2009 Annual Report Of The Chief Medical Officer Of Health Of Ontario To The Legislative Assembly Of Ontario
The 2009 Chief Medical Officer of Health annual report begins with a review of an extremely busy year. Despite the fact that H1N1 consumed an extraordinary amount of time and a huge number of resources, the work of public health continued, every day, all around the province. Achievements in public health in 2009 include the introduction of the Ontario Public Health Standards, expansion of the Children In Need of Treatment (CINOT) dental program, release of a comprehensive plan of action in support of early childhood development and learning, and the Initial Report on Public Health 2009.
The report goes on to discuss both the medical and economic case for focusing public health resources on prevention. Every year in Canada, more than two-thirds of all deaths result from chronic diseases and they are often preventable. Cardiovascular disease, cancer, type 2 diabetes and respiratory diseases all share the same common preventable risk factors - physical inactivity, unhealthy diet and tobacco use. The total cost of illness, disability and death attributable to chronic diseases is estimated to be more than $80 billion annually.
The importance of understanding the social determinants of health is also emphasized in this report. These are economic and social conditions - such as income or education - that are known to greatly influence health. If the province is to address the social determinants of health and do a better job of preventing disease and injury, then Ontario needs a system-wide approach, one that encompasses all three levels of government, the health, education, financial and social sectors, as well as the people of Ontario. It must become everybody's business.
The report identifies five critical areas where efforts must be made.
Reducing Obesity and Physical Inactivity
Today, almost, 60 percent of Ontario adults are overweight or obese. Currently 52 percent of Ontario adults over 20 are still not reaching the recommended physical activity level in Canada's Physical Activity Guide to Healthy Active Living. If current trends continue, the children of the next generation will have a lower life expectancy than their parents. That has not been the case in Canada for many generations.
The government is tackling this problem in a number of ways, but more needs to be done.
Healthy Child Development
The earliest indicators of the kind of health a human being will enjoy can be found at the very beginning of his or her life. Early childhood experiences do an extraordinary amount to shape the future health of children and the adults they will become. Good schools, safe communities, clean water - these and many other factors are critical to healthy human development, and governments must be aware that they have a role to play in ensuring that children start their lives in the right kind of environment.
Injuries are the leading cause of death for Canadians under the age of 45 and the fourth leading cause of death for Canadians of all ages.
In 2007, the government launched Ontario's Injury Prevention Strategy. In addition, Ontario's 36 public health units support injury prevention through Ontario's Prevention of Injury and Substance Misuse public health standard.
Although these and other initiatives have decreased preventable injuries, injury prevention must remain a priority.
The effects of the social determinants of health can be seen and felt in many parts of this province. However, the public health situation in remote and northern communities is of serious concern because remote and isolated First Nation communities often bring together, contain, and compress all of the various determinants of poor health. With respect to Aboriginal communities, determinants of health contribute to compromised health status, on and off reserve, in the north of the province and in the south. But it is in remote northern Aboriginal communities where poverty, isolation and jurisdictional issues have come together to create what is, from a public health point of view, a perfect storm.
Tobacco use and smoking cessation
The facts about tobacco use are beyond dispute. It kills, it burdens the health care system, and it costs the provincial economy close to $8 billion in direct health care costs and productivity losses annually. In Ontario, more than two million people smoke.
Ontario has acknowledged this reality and has been fighting to reduce tobacco consumption for many years. There is pride in accomplishments to date, but it is time to take the next step in tobacco control according to the report. Ontario needs to make additional investment in tobacco control, adopt a cross-sectoral and pan-Ontario approach to fighting tobacco and improve smoking cessation programs.
Comprehensive public health strategy
The report is a call to action to all three levels of government, the health, education, financial and social sectors, as well as the people of Ontario. Dr. King concludes by saying that Ontario needs a comprehensive public health strategy that outlines the direction Ontario should be taking over the next five years. She plans to release recommendations for this strategy later in 2011.