Mr. Chairman, I'm pleased to be here today before this committee to discuss Health Canada's role with respect to housing on-reserve and the actions we've taken subsequent to the Auditor General's report.
The first nations and Inuit health branch is responsible for a number of health services for first nations and Inuit. We provide public health services on reserve, south of the 60th parallel. We provide primary care on a number of isolated reserves. And we fund the provision of supplementary health services, including pharmaceuticals, dental care, and vision care, for status Indians and Inuit.
In communities north of the 60th parallel, the territorial governments are responsible for public health as the result of territorial transfer agreements on universal health care services. For reserves south of the 60th parallel, Health Canada inspects houses from a public health perspective at the request of the communities. In cases where a health hazard is identified, Health Canada advises the occupants, chief and council, and maintenance personnel, as appropriate, on remedial actions that should be taken to protect public health. Health Canada also promotes the broad concept of healthy housing through awareness education activities in the community.
Healthy housing is defined by the World Health Organization as a place that protects privacy, contributes to physical and psychological well-being, and supports the development and social integration of its inhabitants. Healthy housing is a comprehensive concept that takes into consideration a variety of factors contributing to the quality of housing and housing environments, such as adequate basic infrastructure, adequate space, and a quality of neighbourhood that promotes social interactions through the provision of diverse public places for residents.
Following the Auditor General's report of 2003, Chapter 6: “Federal Government Support to First Nations—Housing on Reserves”, Health Canada formed a Healthy Housing Working Group to coordinate the work of the branch. In addition we conducted a literature review entitled “Housing as a Determinant of the Health of Aboriginal Canadians”. This was to provide all those involved in housing with the best information available that links health and housing. The findings from this review of research and evaluation studies are not surprising to those who have worked in the area but have confirmed that: increasing occupant density of housing is associated with increased risks of respiratory illness; inadequate water and sanitation increases risks of enteric infections; even though scientific evidence available at this time indicates that mould exposure alone does not appear to cause asthma, mould found in indoor air is associated with decreased lung function and increased frequency of respiratory symptoms; and that mould remediation without attention to environmental tobacco smoke, pet dander and other allergens is unlikely to significantly decrease asthma symptoms.
Health Canada also recognized that an improved information system was needed to keep track of inspection and other activities so that we can better analyze information at a regional and national level. Health Canada has now developed an environmental health information system and expects to be able to better identify problems and patterns of concern. This information system is expected to complement the information that can be generated from INAC's database.
Since appearing before the Standing Committee on Public Accounts in June 2006, Health Canada has worked with INAC, CMHC, and the Assembly of First Nations to draft a strategy to address mould in first nations communities. The strategy builds on education and training already under way to increase the technical expertise among first nations to prevent and address mould problems. It will also provide advice and guidance in the rehabilitation of the affected housing stock and improving construction practices.
The strategic directions in this strategy document include building awareness and capacity to deal with mould through education and training, providing guidance and support to the communities in prevention and remediation of mould in existing housing, preventing mould in new first nations housing, identifying communities with significant mould problems, and building awareness and support for the strategy through proactive communications.
The strategy is a work in progress, as we are still in discussions with first nations. According to the draft strategy, Health Canada will develop and lead a health promotion campaign and monitor the impact of the implementation. The health promotion campaign will encourage communities and occupants to do what is necessary to minimize mould in their homes. We'll aim at changing attitudes and behaviour of the occupants with respect to home maintenance.
In preparation for such a campaign, we are gathering information on the target audience's awareness, attitudes, and behaviour surrounding mould and indoor air quality issues in the household. The overall objective of this research is to establish a baseline against which the health promotion campaign and social marketing results can be measured. The campaign is expected to occur in the next fiscal year. We'll bring together national and regional representatives of the three organizations here, as well as the AFN, to make sure we have developed a campaign that meets the needs of the audience.
After the campaign is launched, we will monitor the impacts and revise our approach. Health Canada's efforts will be complemented by a CMHC strategy to share best practice and success stories with first nations communities. Health Canada is also working with CMHC in reviewing existing training packages to ensure that the CMHC's housing quality training courses and Health Canada's efforts in increasing public awareness of mould and indoor air quality are consistent. We'll bring together our environmental health officers, first nations building inspectors, and technical service providers to review current inspections, to be sure that public health aspects are covered in training material.
Health Canada is working with INAC, CMHC, and the AFN to more fully develop the data on the extent of mould at the community. For example, through inspections upon request, Health Canada is gaining information on communities with mould problems.
Health Canada will continue to work with CMHC and INAC to support first nations communities and organizations in improving the planning and management of housing and enabling first nations to enjoy the benefits of healthy housing.
Mr. Chairman, thank you very much for this opportunity.