Transcript Slide 1

Towards a Comprehensive
Food Policy for Canada
Championing Public Health Nutrition
Centre for Science in the Public Interest
Dr. Carolyn Bennett, MP
October 23, 2008
Food, Glorious Food
Comprehensive Food Policy for
Canada
Healthy Canadians…. Healthy Planet
Good social policy
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Good economic policy
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Good environmental policy
National Food Policy
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Food security
Food protection
Ethical international development
Sustainable agriculture, fishery
Industry - strategy like tobacco won`t work
Healthy choices
Multicultural buffet
Across all departments
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Agriculture
Fisheries
Industry
Health
Indian and Northern Affairs
Environment
International Trade
International Development
Finance
Human Resources and Skill Development
Transportation
Sir Michael Marmot
Chair, WHO Commission on Social Determinants of Health
“The worst thing for a physician is to help
someone get well and then send them straight
back into the situation that made them sick in
the first place”
Canadian Institute for
Advanced Research
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25% health attributable to health care system
15% biology and genetics
10% physical environment
50% social and economic environments
HEALTH VS HEALTH CARE
“Reorienting health systems”
FROM
a health CARE system
TO
a true system for HEALTH
Humbling reality
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The health of our population cannot be the sole
responsibility of the Ministry of Health and the
health care sector.
Canadian legacy
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Tommy Douglas… Father of Medicare
Lalonde Report 1974
Ottawa Charter 1986
SARS, Naylor Report 2003
WHO Commission SDOH 2005
Health Goals for Canada 2005
Goal of Medicare…
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Sharing risk
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getting people the health care they need when they
need it
Keeping people well not just patching them
up once they get sick
The Tyranny of the Acute
As long as citizens think of the sickness care
system whenever they hear the word ‘health’
we are not going to be able to reorient health
systems.
Fantasy
The Em PHA sis
is on the wrong
syl LAB le
Fleeing the Medical Model,
Embracing the Medicine Wheel
Blame Hippocrates?
Affirm Hygeia
HYGEIA:
Goddess of Health
The solutions are complex
For every complex human problem, there is a
neat simple solution, it’s just that it’s wrong…
HL Mencken
Complex doesn’t fit
into a 7 second sound bite…..
or on a bumper sticker
We must fiercely defend the complex solutions
for the complex problems ..
BUT……we need simpler messages
Citizens have to ‘get it’
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More health …less health care
Service contract ??????
Or longer warranty ????
Putting the Public back into
Public Health
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Civic Literacy ….. individual
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Civil Society…. Community Action
HOWEVER……
Public policy usually follows public
opinion….
BECAUSE…….
Doing the right thing is very difficult is the
people aren’t onside…
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“Father knows best” not great politics
Political Will
to do the right thing
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Dramatically improves with an educated
public…… health literacy
Citizens pulling healthy public policy…. Civic
efficacy
“What we have here is a failure to communicate”
Cool Hand Luke 1967
Health Literacy Quiz
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Empowerment
Pulling
Healthy Public Policy
Putting the Public back into Public Health
Public Health 101
1.Do you think we should have a:
A) strong fence at the top of the cliff
B) state of the art fleet of ambulances and
paramedics waiting at the bottom ?
2. Would you prefer:
A) Clean air
B) Enough puffers and respirators
for all
3. Would you prefer that wait-times
were reduced by:
A) a falls program to reduce preventable hip
fractures
B) private orthopaedic hospitals and more
surgeons
4.Should we invest in:
A) early learning, child care, literacy,the early
identification of learning disabilities and
bullying programmes
B) increase the budget for young offenders’
incarceration
5.Should we:
A) assume that the 'grey tsunami' will bankrupt
our health care system
B) include our aging population in the planning
of strategies to keep them well
6. Is the best approach to food
security:
A) food banks and vouchers
B) Income security,affordable housing,
community gardens and community kitchens
and a national food policy
7. Pick the one that is NOT correct
Pandemic Preparedness should focus on
A)
Tamiflu for all
B)
Working with the vets to keep avian flu a disease of
birds
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Making sure people wash their hands especially the
doctors and nurses
D)
Research on vaccines
E)
Community care plans for our most vulnerable
8.Governments should boast about:
A)
how much they spent on the sickness care
system
B)
the health of their citizens, leaving no-one
behind
Social Determinants of Health
vs
Choose Health
(modifiable risks)
The Causes of the Causes
Versus
The Causes
Evolution of the Healthy Canadians Tree
Communiqué
FMM September 2004
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“In addition, governments commit to accelerate work
on a pan-Canadian Public Health Strategy. For the
first time, governments will set goals and targets for
improving the health status of Canadians through a
collaborative process with experts.
