Health Committee on Oct. 5th, 2011

[Kim Elmslie]

Physical activity--keeping seniors active through engaging them in group walks so that they've got social interaction while they're being physically active at the same time. That's a major part of a number of programs. The work we do through ParticipAction is also helping to advance that.

Cathy, do you have any others?

[Cathy Bennett]

Yes. Age-friendly communities are an excellent example of looking within a community as a built environment to what can be done to create conditions for seniors to be more physically active, and to what the barriers are. We're learning things such as lighting, width of sidewalks, curbs, those kinds of things that actually do not facilitate seniors being more physically active within their community, but actually serve as barriers. That's the kind of thing we're working at, a community approach to identifying and reducing barriers to things like physical activity.

[Patrick Brown, Conservative, Barrie, ON]

Is there a timeline or a goal you have in terms of sharing best practices or innovative approaches? Through what mechanism would you do that sharing of information?

[Kim Elmslie]

The mechanism that we use to share best practices is the Canadian best practices portal, which is a web-based portal that is on the Public Health Agency of Canada website. It gathers the best practices that have been evaluated and identified in various topic areas such as injury prevention or diabetes prevention or whatever.

We don't think that goes far enough, so we're working on how we can expand the scale and scope of it and how we can take lessons learned and shine a spotlight on them that really matters to communities picking these up and running with them. At the moment, our main federal mechanism for profiling those is that web portal.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Elmslie.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

I was wondering if you could elaborate about the database that is put together by the Centre for Chronic Disease Prevention and Control. Does it track disease across the country, and are you able to determine whether certain areas have higher incidences of certain chronic diseases than do others?

Could you let us know? We talked about best practices, and I was just wondering what we could learn from keeping statistics like that.

[Kim Elmslie]

Sure. Our surveillance system on chronic disease does track chronic disease rates and risk factors across the country. So we're able to identify areas where there seem to be higher rates of certain diseases or risk factors, and therefore help our provincial and territorial colleagues by providing that data so they can target their efforts and so we can also target our efforts collectively toward improving prevention in those locations.

We're expanding the work of our chronic disease surveillance system to get a much better sense of issues around hypertension and cardiovascular disease. Our data systems on cardiovascular disease have not been as robust as we would like them to be. Hypertension is an important public health issue in Canada, and of course with an aging population we will see more hypertensive Canadians. The good news--and we learn this through our surveillance programs--is we're among the best in the world at controlling hypertension. So those Canadians diagnosed as having hypertension are getting the drugs they need. Their hypertension is being controlled. But rates of newly diagnosed hypertension are still on the rise, and that is the kind of thing that our surveillance programs tell us. They tell us about those particular risk factors we need to be putting a priority on if in fact we're going to be successful in prevention.

[Colin Carrie, Conservative, Oshawa, ON]

With these databases, has anybody ever looked at the different chronic diseases that men get versus those that women get? I know there has been a lot of research, for example, into heart disease, but they tend to use overweight middle-aged guys, and the way that a heart attack presents in a man is different from how it does in a woman.

I look at what we're doing here. I had an opportunity to have a meeting with the minister of health from China, and I was really surprised to see that they're dealing with a lot of the same challenges and issues we're dealing with. So I'm wondering, if Canada has an opportunity to take a leadership role in the world, and if we have these databases, do they actually address the differences between men and women?

[Kim Elmslie]

Yes.

[Colin Carrie, Conservative, Oshawa, ON]

How can researchers actually access that data and start manipulating it? Could you comment on that?

[Kim Elmslie]

The databases always provide sex-specific information. So they do look at what's different for men and women. We think about cancer rates and lung cancer rates. We know that lung cancer rates in men, although they were rising very rapidly, have now stabilized, whereas we're still seeing a little bit of growth in those rates for women. So yes, we look at that all the time, because as you said, the two sexes operate differently on many different levels, and for chronic disease it's no different. So it's important for us to look at both age and sex as part of the analyses we do.

With regard to the China example, in fact, we share a lot of information with China around chronic disease prevention. With their smoking rates, and so on, they're facing cancer rates going through the roof moving forward. They also have a problem with hypertension. Because we have databases that have been following our population over time and because we understand how these diseases are developing in men versus in women, and since we're also understanding and seeing earlier age of onset of some chronic diseases because of the risk factors that are driving them, we're able to help other countries that are facing chronic disease epidemics that are maybe even worse than ours are.

