HESA Committee Report
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Ms. Joy Smith Dear Ms. Smith: Pursuant to Standing Order 109 of the House of Commons, I am pleased to respond on behalf of the Government of Canada to the Eighth Report of the Standing Committee on Health (HESA) entitled Chronic Diseases Related to Aging and Health Promotion and Disease Prevention, tabled in the House of Commons on May 18, 2012. I would like to thank the Committee for its work in examining health promotion, prevention of chronic diseases and healthy aging, each an issue of vital importance to Canadians. The following information, organized along three broad themes ‑ Health Care, Research, and Promoting Healthy Choices ‑ outlines the significant contributions the Government of Canada is making with regard to the Committee’s recommendations. For ease of reference, the full text of the Committee’s recommendations may be found in the appendix to the letter. Health Care – Recommendations 1, 2, 3 There are few things as important to Canadians as health care. Canada’s universal publicly funded health care system is also a source of pride for people across this country. Our Government supports the Committee’s comments and recommendations on the importance of intergovernmental and multi‑sectoral collaboration in health care. The Government of Canada recognizes that Canadians expect their health care system to be there when they and their families need it – today and in the future – and is committed to working with provinces and territories to ensure the system remains sustainable and continues to deliver improved patient outcomes. The Minister of Finance recently announced the Government’s health funding plan that will come into effect after the current arrangements expire in 2013‑14. Under the new plan, funding provided through the Canada Health Transfer will increase from $28 billion this year to over $40 billion in 2020‑21. Transfers will continue to increase by 6% annually until 2016‑17, a rate of growth that is well above what most provinces and territories are budgeting for health care. This will provide jurisdictions with additional fiscal flexibility to undertake needed reforms to make the system more sustainable. Over the past several months, I have been meeting with my provincial and territorial colleagues to discuss how the Government of Canada can best partner with them as they innovate to make the health system more sustainable while strengthening accountability to Canadians. The Government of Canada currently invests more than $1 billion annually to support healthcare innovation through the Canadian Institutes of Health Research (CIHR), Canada Health Infoway, and Health Canada’s Health Care Policy Contribution Program (HCPCP). This last program was created to respond to emerging health policy priorities and establish collaborative working arrangements with provincial and territorial governments to effect change on a pan‑Canadian scale. Our Government looks forward to working with provinces and territories to explore ways in which these programs can better support them in their health care reform efforts, including in the areas identified by HESA. Recent examples of related federal investments include:
Health Canada also invests $112 million annually in the First Nations and Inuit Home and Community Care Program for community‑based services which help people living with disabilities, chronic or acute illnesses and the elderly to receive care in their home community. This program fosters the development of collaborative relationships with provincial primary care services and research initiatives to improve the prevention and management of chronic diseases at the community level. The federal government remains committed to improving Canada’s evolving universal health care system through ongoing collaboration with our provincial and territorial counterparts and the provision of stable and predictable funding. Research – Recommendation 4 As the Committee is aware, the CIHR seeks to transform health research in Canada by focusing on health priorities, building capacity, contributing to the training of the next generation of health researchers and by transferring knowledge gained to health care partners and practitioners to better inform health policies, procedures, products and services. This approach demonstrates our Government’s support for the Committee’s recommendation highlighting the need for health research that addresses chronic diseases. This is also further exemplified by the direction of our future work. Currently several of CIHR’s 13 Institutes are leading major research initiatives on health promotion, prevention of chronic diseases and healthy aging, notably the Institute of Aging, the Institute of Population and Public Health, and the Institute of Cancer Research. In fact, given CIHR’s multidisciplinary approach, each of CIHR’s Institutes have either direct or indirect implications for research in the areas studied by the Committee. Since 2006, investments in chronic disease research have increased by 10.5%. In 2010‑11, CIHR invested over $445 million to support research on chronic diseases, representing over 46% of CIHR’s expenditures. With respect to aging and aging‑related research, in 2010‑11, CIHR invested $112.3 million in initiatives including those related to age‑friendly communities ($2.1 million), elder abuse ($860,000) and mobility in aging ($19.3 million). CIHR’s