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Submission to the Standing Committee on Finance on the by icecube

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									 Submission to the Standing Committee on Finance
                      on the
          2006 Pre-Budget Consultations

                     September 6, 2006




                     2305 St. Laurent Blvd.
                     Ottawa, Ont. K1G 4J8
                      Tel.: (613) 526-9397
                      Fax: (613) 526-3332
www.cps.ca; www.caringforkids.cps.ca; www.soinsdenosenfants.cps.ca
A society’s good health is the cornerstone of well-performing, competitive economies and key to
economic growth and sustainable development. There is ample evidence that investing in health
yields substantial economic benefits. In a World Health Organization (WHO) study, Dr. Jeffrey
Sacks noted that increasing life expectancy at birth by 10% will increase economic growth by
0.35% a year. Ill-health and shortened life expectancy, on the other hand, account for about 50%
of the growth differential between rich and poor nations.


Good health is not achieved through a laissez-faire approach. It requires far-sighted, proactive
and long-term measures. It requires policies and programs that foster not only an effective health
care system to treat the sick, but also promote good health through evidence-based disease
prevention and health promotion strategies. It is an investment in our future, and leads to longer,
happier and more productive lives.


National Injury Prevention


Unintentional injuries are the No. 1 killer of children, adolescents and young adults. Children
die of injuries more than all other childhood diseases combined. They are the major cause of
disability and the major cause of morbidity. They represent a huge financial burden on the
health care system and have a significant negative impact on productivity and the economy.


The cost of injuries is staggering—an estimated $9 billion in Canada in 1995—but the potential
economic benefits of investing in injury prevention are equally impressive. WHO data show that
one euro spent on child safety seats results in a saving of 32 euros to the economy, one euro
spent on bicycle helmets results in a savings of 29 euros, and for every euro spent on injury
prevention counselling by paediatricians, the economy saves 10 euros.


Canada has made remarkable progress over the past 50 years in instituting various safety
measures, but we remain far too complacent about the inevitability of “accidents” and injuries.
Research has shown that well-organized efforts to provide safer physical and social
environments can result in marked, and often rapid, reductions in injury mortality and morbidity.


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The WHO framework for any country wanting to address the problem of injury includes the
development of a national plan, the formation of an inter-sectoral injury prevention committee to
ensure the proper integration of this issue into different government policies, a national
surveillance system, strengthening the national capacity to respond through primary prevention
and care, legislation and government programs, and the promotion of evidence-based practices,
and research and development into primary prevention and care.


In view of the very significant importance of this issue to the national economy, the Canadian
Paediatric Society recommends that the federal government allocate $20 million this year
for the development of a federal/provincial/territorial strategy on injury prevention,
together with a multi-year financial commitment which would facilitate the effective
implementation of related policies and programs.




Investments in Immunization and Infectious Disease Prevention


The $300 million allocated under the National Immunization Strategy for the purchase of new
childhood vaccines has been an outstanding success. Almost all provincial/territorial
governments now make these vaccines available as part of their publicly funded routine
immunization schedule. The result is that parents, who at one time may have questioned the
necessity of paying for vaccines, are readily agreeing to have their children immunized free of
charge, and anecdotal evidence suggests a remarkable decline in the rates of these diseases.
Immunization is still one of the most cost-effective methods of ensuring good health. The one
noteworthy flaw in the current system, however, is the patchwork of varying immunization
schedules across the country. Not all governments provide all four new vaccines recommended
by the National Advisory Committee on Immunization and the Canadian Paediatric Society, and
not all governments comply with recommendations on the optimum age at which the vaccines
should be administered. The CPS recommends a uniform immunization schedule for all
Canadian children regardless of where they live.




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Infectious disease prevention is especially critical with the prospect of an influenza pandemic.
Here is how the Public Health Agency of Canada estimates the impact of an influenza pandemic:
15% to 35% of the Canadian population (4.5 to 10.6 million citizens) will become clinically ill,
with 2.1 to 5 million requiring outpatient care, 34,000 to 138,000 requiring hospitalization, and
between 11,000 and 58,000 deaths.1 Dr. Sherry Cooper, Chief Economist for BMO Nesbitt
Burns wrote in a 2005 report that, “depending on its length and severity, [an influenza pandemic]
impact could be comparable, at least for a short time, to the Great Depression of the 1930s.”2 In
another 2005 report, the Conference Board of Canada warned that “a flu pandemic on a large
scale would throw the world into a sudden and possibly dramatic global recession.”


Experience has shown that infectious disease outbreaks have the potential for immense human
and economic costs. The 2003 SARS outbreak, which in Canada was largely confined to the city
of Toronto and resulted in 252 cases and 44 deaths, cost Ontario’s tourism industry $2-billion.
The Bank of Canada estimates that SARS caused a 0.6% drop in GDP. And while it was
devastating to those involved, the SARS outbreak was comparatively small in light of the
potential of an influenza pandemic.


