Docstoc

Chronic Disease in Canada

Document Sample
Chronic Disease in Canada Powered By Docstoc
					Chronic Diseases in Canada


    Canada Report presented to the CARMEN
                    Directing Board Meeting

                      San Juan, Puerto Rico
                             June 30, 2003
The Burden of Chronic Disease
         in Canada
Individuals and families
    16,000,000 live with chronic illness
    Chronic disease accounts for 87% of disability
High risk groups
   Increased prevalence in vulnerable communities (e.g.
   Aboriginals) and in socio-economically disadvantaged
   groups.
Economy
   Direct health care costs: 67% of total direct costs are
   expended on chronic diseases
   Indirect costs: 60% of total indirect costs ($52B), e.g, loss
   of productivity and foregone income
All these numbers will increase
    Aging, increased prevalence of some risk factors, e.g.
    obesity
                                                                   2
First, some good news….




                          3
  Age-Standardized Mortality Rates for
Cardiovascular Diseases, Canadian Males
        and Females, 1950-1999

                       800
                       700
                       600
      Deaths/100,000




                       500
                       400
                       300
                       200
                       100
                         0
                           50 53 56 59 62 65 68 71 74 77 80 83 86 89 92 95 98
                         19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19


                                                Males        Females

 Source: Health Canada, 2003. Age-standardized to the 1991
 Canadian population.                                                           4
   20-Year Trends in Smoking
Current smokers by age, Canada,
           1981-2001




                                  5
The not so good news…




                        6
      Age-standardized mortality rates, by
     neighbourhood income quintile, urban
             Canada, 1971 to 1996




Source: Statistics Canada, Catalogue 82-003. Supplement to Health
Reports, volume 13, 2002, p. 57.                                    7
 Age-standardized mortality rates, by
neighbourhood income quintile, urban
        Canada, 1971 to 1996




Source: Statistics Canada, Catalogue 82-003. Supplement to
Health Reports, volume 13, 2002, p. 57.                      8
Cardiovascular deaths in women
    is projected to increase




       Growing Burden of Heart
            & Stroke, 2003
                                 9
 Burden of cancer in Canada is
expected to double over the next
            20 years




         Cancer Progress Report,
                  2003
                                   10
Diabetes deaths projected to
         increase…

   Number of diabetes deaths (1950-1995) and
  projections to year 2016, by gender — Canada




            Diabetes in Canada,
            Second Edition, 2003


                                                 11
12
A Rich History in Health
       Promotion




                           13
  Canadian Investment in Health
Promotion and Prevention to date…


Health promotion and disease
prevention strategies mainly focused
on:
   Single Diseases
   Single Risk Factors
   Specific Population Groups


                                       14
Towards a Common Risk
   Factor Approach




                        15
     National Disease / Risk
       Factor Strategies

 Partnership models
   Good foundation for integrated
    chronic disease policies / programs




                                          16
Canadian Strategy for
  Tobacco Control

        Governance
        - Multisectoral Partnerships

        Multi-pronged Strategy
        - Access
        - Advertising and Promotion
        - Packaging and Labelling
        - Product Regulations
        - Taxes
        - Smuggling
        - Enforcement and Education

        Sustained over 15 years
                                       17
Canadian Diabetes Strategy

        A partnership model
           – Diabetes Council of Canada

        A comprehensive approach
           – Social marketing
           – Community programs
           – National Diabetes Surveillance
             System
           – Addresses needs of vulnerable
             populations – Aboriginal Diabetes
             Initiative

                                             18
Canadian Cancer Control
       Strategy

       Governance – a thorough and
       inclusive process
            - Canadian Council for Cancer
              Control

       Priorities for Action
           - Standards and Guidelines
           - Primary Prevention
           - Rebalancing Focus
           - Human Resources Planning
           - Research


                                            19
        National Action Plan for
               Children

   Intersectoral and inclusive partnership
   Multi-pronged approach
    - Centres of Excellence for Children’s Well-
      Being
    - Aboriginal Head Start
    - Community Action Program for Children
    - Canada Prenatal Nutrition Program
    - Fetal Alcohol Syndrome/Fetal Alcohol Effects Initiative



