Abstract

Improving the health of individuals and populations while assuring the sustainability of modern healthcare systems requires a greater commitment to chronic disease prevention and management. In Canada, national challenges in the management of health care systems, such as prolonged wait times, have benefited from targeted federal investment, with provincial and territorial collaboration in the development and implementation of local strategies. The lead paper "An Inconvenient Truth: A Sustainable Healthcare System Requires Chronic Disease Prevention and Management Transformation," makes a sound argument for a similar investment toward the epidemic of chronic disease. Any strategy that might emerge from such a federal commitment ought to recognize two fundamentally important issues. First, as chronic disease prevention and management activities are largely community-based (rather than hospital or facility-based), Canada has an opportunity to move beyond a potentially disparate collection of provincial and territorial approaches to a truly national strategy. Second, and more important, effective chronic disease prevention and management will only be achievable if we reframe the challenge as a societal issue, not simply a health system concern. This reframing exercise might benefit from a greater understanding of how societal responses to other crises, such as global warming, have been triggered or accelerated.