Protecting our Gifts and Securing Our Future: Fighting the Growing Epidemic of First Nations Childho

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Protecting our Gifts and Securing Our
FutureFighting the Growing Epidemic of First
Nations Childhood Obesity

• AFN Presentation to Standing Committee on Health
• Regional Chief Katherine Whitecloud
• Chair, Chiefs Committee on Health

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The Legacy of Colonization

• A movement away from traditional foods to more
  processed foods
• Restrictions to hunting, fishing and gathering of
  foods and limited organized physical activities
• Poor understanding of nutrition and nutritious
  food choices as a result of Indian Residential
  School experiences and
• Depression, addiction and other mental health
  issues, again resulting from intergenerational
  impacts

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A Growing Epidemic

• Over half of First Nations children are either
  overweight (22.3) or obese (36.2)
• 4 out of 10 First Nations children sometimes eat
  a nutritious, balanced diet
• Nutritional and dietary practices are similar
  among children of all BMI categories however,
  overweight or obese children are more than twice
  as likely to report engaging in physical activity
  less than once a week (compared with normal
  weight children).
• Older children are less likely than their younger
  counterparts to participate in daily physical
  activity

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A Growing Epidemic (ctd)
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• Younger children are more likely to be obese
• Older children are more likely to be overweight

61.8
60.7
55.2
60
50
26.4
41.2
40
48.7
30
20
28.8
10
19.5
Obese
13.1
Overweight
0
3-5
6-8
9-11
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Age Group
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Poverty among First Nations Children

• Direct correlation between family income,
  overcrowding, poor nutrition, lower levels of
  physical activity and educational achievement
• 1 in 3 First Nations children live in an
  overcrowded home
• 1 in 4 First Nations children live below the
  poverty line
• Children in lower income families do not
  participate as frequently in physical activity
  (10 vs. 4.2)
• Comprehensive community development that
  reinforces the capacity of First Nations
  governments to respond to the needs of children
  is essential to achieve marked improvements in
  First Nations childrens health and well-being

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Health and Social Fiscal Imbalance

• Since 1997-98, arbitrary 2 cap on all First
  Nations social programming
• Since 1996-97, 3 cap on all First Nations health
  programming
• Caps ignore basic cost drivers such as population
  growth and inflation
• Caps represent less than one-third of the average
  6.6 increase that most Canadians will enjoy
  through the CHSTs in each of the next five years
• When adjusted for inflation and population growth
  over time, the total budget for INAC has
  decreased by 3.5 since 1999-2000
• Core program budgets, incl. social development
  and capital, have decreased by almost 13 since
  1999-2000.
• If communities had been funded in alignment with
  population growth and inflation, their budgets
  would be 45.5 higher than they are today.
• Close to 2 billion in health funding shortfalls
  over the next 5 years

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A Bleak Future

• Human Cost
• Greater prevalence of chronic diseases (such as
  diabetes, high blood pressure, cardiovascular
  disease, asthma, orthopedic problems, obstructive
  sleep apnea, menstrual abnormalities,
  neurological disorders and cancer) social and
  emotional problems difficulties in school
• Fastest growing population in Canada will lack
  opportunities to contribute to the cultural
  fabric and overall Canadian economy.
• Financial Cost
• Failure to act will result in greater burden on
  the Canadian health system, and overall
  productivity
• Royal Commission on Aboriginal Peoples cost of
  status quo was 7.5 B in 1996, climbing to 11B
  by 2016 due to net cost of foregone production
  and government revenues, and extra costs of
  remedial programs and financial assistance
• Royal Bank of Canada costs of implementing RCAP
  are more affordable in the long-run than
  maintaining the status quo, the truly daunting
  cost of doing nothing (1997)

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Protecting Our Gifts

• Physical Activity
• Lower levels of activity are related to poor
  nutrition and reduced consumption of traditional
  foods
• Children 9-11 yrs are unlikely to be physically
  active daily
• Boys are more engaged in traditional physical
  activities, team sports and activities of greater
  intensity
• Breastfeeding
• Numerous studies have linked breastfeeding with
  the reduction of obesity later in life
• Prevalence of breastfeeding among First Nations
  infants has increased from 50 to 62.5 in 5
  years
• Nutrition
• Children living in smaller communities are more
  likely to eat a traditional, protein-based diet,
  and less likely to be obese
• Children who always or almost always eat a
  balanced and nutritious diet are more likely to
  get along with the rest of the family very well

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Protecting Our Gifts (ctd)

• Understanding First Nations childrens physical
  activity and dietary patterns flow from an
  ecological and cultural framework that considers
  several factors
• Physiological level of growth, development
• Psychological motivation, self-esteem
• Socio-cultural role of family, poverty
• Environmental climate, food security

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Securing Our Future
A First Nations Wholistic Policy and Planning
Model

• Community at Core
• Total Person Lifespan
• Emphasizes all non-medical determinants
• Self-government as key to promoting positive
  health outcomes
• Linkages within, across and outside First Nations
  communities must be considered

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Securing Our Future (ctd)

• First Nations Wholistic Health Strategy endorsed
  at the First Minister Meeting on Aboriginal
  Issues (2005)
• Key Principles
• First Nations driven
• Community health approach
• Building on successes
• Wholistic approach to healthy living
• Adequate funding to support infrastructure,
  programs and resources
• Inclusive of solutions around non-medical
  determinants specific to First Nations

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Securing Our Future (ctd)

• More targeted strategy could be specifically
  aimed at First Nations children and obesity,
  including
• Improving access to safe and minimal/no cost
  opportunities for physical activity (traditional
  activities and walking)
• Encouraging nutritious foods during a childs
  critical growth period
• Minimizing exposure to food advertising and
  marketing that targets children
• Improving access to a safe, secure, inexpensive
  and nutritious food supply, including traditional
  foods
• Supporting the home and family environment
• Reducing socio-economic disparities and improving
  community support in encouraging healthy
  lifestyle practices

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Recommendations

• Community-based, wholistic approach to childrens
  obesity prevention programming involving the
  meaningful engagement of First Nations
  governments in related FPT initiatives
• First Nations-developed strategies focused at
  multiple levels to address significant health
  disparities due to non-medical determinants of
  health including poverty and social conditions
  (e.g. overcrowding)
• Resources that match cost drivers and needs
  (incl. community size and location)
• Leverage existing successful programming
• Aboriginal Head Start expanded as a universal
  program and its Nutrition component changed to
  Nutrition and Physical Activity, as well as
  expansion of Health Promotion component

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Recommendations (ctd)

• Minimize exposure to marketing of non-nutritious,
  energy-dense foods to children, and instead,
  market enhanced healthy eating and physical
  activity within the home and family environment
  (Retail-based nutrition intervention)
• A Health Human Resource Policy to address
  nutrition capacity in First Nations communities
• First Nations-driven research to identify
  appropriate measures of First Nations childrens
  health and of effective practices
• Policies and programs for supportive school
  environments

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