Health policy stuck in past
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.