Submission to the Standing Senate Committee on Social Affairs, Science and Technology

Thank you for inviting the BC Alliance for Healthy Living to present and provide input into your report on ‘the increasing incidence of obesity in Canada: causes, consequences and the way forward’.

The BC Alliance for Healthy Living (BCAHL) is a group of nine non-profit organizations that came together to improve the health of British Columbians. Our focus is on leadership and collaborative action to address the risk factors and health inequities that contribute significantly to chronic disease.

As you will have already heard, obesity is significant problem in Canada as a risk factor for a number of chronic diseases including type 2 diabetes, hypertension, cardiovascular disease, and some forms of cancers.

Furthermore, it also has negative impacts on mental health and has been associated with anxiety and depression and new research shows that this can be further exacerbated by weight stigma and bias.1

And so, we must be sensitive as we seek to improve the overall health – including both physical and mental well-being of overweight and obese Canadians.

Fortunately, there are lessons on healthy living that apply to all Canadians – of every age and size.i Today, I will be focusing my presentation on the importance of physical activity and how this can be supported by government as an important actor in an all of society approach.

Physical activity supports physical and mental health through the life course.i,iii,v,viii It is critical for the healthy development of children – as infants and young children develop healthy bones, muscles and physical literacy skills that will serve them for life. At later stages of life, it is essential for healthy aging as it “is among the most promising and cost effective strategies to reduce physical and cognitive decline and premature death.”ii

The Canadian Physical Activity Guidelines recommend at least 150 minutes of moderate to vigorous activity per week for adults and 60 minutes per day for children and youth.iii Recent evidence says that even a little bit helps. Mortality was reduced by 20% when people were somewhat active, even if they didn’t meet the guidelines, when compared to those who were completely inactive.iv

In BC, as in other places, the inactive population tends to be prevalent among those: with low socio-economic status; residing in small communities, often rural, or in the Northern part of the province; in minority or immigrant populations; and with low literacy.v, vi Not surprisingly, there are parallels with populations that have an elevated risk for obesity and for numerous chronic diseases.vii, viii, vi And so, as we plan where we can make the most difference – we should be thinking of how we can prioritize action for these inactive populations.

So how do we overcome the barriers? How do we motivate those who are inactive to get moving and how do we get more people adding activity in to their daily routines? We need to act by investing in physical activity infrastructure and programs – so that Canadians live in healthy communities where they can easily add physical activity into their daily patterns.

WHAT CAN WE DO ABOUT IT?

1)  We can invest in walkable and transit-oriented community design that supports active transportation.
• The influence of healthy built environments on activity levels and weight is strong.ix, x, xi, xii A recent study in Metro Vancouver found those that took transit were 22% less likely to be overweight or obese and those who commuted by bike or on foot were 48% less likely.xii

2) We can provide opportunities for children and youth to develop active lifestyles, by
• Building physical literacy skills and increasing physical activity programming in schools and childcare centres.
• Supporting after school initiatives – continue Public Health Agency of Canada (PHAC) funding of programs, particularly those that are targeted to populations and in areas with low activity rates.
• Increasing access to sport opportunities for low income families.

3) We can revitalize recreation centres and parks to better serve communities
• Parks, trails, pools, arenas and community centres are hubs for physical activity. However, they are increasingly challenged to deliver what communities require. Almost three quarters of BC’s recreation, parks and sports facilities are 25 years of age and older and half are over 35 years old and in need of renovation or replacement.”xiv
• Renovated neighbourhood parks have been shown to attract more users and increase physical output.xv,xvi

4) We can work together with First Nations and Aboriginal Peoples to increase participation in regular physical activity and sport
• By collaborating with First Nations governments and groups such as the Aboriginal Sports and Recreation Association of BC, Canada can look at how best to remove barriers and expand opportunities for the development of culturally appropriate programs, leadership and facilities that support physical activity among Aboriginal peoples living in urban centres and on-reserve.xvii

5) We can look at ways to ‘nudge’ healthier behaviours
• The practice of nudging individuals by providing incentives or positive reinforcement of specific choices is a concept that has been adopted by both governments of the UK and the USA.
• This is a potentially promising practice for making the healthy choice, an easy choice.

6) We can build on existing networks
While many of the recommendations that I have highlighted today fall within the purview of other levels of government, I would suggest that the Federal Government still has a role to play. As a funder, convener and knowledge broker, the government of Canada has many levers and networks to facilitate an integrated approach to physical activity promotion.

We encourage you to look at existing networks where the Federal Government brings people together and see where there are opportunities to promote physical activity. For example, the Community Action Program for Children (CAPC) provides an appropriate audience and vehicle for promoting physical literacy to pre-school children.

