Health Committee on June 6th, 2022

[Jocelyne Voisin]

We are indeed monitoring that; however, I don't have that number in front of me directly. We can certainly follow up with that.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Great. Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Lake.

Next is Mr. van Koeverden, please, for five minutes.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you very much, Mr. Chair, and thank you to the officials for all the hard work you've been doing over the past two years. We appreciate that.

We have been talking about COVID-19 a lot and the impacts on the broader society, but I am glad that we're focusing in on children, given that children are naturally some of the most vulnerable people in society and don't often get invited to the decision-making table. I'm glad that we're focusing on this for a little while. My questions are going to focus on health and fitness, food nutrition and physical activity, those sorts of things.

Mr. Aziz, I see that you're online, and you and I have had a couple of discussions on this very important topic. There are three plans that I would like to focus in on, the national school food program, front-of-pack labelling and ending marketing to kids. Could you just elaborate on that and perhaps update us on any current initiatives being undertaken to help young Canadians and their families maintain healthy and physically active lifestyles?

I'll just note before I pass it along that the vast majority of children in Canada get most of their physical activity at school, and there's also a great opportunity to make sure that they get a healthy meal at school as well and improve the quality of the physical activity that they get at school. Please outline, if you could, some of our initiatives as a government and some of the work we've done to date on those.

[Dr. Alfred Aziz]

Sure. I'll speak mostly to the importance of healthy eating for children and some of the initiatives we're undertaking under Canada's food guide. I'll defer to my colleague, Ms. McIntyre, to talk specifically about front-of-package labelling and marketing to kids, and then Ms. St-Aubin to talk about some of the work on physical activity that falls under the mandate of the Public Health Agency of Canada.

We all know that good nutrition and healthy eating from a young age are fundamental to promote the healthy development of children and to reduce the risk of diet-related chronic diseases. We know also that childhood and adolescence are a time for learning and shaping food skills, attitudes and eating behaviours.

We also know that COVID-19 has really disrupted the routines of children and families and affected their meal choices and eating patterns. Health Canada pivoted to help people in the early days of the pandemic by adapting our messages to the new public health reality. In March 2020, we launched an at-home campaign to promote food skills and provide tips on healthy meals at home in order to help families eat healthily during this challenging time. To also help encourage healthy eating from childhood into adulthood, Canada continues to focus its efforts on finding effective ways to increase the reach of the food guide by promoting it directly to children and youth.

For example, over the last two years, we have established new youth engagement groups to promote awareness of the food guide through peer-to-peer engagement, and to seek their advice on how to make food guide resources more relevant to them. We launched social media campaigns targeting youth, including the first-ever Government of Canada TikTok challenge in March 2021, which encouraged teens to build food skills and share their own healthy snack ideas.

We tested immersive social marketing in schools across the country to raise awareness of food marketing, with a larger rollout being planned for online modules for the fall. We incorporated new child- and teen-specific food guide branding to make healthy eating information more appealing to these age groups, and as part of our work to promote food skills, we collaborated with stakeholders, including the University of Guelph, on a study designed to make it easier to cook healthy, plant-focused meals at home, with a particular focus on families.

We are also working to stimulate—

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Aziz, I'm sorry. I don't want to interrupt, but I'd like to hear about some physical activity as well, so if we can move on, I think we just have one minute left.

[Dr. Alfred Aziz]

Yes, absolutely. I'll turn to my.... Go ahead.

[Candice St-Aubin]

Thank you for that. Yes, we agree that physical activity and healthy eating are a priority, and they certainly can reduce the risk of chronic disease.

We are working across sectors right now to ensure that we are promoting good health and well-being, which are key issues with the latest phase of the COVID-19 pandemic.

I also just want to highlight areas such as Wellness Together Canada or the Hopewell app. They have components in addition to mental health and substance use that also provide free physical activity resources to support Canadians in this area, because maintaining a healthy lifestyle is really critical.

We also have a $20-million annual fund to support community-based initiatives, called the Healthy Canadians and Communities Fund, which is improving health behaviours and addressing the health inequalities that we also have addressed—have flagged here in this conversation today—among those priority populations that are maybe at greater risk of developing chronic disease. That really supports those common risk factors like physical inactivity, along with healthy eating and tobacco use, etc., that are often associated with chronic diseases such as diabetes, cardiovascular disease and cancer.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. St-Aubin and Mr. van Koeverden.

Mr. Barrett, go ahead, please, for five minutes.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Thanks very much, Mr. Chair.

Chair, I'd like to seek the agreement of the committee to formally request the study results, with the provincial breakdowns, from the Department of Health, as I requested from Madame Voisin.

[The Chair, Liberal, Sean Casey]

I thought it was done.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Instead of the request being from me individually, I'm looking for agreement, concurrence among the committee members, for that to happen.

[The Chair, Liberal, Sean Casey]

Is there any objection to Mr. Barrett's requesting that information?

I hear none.

[Michael Barrett, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

That's terrific. Thanks very much, Chair.

I'll give the rest of my time to Dr. Ellis.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thank you, Mr. Chair, and thank you, Mr. Barrett.

To the witnesses, I have just a few comments. There's an interesting study from 2020, a UNICEF report, in which Canada ranks 30th out of 30 wealthy countries regarding children's physical health and 31st out of 38 countries with respect to children's mental health. We know very clearly that the children's mental health systems are stretched to their limits. There's a very interesting comment here from Children's Healthcare Canada that says—and I think this is very poignant:

We have normalized rationing and waiting for mental health services to the detriment of children, youth and families, while we know that early intervention pays lifelong dividends.

