By Canada’s Health Ministers are coming to Vancouver on January 20th. It is good to know that we now have a federal government that will engage with the provinces on health care. Now let’s hope they will engage on health, not just health care.
Forty years ago, the Trudeau government of those days produced the fabled Lalonde report. They became the first government in modern times to acknowledge that further improvements in the health of the population would not mainly come from more health care. Instead, the report boldly stated “there is little doubt that future improvements in the level of health of Canadians lie mainly in improving the environment, moderating self-imposed risks and adding to our knowledge of human biology.”
Initially there was a strong focus on changing personal behaviour, forgetting that our choices are largely shaped and constrained by environmental, social, cultural, economic and commercial pressures, and that ‘lifestyle’ is a collective noun. But our experience with tobacco has shown clearly that a combination of legislation, taxation, environmental change, enforcement, social marketing and education can change the social norm and massively re-shape individual and collective behaviour.
Today, perhaps the greatest threat to our collective health comes not from what we smoke, but what we eat. Obesity, it is said, is the new tobacco, while unhealthy food also contributes to heart disease, cancer, dental decay, diabetes and other ailments. So while the Ministers may want to talk a lot about the costs of healthcare, they need to recognise that the burden of disease – and the economic cost of treating these diseases – could be significantly reduced if they focused more on a healthy food policy for Canada.
A good place for the Ministers to start is with the failed efforts to reduce salt levels in our diet, especially in processed and fast foods. In a 2012 article in the Canadian Medical Association Journal, it was noted that “the numbers of deaths averted by moderate reductions in population salt consumption would be at least as many as those achieved by plausible reductions in population smoking rates”.
Moreover, that same article reported that for a variety of fast food products from six major companies in six Western countries, “individual items marketed as the same product had very different levels of salt in different countries”. Levels were generally highest in the USA and Canada and lowest in France and the UK.
Regrettably, but consistent with its general preference to protect the health of corporations rather than the health of people, the Harper government did very little. Its voluntary approach, as predicted, has largely failed. It didn’t ever work with tobacco, so why would it work for salt? It’s time for a much stronger response, Ministers. Time to take what we learned from fighting tobacco and turn it on eating, starting with salt.
But its more than salt, we also need to address levels of sugar and fat, and we also need to address the elephant in the room – portion size. The food industry’s unhealthy private policies are a major public health problem that must be tackled forcefully.
A good place for positive action is healthy food for our kids, because if we can establish healthy eating patterns early, we have some hope that they will remain healthy for life. Moreover, the benefits of healthy food for our kids extend beyond better health to include learning and economic benefits.
The National Coalition for Healthy School Food, which includes the Heart and Stroke Foundation and several Indigenous health organisations among others, notes that “1/3rd of students in elementary schools and 2/3rds of students in secondary schools do not eat a nutritious breakfast before school, leaving them at risk for learning, behavioural and health challenges at school”. This also reduces their likelihood of graduating, and harms their future job prospects and income potential.
The Coalition is calling on the federal government to invest $1 billion over 5 years “in a cost-shared Universal Healthy School Food Program that will enable all students in Canada to have access to healthy meals at school every day”.
It’s time for a healthy food policy for Canada, one that promotes healthy eating and combats unhealthy food products. This needs to be on the Ministers’ Vancouver table.
© Trevor Hancock, 2016
Originally published Times Colonist 6 January, 2016