Concluding Remarks

As Senator Nancy Greene Raine so eloquently stated, “it’s essential to get Canadians moving, and the stakes are high, especially for youth.”xvii

Investing in efforts to get Canadians active is worth it. Inactivity takes a toll on our “economy – between $4.6 billion to $7.1 billion a year in direct health care costs and indirect costs. Compared to an active Canadian, an inactive person will spend 38% more days in hospital and make 5.5% more family physician visits and 12 % more nurse visits.”xviii

The non-profit sector and local government are your partners in this but we need the Federal Government to be involved and to make physical activity infrastructure a priority. It’s time to move beyond talking, it’s time to get active.

May 2015

References:

[i] BC Provincial Health Services Authority. (2013) Technical Report: From Weight to Well-Being: Time for a Shift in Paradigms? A discussion paper on the inter-relationships between obesity, overweight, weight bias and well-being. http://www.phsa.ca/population-public-health-site/Documents/W2WBTechnicalReport_20130208FINAL.pdf

[ii] Anderson D, Seib C, & Rasmussen L. (2014). Can physical activity prevent physical and cognitive decline in postmenopausal women? Maturitas, 79(1), 14-33.

[iii] Canadian Society for Exercise Physiology The Canadian Physical Activity and Sedentary Behaviour Guidelines Handbook http://www.csep.ca/CMFiles/Guidelines/CSEP_Guidelines_Handbook.pdf Accessed 15-04-19

[iv] Arem H. et al. Leisure Time Physical Activity and Mortality: A Detailed Pooled Analysis of the Dose-Response Relationship. Journal of the American Medical Association internal medicine2015 Apr 6.

[v] BC Alliance for Healthy Living. (2007) BCHLA Physical Activity Strategy. http://www.bchealthyliving.ca/wp-content/uploads/2014/07/BCHLA_PhysicalActivityStrategy.pdf

 [vi] BC Alliance for Healthy Living. (2014) On the Path to Better Health. http://www.bchealthyliving.ca/wp-content/uploads/bchla-path-final-mar14-screen.pdf

 [vii] Tjepkema M, Wilkins, R, Long A, Cause-specific mortality by income adequacy in Canada: A 16-year follow-up study Health Reports 2013 Vol. 24 no.7 pp. 14-22

[viii] British Columbia. Office of the Provincial Health Officer. Investing in prevention: improving health and creating sustainability: the Provincial Health Officer’s special report., August, 2010 http://www.health.gov.bc.ca/library/publications/year/2010/Investing_in_prevention_improving_health_and_creating_sustainability.pdf

[ix] Provincial Health Services Authority. (2007). Creating a Healthier Built Environment in British Columbia http://www.phsa.ca/Documents/creatingahealthierbuiltenvironmentinbc.pdf

[x] Canadian Urban Transit Association. Economic Impact of Transit Investment in Canada: A National Survey.(2010) http://www.cutaactu.ca/en/public-transit/publicationsandresearch/resources/Final_CUTA-EconomicBenefitsofTransit-FinalReportESept2010.pdf

[xi] BC Recreation and Parks Association. (2009). Physical Activity and Transportation Benefits of Walkable Approaches to Community Design in British Columbia. Available at http://www.bcrpa.bc.ca/recreation_parks/active_communities/documents/BCRPA_Transportation_Study_2009.pdf

[xii] Frank L. D.& Kershaw, S. E. UBC School of Population and Public Health (2015) Health Benefits of Transit Investment: Policy Brief  http://med-fom-spph-health-design.sites.olt.ubc.ca/files/2015/03/Health-Benefits-of-Transit-Investment-Summary-Mar-0515_ju.pdf

[xiii] Vancouver Coastal Health & Fraser Health. My Health, My Community. (2015) Transportation and Health in Metro Vancouver. www.myhealthmycommunity.org/Portals/0/Documents/MHMC%20Transportation%20and%20Health%20vPUBLIC%2012MAR2015.pdf

[xiv] BC Recreation and Parks Association, (2009) A Time for Renewal An Assessment of British Columbia’s Recreation Facilities. http://www.bcrpa.bc.ca/recreation_parks/facilities/sports_recreation/documents/Full_Report_Final.pdf

[xv] Gohen, A. D., et al. (2015) Impact of Park Renovations on Park Use and Park-Based Physical Activity. Journal of Physical Activity and Health Volume 12, Issue 2, February

[xvi] Hannon JC, Brown BB. Increasing preschoolers’ physical activity intensities: An activity-friendly preschool playground intervention. Preventive Medicine 2009; 46:532-536.

[xvii] Aboriginal Sport, Recreation and Physical Activity Partners Council. Aboriginal Sport, Recreation and Physical Activity Strategy http://www.bcaafc.com/~bcaafc/images/stories/PDFs/asrpa_strategy.pdf Accessed Apr 20,

[xviii] Nancy Greene Raine NATIONAL HEALTH AND FITNESS DAY BILL, Third Reading of bill S-211 (June 12, 2014) http://nancygreeneraine.ca/pdf/BillS-211-3rdReading-e.pdf