Health Committee on Oct. 5th, 2011

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Or among them.

It could be specific cities or communities that have been very successful or that were particularly effective in implementing the program.

[Kim Elmslie]

Okay. Particular cities that are going a good job...? I'm not aware of them, but Cathy...?

[Cathy Bennett]

Yes, if you don't mind me answering.

[Kim Elmslie]

Please do.

[Cathy Bennett]

About seven provinces are involved in the age-friendly communities, and I would say that the one that has probably moved it the furthest along is Quebec. They have well over 300 age-friendly communities just in Quebec, and that number is growing. So if I had to point to.... While there's a lot of movement going on across Canada, I would say that Quebec is certainly leading the way in terms of looking at indicators, of evaluating what an age-friendly community is. What are those factors? How do we create them and how do we get that information out? As soon as they get it, they're implementing it at their provincial level, so we're seeing this momentum across Quebec in particular, with a large number of those communities.

[The Chair, Conservative, Joy Smith]

Thank you so much.

Mr. Strahl.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Thank you.

Thank you very much for coming to speak to us today.

I want to give you a chance to expand on the international partnerships that my colleague Ms. Block asked about. Could you tell us a little bit about the partnerships? We've heard about the provincial and territorial, but maybe you could tell us about the international ones.

[Kim Elmslie]

I'd be glad to. Let me start by talking about the partnerships we have within the Americas region, with our colleagues in Caribbean countries and Latin American countries.

There's a network of countries that we work with called the CARMEN network. These countries work together to determine how best to make policy change in their own context to support prevention.

As I said earlier, the developing countries have a double burden. They have obesity and they have malnutrition. They're also dealing with infectious diseases.

What our partnerships with these countries does is to bring them together to help them learn from each other about prevention of chronic disease. Most of them are looking at obesity and overweight as a serious situation for them right now. The network develops case studies from each of these countries and then shares those case studies to help advance the prevention discussion and change policy. That's one partnership we have.

We work closely with the Pan American Health Organization on sodium reduction. That's an important international policy discussion. PAHO has taken leadership in the Americas region in terms of bringing business around the table to look at solutions to reduce sodium in foods. That is an issue-specific partnership, but it's a really important one for public health.

With the WHO, the World Health Organization, we're working to build surveillance capacity. Going back to your colleague's discussion around having good data, there are many countries that don't have the infrastructure to gather good data. They can't afford even the basics. Our partnerships with the WHO are helping countries put in place the rudimentary structures so they can use good data to drive their programs.

Those are three. Do you have more, Cathy?

[Cathy Bennett]

Yes, I could elaborate on the World Health Organization, which is a key partner in advancing age-friendly communities. In fact, that's where it started; it was through the World Health Organization and it was picked up by Canada and adopted. They are a key role and partner in this, and they have created the global age-friendly network, which links all of these participating countries in this effort.

Also related to age-friendly communities, we work with the International Federation on Ageing. Again, it's to advance those principles and work collaboratively on the age-friendly approach.

So there are two other examples.

[Kim Elmslie]

And on the research on Alzheimer's disease, if I can say quickly, to Ms. Duncan's point, the Canadian Institutes of Health Research is providing exceptional leadership in an international partnership around Alzheimer's disease to bring the world's best researchers together to accelerate discovery on diagnosis and treatment of Alzheimer's disease.

[Mark Strahl, Conservative, Chilliwack—Fraser Canyon, BC]

Sticking with the partnership theme, you said you work closely with non-governmental and business partners to find ways to collaborate on seniors' health. Maybe you could give us some examples of who in the business community or non-governmental organizations you've been working with.

[Kim Elmslie]

The conversations with the business community have largely focused on food and beverage as a first step because we're concerned, obviously, around the healthy eating dimensions of healthy seniors and healthy Canadians overall. The conversations are around how the food and beverage industry can be part of the solution to encourage healthy eating and to reformulate products so they are healthier. Those are the discussions and the partnerships we're trying to build right now.

We also see a broader role for the business sector because they are workplaces with large populations of employees. They could be playing a really important role in education around healthy living and in providing their employees with the tools to adopt and sustain healthy living practices.

So we're coming at it from a number of angles to engage the private sector. I'm happy to say that the private sector is very willing to be engaged in these conversations, and I think it's because they see the productivity dimensions of this argument. To have a productive workforce they need to invest in a healthy workforce, and we're finding good receptivity to that message.

Some corporations are quite innovative in their approaches to encouraging healthy eating and healthy living by providing, for instance, opportunities for employees to have free gym memberships and those kinds of things. Again, we have to remember this only addresses one dimension: these are people who are employed and who are able, therefore, to take advantage of these perks that are offered. We don't want to create health disparities in terms of the population who can't afford such advantages; we can never forget that. But I'm seeing a receptivity by corporate Canada, the business community, to be a partner with government to move forward on these very complex issues. Nobody believes they'll be simple to solve, but there certainly is forward momentum there.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Elmslie, and thank you, Mr. Strahl.

We'll now go to Madame Raynault.

[Francine Raynault, NDP, Joliette, QC]

Thank you, Madam Chair.

I would like to thank the two women who are in attendance today. This is my first visit here and I listened very carefully to what they had to say.

Since I am the last to speak, many things have already been said.

[The Chair, Conservative, Joy Smith]

Well, we're very pleased to have you here.

