Health Committee on Nov. 27th, 2023

[The Chair, Liberal, Sean Casey]

Please keep your answer brief if possible, Ms. Moriarty.

[Cindy Moriarty]

When it comes to data in general, we share what’s available wherever possible. We’re not out to reinvent the wheel. When it comes to developing strategies on data and its collection, we work closely with other countries and international organizations.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Larouche.

Next, we have Ms. Idlout.

Welcome to the committee. You have the floor for the next two and a half minutes.

[Lori Idlout, NDP, Nunavut, NU]

Qujannamiik, Iksivautaq. Thank you, Chair.

I'd like to thank the witnesses for their important testimony.

I'd like to ask one question for all three witnesses to answer. My question will be related to the calls for justice.

As you'll remember, the missing and murdered indigenous women and girls commission was started in 2016. Three years later, the final report was published. There were 2,038 participants who engaged in the important work of the commission. Unfortunately, out of the 231 calls for justice, only six of the seven are being implemented.

Could each of you explain why the federal government has failed to meaningfully address these calls for justice to date?

Qujannamiik.

[Cindy Moriarty]

Thank you for the question.

I can't speak on behalf of all departments. I can share a little bit about what is happening at Health Canada.

We have a program that provides funding directed at addressing anti-indigenous racism and making changes in the health system. We're providing funding for various projects through that to make systemic change. We're certainly looking within the department at everything we're doing with that context in mind.

We also contributed recently to a study that was done on forced and coerced sterilization, which has targeted largely—but not exclusively—indigenous women. It's something we're looking at with great attention.

I'll refer to my other colleagues from the Public Health Agency and CIHR to see if there's anything else they want to add.

[The Chair, Liberal, Sean Casey]

Ms. Hurley, go ahead, please.

[Shannon Hurley]

I'd be pleased to add.

From the point of view of the Public Health Agency of Canada, addressing the calls for justice is a multi-sector, all-of-government responsibility, and we are contributing from a health perspective.

I have mentioned some of the programming we do to address family violence and gender-based violence. That includes projects that are specifically supporting the needs of indigenous women and girls and indigenous communities. Our department also works with indigenous partners on data collection, so we can better understand what family violence, including child maltreatment, looks like for all populations, including indigenous populations.

That's part of our contribution and—

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Hurley and Ms. Idlout.

Next we have Mrs. Vecchio, please, for five minutes.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thanks for having me back on this.

I would like to talk about eating disorders.

When we're looking at mental health and wellness, eating disorders are very prominent among our young women. What are we doing through education and awareness programs to encourage young women to understand healthy eating?

[Cindy Moriarty]

Shannon, is that something you can take?

[Shannon Hurley]

Thank you.

From the point of view of the Public Health Agency of Canada, as I've mentioned, we work in programming to promote mental health and prevent mental illness. That's addressing risk and protective factors across a range of areas.

We are currently supporting two projects that I can think of in particular. One is working to create a peer support network for people with eating disorders. One is working on addressing weight-related bullying and unhealthy body images. Those are some examples of how that programming can address that issue.

Others may have other comments.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

I know, but I have questions on a variety of different things. I'm sorry.

I believe Mr. Garrison also talked about dosages when it comes to medication. Something I've found really strange is that my son, who is a 20-year-old, six-foot-two man, and his 52-year-old mom are taking the exact same dose of a medication.

Can you give me some ideas on what we're doing to ensure...? What studies have been done or when are we expecting studies to come out indicating what the dosage properly should be based on gender?

[Ed Morgan]

Maybe I can jump in quickly, if it works.

One thing we're doing right now is actually moving regulations. We've just gone to Canada Gazette, part I, to ask companies or people to basically bring forward submissions of disaggregated data. Whatever data they have that they may have provided to other jurisdictions, we want them to provide to us.

That's one step. Again, it's gone to CG, part I. I think stakeholders were quite happy with it. We're hoping to move that forward within the next year or so to finalize it .

A second step we're taking is part of our clinical trials reform. We're looking at the whole regulatory structure of clinical trials. One thing we want to ask companies to do is to provide us with a diversity plan. We've gone out and my colleagues have consulted on it. Right now, it seems to have been received favourably, so that would again require providers to try to provide us with disaggregated data.

Those would be—

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thanks so much.

That, to me, is just so important. I look at it and think, “We're so different. How are we taking the same medication?” It just doesn't make any sense to me. I really appreciate that.

