Evidence of meeting #146 for Health in the 42nd Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was school.
A recording is available from Parliament.
Liberal
The Chair Liberal Bill Casey
We're resuming meeting number 146 of the Standing Committee on Health.
We're very pleased to have the Canadian Society for Exercise Physiology, represented by Panagiota Klentrou, the chair. Welcome.
Welcome also to Mary Duggan, manager.
From Participaction, we have Elio Antunes, president and CEO. Welcome.
We're very pleased you're here.
We're going to start with the Canadian Society for Exercise Physiology. You have 10 minutes for your opening statement.
Panagiota Klentrou Chair, Board of Directors, Canadian Society for Exercise Physiology
Thank you, Mr. Chair.
Thank you for inviting the Canadian Society for Exercise Physiology to address this important issue. We applaud the committee for undertaking this study and MP Kyle Peterson for spearheading this initiative.
Our organization is the resource for translating advances in exercise science research into the promotion of fitness, performance and health outcomes. Our 6,000 members include academic researchers focused on the scientific study of exercise physiology, biochemistry and more, as well as highly qualified professionals working in rehabilitation, work physiology and high-performance sport.
CSEP, together with stakeholders that include CHEO, Participaction and the Public Health Agency of Canada, launched the world’s first 24-hour movement guidelines for children and youth aged five to 17 years. Released in 2016, these evidence-based guidelines were the first to address the whole day, breaking it into four integrated movement behaviours: sweat, step, sleep and sit. They have been widely adopted by key partners in the sector, including the World Health Organization. More information about these guidelines is available in our brief.
Building upon this work, CSEP is currently spearheading an update to two additional guidelines focused on adults aged 18 to 64 and older adults aged 65-plus.
No one in this room needs to be convinced that fitness and physical activity are the cornerstones of a healthy lifestyle. More and more, we are seeing what used to be everyday natural fitness opportunities fade away. Children are driven to school, new subdivisions have limited yards and often no sidewalks, and we are even seeing municipalities banning street hockey. This, coupled with screens being more and more readily available, is a dangerous recipe for the health of all Canadians.
Research has shown that significant health implications can be linked to childhood inactivity, including chronic diseases, metabolic disorders and more. Perhaps more alarmingly, obesity rates among children and youth in Canada have nearly tripled in the last 30 years. Approximately one-third of six-year-olds to 17-year-olds are considered overweight or obese.
Last year the federal government, together with the provinces and territories, released the Common Vision report, a national policy on physical activity. CSEP and other stakeholders were encouraged by this event. The report set forth common goals and identified strategic imperatives.
However, if we are to begin changing behaviours in a positive way and increasing the level of fitness and physical activity for all Canadians, we believe that concrete, long-term implementation plans are needed to achieve the goals set forth in the report. We believe that the commitment to sustained funding for the wider adoption and promotion of physical activity guidelines—including the Canadian 24-hour movement guidelines—will give more Canadians the tools they need to make healthy choices and lead to improved overall health.
Research has shown that there are more benefits to increased physical activity and fitness than just the obvious ones, including economic and social and mental health benefits.
CSEP believes that the federal government has a role to play to bring stakeholders together to promote the use of the healthy living guidelines in their respective regions. Encouraging collaboration and coordination among stakeholders to promote the use of these guidelines will benefit Canadians across the country.
Like stakeholders in other sectors, CSEP was encouraged by the federal government’s commitment to creating and advocating evidence- and science-based policies. In that regard, we would also call on the federal government to support the further development of evidence-based guidelines and increased support for population health measurement tools.
Finally, we believe that the federal government has a responsibility to demonstrate leadership to normalize physical activity in the lives of all Canadians—children, youth, adults and older adults.
The Common Vision report notes that “physical activity has largely been designed out of our lives.” What was once a common part of daily life—physical activity—is now something that Canadians believe they can only undertake during leisure time, which can be hard to come by in our busy lives.
We believe that with federal support and engaging traditional and non-traditional sectors, we can create a fundamental societal change that will have a profound impact on generations to come.
In summary, in order to bring the goals outlined in the Common Vision report to life, CSEP has three central recommendations.
The first is to commit to sustained funding for the wider adoption and promotion of the 24-hour movement guidelines.
The second is continued support for the development of evidence-based guidelines and population health measurement tools.
The third is for the government to take steps to normalize healthy physical activity in the daily lives of all Canadians.
In Canada, inactivity and obesity have become epidemic. It is clear that a new approach is needed to improve the overall health of Canadians.
We know that healthy children mean healthy adults and older adults. In that spirit, we look forward to working with the federal government and other partners to bring the goals outlined in the Common Vision report to life and to meet these challenges head on.
Thank you very much for inviting CSEP to participate in this study.
