Towards an Integrated System for the Prevention of Chronic Disease in Canada

1
Towards an Integrated System for the Prevention
of Chronic Disease in Canada

• Chronic Disease Prevention Alliance of Canada
• Nancy Dubois
• Presentation to the OHHN
• May, 2003

2
Presentation Outline

• Foundation of CDPAC
• Building on previous gains
• Current Context
• Direction
• Vision, provincial/territorial scan and current
  activities
• Policy Messages
• CDPAC engagement opportunities

3
CDPAC Foundation

• Canadian Heart Health Initiative
• Canadian Diabetes Strategy
• Canadian Strategy for Cancer Control
• Risk Factor plans e.g. tobacco
• WHO Country-wide Integrated Non-Communicable
  Disease Intervention (CINDI)

4
Current Canadian Context

• Government interest and/or investment in risk
  factors sustainability of health care
• Advisory Committee on Population Health and
  Health Security
• Policy papers public health capacity, chronic
  disease prevention
• Strategy development of a research agenda,
  national consortium for BP in CDP,
  forum/meeting/summit

5
Current Canadian Context (contd)

• Health reform - Kirby, Romanow
  provincial/territorial reports
• CIHR health services and population research
  pillars
• Chronic disease surveillance system development
• National Best Practices Consortium

6
CDPAC Vision

• There will be systems change to support health
  promotion and disease prevention efforts.
• Canadians will have access to a comprehensive,
  sufficiently resourced, sustainable, and
  integrated system of research, surveillance,
  policies and programs that maintain health and
  prevent chronic disease.

• The systems will link together and build upon
  existing initiatives in a coordinated and
  synergistic way.
• The systems will be broader that just the health
  sector, and will include other relevant sectors
  such as transportation, education, social
  services, recreation, and others.

7
Mission

• CDPAC will work to foster and help sustain a
  co-ordinated, countrywide movement for an
  integrated, population health approach to chronic
  disease prevention through collaborative
  leadership, advocacy and capacity building.
• November 2002

8
Current Structure
Alliance members, active participants and
subscribers
National Stakeholders
Provincial and Territorial Alliances

Steering Committee Working Groups
Secretariat
9
StakeholdersEngaged Communities of Practice
Tobacco
Prevention Research
Canadian Municipalities
Professional Assoc
Nutrition
Physical Activity

Others
Workplace
Public Health
School Health
10
Guiding Principles

• Population-based
• Reduce inequalities
• Leadership
• Integration and coordination
• Comprehensiveness
• Focus on excellence

11
Guiding Principles (contd)

• Best practices
• Capacity building
• Accountability
• Sustainability
• Linked to and shape developments in Canadas
  health system

12
Steering Committee

• Canadian Cancer Society
• Cheryl Moyer
• Canadian Council for Tobacco Control
• John Garcia
• Canadian Public Health Association (Apr 03)
• Christine Mills
• Coalition for Active Living
• Nancy Dubois

• Canadian Diabetes Association
• Donna Lillie
• Dietitians of Canada
• Marsha Sharpe
• Federation of Canadian Municipalities (May,
  2003)
• John Burett
• Health Canada
• Greg Taylor
• Heart and Stroke Foundation of Canada
• Elinor Wilson

13
Provincial / Territorial Consultation
(November 2002)

• Recommendations for CDPAC
• Assemble the evidence base
• Facilitate transfer of best practices / knowledge
• Champion CDP
• Enable communication
• Enable networking
• Enable resources / capacity building

14
National Stakeholders Consultation (April,
2003)

• Recommendations for CDPAC
• 1. Build national stakeholders capacity to work
  together
• 2. Clarify the outcomes for the movement
• 3. Exercise leadership and engage others

15
CDPAC Functions Activities

• Cheryl Moyer
• receied funding from Health Canada to support a
  start-up phase

• Collaborative Leadership - work together
  for integration / alignment of systems through
  working / reference groups and providing portal
  for others to lead
• Capacity Building - work for resource and
  skill acquisition through advocacy and learning
  opportunities (web, workshops conferences)
• Advocacy work with decision-makers to
  ensure implementation of policies

16
CDPAC Policy Messages for Systems Change(as of
March 2003)

• The framework needs to be comprehensive and built
  on demonstrated success.
• Public health and municipal capacity needs to be
  a priority for sustained investment.
• Government coordination and leadership is
  essential for successful implementation.

