Health pol­icy stuck in past

Cape Breton Post - - COMMENT -

Here’s hop­ing that Canada fin­ishes close to its Own­the-Podium goal of around 30 medals at the Win­ter Olympics in Bri­tish Columbia. It could help save a lot of lives if pol­icy-mak­ers, in­clud­ing politi­cians, re­tain the take-home mes­sage that a well-de­signed, fo­cused and funded multi-year plan can change the out­comes in a field like elite ath­let­ics which on first blush seems to be gov­erned by fac­tors not eas­ily ma­nip­u­lated.

When Cana­dian women trounce Slo­vakia at hockey, we think that’s be­cause we’re a hockey-mad coun­try where even our women have caught the bug. It looks like a cul­tural tri­umph, al­most nat­u­ral, rather than the prod­uct of a long-term plan to de­velop prow­ess in the sport.

As a coun­try, a prov­ince and an is­land, we need to do more of that sort of thing – not just in sports but in var­i­ous fields of so­cial and eco­nomic de­vel­op­ment, such as pop­u­la­tion health.

The Con­fer­ence Board of Canada has just pub­lished an anal­y­sis of a strat­egy de­vised by the Heart and Stroke Foun­da­tion of Canada to bring down the in­ci­dence of car­dio­vas­cu­lar dis­ease. Us­ing con­ser­va­tive as­sump­tions, the anal­y­sis con­cludes that thou­sands of Cana­di­ans can be spared pre­ma­ture death and dis­abil­ity at an eco­nomic sav­ing of $76 bil­lion if the five-point plan is put into ef­fect.

The 10-year plan aims to cut the preva­lence of high blood pres­sure in adults by 32 per cent, smok­ing by 25 per cent, and the pro­por­tion of over­weight Cana­di­ans by 20 per cent. In the other di­rec­tion, the aim is to in­crease the pro­por­tion of chil­dren and adults eat­ing the rec­om­mended serv­ings of fruit and veg­eta­bles, as well as the pro­por­tion of phys­i­cally ac­tive Cana­di­ans, by 20 per cent.

There is no guar­an­tee that all th­ese num­bers can be achieved, just as there’s no guar­an­tee of 30 medals. But ex­perts tell us th­ese are rea­son­able ex­pec­ta­tions.

We still ex­pect mir­a­cles from med­i­cal sci­ence, and med­i­cal sci­ence con­tin­ues to de­liver, though al­ways more slowly than any­one would like. But it is no ex­ag­ger­a­tion to say that pub­lic health pol­icy is stuck in the past, know­ing large-scale so­lu­tions but lack­ing the po­lit­i­cal sup­port to im­ple­ment them with suf­fi­cient vigour.

The de­vel­oped world owes its rel­a­tive good health not to peni­cillin or ra­di­a­tion ther­apy but to clean wa­ter, good nutri­tion and the like. Yet here we are in 2010 looking again to the way we live for the next big gains in pop­u­la­tion health, and in­deed to stop the ero­sion in what’s al­ready been achieved.

Cana­di­ans are pack­ing on kilo­grams, es­pe­cially in the danger­ous mid-sec­tion, yet nutri­tion de­fi­cien­cies are a stan­dard item now in any list of life­style fac­tors that need to change. John Mal­com, chief ex­ec­u­tive of the Cape Bre­ton District Health Au­thor­ity, was struck by the statis­tic in the district’s sec­ond Our Health re­port card that a quar­ter of 500 peo­ple sur­veyed in Glace Bay and New Water­ford had ex­pe­ri­enced food in­se­cu­rity – that is, had wor­ried lit­er­ally about putting food on the ta­ble. Our Health cites the es­ti­mate of 40 per cent as the pro­por­tion of Cape Bre­ton­ers meet­ing the daily Canada Food Guide re­quire­ment for fruit and veg­eta­bles in their diet.

Knowl­edge, af­ford­abil­ity and the will­ing­ness to change be­hav­iour: th­ese are the keys to a health­ier pop­u­la­tion and it’s high time we acted ur­gently on what we know.

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