As June 1 is National Health and Fitness Day, we encourage all MPs and all Canadians to get active and find more ways to incorporate fitness and physical activity in their lives.
Thank you.
Liberal
Elio Antunes President and Chief Executive Officer, ParticipACTION
Good afternoon, Mr. Chair and honourable members of the committee. Thank you for the invitation to speak to you about the importance of supporting increased physical activity participation among Canadian children and youth.
As I hear all the presenters, I am struck by the consistency among their presentations and the points I'm going to make, so it may seem repetitive, but I think it's important that these issues be talked about more than once. It's also quite striking for me that many of the solutions we're proposing are very consistent, and we have not compared our notes prior to today. I think there's a lot of consensus among physical activity-related stakeholders with regard to what needs to be done.
As Canada's recognized physical activity brand, Participaction, a national not-for-profit organization, strives to help all Canadians to sit less and move more through innovative engagement initiatives such as our upcoming Canada-wide Community Better Challenge, which is being launched on May 31 as part of National Health and Fitness Day. I hope you all get involved with your communities, and through thought leadership. We are grateful for the federal government's support in these efforts, most recently through budget 2018's investment of $25 million over five years.
I do want to clarify that this funding is targeted for all ages and not just for children and youth.
Since 1971, Participaction has spoken out and made people aware of how our modern lives are leading to a physical inactivity crisis. As we move forward, however, our focus is on actually helping Canadians change their behaviour through a movement for more movement. By working with our various partners, such as CSEP and other stakeholders, we have tasked ourselves with making physical activity a vital part of everyday life.
I'm not going to spend a lot of time talking about the specific initiatives that Participaction is undertaking, but I certainly can do that as part of the questions and answers afterwards.
The evidence is very clear: Physical activity is essential to living a long, healthy and productive life. Unfortunately, 80% of Canadian adults fall short of meeting the national physical activity guidelines of 150 minutes of moderate- to vigorous-intensity physical activity per week. Physical activity has been socially engineered out of our day-to-day lives, resulting in a social climate that permits and even encourages more sedentary living.
Children and youth are not immune to these downward trends. Only about one-third of Canadian children under 18 are engaging in enough physical activity to reap reported health benefits.
More specifically, this equates to 62% of three- to four-year-olds achieving 180 minutes of daily physical activity per day, 60 minutes of which should be energetic play. As they enter school, just 35% of five- to 17-year-olds are getting the 60 minutes of moderate- to vigorous-intensity physical activity per day that they need.
Worse still, as you've heard, girls are notoriously less active than their male counterparts, placing this group at an even greater disadvantage. These trends become even more alarming, as research shows that inactive children become inactive adults.
In addition to the low levels of physical activity, sedentary behaviours are at an all-time high. Close to 76% of three- to four-year-olds and 51% of five- to 17-year-olds are currently surpassing national screen use recommendations of one and two hours per day, respectively.
As is the case with physical activity, girls reportedly engage in higher proportions of sedentary behaviours compared to boys.
As levels of physical activity tend to decrease with age, and sedentary behaviours increase, intervention is required early to ensure that children are establishing strong physical activity and screen-use habits at a young age to ensure healthy growth and development across their lifespan.
The benefits of physical activity are numerous. From a physiological perspective, regular participation in physical activity is associated with many positive health benefits, such as decreased risk for type 2 diabetes, improved weight management and musculoskeletal health, improved functioning of the brain, and decreased risk for cardiovascular disease.
Children and youth who are physically active demonstrate improved thinking and learning skills. Specifically, active kids problem-solve better. They think more clearly, retain and recall information more easily, and score better academically, particularly in mathematics, reading, language and science.
Physically active children and youth also have an easier time developing and maintaining peer relationships.
Regular participation in physical activity is associated with decreased symptoms of anxiety among children and youth. In terms of depression, engaging in physical activity, particularly at higher intensities, has reportedly not only improved symptoms of depression but also been shown to prevent the onset of such symptoms. Active kids also demonstrate increased self-confidence, self-worth and self-esteem, and report higher resiliency to stressful situations.
Little evidence exists on the direct economic burden of physical inactivity among children and youth in Canada. However, adult data does exist. The Conference Board of Canada states that getting just 10% of Canadian adults to sit less and move more would increase workplace productivity and decrease absenteeism, injecting $7.5 billion into the economy. Additionally, it would reduce health care spending on chronic disease by $2.6 billion.
Addressing the physical inactivity crisis is complex and thus requires a comprehensive and multi-faceted solution. I've heard a lot of the questions and answers, and you are very focused on what programs would work, but I would suggest to you that it has to go beyond singular programs. From a government perspective, collaboration and alignment should be enhanced across federal departments and between federal and provincial/territorial levels to develop, support and sustain physical activity efforts, including research, program implementation and evaluation. Governments at all levels should intentionally address people with the greatest need by targeting policies to eliminate disparities in participation levels.