[Colin Carrie, Conservative, Oshawa, ON]

So we do share that data? I know in Canada we're very fortunate. We're a very wealthy country, and we are doing some of the best work in the world. So we actually do actively get out there--

[Kim Elmslie]

Yes, absolutely. We collaborate. We share data. We share best practices.

[The Chair, Conservative, Joy Smith]

Thank you so much.

Now we'll go to Dr. Duncan. And did you have a call, Dr. Duncan?

[Kirsty Duncan, Liberal, Etobicoke North, ON]

First, let me apologize for that. I was doing research and clicked on a video, so my apologies, everyone.

I'm going to pick up on something Dr. Carrie briefly mentioned. I don't know how to do this. We've talked about healthy living across the life range, and this week in Toronto it's Feeding Toronto's Hungry Students Week. On Monday I was on a bus tour, and the idea was to take decision-makers back to school on a school bus, for them to go to school and walk in the shoes of a hungry child.

In Toronto we feed 110,000 children every morning. One out of four of our kids goes to school hungry; 40% of our elementary children go to school hungry, and 63% of our secondary school students do. We know that hungry children cannot learn. We know that when they have food, behaviour improves, memory improves, and cognition improves. If they're malnourished as children, they could have long-term intellectual impairment. The right to access to safe, nutritious food is a right of every individual, and despite this we are one of the few industrialized countries without a national nutrition program.

I appreciate the difficulties with jurisdiction. When we talk about healthy living, generally we talk about diet and exercise. And I wonder how we change that. Are there discussions that are beginning with the provinces and the territories to ensure that our kids go to school nourished, and particularly in our aboriginal communities?

[Kim Elmslie]

There are two things that come to my mind when you raise that, Dr. Duncan. One is that we're making progress through the Joint Consortium for School Health to bring the health and education needs together from a policy and program perspective. It's not delivering a national nutrition program, but it is saying that we have to treat health and education hand in hand, and we're bringing those two sectors together.

The other thing that comes to my mind when we talk about this—and I'm going to repeat myself—is that many of the things we've talked about today reinforce the roles of different parts of our society coming together. We can make a difference collectively, as opposed to trying to do things in silos or trying to do things that can't be sustained because they're not in our jurisdiction in the first place.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Yes, partnerships, but it's just....

Dr. Butler-Jones has been very clear. I can't remember if it was his 2008 or 2009 report that noted that if we want to improve health in the future we have to feed our kids, exactly.

Okay, I'm going to switch to later in life. I'm going to come back to the idea that we absolutely need a national brain strategy, a brain health awareness month. We talk about the different conditions. We need to have a focus. People need to understand. We have to raise awareness and education about neurological diseases, and we have to let people know how to prevent them. That's huge.

And the last thing I want to say—picking up on Patrick's question—comes back to the worldwide concern over Alzheimer's disease. Have we thought about having a national office in the Public Health Agency of Canada where, working with the provinces and territories, you develop a national plan? And there could be a round table so you would get input from the caregivers, the families, and those living with these diseases. We could be making greater investment in research, and developing a real plan. And each year it can be reported back to Parliament what successes we have had in that year.

[Kim Elmslie]

Our first step is the national neurological study. We are working with the health charities—the raising of awareness is an important thing from their point of view. I'm sure you've heard this if you've spoken to them about Alzheimer's and other neurological diseases.

One of the best things they did was form a consortium of neurological health charities. Together, they are much more effective in their message and in their visibility than they ever were alone, and they recognize and celebrate that. So the things that we do at the Public Health Agency of Canada with that group are moving us forward. We are working to identify what we need to do as a country. We are ensuring that we have conversations going with the right people to move the agenda forward. That's where we are right now.

[The Chair, Conservative, Joy Smith]

Thank you.

We've come to the end of our page and we've had some very interesting information today, a lot of food for thought. It was amazing how you had so much information for us today, and this is a very important topic to this committee. So I want to thank you and the committee for an insightful and productive meeting.

With that, I will say the committee is adjourned.