The following OP-Ed article has been disseminated to key Ontario media outlets on the occasion of the 20th anniversary of the signing of the Ottawa Charter:


A robust prevention 'system' will save Medicare for generations to come
<http://www.opc.on.ca/english/about_us/pdfs/OP_ED.pdf>

Twenty years ago today Canadians led the world in creating the visionary Ottawa Charter for Health Promotion, signed by 38 nations. The Charter defines requirements to build healthy public policy, create supportive environments, strengthen community action, develop personal skills and reorient health services.  

Canada's international reputation for championing health promotion is based mostly on rhetoric and hot air. Canada spends millions treating illness and does almost nothing to create healthy conditions and prevent those same illnesses. The Ontario Ministry of Health Promotion's budget is less than 1% the budget of Health and Long-Term Care.  Throughout Canada, public health generally receives only 2% of the health budget. 

The British Columbia Government estimates that if health care spending continues to rise on its present trajectory and education funding is kept stable, there will be no money left for any other government services by 2017 - just 10 years from now. Medical costs will swallow up all other social needs unless we reduce the demand for treatment and care. 

It really is a question of priorities not affordability  - Canadians spend 15 billion per year on alcohol, 14 billion on tobacco and a further 12.5 million on gambling according to Armine Yalnizyan, economist for the Canadian Centre for Policy Alternatives. Health care costs are rising as a proportion of government spending in Ontario. Is this because health care is unsustainable?  An alternate view is that government is spending less on other social needs while their revenues are shrinking due to cuts to personal and corporate income taxes.

It's not as though we don't know what we need to do. Successes are widespread.  For many Canadians, housing and working conditions have greatly improved. Tobacco control legislation, municipal alcohol policies and pesticide control by-laws are reducing illness and social problems.  Family violence is treated seriously. We know how to support healthy child development. The public understands the difference between healthy and unhealthy behaviours.

 Even so, political will to apply promising practices is soft. Negative health impacts on Canada's population can be seen most in our failure to address health inequities and our failure to reorient the health system toward prevention.  Socioeconomic status, Aboriginal identity, gender and geographic location are the most important factors associated with health inequalities according to the Health Disparities Task Group. 

Reorienting health systems means a more balanced approach to prevention and treatment. Tommy Douglas, Canada's father of Medicare and 'favorite Canadian,' argued that access to treatment was just the first stage of Medicare, and that the second stage, creating an effective prevention system, was equally important. 

According to the Chronic Disease Prevention Alliance of Canada, healthier communities, better nutrition, more physical activity and less exposure to tobacco would prevent over 50% of the most common chronic diseases like cancer, cardiovascular disease and type 2 diabetes.  The cost of treating chronic diseases, which are largely preventable, is $80 billion per year in Canada.

It is vital that all Canadians, our governments, non-governmental organizations, and private companies must band together to demand and create an effective prevention system. Such a system must include capacity development, policies and programs, research, evaluation, best practice dissemination, surveillance and monitoring, along with planning and coordination, knowledge exchange and advocacy. 

OPC calls on the Ontario Government to double the budget of the Ministry of Health Promotion and to establish a robust prevention system. And, while you're getting that going, here are a few sure-fire-winner public policies. How about replicating Quebec and Manitoba by stopping the claw back of the child tax benefit? How about requiring public health units to address health inequities? How about subsidizing more licensed, non-profit early learning childcare centres? Failing to do so is bad for our parents, ourselves, our children, our neighbours, our communities. Taking a risk and being visionary will be good for the health of all. 

By: Connie Clement, Executive Director of the Ontario Prevention Clearinghouse and Chair of the Ontario Chronic Disease Prevention Alliance
 
Media Contact: Krissa Fay, Communications and Policy Specialist, Ontario Prevention Clearinghouse, 416-408-6902

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