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Letters to the Editors and News from the Field, January 2006

A Introduction

At the end of 2005, we invited colleagues in the field of health
promotion to submit their thoughts on the past year and their hopes for
2006.  Their letters are presented here, following a new round up
of news from the field and a letter from one of our readers.

If you would like to contribute your reflections on health promotion in
2005 and what you would like to see happening this year, send your
contribution to editor@ohpe.ca (maximum 250 words) before January 31,
2006!

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B People News

1 New President at Canadian Policy Research Networks

Arthur Kroeger, Chair of the Board of Canadian Policy Research Networks
(CPRN), is pleased to announce the appointment of Dr. Sharon Manson
Singer to the position of President, effective February 1, 2006.

Dr. Manson Singer of Victoria has more than two decades of experience
in the public policy environment. From 1997 to 2001, she held a number
of deputy minister positions in the British Columbia government,
including being the lead deputy minister during the creation of the
National Child Benefit and the National Children's Agenda. Dr. Manson
Singer has also lectured at the graduate level at the University of
British Columbia and at the University of Victoria. Her PhD in social
welfare economics is from Brandeis University in the United States.
Since 2001, she has operated her own consulting firm, providing
corporate advice, public policy design and advice, strategic
management, business development and human resources development
counsel to the private, public and voluntary sectors. 

Canadian Policy Research Networks was founded by Judith Maxwell, who,
over the last decade, built CPRN into one of the country's most
respected think tanks. Maxwell is one of Canada's top thinkers and a
highly regarded advisor to governments and commentator on economic and
social issues. She stepped down as President of CPRN in December 2005.

"No one should underestimate the contribution she has made as the
former Chair of the Economic Council of Canada, and in creating CPRN,"
says Kroeger. "Public policy across the country bears her imprint. We
are all delighted that she will continue her involvement as a CPRN
Senior Research Fellow."

[Source: Urban Nexus, http://www.cprn.org/en/e-network/html-subscribe.html]

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2 New Director, Chronic Disease Prevention & Health Promotion

I am very pleased to announce that Pegeen Walsh will be joining us as
Director, Chronic Disease Prevention & Health Promotion, effective
Monday, December 5, 2005.  Pegeen brings 24 years of experience
developing and managing social and health policies and programs at the
national and regional levels of the federal government as well as with
the provincial and voluntary sectors. 

As Ontario's Regional Director with Health Canada, and now the Public
Health Agency of Canada, she launched a wide range of health promotion
and disease prevention initiatives in areas such as healthy child
development, Aboriginal Headstart, diabetes, HIV/AIDS, Hepatitis C,
seniors and injury prevention, tobacco reduction, health and the
environment and social inclusion.  She is a former Director,
Public Policy, at the YMCA of Canada where she trained CEOs and Board
members on strategies for influencing public policy and social
change.  With the Ontario Native Affairs Secretariat she provided
leadership to an interministerial team that secured funding for
Ontario's first Aboriginal Healing and Wellness Strategy. This is an
exciting time for health promotion in our province.  I know that
we will benefit immensely from Pegeen's breadth and depth of knowledge
and experience and her commitment to innovation and creativity in
health promotion programming.

Please join me in welcoming Pegeen to the Ontario Public Service and our health promotion team.

Yours truly,
 
Dr. Sheela V. Basrur
Chief Medical Officer of Health and Assistant Deputy Minister
Public Health Division
Ministry of Health and Long-Term Care

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3 Kathy Leep Moves to the Grand River Regional Cancer Centre

Just a quick update on my recent job change.  My previous position
was as a Public Health Nutritionist at Region of Waterloo Public
Health, where I worked for three years in the areas of research and
policy development around food security.  I arranged a special
learning opportunity this summer to train in a new field -clinical
nutrition.  I spent a total of 18 weeks training in a number of
different clinical nutrition areas (e.g., Surgery, Oncology, Renal)
under the supervision of Registered Dietitians specializing in these
areas.  Once my training was complete, I managed to get hired for
a new opening at Grand River Regional Cancer Centre.  I am now
working as an Oncology Dietitian, caring for cancer patients in an
outpatient setting.  I am thrilled to have successfully made a
career transition from community to clinical nutrition.

