Healthy Living E-Bulletin November 2008
  Theme: Health Disparities

E-Bulletin Archives

• Welcome
• Fast Facts: Supportive Environments and Leisure Physical Activity among People Living with Disabilities
• Feature Articles: Physical and Health Education Canada; Canadian Population Health Initiative Report; Canadian Parks and Recreation Association 2008 World Leisure International Innovation Prize Winner
  
• Healthy Living Best Practices and/or Evidence-based Practices: Call for Nominations of Canadian Best Practices in Health Promotion and Chronic Disease Prevention
• Updates from Federal, Provincial and Territorial Governments
• Healthy Living Campaigns: WinterActive 2009
• Key Dates & Events
• Potential Funding Sources: The Canadian Institute for Health Research Partnerships for Health System Improvement Program; BC Healthy Communities; Community Health Promotion Fund; Green Communities Fund; Team Grant in Physical Activity, Mobility and Health
• Research and Resources

Welcome

Welcome to the Healthy Living E-bulletin, a quarterly newsletter designed to keep healthy living stakeholders informed on efforts to promote physical activity, healthy eating and healthy weights across the country. It is produced by the Public Health Agency of Canada (PHAC) on behalf of the Healthy Living Issue Group (HLIG) of the Intersectoral Healthy Living Network.

This edition focuses on Health Disparities.

We want to hear from you! Please send your comments and feedback to our editor at: healthylivinge-bulletin@phac-aspc.gc.ca

Fast Facts

In a recent article, Canadian researchers found a strong association with supportive environments (i.e., the presence of access ramps, adapted transportation) and leisure physical activity among people living with disabilities. The authors note that people with physical disabilities are less likely to be active than the general population, and that this issue will continue to grow as the population ages and faces disability.  This supports the growing body of research highlighting the importance of supportive community planning to encourage daily physical activity in the population.

Reference: Spivock M. et. al. 2008. Promoting Active Living Among People with Physical
Disabilities:  Evidence for Neighbourhood-Level Buoys.  American Journal of Preventive Medicine. 34(4). p.291-298.

Feature Articles

Physical and Health Education Canada (PHE Canada) launched as new name for the Canadian Association for Health, Physical Education, Recreation and Dance (CAPHERD)

On September 3^rd, 2008 the CAHPERD officially changed its name to PHE Canada. This concludes an intensive process that involved membership, partner and stakeholder consultations; social marketing expertise; General Assembly acceptance; and official legal consent and approval from Industry Canada. A transition period will take place until May 2009 where a reference and link to CAHPERD will continue. This transition period will allow for a smooth changeover to the new PHE Canada name. PHE Canada is requesting that partners and stakeholders notify their constituents of their new name and update any logos or links in all existing materials (publications, websites, etc.).  Along with the new name, PHE Canada launched its new logo. In addition, please note the new website: www.phecanada.ca / www.eps-canada.ca

Canadian Population Health Initiative Report: Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada

On November 24^th 2008, the Canadian Population Health Initiative (CPHI), a part of the Canadian Institute for Health Information (CIHI), will release its much anticipated report, Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada at the Chronic Disease Prevention Alliance of Canada annual conference in Ottawa, Ontario. Using a Deprivation Index for health in Canada developed by the Institut national de santé publique du Québec, Reducing Gaps in Health provides a broad overview of the links between socio-economic status and health, while profiling differences within and across 15 of Canada’s census metropolitan areas (CMAs). The new CPHI analyses presented in the report examine how health, as measured by a variety of indicators, varies in small geographical areas in those CMAs with different socio-economic characteristics by exploring patterns and gradients within those CMAs and across urban Canada. To download a copy of the report or access the various complementary products available for Reducing Gaps in Health, please visit the CPHI website at www.cihi.ca/cphi after November 24^th. For further information, please contact CPHI at cphi@cihi.ca

Canadian Parks and Recreation Association (CPRA) 2008 World Leisure International Innovation Prize Winner

The Canadian Parks and Recreation Association’s Everybody gets to playÔ Initiative was awarded the 2008 World Leisure Innovation Prize on October 8^th, 2008 during the World Leisure Congress in Quebec City.  The Congress drew close to 3000 delegates, students, exhibitors and volunteers.

