CDPAC,Fourth Pan-Canadian Conference

Report from the Conference: Integrated Chronic Disease Prevention: It Works Feb 7 -10, 2012

CDPAC, Ottawa, 2012 2

The Messages were Encouraging

“This is everyone’s business – Leona Aglukkaq

“Prevention must drive the system” – David Butler Jones

Feb 7- 10, 2012

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Information Available

Conference outline: http://cdpac.ca/content.php?doc=196

Abstracts available: http://cdpac.ca/media.php?mid=892

Conference report expected by end of March.

Feb 7- 10, 2012

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First Plenary: Global trends – what Does it Mean for Canada Trend, in Canada, is for the health

inequities to increase. Need to reinforce that public health is

local. CPHO report links was is happening

globally to what is happening in Canada http://www.phac-aspc.gc.ca/cphorsphc-

respcacsp/2011/index-eng.php– annual report

Feb 7- 10, 2012

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Health Imperialism and Health Determinants

Key to successful intervention was when resources were put on the table.

Poverty is not the only factor.

Feb 7- 10, 2012

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Working Together Ministers/governments are seized with

the understanding of how to work together

Recognise that prevention is cornerstone Needs:

a multicultural approach strengthened polices and program strengthened health systems – based on

primary health care

Feb 7- 10, 2012

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Three Consistent (emerging and refined) Issues:

Scaling back sodiums Tobacco reduction Access to cardio vascular supports

Feb 7- 10, 2012

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We Need a Systematic Approach Strong leadership and governance

structures Increased dialogue Build trust Be consistent and resilient – find the

right mix of tools Demonstrate a strategic advantage in

working together Must expand membership

Feb 7- 10, 2012

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Some Tools to Consider Incentives i.e. senior bureaucrats

rewarded for working cross sector to meet targets (used the example of Australia – all departments had to define their targets and report on their initiatives to combat chronic disease)

Arguments to make the case - win the hearts and minds. Need to make the case both internally and externally (make sure that there is not a resistance to the ‘nanny state’).

Feb 7- 10, 2012

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Economic Case is Clear

Investments on health are taking a huge percentage of budgets.

By 2025 governments will be bankrupt – not just the health sector.

If we don’t include the private sector – we will not succeed – we need a more productive workforce.

Feb 7- 10, 2012

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Childhood Obesity

Consistent use of the Foresite Map http://www.shiftn.com/obesity/Full-Map.ht

ml http://www.bis.gov.uk/assets/

bispartners/foresight/docs/obesity/12.pdf

Feb 7- 10, 2012

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Childhood Obesity

Models that could be replicated were important.

Build on existing partnerships. Both formal and informal partnerships

can be successful. Education system is a critical partner.

Feb 7- 10, 2012

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Childhood Obesity (con’t)

Communicate in familiar language Quick fact sheets are well received.

Incentive programs make a difference in uptake.

Sharing local stories is really important. Challenge was engaging youth. Commit to multiyear; partners are

interested in change over time.

Feb 7- 10, 2012

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Childhood Obesity: Regulations

Focusing on regulations are important but we have learned that: price is important (i.e. 10% increase in

tobacco prices relates to a 3% decrease in smoking)

we don’t need all the ‘evidence ‘ before we proceed

Feb 7- 10, 2012

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Childhood Obesity (evidence and potential response) Unrestricted income transfer programs

Helps improve birth weight for children Some association with obesity in

women Physical activity

Overall evidence not that convincing Children’s Fitness Tax Credit - not a lot of

positive evidence Fast food prices

The more consumed – the higher the weight

Feb 7- 10, 2012 CDPAC, Ottawa, 2012

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Childhood Obesity (evidence and potential response)

Agricultural policies Very influential i.e. in the USA the

subsidy for corn adds to sugar consumption.

Should be a transportation incentive.

Insurance for fruit and vegetables should be subsidized .

Consistent evidence that fruit and vegetables are associated with BMI.

Feb 7- 10, 2012

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Childhood Obesity (evidence and potential response)

Sugary drinks Tripling in consumption from 77. 77 –prices have been consistent – now

fresh fruit and vegetables have increased more.

Taxation - no evidence that this would be regressive and could direct revenues.

Easy to define: no known nutritional value.