Kathy Lepp, RD

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4 New Bilingual Health Promotion Consultant at the Ontario Prevention Clearinghouse

Louise Choquette is the new part-time Bilingual Health Promotion
Consultant for the Health Promotion Resource Centre of the Ontario
Prevention Clearinghouse (louise@opc.on.ca). She will primarily be
working with Francophone service providers in Ontario, while continuing
to service Best Start on a part-time basis. She has a broad health
promotion background and has worked for public health and for Ophea
over the past decade, coordinating heart health and substance abuse
programs, delivering numerous workshops and implementing a variety of
health promotion initiatives.

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5 Alder Group Wins Ottawa Chamber of Commerce Business Achievement Award

At the Ottawa Chamber of Commerce Annual Business Achievement Awards
Gala on December 1, 2005, the Alder Group won a Bronze in the Small
Business of the Year category.

To view the complete list of winners, visit http://www.greaterottawachamber.com/events/awards/index.html.

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6 In Memory of Dr. Oded Bar-Or

Active Healthy Kids Canada sadly mourns the loss of one of our longest
standing Board members and one of the pioneers in research and advocacy
in the field of physical activity and children's health.  Dr. Oded
Bar-Or died on Friday after battling cancer for the past year and a
half.  We were very fortunate to have had the experience of
working with him, which was enriching for all on a professional and
personal level.

The Active Healthy Kids Canada Physical Activity Report Card for
Children and Youth is just one notable legacy of Oded's work with our
organization, and only a very small example of the contributions Oded
made over the course of his professional life, for which he has
received prestigious recognition through awards and honours.  The
Report Card will be dedicated to Oded at its release in May 2006, and
we are also discussing other appropriate ways to honour Oded.

Oded, his colleagues, and family have also worked with Brock University
to create the Bar-Or Travel Award that will support ongoing work in the
field of physical activity and children's health.  If you would
like to make a contribution to this Award you can direct it to the
Brock University Development Office, Attn:  Bar-Or Travel Award,
St. Catherine's, ON L2S 3A1.

Oded will always be respectfully and fondly remembered.  Please
feel free to share this message with your networks who have been
touched by Oded's work.

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C Letter to the Editor

Dear OHPE Bulletin,
 
I am writing from The Association for Research on Mothering (ARM). We
recently received notification of the OHPE Bulletin  434.1 re:
Grandparenting in the 21st Century [http://www.ohpe.ca/ebulletin/index.php?option=com_content&task=view&id=6892&Itemid=78].
 
Our most recent journal issue -- Grandmothering and Grandmothers -- is hot off the press for November!
 
Here is a link to our website with more detail about the Journal of the
Association for Research on Mothering, and this Grandmothers, Volume
7.2 specifically: http://www.yorku.ca/crm/Journal/vol7no2.htm.
 
Thank you in advance,
 
Renée Knapp
ARM, arm@yorku.ca

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D 2005 In Review

1 SPHERU

2005 saw the Saskatchewan Population Health and Evaluation Research
Unit (SPHERU) fine tune its research focus.  In response to the
Province of Saskatchewan's Health Research Strategy, SPHERU now
concentrates on three key areas: Aboriginal/ Northern / Rural Health,
Children's Health, and Policy / Governance and Health.  The three
theme areas are also a good fit for our researchers.  SPHERU's
dedicated researchers continue to churn out results, working together
and as individuals, obtaining provincial and federal funding for new
projects, submitting articles for publication, writing reports and
attending conferences.  SPHERU continues its work to create new
knowledge and understandings of population health and inform public
policy locally, provincially and beyond.

-- SPHERU, University of Regina

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2 Susan Murray, Consumer Health Information Service

I was encouraged by the creation of the new Ministry for Health
Promotion.  However, I think it's going to take a lot of smart
planning to "sell" it to the general public when there are competing
and pressing threats, such as the avian flu crisis.
 
I was discouraged that what little publicity the Ministry for Health
Promotion received was negative. Below are some news items from
July  2005.
 
Helping Ontarians to Choose Healthier Food: Comment ? Toronto Sun
"Jim Watson was recently bumped from the Consumer ministry to Health
Promotion, a new and -- some believe -- make-work portfolio?. "You
can't legislate good behaviour, but I think you can encourage it. And I
think if people understand the consequences of eating fast food, or
deep-fried foods, or unhealthy foods too often, hopefully that will
change their attitude," he said. Fair enough. Now if the government
could find a way to run the province without relying on tax revenues
from cigarettes and income from the LCBO, perhaps we could all start to
take them seriously."
 