That is very poignant, as I said, with respect to children.

There are a couple of other interesting things around the data with respect to surgical procedures:

Data collected...by the Pediatric Surgical Chiefs in seven (of sixteen) children's hospitals shows that there is currently a waitlist of over 20,200 pediatric patients for elective and medically necessary surgery across surveyed children's hospitals.

The average number of wait-listed patients per hospital surveyed is 2,891; 49.3 per cent of surgery patients have passed the window for timely intervention. Many children are experiencing backlogs of up to one year for elective (essential) surgeries, and in some cases, wait times for pediatric patients have exceeded 24 months.

Why did I read all that? I think it's important that folks here at the committee know that data does exist, even if the government doesn't have it, and I think data sharing is certainly something that perhaps we should think about getting better at.

Where does that leave us in terms of children's health? Certainly we can talk about some of those high-profile things, but when you listen to some of the experts, what's important now in children is that their literacy and their numeracy—or, as we might have said in the old days, their readin', writin' and 'rithmetic—are, obviously, falling behind.

I'm curious to know whether CIHR has any evidence of that, and if they do, or even if they don't, what we are going to do about it.

[Dr. Tammy Clifford]

What I can commit to doing is to look back at the number of research projects we have funded over the past little while. I will note that some of this funding has been in conjunction with that from our colleagues at the Social Sciences and Humanities Research Council.

Between those pots of funding, we can look to see which studies have been funded, whether they have data available and, if not yet, when those data will be available. I can certainly commit to sharing those with this group. That will be for me and CIHR to follow up on.

Thank you.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Thanks.

Mr. Chair, if I might, you know, clearly Canada was falling behind before the pandemic, and I would say that we wouldn't need to spend much time or effort to understand that things have gotten only worse, not better. I guess the questions that then beg to be asked are, what are we going to do about it and when are we going to do it? How long are we going to study things before we go into action? The patient, unfortunately, is hemorrhaging on the table, and we're all watching it happen. What are we going to do about it?

That's for anybody who's in charge there. Department of Health, I would suggest maybe that's for you, or maybe it's for the Public Health Agency.

[Jocelyne Voisin]

I wasn't sure it was directed at us.

I can speak to actions that are already under way. For instance, the government is already providing funding to the provinces and territories to improve access to mental health services—$5 billion over 10 years—and, as I said at the beginning, youth mental health services and integrated youth services are one of the priorities under the framework of those bilateral agreements. That work is already under way.

The federal government has also initiated Wellness Together Canada, which provides 24-7 access to mental health services. We have seen, through the pandemic, that while mental health has become a greater issue for youth, access to virtual mental health services has increased exponentially as well, not only through the federal government but also through provinces' and territories' really leveraging virtual services to support mental health services and access and exploring issues like peer-to-peer support and these integrated youth services models, examples of which are expanding across the country.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Voisin.

Mr. Jowhari, go ahead, please, for five minutes.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair. I'll go back to Ms. Voisin.

I want to spend a bit of time talking about child poverty, what kind of data is available and what kind of data the government has, especially with a racialized and ethnic lens. If that data is available, I would appreciate if you could share it with us and if you could share what our government plan is to deal with that.

[Jocelyne Voisin]

We will have to get back to you. I need to consult with my colleagues at Employment and Social Development Canada, who really have the lead on child poverty as a policy issue. We can certainly consult with them and get back to you on available data.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Okay. Thank you.

Next I will turn to pediatric cancer. As you know, cancer is one of the leading causes of disease-related deaths in Canadian children over the age of one month. While children's cancer accounts for less than one per cent of all the new cancers in Canada, it is estimated that about a 1,000 children and youth will be diagnosed with cancer.

Can you update us about what type of research on pediatric cancer is being done and what government program is there to help us deal with this issue?

[Dr. Tammy Clifford]

Many thanks. Perhaps I can start off with the research that CIHR is funding.

Budget 2021 committed $30 million for CIHR to fund targeted research into pediatric cancer. That funding is still active. We do not yet have specific projects or their results.

However, that being said, one of the very prominent opportunities that have arisen with this additional funding is the creation of a pediatric cancer consortium. The consortium is going to cover the entire cancer control continuum, from prevention to diagnosis, treatment and survivorship. What we envision is that this funding will improve the research pipeline, advance equitable access to care and, importantly, maximize the impact of research through knowledge mobilization.

Again, the funding opportunity that I mentioned just recently closed, so these applications are undergoing peer review and funding is expected to start this summer. I'd be very happy to come back to you and provide details as to the group that's been successful in being awarded the opportunity for the pediatric cancer consortium.

I wonder if one of my colleagues might be able to add something.

Candice, perhaps you would like to?

[Candice St-Aubin]

I would just say that PHAC continues to conduct surveillance in the area of childhood cancers. It is updated on an ongoing basis.

I would have to come back in writing with the most recent surveillance data on childhood cancers, but it is something that is part of PHAC's routine surveillance activities.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Okay.

Let's talk about some of the drugs for rare diseases, especially for children.

I know there's some research going on, but can any of you briefly talk about the government agenda and what we've done over the last seven years as it relates to drugs for rare diseases, especially for children?