Mr. Speaker, the hon. member raised the matter of a national strategy to fight disease. I agree with him. A real strategy is vital in order to demonstrate what, when and how.
We began with the integrated strategy on healthy living and chronic disease and the Canadian diabetes strategy.
It was very exciting last year to hear the first ministers talk about prevention promotion in the same sentence as the sustainability of our cherished public health system. The first ministers focused on three things: an integrated disease strategy; choosing some public health goals for Canada; and school health, which is probably the best place to focus on these modifiable risks.
As Canadians, it is important for us to understand that it is time we put the health back into health care. We have to recognize that the health of Canadians will not be solved in just one government department. It must involve all government departments across all jurisdictions.
We also have to work on the determinants of health, such as poverty, violence, the environment, shelter, equity, and education. When we look at the numbers based on those determinants we find that there are unacceptable disparities in health outcomes.
It is hugely important that we put together the modifiable risks that are common for heart disease, cancer, lung disease and many other diseases. We could do much better by using an integrated strategy rather than parallel strategies disease by disease.
The Prime Minister showed leadership in establishing the Public Health Agency of Canada and by putting in place a Chief Public Health Officer of Canada. He has actually begun the work on getting back to what Tommy Douglas said would be the ultimate goal of medicare, which is to prevent disease before it occurs rather than just patch people up once they are sick. This is about what David Butler-Jones, the Chief Public Health Officer of Canada, calls the moral responsibility, that we all have to prevent the preventable.
We want to ensure that as we move forward that no one in this country gets cancer who need not have and no one gets heart disease who did not need to. It is important that we prevent all kinds of lung disease and that we put in place a society that prevents and supports people's mental health such that they end up not in trouble.
Every year in Canada more than three-quarters of deaths result from one of the four groups of chronic diseases: cardiovascular; cancer; diabetes; and respiratory. Half of all Canadians have a chronic disease. Risk factors leading to these diseases, such as physical inactivity and unhealthy eating are growing. Health disparities between population groups are growing, as is the burden of preventable diseases, disability and death.
These diseases are highly preventable. The World Health Organization has found that 90% of diabetes type II adult onset is preventable; 80% of heart disease and 30% to 50% of cancer is preventable by changes to the risk factors such as smoking, physical inactivity and healthy eating. It is not simply a matter of individuals changing their own habits to prevent the onset of disease or improve their health once they have a disease. It is a matter of changing our entire society so that the healthy choices are the easy choices to make.
The best example of the comprehensive approach to risk factor reduction is tobacco control. The percentage of the population who smoke has changed radically over the last three decades. Individual actions have been complemented by the efforts of government, NGOs, health professionals and researchers who offer one on one interventions, supportive community programming, social marketing, tax policy, regulations and legislation.
This is an example of how a strategy can really work. In 1985, 35% of Canadians smoked. In the past year only 20% smoked. We know that smoking reduction has had a tremendous effect on heart disease, lung cancer and the other affected diseases.
There are two different approaches. Comprehensive strategies to address chronic disease and injury can be divided into two categories. One is the integrated strategy that the first ministers asked us to focus on. Those address more than one risk factor of one disease at once. The other is the specific, those that focus only on one risk factor or disease. Health Canada and the Public Health Agency have been working in both of these areas. This is consistent with the approach endorsed by the WHO.
The disease specific strategies for the major chronic diseases of diabetes, cancer and heart disease are at various stages of development. To date, only one, the Canadian diabetes strategy, has had any significant investment by the federal government at $30 million annually.
National strategies are done by collaboration among governments and a wide variety of stakeholders. It is envisioned coordinated action from upstream to downstream, taking and promoting health, preventing the onset of disease, finding it as early as possible, treating it and preventing it from getting worse, and caring for the people dying of the disease.
These strategies will also complement the development of a health and environment agenda. As we debate this motion today we must understand that having a Canadian strategy for cancer control will be extraordinarily important as it is the leading cause of premature disability in Canada.
We acknowledge the collaborative work of the coalitions on the strategy for cancer control. We now have to ensure that proper investments are determined to ensure the effective focus on prevention promotion and also in actually determining the causes of certain diseases. We are interested right now in how second-hand smoke may actually be involved in the incidence of breast cancer. It is important to be able to figure out causes, then move to prevention promotion, as well as early detection and management.
We must focus on things that we already know we should be doing better, such as mammography. It is unacceptable that the majority of Canadian women over the age of 50 are still not getting a mammogram even though we know it can affect their length of life.
As the fabulous Ian Shugart said to me this morning, there are some things we know we are doing, some things we know we are not doing, some things we know we are doing but we do not know enough about, and some things we just do not know. We have to look into all of this with the appropriate research so that we always fund what works and stop funding what does not work. We need a capacity for real surveillance to put together the pieces around cause, determinants, risk, as well as where it overlaps with heart disease.
I look forward to working with all the partners and particularly with our provincial and territorial colleagues in looking at the dollars that are already being invested in tobacco strategies, the dollars already put aside for the wait list strategy that will affect both cancer and heart disease. We need to know what is there in the strategy for cancer, what is there in the integrated strategy and what is there in these other strategies around wait times and tobacco so we come up very quickly with a very comprehensive approach.
As we look into what the member outlined in terms of the needs around mental health, we need to focus on how the federal government needs to do a better job. The Minister of Health's appointment of Michael Wilson is absolutely brilliant in making us, as the Public Service of Canada, the best we possibly can be in terms of exemplary employers. We need to look at the mental health issue and what we will do interdepartmentally in the areas for which we have direct responsibility, our veterans, our military, corrections, the RCMP, as well as the public service.
It is important to move forward on developing a strategy on heart disease, although heart disease is probably the one thing on which we are doing a little bit better, because of the smoking and tobacco control. We have done groundbreaking work in Canada on cardiovascular disease prevention and control. It is important that we pass the 2005 budget so we can deploy that $300 million to the integrated strategies.
The 2005 budget further expands initial investments in the Public Health Agency of Canada and provides $300 million over five years for an integrated strategy on healthy living and chronic disease.
It is going to be extraordinarily important to work together with the provinces and the territories, with the voluntary sector, with all of the health care providers, and with the citizens of Canada who understand that they can have input on health policy as well. We want to move forward. We need to pass the budget. Then we need to work with our partners to get this done.