If we look to past successes, we see that the smoking cessation effort in Canada is one of the greatest wins from a public health perspective. Smoking was once regarded as a socially accepted behaviour. However, as evidence of its toxicity emerged, many key institutions—not just the health care system, but the education systems, business systems, community and religious institutes, and all levels of government—joined forces with a coordinated and aligned vision of decreasing the prevalence of smoking among Canadians.
Despite many noted parallels, few learnings have been applied from this social health issue to the physical inactivity social health issue. Regardless of the strong evidence to support the detrimental outcomes of physical inactivity, not only to the health of Canadians but to productivity and the health care system as well, little progress has been made in terms of shifting the needle toward a more active society.
Ironically, though, Canada remains a leader in the field of physical activity and sedentary behaviour research, as well as exercise science. Specific examples include the Participaction report card on physical activity for children and youth, which has now been replicated by 48 countries, as well as the 24-hour movement guidelines for children and youth and the early years developed by CSEP, which has been recently endorsed by the World Health Organization.
Despite this recognized leadership of Canadian researchers and organizations on a global scale, there continues to be a significant disconnect between our international recognition and progress here in our own country.
In June 2018, you heard many times from the other presenters that after several years of development, the federal-provincial-territorial ministers responsible for sport, physical activity and recreation endorsed Canada's first singular policy focused on physical activity, “A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let's Get Moving”.
This policy framework must now be supported by a comprehensive, coordinated and appropriately resourced implementation plan. We need to ensure that physical activity is embedded into our cultural and social norms and that it receives the priority, attention and level of investment commensurate with the smoking cessation movement.
Many recommendations have been highlighted in the literature by top national and international researchers pertaining to supporting increased physical activity participation among children and youth.
Overall, efforts to promote physical activity in Canadian children should be started as early as possible, given that evidence suggests that physical activity patterns in early childhood continue into late childhood and adolescence.
When developing strategies aimed at increasing physical activity, we must all focus on reducing inequalities by targeting high-risk segments of the population, such as teenage girls, racial and ethnic minorities, and low-income families.
There is a strong positive association between outdoor time and physical activity. We need to send our kids outside and ensure that they have adequate outdoor active play opportunities in a variety of settings, such as the home, at school and at child care facilities. We must embed nature in everyday places used by children, such as schools, backyards, parks, playgrounds and city streets, thus creating natural outdoor play spaces that promote physical activity.
Canada needs to create a culture of active transportation. This, however, may require strategies to alleviate parentally perceived safety concerns by informing them that the risks are very, very low. Physical education must be prioritized and treated as an important core subject area like others, such as science, math and reading. School curriculums should be promoting it to children and youth as a fun, inclusive and welcoming school subject. We must enhance capacity and training among educators to be able to provide opportunities for children and youth to develop physical literacy and to foster positive behaviours regarding physical activity and sedentary time outside of school hours.
We must also provide better support to programs and opportunities geared towards the entire family being physically active together in their communities. Finding time for parents to participate with their children of all ages and to be active role models will support a culture of physical activity in the home.
Lastly, communities should dedicate part of their capital plan to recreation facility revitalization.
Leadership development, training and community capacity-building should also be provided for those living in rural and remote communities, new Canadians and marginalized populations.
In closing, it is clear that the physical activity problem is a socially ingrained issue; consequently, it will not be solved quickly. However, progress is possible and critical. Our health care system is not equipped to handle the increased impacts of physical inactivity and sedentary behaviour.
I urge this committee to consider two things. The first is to strongly endorse the development and resourcing of a federal-provincial-territorial coordinated implementation plan for Common Vision. It is time to move from common vision to common action.
I also encourage this committee to consider endorsing the establishment of a parliamentary secretary for physical activity to prioritize and champion the physical activity agenda within government and to ensure that the support, alignment and coordination required across all levels of government and non-governmental organizations is facilitated.
Thank you.
Liberal
The Chair Liberal Bill Casey
Thanks very much. You packed a lot into 10 minutes.
We're going to start our question period with seven minutes for Ms. Damoff.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
Thank you.
My first question is to both organizations.
Active and Safe Routes to School has talked about how the number of kids walking and cycling to school has gone down. I think it's about one in three now.
Is stranger danger real, and how can we get parents to get over their fear of sending their kids to walk and bike to school? It's what we hear so often, yet kids are just as safe today as they were 35 years ago, if not more so.
We also know that if more kids are walking, the busier the streets will be and the better it is for all of them. How can we educate parents around building that daily physical activity of going to and from school?
