both personal health impacts for individuals and financial health impacts for Canada in health costs reduction. So the recommendation is that the federal government should accelerate the introduction of the announced federal adult tax credit to realize early gains from improved health outcomes.
The third area of recommendation is actions to improve health outcomes for vulnerable populations, which again is very strongly supported by the determinants of health. We know that certain groups of Canadian children are at even greater risk than others when it comes to the whole range of health determinants, among them children from low-income households, newcomer populations, and first nations and other aboriginal communities, as we've seen so visibly in the last little while in the press.
I guess I should jump to recommendations.