17
Systems ChangeNext Steps

• Engage the leaders for systems change
• public health, primary care, education,
  recreation, transportation, etc.
• Support Canadas investment
• invest in provincial/territorial alliances, CDPAC
  and risk factor alliances for integrated healthy
  living strategy

18
What the Alliance is not

• Does not intend to become a mechanism for
  coordinating all aspects of chronic disease
  control -- primary prevention focus
• Does not aspire to become the supra-ordinate
  alliance that can lead and coordinate all other
  prevention coalitions in Canada -- not the
  mother of all coalitions
• Does not intend to be top-down and directive

19
Engagement Opportunities

• Consider becoming an active participant on the
  CPDAC Web site (www.cdpac.ca OR www.apmcc.ca)
• Use the Web site to share resources, participate
  in discussion forums receive regular email
  newsletter and press releases

20
(No Transcript)
21
Web Site Tools

• CDPAC Definitions
• NewsBytes
• The Case for Change other documents
• Updates on each province
• National risk factor strategic papers

22
Concluding CDPAC Messages

• The integrated CDP movement is gaining momentum
  and growing.
• History will be a driver Standing on the
  shoulders of giants
• Success will be achieved through a systems
  approach bring everyone to the table
• The preventive dose needs to be achieved in
  communities.

23
Integrated Pan Canadian Healthy Living Strategy
24
Presentation Outline

• http//healthyliving-viesaine.ca/english/index.ht
  ml
• Background
• What is Healthy Living?
• The Goals Objectives of the strategy
• 4 Proposed Strategic Directions
• The process for the development of the strategy

25
Background

• Renewed commitment by governments to health
  promotion, and disease / injury prevention.
• September 2002 agreement among Canadas
  Federal/Provincial/Territorial (F/P/T) Ministers
  of Health to work together on pan-Canadian
  Healthy Living strategies initially emphasizing
  nutrition, physical activity and healthy weights,
  and announcement of a national healthy living
  symposium to take place in 2003. (report on Web
  site)
• Recent federally- and provincially-commissioned
  reports indicate that we need to pay more
  attention to the broader determinants of health
  and their impacts. (Health Care Renewal Accord on
  Web site)

26
What Is Healthy Living?

• Through a population health lens, healthy living
  encompasses a number of levels
• At a population level, healthy living refers to
  the practices of population and sub-population
  groups, that are consistent with improving,
  maintaining, and/or enhancing health.
• As it applies to individuals, healthy living is
  the practice of health enhancing behaviours, or
  put simply, living in healthy ways. It implies
  the physical and mental capacity to make healthy
  choices.
• At all levels the social, economic, political,
  cultural, and environmental conditions which
  support health must be in place for healthy
  living to become a reality.

27
An Integrated Pan-Canadian Healthy Living Strategy

• What?
• The Integrated Pan-Canadian Healthy Living
  Strategy is an umbrella framework under which
  links will be created among existing strategies
  around healthy living, those currently under
  development, and new strategies to be developed,
  in the short-, medium-, and long-term.
• For example, through its overall integrative
  approach, the Strategy will link ongoing
  strategies on tobacco use and control, diabetes,
  heart health, and chronic disease prevention,
  with a new strategy for Healthy Eating and
  Physical Activity.

28

• What? (contd)
• Action in this area reflects an initial priority
  and emphasis on partnership (inter-jurisdictional,
  inter-sectoral, stakeholder) and collaborative
  action around physical activity, healthy eating,
  and their relationship to healthy weights.
• Agenda will broaden to include other health
  issues over the medium- and long-term.
• Overall Strategy is characterized by a
  collaborative effort for health promotion, and
  disease and injury prevention, based on a
  population health foundation.

29
(No Transcript)
30

• Why?
• Many successful health promotion and disease
  prevention efforts are underway. However, a more
  concerted Pan-Canadian and integrated approach is
  necessary to make substantive gains in health
  outcomes and to reduce health disparities,
  thereby improving the quality of life of
  Canadians.