Finding a Healthy Balance? Kingston Whig Standard
"Ontarians asking why the province needs a minister of health promotion
haven't had much help from Jim Watson, who holds the new portfolio. He
recently told reporters he will encourage healthier lifestyles, saying
"fat is the new tobacco" and "you are what you eat." It's not clear why
the province's health minister, George Smitherman, couldn't get these
messages across on his own".

My hope for 2006 is that health promotion will become important in the
minds of the government funders and the public. I am encouraged that
the Ministry of Health Promotion will be holding a series of roundtable
meetings across Ontario this year to discuss health promotion and the
new Ministry's role in promoting health and wellness throughout Ontario.

- - Susan Murray, CHIS

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3 Marie Traynor, Acting Manager, Nutrition Resource Centre

Nutrition--it's always a big topic. People talk about food, nutrition
and eating a lot! At the workplace, in and about schools, in recreation
centres, in restaurants and cafeterias, at the health care provider's
office, in the staff room, on the subway, in the grocery store
check-out line, everywhere and a lot! We also know that folks get their
information from a variety of sources some evidence-based, some not. In
the health promotion field we discuss effective strategies to make both
small eating habit changes in a lot of people and more comprehensive
changes in particular sections of the population.

In 2004, the Ontario Chief Medical Officer of Health Report "Healthy
Weights, Healthy Lives" focused the interest and attention of
individuals and groups, province wide and across all sectors, on
healthy eating and regular physical activity. We know these behaviors
are fundamental to enjoyably and realistically reach and maintain age,
shape, gender and health status appropriate healthy weights. So many of
us who work in nutrition and physical activity promotion were thrilled
to see the report published! I heard dietitians sighing a cautious
collective sigh of relief that this valuable attention could move these
issues up "the political agenda" items list!

In 2005 great time, effort and passion led provincial and national
collaborative groups and alliances to form and/or strengthen. Large
groups of people met to seriously talk about strategies that would take
a wide and long-term view at what their members are doing and need to
do to reduce sedentary behaviour and unhealthy eating habits. We are
confident in the fact that these two and very complex risk factors
contribute to the development of many types of chronic disease.

So confident that, also in 2005, a new Ontario Government Ministry, the
Ministry of Health Promotion began to develop its mandate.

So now it's 2006. We have been invited by this new Ministry to give our
input. Let's take advantage of that invitation to express the ongoing
need for nutrition and physical activity common messaging based on
evidence, reliable and province wide environmental supports, realistic
policies based on credible standards, health promotion education for
professionals in these fields, effective skill building programming for
the public, research to comprehensively test nutrition and physical
activity promotion and intervention strategies and, most importantly,
the accessibility to healthy, safe and enjoyable food by all.

Happy New Year!

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4 Brenda Perkins, (A) Manager, Ministry of Health Promotion

From a Government perspective, the year 2005 was seen as one of
substantial change in relation to health promotion.  The Ministry
of Health Promotion was created on June 29, 2005, with the Honourable
Jim Watson becoming Ontario's first Minister of Health Promotion and
Peter Fonseca becoming the Parliamentary Assistant to Minister
Watson.  In August, Marg Rappolt became the Deputy Minister of the
Ministry of Health Promotion.

Throughout the fall, the Minister and the Deputy Minister met with many
stakeholders to learn about their organizations, to understand the
issues related to health promotion and to have a dialogue about future
directions.  Further stakeholder consultations will occur in early
2006 throughout the province.  The information gained from these
consultations will assist the Ministry in its strategic planning for
2006 and beyond.

It is expected that in 2006, we will see continued implementation of
the Smoke Free Ontario strategy and Active 2010, integration of public
health programs, including chronic disease prevention, details for a
plan for healthy active living, and policy development in the area of
injury prevention and mental health and addictions.