Public is supportive if you can identify taxation as to be used in prevention.

Feb 7- 10, 2012

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Childhood Obesity (CDPAC – comprehensive approach)

Create a health filter when developing agricultural policies.

Provide subsidies to low income. Implement sugar sweetened

beverage tax. Paper on Taxation of Sugar

Sweetened Beverages at:   http://cdpac.ca/media.php?mid=840

Feb 7- 10, 2012

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Childhood Obesity (Food and Beverage Industry Perspective)

The recommendation of the Food and Beverage Industry is to reduce (not eliminate) marketing to children.

Children’s Advertising Initiative – already has reduced the type of products and promotes the advertising of the ‘better for you’ products.

Feb 7- 10, 2012

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Childhood Obesity (Food and Beverage Industry Perspective)

Quebec has not demonstrated effectiveness from their ban on children’s advertising (heatedly objected to from the audience).

Adverting works best when promoting a product (e.g. carrots, broccoli).

Industry has stepped up and they are part of the solution.

Feb 7- 10, 2012

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Childhood Obesity(Collaborative Action on Childhood Obesity CACO)

Obesity tracks into adulthood 70% adult by 2026 will be overweight or obese Nearly all behaviour is learned

Many behaviours are undesirable and have low/no consequences

Screen time reduces sleep Children who watch less than one hour – less

than 16% risk of obesity; two hours - 36%; more than two hours - 80%. One rule should be no screen time before two years

Feb 7- 10, 2012

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Sugar Sweetened Beverages and Tobacco Individual factors don’t explain the rise and fall

in tobacco or in obesity. Reduction in smoking were not driven by

clinical interventions – they are primarily the result of policy interventions.

Neither problem began with individual choices. Attempts to pursue/cajole/shame people into

quitting smoking or losing weight have only modest success and seldom produces a permanent behaviour change.

Feb 7- 10, 2012

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Similarity of Causes of Sugar Sweetened Beverages and Tobacco

Mass marketing Ubiquity Addiction Cultural normalization Low prices/low taxes Lack of regulation

Feb 7- 10, 2012

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Sugar Sweetened Beverages and Tobacco -How Smoking was Tackled

Identified Tobacco as a dangerous product.

Got government to raise taxes. Limited media exposure of tobacco

advertising. Required warnings. Litigation.

Feb 7- 10, 2012

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Sugar Sweetened Beverages and Tobacco: Alberta Experience Obesity rates are going up and tobacco rates

are going down Evidence of harm is necessary but it is not

enough Address the individual responsibility vs

collective Comprehensive package of measures have

greater impact Rules of engagement with industry are different

but needs consideration

Feb 7- 10, 2012

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Sugar Sweetened Beverages and Tobacco: Alberta Experience

Policy readiness tool: knowledge attitude and beliefs - survey to determine the attitude for changes

Did this with general population as well Do you believe that ….is personal vs.

societal Did a survey

Obesity is perceived as a societal responsibility more so than tobacco

Feb 7- 10, 2012

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Health Literacy Health literacy - access, comprehend,

evaluate, communicate Low levels of health literacy - low levels

income, poorer health status, Health literacy increases use of prevention Vulnerable populations are more likely to have

high levels of health illiteracy. Most important in building in health literacy is

reading to a child.

Feb 7- 10, 2012

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Partnership Protocol

Share each other’s equity Stay true to who you are Acknowledge and manage risk Create compelling messages Inspire, Motivate and Activatestakeholders Be Clear Measure and Evaluate:celebrate :Feb 7- 10, 2012

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Partnership Protocol

http://www.cheori.org/halo/pdf/tpp-eng.pdf

Feb 7- 10, 2012

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Conference Conclusions

Key issues throughout the conference were need for: Partnerships Integration

There has been increased collaborative but more is needed in the area of: Mental health Alcohol

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Conference Conclusions More is needed in the area of evaluation

How to share Surveillance gaps

Mental health Health literacy

We still have to learn how to create policy change Processes Complex systems

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Conference Conclusions

Important to ensure that Ministers get the message that health promotion needs to be part of the health care renewal discussion

“Prevention must drive the system.” – David Butler Jones

Conference proceedings – end of March http://cdpac.ca/splash.php

Feb 7- 10, 2012