Health Goals for Canada
Overarching Goal
As a nation, we aspire to a Canada in which every
person is as healthy as they can be – physically,
mentally, emotionally and spiritually.
Health Goals for Canada
Canada is a country where:
Basic Needs
(Social and Physical Environments)
Our children reach their full potential, growing
up happy, healthy, confident and secure.
The air we breathe, the water we drink, the
food we eat, and the places we live, work and
play are safe and healthy - now and for
generations to come.
Health Goals for Canada
Canada is a country where:
Belonging and Engagement
Each and every person has dignity, a sense of
belonging, and contributes to supportive
families, friendships and diverse communities.
Health Goals for Canada
Canada is a country where:
Belonging and Engagement
We keep learning throughout our lives through
formal and informal education, relationships
with others, and the land.
We participate in and influence the decisions
that affect our personal and collective health
and well-being.
We work to make the world a healthy place for
all people, through leadership, collaboration
and knowledge.
Health Goals for Canada
Canada is a country where:
Healthy Living
Every person receives the support and
information they need to make healthy
choices.
Health Goals for Canada
Canada is a country where:
System for Health
We work to prevent and are prepared to
respond to threats to our health and safety
through coordinated efforts across the country
and around the world.
A strong system for health and social wellbeing responds to disparities in health status
and offers timely, appropriate care.
Health Goals
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Choose indicators
Include stakeholder in choosing meaningful
and realistic but bold targets
Develop real strategies….
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what, by when and how
French Paradox
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Celebrating FOOD & DRINK…… thinner
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North America
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Food = Guilt
Obesity epidemic
Canada’s Food Guide
?? Evidence ?? Changing behaviour
Canada’s Food Rules - 1949
Canada’s Food Guide -1961
Canada’s Food Guide -1977
Canada’s Food Guide -1982
Canada's Food Guide to Healthy Eating -1992
Eating Well with Canada's Food Guide - 2007
Previous US Dept of Agriculture
Pyramid
Walter Willett’s Healthy Eating Pyramid
(from Eat, Drink and be Healthy)
New USDA Pyramid
What are Canadians to do ?
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farmed salmon
blueberries
pomegranates
red wine
Carbs yes, carbs no
No fats, good fats
Dr. Jay Wortman
Alert Bay Project
National Food Policy
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Food security
Food protection
Ethical international development
Sustainable agriculture, fishery
Industry - strategy like tobacco won`t work
Healthy choices
Multicultural buffet
National Food Policy
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Food security
Food protection
Ethical international development
Sustainable agriculture, fishery
Industry - strategy like tobacco won`t work
Healthy choices
Multicultural buffet
Community Action
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Food Security
Farmer`s Markets
Community Gardens
Community Kitchens
Schools….
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Enrichment Clusters
Home Economics
horizontal – departments
Structure
Gridlock
vertical - jurisdiction
Structure
Silo- busting - Horizontality
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Ministries or Ministers
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Cabinet committees
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Parliament
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Officers of Parliament - Commissioners
Structure
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Jurisdictional squabble
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SARS …. Naylor report..
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Collaboration
Cooperation
Communication
Clarity of who does, what, when
Population Health:
Keeping Canadians healthy….
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‘Citizen centered’ federalism…
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bottom up
Complexity
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Strong common purpose
Local wisdom, local knowledge to get it done
Whole of government
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`total cost accounting`
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Marilyn Waring …`Who’s counting ?’