The Canadian Paediatric Society therefore recommends that current funding for the
provincial childhood vaccine programs be made permanent, and that it be reviewed
annually to ensure it is sufficient to ensure that all Canadians, regardless of where they
live, have equal access to new vaccines approved by the National Advisory Committee on
Immunization. The CPS also recommends that the funds for First Nations and Inuit
immunization programs be utilized to ensure that Aboriginal children and youth of
Canada have equal access to immunizations. Lastly, we recommend the continued
allocation of $10 million per annum to the Public Health Agency of Canada to ensure that
the objectives of this National Immunization Strategy are achieved.




1
  Public Health Agency of Canada. Canadian Pandemic Influenza Plan. Available at www.phac-aspc.gc.ca/cpip-
pclcpi/s02_e.html
2
  Cooper, Sherry and Donald Coxe. An Investor’s Guide to Avian Flu. August 2005, BMO Nesbitt Burns. Available
at www.bmonesbittburns.com
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Mental health of children and adolescents


Mental health problems among children and youth have increased in recent years and are
predicted to increase by 50% by the year 2020. Twenty per cent of children and adolescents
suffer from developmental, emotional and behavioural problems, and one in 10 children has an
aggressive behaviour problem.3


The cost to the Canadian economy due to mental illness is estimated at $30 billion. Mental health
problems deprive individuals of quality of life and happiness (missed educational, job and
personal opportunities, broken relationships, stigma and discrimination). There are direct costs
such as health and social services and indirect costs such as the breakdown of families, crime,
vandalism and social disruption, poverty, marginalization, working days lost through death and
disability. Mental health problems also increase other risk factors, such as early sexual initiation
for girls and teenage pregnancy.


Prevention and early intervention are critical to reducing the economic and social burden of
mental illness. In May 2006, a Senate committee chaired by Senator Michael Kirby released a
comprehensive report on mental health and mental illness in Canada, Out of the Shadows: Report
of the Senate Committee on Social Affairs, Science and Technology,4 which concluded that
“children and youth are at a significant disadvantage when compared to other demographic
groups affected by mental illness, in that the failings of the mental health system affect them
more acutely and severely.”

The Canadian Paediatric Society calls on the federal government to invest $536 million
annually to ensuring that the recommendations of the Senate Committee on Social Affairs,
Science and Technology report, “Out of the Shadows,” are implemented, which includes
developing a national and coordinated strategy for mental illness and mental health in
Canada and establishing a Mental Health, Mental Illness and Addiction Branch in Health
Canada, with a special focus on the needs of children and youth.

3
  Offord, D.R., Boyle, M.H., Szatmari, P. et al. Ontario Child Health Study: II. Six Month Prevalence of Disorder
and Rates of Service Utilization. Archives of General Psychiatry, 44:, 832 836, 1987.
4
  Standing Senate Committee on Social Affairs, Science and Technology. Out of the Shadows: Report of the Senate
Committee on Social Affairs, Science and Technology. May 2006. www.parl.gc.ca/39/1/parlbus/commbus/senate/
com-e/soci-e/rep-e/rep02may06-e.htm
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Millennium Development Goals


Worldwide, 11 million children die every year before they reach the age of 5, including 4 million
in the first month of their lives. Another 4 million babies are stillborn. The human and economic
cost of so many deaths is overwhelming, yet most of these deaths are preventable through
already available and low cost interventions.


Canada is very much a part of the global economy, and health is increasingly acquiring a global
dimension. We have much to contribute and share in improving health in the global community,
particularly in developing countries. This is not pure altruism, however. Helping the third world
develop their health systems and fight disease benefits them and contributes to our own health
and economic security. The Canadian Paediatric Society urges the Government of Canada
to fulfil its commitment to increase international aid to 0.7% of GNP by 2015, and we call
on the Government again to increase its annual allocation to international development to a
percentage which would enable it to meet its pledge.




School Health


Effectively implementing health promotion and disease prevention strategies in the areas of
injury prevention, immunization and infectious diseases, and mental health will require
multifaceted approaches that deliver education and care at many points of entry. Schools are a
critical venue for delivering health information, and can also be used to deliver programs and
services. Although many Canadian children do not have regular access to a primary care
physician, the overwhelming majority of them (with the exception of those who are home-
schooled or those who are unable to attend school due to serious illness) do attend school daily.
Thus, investments in school health infrastructure are critical for the system to contribute to
widespread public health initiatives.


In addition, there is increasing recognition that schools can play a vital role in encouraging
healthier lifestyles. Some jurisdictions are considering or have implemented mandatory daily
physical activities, smoking cessation campaigns, a ban on junk food and drinks from schools

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and have instituted nutrition education programs. There is much more that could be done.
Schools present ideal venues for other early intervention programs to promote mental health,
avoid addictive or risky behaviours, and prevent injuries. The potential benefits are immense.


The federal government can play a pivotal role in encouraging the provinces and territories to
implement comprehensive school-based health strategies, including demonstration projects,
feasibility studies and evaluations. The Canadian Paediatric Society therefore recommends
that the federal government allocate $40 million to facilitate the implementation of
comprehensive school-based strategies.


Conclusion


Children are Canada’s most precious resource. In an increasingly competitive world, maintaining
their good health is fundamental to our future social and economic progress. This has never been
more true given our declining birth rates and a growing elderly population. Investing in these
measures will help to protect and promote children’s health, and will contribute immeasurably to
sustainable development and long-term prosperity in this country.




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