I'll go back to a different area of public awareness and fetal alcohol syndrome. We know that just a drop of alcohol can cause problems, especially in the first few weeks of pregnancy. What are we doing to ensure that Canadian women are aware that they could be at risk of fetal alcohol syndrome for their child? What are we doing for prevention there?

[Mark Nafekh]

Thank you for the question.

The FASD national strategic projects fund funds $1.5 million annually to collaborate with key stakeholders and partners across Canada to develop nationally applicable tools, resources and knowledge that can be used to prevent FASD and improve outcomes for those who are already affected, including families and communities. Also, through the programs I mentioned earlier—the Canada prenatal nutrition program and the community action program for children—we provide information, guides and facilitators to share information with pregnant people about the risks of alcohol and substance use in general during pregnancy.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thanks very much.

I'm getting into a bit more of a dicey area, but when we talk about safe supply, I look at safe supply and I look at women using safe supply, and the environment where the safe supply is being used becomes extremely unsafe for women.

Are there any comments on that when it comes to safe supply, the safety of women and how it could lead to violence?

[Cindy Moriarty]

Thank you for the question.

I'm sorry. We don't have anyone here who has expertise in substance use and addiction. My understanding is that there is a separate study under way or that's going to be under way on it.

In terms of your link to violence, I don't know if my Public Health Agency colleagues have something to say.

[Shannon Hurley]

I will only add that I don't know the details about safe supply, but certainly substance use and its links to violence, and as an outcome of having experienced violence, are really interconnected issues. A lot of the work we fund and support addresses both of those issues together. For example, we're supporting mothers who have experienced abuse and substance use. That's just as an example.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you.

We'll go to Ms. Atwin, please, for five minutes.

[Jenica Atwin, Liberal, Fredericton, NB]

Thanks, Mr. Chair.

We've really covered the gamut here of a lot of different topics. I'm so appreciative of our witnesses for their wealth of knowledge.

Ms. Clifford, in your opening, you mentioned that there's been a marked shift over the last decade or so as far as a renewed focus on women's health and women's health research, in particular, is concerned. Can you expand on that?

What do you account for in this shift? Certainly, government support is one piece, but I'd really love to highlight the different women's voices and advocacy that have created this very important shift.

[Dr. Tammy Clifford]

Great. Thank you for the question. How long do you have?

First of all, I have to credit so many people, including Dr. Kaida, who is here today as our current scientific director of the CIHR institute of gender and health. Dr. Kaida joined us within the past year or so. Before her, it was Dr. Cara Tannenbaum, who held the tenure of that institute for eight years.

Again, I would say it's through a combination of efforts that CIHR recognized early on the importance of encouraging the research community to pay attention to the importance of studying sex and gender in their research projects. It probably won't come as a surprise to you that, initially, what we did was simply put a tick box on an application asking, “Did you consider this—yes or no?” It didn't take us long to figure out that it was inadequate, because you can tick a box, but that doesn't mean you did it or you did it well.

Over the years, what we have done is, little by little, ensure that those who apply for our funding and those who are peer reviewing funding must take training modules to make sure that they're aware of this. When the actual research protocols are then reviewed, there is a discussion about this.

The entire academic research community is much more aware of these issues. I have to say it's thanks to champions like Dr. Tannenbaum, Dr. Kaida and others who ensure that this topic remains front of mind for all of us who are doing this work.

Thank you for the question.

[Jenica Atwin, Liberal, Fredericton, NB]

Thank you very much.

Ms. Moriarty, I can't help but think about how there are so many women, in particular, who are nurses or nurse practitioners—of course, they are physicians as well. It's very female-dominated in certain sectors. I also think about how we're seeing a lot of burnout.

I'm wondering if you can provide us with some direction for or advice on how we can better care for those who take care of us.

[Cindy Moriarty]

Thank you for that question.

I wish I had an easy answer for you. I think the COVID pandemic really did a number on everyone. I'm not saying anything you don't know. The system was so stretched, and then the pandemic just put everything at the individual level and the system level over the edge.

I don't have easy answers for you. The mental health supports that my colleague Suki Wong talked about are available to practitioners just as much as they are to patients. I think there's other work that's going on among the department and provincial and territorial governments to look at this crisis in terms of health human resources, but I don't have a specific solution for you. I'm sorry.

[Jenica Atwin, Liberal, Fredericton, NB]

Would anyone else like to add to that?