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5 Dennis Raphael, York University

2005--A Year of Little Progress in Population Health, Health Promotion,
or Healthy Public Policy, with Appreciation to the Few with the Courage
to State the Obvious

Poverty is the primary determinant of health in Canada. 
Everything health promoters may wish to accomplish through whatever
means will always pale in significance--and effectiveness--when
thousands and thousands of families live in unfit and crowded housing,
are hungry, and are unable to participate in the activities normally
expected of citizens living in an advanced industrialized nation such
as Canada.

Knowing this, the end of 2005 finds the health promotion and public
health fields for the most part mired in irrelevance and
insignificance.  Of course we can applaud the Maritime health
workers who are coming together to establish a social determinants of
health coordinating centre under the auspices of the Public Health
Agency of Canada. And kudos are due to the public health
units--Peterborough, Waterloo, Sudbury, Perth, Interior, Calgary,
Chinook, Edmonton, and Montreal--that have shaken off the shackles of
apathy and impotency to lobby their medical officers of health to get
serious about health. And there are even a handful of health
researchers that are recognizing the obvious--that poor living
conditions are the primary determinants of disease and despair in
Canada.

But the health community remains stuck on tobacco, diet, activity, and
obesity adding insult to injury to those suffering at the bottom of the
income ladder in Canada. We have nothing to say about the starvation
social assistance rates the poor are required to live on.  We say
nothing about the clawback of the child benefit to families with
children on social assistance in every province except New Brunswick
and Manitoba.  We say nothing about the arguably lowest minimum
wages in Canada among the industrialized nations.  Instead we say
don't be fat.

The public health goals of Canada are a parody of the statements Health
Canada has been issuing since 1974.  Addressing inequalities in
health are so low on the public health and public policy agenda as to
be almost invisible.  Indeed we live in dark times.

Any -- virtually all -- public policy that has developed to meet the
needs of our most disadvantaged have come about through the minority
government situation in Ottawa.  It is not a proud time to be a
health promoter in Canada.  It is a time however, when one can
influence public policy through the election.  And to that goal I
offer you the following essay that is still seeking a home in a
Canadian Newspaper somewhere.  Happy New Year!.

The Politics of Poverty

"This House seek(s) to achieve the goal of eliminating poverty among Canadian children by the year 2000."

Despite the House of Commons unanimously passing this all-party
resolution November 24, 1989, Canada's child poverty rate continues to
be amongst the highest in the developed world. Indeed, for many
Canadians, the primary campaign issue in this election is: What is your
party prepared to do about eliminating child poverty?

According to UNICEF, Canada's child poverty rate of 14.9% during the
late 1990s was among the highest in the developed world.(1) This is the
case even though Canada is a wealthier nation -- using the total value
of goods and services or GDP -- than just about every other developed
nation.(2) Denmark's child poverty rate of 2.4% represents a virtual
elimination of child poverty.  This is also the case in Finland,
Sweden, and Norway. As a public health researcher trying to come to
grips with why this might be the case, I reviewed Canadian public
health documents that have accumulated since the famous 1974 Lalonde
Report that put Canada on the world map as a leader in "health
promotion."

Health Canada seems to be onside. Its 1998 Statistical Report on the
Health of Canadians stated "In the case of poverty, unemployment,
stress, and violence, the influence on health is direct, negative and
often shocking for a country as wealthy and as highly regarded as
Canada." (3)  

The Canadian Public Health Association (CPHA) 2000 annual meeting
approved the resolution: "Be it resolved that CPHA... promote dialogue
with the public about the persistence of poverty in the midst of
economic growth and declining unemployment rates; the negative effects
that poverty has on the health of individuals, families, communities,
and society as a whole; and solutions/strategies for reducing poverty
and its negative health consequences." (4)

The appreciation of the importance of poverty is present.  Why is
nothing being done? An increasing body of research finds that child
poverty rates cannot be attributed to failings of those children and
families who are poor.  It does not even lie with the presence or
absence of well-meaning intentions of policymakers.  It reflects
the general operation of the economy -- heavily influenced by the
politics -- of a nation.  International studies reveal the best
predictors of child poverty rates are a) the percentage of low-paid
workers within a nation; b) levels of minimum wages; and c) percentage
of national resources or revenues invested in social infrastructure.
(5, 6)

Among developed nations, Canada has the highest percentage of low-paid
workers (23%) exceeded only by the USA. (6)  Our minimum wages are
among the lowest. Despite Canadians' beliefs about the generosity of
our welfare state, we actually have one of the least developed welfare
states.  Indeed, Canada is identified by scholars as a "liberal
welfare state" that shares characteristics with nations such as the
USA, UK, Ireland, Australia, and New Zealand. (7, 8)  These
nations spend relatively little on social and entitlement programs,
which results in higher levels of child and general poverty, and
greater income and wealth inequality.