strategic plan, 2009/10 – 2013/14 Health Research Roadmap, along with its consistent funding record, reflect the Government of Canada’s commitment to support health research, including research into chronic diseases and health promotion. Several relevant examples of these investments in research related to the Committee’s recommendations are discussed below. Canada’s Strategy on Patient‑Oriented Research Canada’s Strategy on Patient‑Oriented Research (SPOR), one of CIHR’s key initiatives, was launched in August 2011. It aims to improve health services and health outcomes through the timely and appropriate application of research results. Through SPOR, several national clinical research networks, notably on mental health and community‑based primary health care, are now being developed. CIHR is also brokering discussions with provincial ministries of health and innovation, health authorities and health research organizations to create incentives to optimizing the health care workforce and clinical research environment throughout Canada. Canadian Longitudinal Study on Aging The Canadian Longitudinal Study on Aging, a national long‑term study of adult development and aging, will follow 50,000 Canadian men and women between the ages of 45 and 85 for a period of at least 20 years. The study will monitor changing biological, medical, psychological, social, and economic aspects of people’s lives. The objective of the study is to deepen our understanding of how these factors ‑ individually and in combination ‑ impact on health maintenance and the development of disease and disability as people age. The study will also identify modifiable factors to help inform future programs and policies and improve Canadians health and quality of life. Alzheimer’s Disease and Related Dementias (ADRD) CIHR has committed $13.1 million towards the International Collaborative Research Strategy on Alzheimer’s Disease (ICRSAD). ICRSAD’s goals are to prevent or delay the onset and progression of this disease through early intervention and diagnosis; improve the quality of life for those afflicted and their caregivers; improve access to quality care; and enable the health care system to deal more efficiently with the rising number of afflicted individuals. CIHR is also involved in other research initiatives on dementias, such as the Cognitive Impairment in Aging Partnership. This consortium of private, non‑governmental, voluntary and government organizations is working to further research and improve the quality of life for those suffering from ADRD. Over $32.5 million has been invested as a result of the Partnership. Pathways to Health Equity for Aboriginal Peoples Pathways to Health Equity for Aboriginal Peoples aims to increase the capacity of Aboriginal communities to act as partners in the conception, oversight and application of high quality research. The objective of this initiative is to reduce health disparities among Aboriginal Peoples, particularly in the areas of obesity, tuberculosis, suicide, and oral health. It will determine which types of interventions work, for whom and under which circumstances as well as how interventions can be adapted and scaled up in ways that are accessible and equitable. Neurological Conditions The Public Health Agency of Canada (PHAC) is working with Canada’s major neurological charities on a four‑year population study of Canadians affected by these conditions. This investment of $15 million is filling gaps in knowledge about rates of neurological conditions in Canada and their effects on individuals, families and caregivers and health care systems. A comprehensive report will be published in 2014. This will help inform government and health stakeholders as they develop and plan programs and services for Canadians living with neurological conditions. In addition, the Brain Canada Foundation will receive up to $100 million over six years in federal matching funds to support brain and mental health research as well as advance knowledge for the treatment of these disorders. Canadian Partnership for Tomorrow Project The Canadian Partnership for Tomorrow Project is a living population laboratory designed to improve our understanding of the interaction and long‑term impact of behavioural, environmental, and genetic risk factors for cancer and related chronic diseases such as diabetes, and heart and lung disease. The project is a 30‑plus‑year national cohort study, the largest of its kind conducted in Canada. Over 226,000 Canadians have agreed to take part in this project encompassing five regions of Canada: British Columbia, Alberta, Ontario, Quebec, and the Atlantic provinces. The federal government supports this project through the $250 million five‑year investment in the Canadian Partnership Against Cancer, which also plays an important role in cancer knowledge gathering and sharing to support cancer patients, their families and health care providers. Global Alliance for Chronic Disease I am pleased to advise the Committee that Canada is also engaging globally on chronic diseases. CIHR is a founding member of the Global Alliance for Chronic Disease, a group of leading research agencies around the world working together to coordinate a research program on chronic diseases. Its first research program, a study of hypertension, was launched in 2011. This type of international collaboration on research is an effective means to leverage Canada’s research contributions with that of other