Glossary of terms on the Web site
31
Goals of the Strategy

• The Goals of the Strategy are
• To improve overall health outcomes
• To reduce health disparities

32
Objectives of the Strategy

• To build partnerships among health jurisdictions
  and sectors, others that impact health, and key
  stakeholders, to take action on the determinants
  of health
• To develop an integrated and collaborative
  Healthy Living Strategy consisting of short-,
  medium-, and long-term actions addressing the
  common risk factors for a range of health issues,
  working through the determinants of health and a
  population health approach
• To draw upon and build on existing capacity,
  consolidating health promotion, and disease and
  injury prevention efforts targeting populations
  and sub-populations within life settings

33
4 Proposed Strategic Directionsas a Focus for
Action

• Leadership and Policy Development
• E.g. Building relationships/partnerships among
  governments to develop healthy public policy
• Knowledge Development and Transfer
• E.g. Concerted initiatives in research and
  surveillance
• Community Development and Infrastructure
• E.g. Development of community-based demonstration
  projects
• Public Information
• E.g. Public Awareness and Education/Social
  Marketing

34
The ProcessBuilding A Strategy

• 1. Pre-consultation (January-February) to
  share information with key stakeholders on the
  Healthy Living Initiative and engage them as
  partners in building the Healthy Living
  interactive consultation process
• Consultation Reference Group meeting with key
  stakeholders and P/Ts on 30 January, 2003
• CAL Workshop on 07 08 February, 2003 (update
  and seek advice on the Healthy Living agenda and
  consultation process)

35
(No Transcript)
36
The Process Building A Strategy

• 2. Strategic Roundtables (February March)
  to build partnership with a broader range of
  stakeholders in healthy living
• 9 Pan-Canadian Roundtables (including First
  Nations, Inuit, and Métis) February/March 2003
• Roundtables Objectives
• Share expectations of the Federal/Provincial/Terri
  torial Ministers of Health on the development of
  the Integrated Pan-Canadian Healthy Living
  Strategy
• Invite participants to inform the development of
  the Healthy Living Strategy
• Identify key initiatives/actions/strategies for
  consideration as part of the development of the
  Healthy Living Strategy that can occur
  immediately or in the longer term
• Begin to build partnerships
• Web site has agenda, report, participants,
  evaluations by site

37
The Process Building A Strategy

• 3. Consultation Workbook The workbook was
  designed to
• Help inform the reader about the Healthy Living
  Strategy and some specific issues and challenges
  related to healthy eating, healthy weights and
  physical activity.
• Enable interested Canadians to express their
  opinions and ideas on the Healthy Living Strategy
  and these issues.
• Enable Canadians to identify initiatives and
  actions that they would like to see included in
  Phase I of the Healthy Living Strategy.

38
The Process Building A Strategy

• 4. The Symposium (28-29 April, 2003 now June 16
  17) Specific objectives of the Symposium are
  to present and invite input on
• the context in which the Strategy is being
  developed
• the proposed framework, including the vision,
  goals, foundational approach, guiding principles,
  strategic directions, and areas of emphasis of
  the Strategy
• an overview and key findings of the consultation
  processes
• proposed elements of an action plan addressing
  physical activity, healthy eating, and their
  relationship to healthy weights, as the initial
  area of emphasis of the Strategy.

39
The Process Building A Strategy

• 5. Post-symposium
• Conference of Deputy Ministers of Health Meeting
  June 2003
• Ministers of Health Meeting September 2003

40
For more information, contact

• For specific information relating to the content
  on the website, including information on the
  roundtables, symposium or workbook, please
  contact Tina Lalande at Health Canada
  (613.957.0898), or use one of the following
  co-ordinates
• Email info_at_healthyliving-viesaine.ca
• Fax [phone]
• Mail Healthy Living Strategy c/o The Alder
  Group 1306 rue Wellington Street, Suite
  200 Ottawa, ON Canada, K1Y 3B2

41
Health and Wellness, MOHLTC "Exploring Chronic
Disease Prevention in Ontario How to Build
Health Promotion Practice" Focus Groups
42
Purpose of the Focus Groups

• To explore the value, feasibility and interest of
  Ontario organizations in connecting in some way
  regarding chronic disease prevention.
• To explore the related opportunities, challenges,
  expectations and conditions within which a
  partnership of some kind might work.
• To explore the details of a partnership in terms
  of preferred type / structure including a
  leadership model, necessary supports and priority
  functions.
• To recommend next steps in this process to move
  towards coordinated chronic disease prevention
  for Ontario.

43
Results of the Process

• 8 groups planned (7 held)
• Voluntary non-government organizations
• Researchers
• OHPRS members
• Local practitioners
• Regional groups
• HPW, MOHLTC
• Provincial organizations
• MOHLTC (beyond HPW) Education / Recreation
  ministry reps
• Approximately 60 people attended

44
Results of the Process

• 6 themes of the discussion emerging
• Opportunities
• Challenges
• Needs
• The Model
• Potential functions in Ontario
• Recommendations

45
Next Steps in the Process

• Report to be received by HPW
• Circulation to the participants
• Discussion / decision regarding content