[Francine Raynault, NDP, Joliette, QC]

Thank you.

From what you said earlier, aboriginal people have a predisposition to diabetes. Clearly, we are aware of their lifestyle, which has been disrupted over the centuries. They are also living on reserves and are not necessarily active in the labour force.

Do you have a program or help for them?

[Kim Elmslie]

You're absolutely right. We have a major public health challenge with our aboriginal population and we come at that challenge through a number of mechanisms. Let me give you some examples.

Through Health Canada's First Nations and Inuit Health Branch there is an aboriginal diabetes initiative. That initiative is particularly focused on the prevention of diabetes and good management of diabetes among our aboriginal population. So there are programs that are specific to that challenge.

I'd also point you to programs like Nutrition North Canada, which comes out of the Department of Indian Affairs. Clearly, by doing a better job at getting healthy foods into northern and remote populations, we're creating the conditions for people to adopt healthy lifestyles. We feel that programs like these bring us one step further along the path to creating and supporting healthy communities. There is a long way to go, and nobody sees this as a quick fix. The important thing is that we're starting to see those foundations being built through the programs we have federally, but also importantly through work that the territorial governments are doing individually and together.

[Francine Raynault, NDP, Joliette, QC]

Thank you.

With regard to seniors, I read in your document that most seniors remain healthy if they are involved in an activity in their community. They want to continue to be involved and so they likely pay more attention to their health.

However, it is certain that seniors who left paid work and who are receiving a good pension, something reasonable, can also afford better food. Or so I think. We know that the cost of living is increasing a great deal. As a result, seniors who receive a small pension or who receive only their pension with the guaranteed income supplement cannot afford the best food, the best fruits and vegetables on the market. There are farmers markets in our communities, most often during the summer, that allow us to buy locally grown fresh produce.

Do you have a program to help seniors eat better? They do not have the money to eat well and, as a result, over the years, they become ill; they develop diabetes with all that entails.

The fact that they do not have very much money affects their housing. They live in poorer housing conditions. They live in places that sometimes leave much to be desired in the way of heating in the winter, safety in the summer and so on.

Do you have a program to help them? Do you have any suggestions for what they should do?

[Kim Elmslie]

I have to thank you, because you've just made my point about the whole-of-society approach. Within the federal jurisdiction, there are things we can do, but there's a lot more that needs to be done under other jurisdictions as well. The access of seniors to affordable nutritious food is one of the elements we're undertaking with our provincial or territorial colleagues. We're not directing our attention to seniors at this point, though. We're working on childhood obesity under the federal-provincial-territorial framework on healthy weights. We're looking at how we can improve affordable access to food in this country. At present, our focus is on childhood obesity, but it applies much more broadly. No, we do not have a specific program. In our federal role we are facilitating the work of provincial and territorial jurisdictions with non-governmental organizations and the business community. This is a collective challenge, and we need to address it as a society.

[The Chair, Conservative, Joy Smith]

This is compelling food for thought and those were good questions. Thank you.

We'll now to go Mr. Brown.

[Patrick Brown, Conservative, Barrie, ON]

Thank you, Joy.

I wanted to touch on the neurological aspect of your mandate and Alzheimer's. There has been great interest on that topic in this committee. I wanted to know what are we doing to engage seniors in adopting a healthy lifestyle to delay the onset of neurological conditions. I remember a New Horizons program that encouraged active lifestyles for seniors in the home, whether it was painting or physical activity. It was more of a one-off. I saw two of those pilot projects, and I thought programs like that would be extraordinary to have in all senior homes. I wanted to know if you had any thoughts on how to engage seniors in activities that might delay the onset of Alzheimer's.

[Kim Elmslie]

That's a good question. It's a tough question.

We are still learning a lot about delaying onset of neurological conditions. Even beyond that, keeping seniors active and providing them with opportunities in their communities and in long-term care facilities, keeping their brains functioning and keeping them engaged are important parts of the work that we care about and that we try to facilitate through our funding programs working in partnership with others.

You make a really important point. The federal government can fund particular projects under particular initiatives, but to sustain those we need partners. We need provinces and territories. We need local municipalities to extend them and keep the funding going and keep those programs in place. Our role through things like the Canadian diabetes strategy, our cancer work, and neurological health charities work is to find those innovative programs that work, to determine whether they are best practices, to determine how cost-effective they are, and then to share them as widely as we possibly can and encourage their uptake. We definitely do that.

We have an innovation strategy at the Public Health Agency of Canada that is focused on just that kind of thing. The agency finds those things that are working in jurisdictions, whether they be at the provincial and territorial level or more locally, and then profiles and promotes them on a more wide-scale basis. Our children's programs, for instance--through the community action program for children, through aboriginal head start, although not applicable to your question about seniors—are examples of programs where the public health agency is funding services to kids, which can then be applied more broadly.

[Patrick Brown, Conservative, Barrie, ON]

In terms of identifying best practices for Alzheimer's, are there any provinces that you've identified that are utilizing innovative approaches or examples that should be embraced through your findings thus far?

[Kim Elmslie]

Many provinces are doing that. Some of them have their own Alzheimer's strategy. Some of them are focused on Alzheimer's under a seniors strategy. There's actually a lot going on across the country in terms of serving people with Alzheimer's and doing things to keep seniors healthy and their minds working.

[Patrick Brown, Conservative, Barrie, ON]

What types of activities are being encouraged?