At the risk of taking a little too much time, I'm going to describe a study we were involved in, which concluded in 2000—and I can provide it to the committee.
We looked at what forms of intervention would work to get sole-support mothers on social assistance to go off social assistance, and what would be the economic benefit of doing that. What we discovered was that the most frequently chosen option—because this was an option that mothers could select—was to have their children placed in a subsidized recreation program.
What we discovered was that within one year, twice as many moms got off social assistance. On every measure of the mom's use of the health care system, her use of the health care system went down, so fewer emergency department visits and less use of social workers.
So basically by getting her kids into recreation programs, the child's behaviour improved significantly in a measurable way, mom's use of the health care system went down dramatically, and twice as many moms got off social assistance within one year. So even an indirect investment in prevention and promotion of health actually saved us millions and millions of dollars as a society—and that's just in the direct cost of getting the mom off social assistance, let alone the indirect costs from less use of the system.
I know the government has been thinking about things like social impact bonds as a way of funding these kinds of interventions. I think there's a lot of evidence that a return on investment, as Kelly said, in prevention, very specific prevention, not just.... Health promotion is important, but I think it has to be specific interventions in addition to health promotion, and those specific interventions can actually have results in the very short term. Some people say prevention will take us forever. In fact, we have evidence that we can make it pay off within one year.
The reason we haven't done it is that the investment is made by one level of government, and the benefits accrue to other levels of government. So we just can't get our act together in Canada to make those kinds of choices.