“What we see in our studies is that Canada is not getting value for money in its health care,” said Conservative Senator Wilbert J. Keon (Ottawa - Ontario), the Subcommittee’s Chair, and one of Canada’s pre-eminent surgeons. “The Euro-Canada Health Consumer Index has placed us last out of 30 countries in this category, what this tells me is that we are doing something wrong."

"There appears to be a commitment to old-style health care delivery systems," continued former health professional Senator Lucie Pépin - Lib. - (Shawinegan - Quebec). "It is the Subcommittee’s belief that a commitment to population health strategies and community level programs would lead to Canada getting the kind of value for money that we see in other countries’ population health strategies."

These two reports conclude the first phase of the Subcommittee study and launch phase two. The plan is to complete the study with the tabling of a final report to the Senate in December 2008. The final report will detail the recommendations on how to implement population health strategies. The Subcommittee encourages Canadians from across the country to forward by June 30, 2008 their comments and recommendations to help chart a way forward toward dramatically reducing health disparities in Canada.

The Subcommittee’s members are the Honourable Senators:

Bert Brown - C - (Alberta), Catherine S. Callbeck - Lib. - (Prince Edward Island), Ethel M. Cochrane - C - (Newfoundland and Labrador), Joan Cook - Lib. - (Newfoundland and Labrador), Joyce Fairbairn, P.C. - Lib. - (Lethbridge - Alberta), Wilbert J. Keon - C - (Ottawa - Ontario), and Lucie Pépin - Lib. - (Shawinegan - Quebec).

For more information on the Subcommittee, please visit “Subcommittee on Population Health”, under “Social Affairs” at: www.parl.gc.ca/sencom-e.asp.

The interim reports are available on the Committee’s website: http://senate-senat.ca/SOCIAL.asp

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For more information, please contact:

Alexandre Asselin
Media Relations
Tel: (613) 944-4075
Toll free 1-800-267-7362
Email: assela@sen.parl.gc.ca

Barbara Reynolds
Clerk of the Committee
Tel: (613) 990-6187
Toll free 1-800-267-7362
Email: reynob@sen.parl.gc.ca

POPULATION HEALTH POLICY IN Canada:
FEDERAL and PROVINCIAl/TERRITORIAL PERSPECTIVES

· This report describes and compares the efforts of federal, provincial and territorial governments to develop and implement population health policy in Canada.

· The concept of population health was elaborated in Canada in 1974 with the Lalonde report; it then evolved from a focus on improving overall health status to an emphasis on reducing health disparities.

· Both the federal and provincial/territorial governments have devoted considerable attention to population health. However, there is no national plan in Canada to reduce health disparities and improve overall population health status.

· In 1997, the federal government endorsed a Memorandum to Cabinet on Population Health; the proposal involved 18 departments and identified Health Canada as the lead. Yet, it did not succeed in coordinating the activities of the different departments concerned. It failed because significant funding cuts impeded its implementation. Only Health Canada moved forward to apply a population health lens to its programs and initiatives.

· In 2001, Health Canada developed a template that provides guidance to successful implementation of population health policy in both the health and non-health sectors. Though useful, this document has not convinced the non-health sector to embark on an ambitious population health agenda.

· Aboriginal populations bear a disproportionate burden of ill health and social suffering in Canada. The federal government can play a key role in addressing these health disparities. Currently, 30 federal departments and agencies deliver some 360 programs and services at a cost of $8.2 billion to all Aboriginal peoples. These programs and services, however, are not coordinated and integrated in a way as to reduce health disparities.

· In Newfoundland and Labrador and Québec, population health policy emanates from the health department, but the two jurisdictions also have separate policies on poverty and social exclusion. In other provinces, current whole-of-government approaches tend to be structured around singular health determinants, such as ActNow BC’s focus on personal health practices and early childhood development by Healthy Child Manitoba.

· Each province implemented health goals between 1989 and 1998, but by the end of the 1990s they were no longer being used. In 2005, Federal, Provincial and Territorial Ministers of Health established health goals for Canada but, to date, they have not evolved into a national strategy or translated into measurable actions. Moreover, national targets have not been set for reducing health disparities.

· The 1997 Memorandum to Population Health submitted to the federal Cabinet recommended that HIA be used to assess health impacts of federal policies and programs. Similarly, the use of Health Impact Assessment tools has been promoted in numerous provinces and a number of provincial reports have recommended that HIA be part of all Cabinet submissions. To date, only Quebec has passed legislation to ensure that the health impacts of proposed laws and regulations are assessed.

· Canada has sound data on population health status by health determinants and on health disparities. At the national level, reliable information is provided by the Canadian Population Health Initiative, Statistics Canada and the Public Health Agency of Canada, while several useful sources of health indicators and health disparities are available at the provincial level including, to name of few, the Manitoba Health Data Repository, the Community Accounts in Newfoundland and Labrador, and the B.C. Health and Wellness Survey.

· Canada plays an important role in population health research with the work funded or performed at the national level by the Canadian Institutes of Health Research, the National Collaborating Centres on Public Health, the Canadian Population Health Initiative, Health Canada, and the Public Health Agency of Canada, as well as at the provincial level by the Manitoba Centre for Health Policy, the Institut de la santé publique du Québec, the Ontario Institute for Work and Health and the Saskatchewan Population Health and Evaluation Research Unit, among others.

· Between 1994 and 2004, one of the main vehicles for intergovernmental coordination and dialogue in population health was the Advisory Committee on Population Health, which advised the F/P/T Conference of Deputy Ministers of Health. This advisory committee played a key role in taking a long term and integrated view of the health of the population and ensuring policy coherence across issue areas. In 2004, with the publication of Reducing Health Disparities, the Advisory Committee addressed, for the first time in Canada, health disparities from a systemic perspective as opposed to addressing specific populations experiencing health disparities.