Chair, Board of Directors, Canadian Society for Exercise Physiology
I'm an exercise physiologist, so you're going to have to take my word. I don't have specific research in this matter, nor do I think that something has been tried very consistently across municipalities, but we know countries like Japan don't allow schools to be built further away than walking distance to school.
In most municipalities, and I'm from Oakville—
Chair, Board of Directors, Canadian Society for Exercise Physiology
—many schools are not within walking distance. Parents are rushed in the morning because space and time are the two biggest barriers. When they don't have time to walk to school for half an hour, obviously they will get the kids in the car and drive to school. I think one issue is the distance to school—
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
As a federal government, we don't control that, though.
Chair, Board of Directors, Canadian Society for Exercise Physiology
That's true. That's why I think it was clear among us that it has to be a coordinated effort by municipalities and that the federal government can be the leader, the one that takes the message out and encourages and brings stakeholders together.
Perception or reality is a very interesting question. It is a reality because the number of cars is the danger on the street.
President and Chief Executive Officer, ParticipACTION
I have some practical responses to that, but at the end of the day, physical activity needs to be valued by our society. Parents should see driving their kids to school as socially unacceptable.
Right now it's expected. If you walk your kids to school, people ask why you aren't driving them. As a society—and I think this is where the federal government could play a strong leadership role—we need to ingrain the value of physical activity into our social and cultural norms. If we do that, then as they're building cities, city planners will think about that, because they will value physical activity. When schools are being built, our leaders will think about where they're being built, because they will value the role physical activity plays in the health of our children and youth.
This is a significant issue that I think needs to be addressed. We need to ingrain the value that physical activity plays in our society. We need to work with the media. I think a lot of this danger is perceived because we hear things today a minute after they happen, whereas before we didn't. I think we need to work with our media partners to ensure that the messages are somewhat balanced.
We also need to work with our community leaders, such as the children's health services that are saying kids shouldn't be outside playing by themselves. Again, that goes back to not valuing physical activity within our culture.
We also need to work with our school administrators, because even if you have a great walking school bus or wheeling program to schools, if the school doesn't have a safe place for you to lock your bike, kids are not going to wheel to school.
President and Chief Executive Officer, ParticipACTION
How many schools have policies that prevent bikes or skateboards from coming to schools? I think that again it comes back to valuing the role that physical activity plays. We need to work with our workplaces to ensure that we have some employee policies that allow parents to maybe start their days later and walk their children to school. Again, I think this is a societal issue, and if we valued physical activity, we would have very creative solutions to address it.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
You and I have talked about federal infrastructure before. We have billions of dollars available for infrastructure, which is going to municipalities to be able to do not only recreation centres, but.... I think we need to do more around walking and cycling, using the infrastructure that's there. However, municipalities don't know about it.
Is there a role that we could play—I was asking Kyle about this as well—to ensure that municipalities are aware of the value for them in investing in that active transportation infrastructure?
President and Chief Executive Officer, ParticipACTION
It's highlighted in Common Vision, under “Spaces and places”, as a key component, a key area of focus.
What we don't have is an implementation strategy to work with our municipal leaders to make them aware of the opportunities to address these issues and then to work and facilitate partnerships at a local level to make it happen.
Liberal
President and Chief Executive Officer, ParticipACTION
Common Vision—and I think Mr. Peterson said this—is very vague, and it is meant to be vague. It's a national policy framework.
However, we need now to put that policy into action, and I think that right now there's a bit of a gap in leadership between the federal and the provincial and territorial governments. I think someone just has to step up to the plate and make it happen. Certainly the sector has been saying for a while that we need an implementation plan. I would suggest, though, that an implementation plan without resources won't go anywhere, so we need a well-resourced implementation plan.
Liberal
Pam Damoff Liberal Oakville North—Burlington, ON
The roles that I see the federal government could play around research education programs and the infrastructure.... It sounds like we have enough research.
Chair, Board of Directors, Canadian Society for Exercise Physiology
I'm not sure about that.
Chair, Board of Directors, Canadian Society for Exercise Physiology
The way research funding is directed is mainly through the tri-council, and unless it's focused on specific diseases, it's not going to be as easily funded as when it does include chronic diseases. However, keeping people healthy doesn't always get the same amount of funding, or it doesn't get funded as often.
I think it's what Elio says: How do we value, as a society, physical activity and health? I mean staying healthy, not just curing the diseases. It's also promoting how we can keep our population healthier so that they don't need the disease prevention.
Liberal
The Chair Liberal Bill Casey
Time's up. Thanks very much.
Now we go to Mr. Webber for seven minutes.
Conservative
Len Webber Conservative Calgary Confederation, AB
Thank you, Mr. Chair.
Thank you for being here today.
Mr. Chair, I propose that we suspend and have maybe a 25-jumping-jacks body break at this point in time—