countries for global benefit. Promoting Healthy Choices – Recommendations 5, 6 The Government of Canada supports the Committee’s observations on promoting life‑long health and providing Canadians with information and tools to make healthy lifestyle choices. Research and experience indicate that health promotion and adoption of healthy behaviours are especially important during the early age and must continue throughout the life course. Initiatives across the Health Portfolio will continue to promote healthy choices, as recommended by the Committee. Promoting Healthy Choices Requires a Whole‑of‑society Approach To this end, our Government is working in partnership with provinces and territories, non‑governmental organizations, First Nations and Inuit communities and partners, and the private sector to identify ways to strengthen collaboration and improve health. In September 2010, Federal/Provincial/Territorial Health Ministers endorsed a Declaration on Prevention and Promotion and a Framework for Action to Promote Healthy Weights. The Declaration advances a multi‑sectoral approach to chronic disease prevention while the Framework supports collaborative action to promote healthy weights. In addition, Committee Members are aware that in 2011, Canada, along with all member states, endorsed the United Nations Political Declaration on the Prevention and Control of Non‑Communicable Diseases that aligned with the objectives of Canada’s Declaration. Healthy Choices ‑ Actively Assisting Canadians The Government of Canada develops and promotes guidelines, information and tools to help Canadians make informed decisions about the food they eat, including Eating Well with Canada’s Food Guide and Eating Well with Canada’s Guide for First Nations, Inuit and Métis, a tailored food guide, which reflects the values, traditions and food choices of First Nations, Inuit and Métis. Also, the Nutrition North Canada Program provides a subsidy to lower the cost of perishable, healthy foods in isolated northern communities. The Healthy Eating Awareness and Education Initiative promotes healthy eating by encouraging consumers to follow Canada’s Food Guide and to reduce their intake of food and drinks high in calories, fat, sugar and sodium. Additionally, the Government of Canada is continuing to support the most effective ways to help Canadians reduce consumption of foods which may contain ingredients that can negatively affect their health, such as sodium and trans fat. Mandatory nutrition labelling and voluntary reductions by industry help support Canadians to make healthier choices. As well, our Government is continuing to work with industry on education and awareness campaigns, guidance and research initiatives that will help contribute to healthier choices. Promoting life‑long physical activity and injury prevention is key to healthy living. For instance, the Government of Canada promotes healthy and active behavior through the Children’s Fitness Tax Credit, the Eat Well and Be Active Toolkit, and activities related to seniors’ falls prevention. In addition, the Active and Safe Initiative promotes safe participation in sports and physical activity, including physical activity in the after‑school time period. Most recently, Economic Action Plan 2012 has also committed continued support to ParticipACTION and for community‑based physical activity and fitness programs. In addition, the Government of Canada supports initiatives related to aging and seniors, including health and well‑being. For example, the Canadian Best Practices Initiative highlights effective approaches to promoting healthy aging and chronic disease prevention. Furthermore, the Age‑Friendly Communities Initiative promotes healthy active aging. It engages older Canadians in the planning and design of their own communities to create healthy, safe and supportive environments where they can live and thrive. Creating supportive built environments also contributes to preventing falls, the leading cause of injury among seniors. Underpinning these efforts, the Government of Canada supports national disease and health promotion strategies including the Integrated Strategy on Healthy Living and Chronic Disease, the Canadian Diabetes Strategy and the Aboriginal Diabetes Initiative, the National Lung Health Framework, the Federal Tobacco Control Strategy and the Canadian Strategy for Cancer Control implemented through the Canadian Partnership Against Cancer. As well, the Government welcomes the release of the Mental Health Commission of Canada’s Changing Directions, Changing Lives: The Mental Health Strategy for Canada. Conclusion I trust this letter demonstrates the level of commitment and scope of the Government of Canada’s engagement in addressing chronic diseases and promoting healthy living. Consistent with the Committee’s report on Chronic Diseases Related to Aging and Health Promotion and Disease Prevention, the federal government recognizes the complex and inter‑related nature of these issues and the need to engage multiple parties. Our Government will continue to work with all levels of government, non‑governmental organizations, the private sector, and individuals to leverage collective resources and expertise and to provide the best value for taxpayers’ dollars while building the health care system Canadians want and deserve. Sincerely, Leona Aglukkaq Appendix to the Letter Recommendations
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