Annual Report of the Chief Public Health
Officer for Canada
Process ….Health in all Policies
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Article 54 in PQ
HIA…. All MC’s , budget, TB guidelines
Citizen Engagement
Parliament:The Use of Societal Outcomes for
Parliamentarians, 2002.
Process – role of legislation
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Vit D
Folic Acid
Seat belts
Childhood immunization
Exercise
Diet
Drinking and driving
Research
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Evidence-informed practice
Practice-informed evidence
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Courage to fund what works
Courage to stop funding what doesn`t
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Complex adaptive systems…
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Sir Michael Marmot
“Evidence is not enough. There has to be the
desire, the political will for change. Given that
will - a big given but I am an optimist - the
evidence of what works will be a great help.”
No time for pessimists
Research
Practice
Policy
Research
KT
Practice
Policy
Research
KT
Practice
Policy
Political will
Applied
research
Practice
Research
KT
Policy
Political will
ENGAGED CITIZENS
Applied
research
Practice
Research
KT
Policy
Political will
What do we mean by food security?
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Food and the Quality of Life
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the social, cultural and local economics
impacts of food production and
consumption
What do we mean by food security?
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Food, Health, Social Justice and
Security in the Canadian ( &
regional) context
What do we mean by food security?
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Food Production and consumption in
the global context & Canada’s
responsibilty
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global consequences of agricultural
practices and food distribution systems
on human well being and the
environment
Towards a Comprehensive Food
Policy for Canada
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Symposium –
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was supposed to be October 14 !!!
10 Working Groups
Rural/Urban Collaboration –
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Eluminate software
The Global forces of Food Security
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Failed economic policies have privileged
food as a commodity, not as a human right
NAFTA & trade concerns
Fair Trade-ethical international development
Ecological Threats to Food Security
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Climate change and green house gases
Water issues
GMO’s
Pesticides & chemicals
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domestically
SPP with U.S.
Race to the bottom
China !!
Biodiversity and Food Sovereignty
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Aboriginal / traditional foods
“put the culture back into agriculture”
Multicultural
Redressing Food Security: New
Approaches to Farming/Fishing
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Sustainable agriculture
Sustainable fisheries-fish
farming/overfishing
urban agriculture
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bee hives on top of Royal York
Cuba
Food Security and Public Health
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Education/Healthy schools
Nutrition
Tax Policy
Labelling
Marketing
Food Security and Food Safety
Regulation
Labelling
Making informed choices
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ethical, religious, health
GMO’s
nutraceuticals
functional foods
ingredients from elsewhere
masking a poor food system with newly enhanced foods
and vitamins is not the way to go.
Address the root cause by growing healthy food
from good soil that doesn’t have a huge carbon
footprint in the first place
Food Security and Poverty
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Pay the Rent or Feed the Kid?
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Affordable housing
Food banks
Income security
Community gardens
Community kitchens
Food Security and Land Use
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Ethanol-land and water for food or fuel?
Food Security and Local Economies
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Marketing regionally, not just national
(federal support)
institutional food procurement
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federal government could adopt a 10 %
purchasing policy of local foods like U. of T.
ban all bottled water
urban/rural
culinary/agri-tourism
local food markets
Addressing the public’s concerns through
Practice & Policy
Rationale for a Comprehensive Food Policy
``walking the talk``
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Jurisdictional Platform
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Root Causes of the Food Crisis
intergovernmental regulations
subsidies
sliding regulatory system based on scale
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new meat regulations are ruining small producers
like the lamb on Salt Spring
Germany has addressed this issue very well)
ENGAGED CITIZENS
Applied
research
Practice
Research
KT
Policy
Political will
“We are not tinkers, who patch and mend what is
broken. We must be watchmen, guardians of
the life and health of our generation, so that
stronger and more able generations may come
after.”
Dr. Elizabeth Blackwell
first woman physician
“A politician thinks of the next election, a
statesman thinks of the next generation”
James Freeman Clarke