                                                                20
Canadian Heart Health Initiative
     Backbone of CARMEN/CINDI

   Platform for community-based
    comprehensive programs
           311 projects in 10 provinces,
            35 community level programs

   Development of tools and methodologies
           Process evaluation
           Dissemination – research

   Partnership and linkage model
           International, national, provincial and
            community
           Public, private, and voluntary sector
            …                                         21
Many achievements to date…

                   But still…
  Fragmentation and duplication of prevention and
   resources across strategies
  Lack of coherence and consistency of prevention
   messages and approaches
  Lack of integrated evaluation framework
Lost opportunities to maximize prevention
efforts and
… achieve the “preventive dose”
                                                22
Towards an integrated
approach to chronic
disease prevention




                        23
         Current Opportunities
   NGOs moving towards cross-cutting
    partnerships
       Chronic Disease Prevention Alliance of
        Canada
         …
       Coalition of Health Professions for Preventive
        Practice

   Research agencies
       CIHR Institute of Population and Public Health

                                                         24
         Current Opportunities

   Provinces & Territories
       Several provinces and territories have made
        significant strides in strategies and alliances
            Alberta
            Nova Scotia
            British Columbia
            Québec
         …


                                                          25
         Current Opportunities
   Parliamentary committees and Special
    commissions
       Kirby
            Proposed national funding for chronic disease
             prevention
            Supports a multi-stakeholder governance model
             for implementation of a national chronic disease
             prevention strategy
       Romanow
            Strengthening the role of prevention in primary
             care
            focus on tobacco, obesity, physical activity
         …
                                                             26
     Current Opportunities - Centre for
      Chronic Disease Prevention and
                  Control
   Knowledge Generation and Dissemination
       Sharing best practices for policy and community
        interventions

   Policy Development and Analysis
   Surveillance Expertise
       Integrated national chronic disease surveillance
        systems

   International Links
       CINDI – CARMEN
       WHO – Collaborating Centre on NCD Policy
       WHO – Collaborating Centre on Surveillance of
        Cardiovascular Diseases
       CDC - USA
                                                           27
Current Opportunities: Integrated Pan-
  Canadian Healthy Living Strategy


                 Pan-Canadian, comprehensive,
                  collaborative initiative in
                  partnership with national, P/T,
                  and NGO/NVO stakeholders

                 Main goal is to reduce risks
                  associated with diabetes,
                  cancer, respiratory, and
                  cardiovascular diseases




                                                    28
Current Opportunities: Integrated Pan-
  Canadian Healthy Living Strategy


   Initial areas of emphasis on nutrition, physical
    activity and their relation to healthy weights

   Pan-Canadian consultations held in Winter 2003,
    followed by National Healthy Living Symposium on
    June 16-17, 2003

   Agreement on framework for action and
    presentation to F/P/T Ministers of Health for
    endorsement and potential funding in Fall 2003.



                                                       29
Key steps towards an integrated
 approach to chronic disease
           prevention
   Ensuring a high order of collaboration and
    strategic management for chronic disease
    prevention:
       Partnerships, coalition development
         CDPAC
         …

   Strengthening the capacity for a more
    integrated disease prevention approach:
       NGO professional groups and academia
       Public health infrastructure in Canada
    … renewed concern and interest               30
  Ensuring an effective information base to guide
     integrated prevention and control action
Knowledge synthesis and dissemination:
       A systematic approach to building, consolidating, and disseminating
        research evidence to inform policy and action on chronic disease
        prevention and control
            National Best Practice Consortium for Integrated Chronic Disease
             Prevention and Health Promotion

Integrated and Enhanced Surveillance for chronic disease:
       Integrate a range of existing and new data collection activities into a
        comprehensive national surveillance and monitoring system
       Expand current surveillance systems to capture information on
        determinants, risk factors, and also interventions
            FPT Task Group on Surveillance Systems for Chronic Disease Risk Factors

Research:
       Focus on translation / implementing research
            CIHR research funding
       Demonstration model for integrated chronic disease prevention as
        part of WHO CINDI/CARMEN
            New demonstration site in Alberta
                                                                                   31

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:7/27/2012
language:
pages:31