How does a nation get to be a liberal welfare state as opposed to a
nation that takes the well-being of its population seriously? The
answer is deceptively simple.  The best predictor of child poverty
rates is also the best predictor of jurisdictional commitment to
providing its citizens with a modicum of security and well-being: The
influence of "left" parties in government as measured by "Left Cabinet
Share."(5)

Left cabinet share is the percentage of Cabinet members that are
members of a labour or social democratic party. Canada and the USA have
never had a Federal labour, CCF, socialist, or NDP party in power. How
strong is the relationship between left cabinet share and child poverty
rates?

Among 14 developed nations between 1946 and 1990, the presence of left
parties in government is strongly related to the probability that a
child will experience poverty. (5)   To illustrate, Sweden
had a 32% left cabinet share and a child poverty rate of 2.4%. Belgium
had a 13% left cabinet share and a 6% child poverty rate. Canada has 0%
left cabinet share and a 14% rate. And the USA also has the lowest left
cabinet share at 0% and a 25% child poverty rate. Why is this so?
Social democratic parties are committed to full employment, equitable
distribution of income and wealth, and provision of a strong social
safety net. (9)  Indeed, most of the progressive changes that have
occurred in Canada such as Medicare and pensions and, most recently,
increased spending on housing daycare, and transportation, have come
about during minority government situations.

The electoral implications of these findings are clear.  Vicente
Navarro of the Johns Hopkins School of Hygiene and Public Health points
out, "For those wishing to optimize the health of populations by
reducing social and income inequalities, it seems advisable to support
political forces such as the labor movement and social democratic
parties, which have traditionally supported larger, more successful
redistributive policies." (10)

If you vote Conservative or Liberal in January, you are voting for child poverty.

Dennis Raphael, PhD, Associate Professor at the School of Health Policy
and Management at York University in Toronto, is editor of Social
Determinants of Health: Canadian Perspectives published by Canadian
Scholars Press.  

Refrences

1. Innocenti Research Centre. Child Poverty in Rich Nations, 2005.
Report Card No. 6. Florence: Innocenti Research Centre; 2005. Available
at http://www.unicef-icdc.org/cgi-bin/unicef/Lunga.sql?ProductID=371
2. Organization for Economic Cooperation and Development. Society at a
Glance: OECD Social Indicators 2002 Edition. Paris, France 2003.
3. Health Canada. Statistical Report on the Health of Canadians. Health
Canada, Statistics Canada, Canadian Institute for Health Information.
4. Canadian Public Health Association. Reducing poverty and its
negative effects on health: resolution passed at the 2000 CPHA Annual
Meeting. Canadian Public Health Association [Position Paper]. Available
at http://www.cpha.ca/english/policy/resolu/2000s/2000/page2.htm.
5. Rainwater L, Smeeding TM. Poor Kids in a Rich Country: America's
Children in Comparative Perspective. New York: Russell Sage Foundation;
2003.
6. Innocenti Research Centre. A League Table Of Child Poverty In Rich
Nations. Florence Italy: Innocenti Research Centre; 2000. Available at http://ideas.repec.org/p/ucf/inreca/inreca00-1.html
7. Esping-Andersen G. The Three Worlds of Welfare Capitalism. Princeton: Princeton University Press; 1990.
8. Esping-Andersen G. Social Foundations of Post-Industrial Economies. New York: Oxford University Press; 1999.
9. Bernard P, Saint-Arnaud S. More of the Same:  The Position of
the Four Largest Canadian Provinces in the World of Welfare Regimes.
Ottawa: Canadian Policy Research Networks; 2004. Available at http://www.cprn.com/en/doc.cfm?doc=1116
10. Navarro V, Shi L. The political context of social inequalities and
health. In: Navarro V, ed. The Political Economy of Social
Inequalities: Consequences for Health and Quality of Life. Amityville,
NY: Baywood; 2002.