The World Leisure International Innovation Prize recognizes organizations that have implemented creative solutions that foster local, national, or international leisure opportunities for the benefit and development of individuals and communities. This prize focuses on the social, cultural and economic aspects of leisure as an aspect of the lived experience for individuals in a community and for visitors to the community. This prize represents the use of leisure as a creative solution to enhancing collectively the social, cultural, environmental, and economic quality of life in an area. To read more click here.

 

Healthy Living Best Practices and/or Evidence-based Practices

Call for Nominations of Canadian Best Practices in Health Promotion and Chronic Disease Prevention

The Public Health Agency of Canada is currently undergoing updates to the Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention  (http://cbpp-pcpe.phac-aspc.gc.ca/index_e.cfm) and needs your input!  The Portal is a valuable online tool that organizes systematic reviews and effective community and population level interventions, practices and programs within a standardized population health approach.  Its purpose is to deliver consistent and effective information on health promotion and chronic disease prevention to decision makers who influence chronic disease prevention and health promotion practice and policy through development, implementation and evaluation. The Portal supports decision-making capacity by promoting the adoption or adaptation of proven and effective community interventions.

The first phase of the Portal addressed various topics and diseases (e.g., cardiovascular disease, cancer, diabetes, chronic respiratory diseases) and key risk factors (e.g., physical inactivity, unhealthy eating, hypertension).  Submissions are welcome in these topic areas as well as content for Phase two (2008-2009) of the Portal.  For more information on the focus for Phase two and on how to submit a nomination please click here.

Updates from the Federal, Provincial and Territorial Governments

British Columbia

Many thanks to BC officials who provided submissions that can be found in the ‘Potential Funding Sources’; ‘Key Dates and Events’; and ‘Research and Resources’ sections.

Manitoba

Manitoba in Motion – This provincial strategy helps all Manitobans make physical activity part of their daily lives for health benefits and enjoyment.  The provincial government has joined with community partners in the area of physical activity, health, healthy living, recreation, sport and education to raise physical activity levels and reduce barriers to physical activity.  Tools and resources are available to help individuals, communities, workplaces and schools get “in motion” (www.manitobainmotion.ca).

Moving around Manitoba – This initiative encourages Manitobans to get “in motion” by increasing physical activity, making healthy eating choices and supporting emotional well-being.  Collectively, Manitobans are making virtual trips around the province tracking physical activity on the Moving Around Manitoba website.  Distance log sheets, physical activity trackers and food trackers are available (www.movingaroundmanitoba.ca).

Northern Healthy Foods Initiative – This initiative is an inter-departmental effort led by Aboriginal and Northern Affairs and implemented by partner community organizations that aims to increase access to affordable nutritious food in the north.  Strategies include community gardens, greenhouse projects, school programs, and a freezer loan program. 

Baby Friendly Manitoba Conference: Promotion and Problem-Solving – This conference took place on October 10^th, 2008, and provided health professionals with knowledge and skills to support and promote breastfeeding (www.gov.mb.ca/healthyliving/bfm.html).

Safe Play Areas Grant Program – Manitoba Health and Healthy Living is offering a small grant of up to $500 for farm owners with children under the age of 12 years to build a safe enclosed play area on their farm.  This is one solution to the challenge of not always being able to provide close supervision on the farm, while children learn to recognize and understand the risks that surround them (www.gov.mb.ca/healthyliving/farmsafety.html).

Nova Scotia

New position in Nova Scotia focusing on health disparities - The Government of Nova Scotia has recently filled a new position under the umbrella of Chronic Disease and Injury Prevention in the Department of Health Promotion and Protection.  The Coordinator – Health Disparities will lead and support strategic initiatives and projects related to the reduction of health disparities. A critical role of the Coordinator is to enhance capacity to address health disparities through the development of intersectoral mechanisms for collaboration at all levels of government and between government and civil society.  Food security, poverty reduction and cultural competence in illness and injury prevention are among the areas of current emphasis for the position. The Department of Health Promotion and Protection has funded the Nova Scotia Food Security Network to produce a new document designed to build awareness and policy coherence related to food security. To access the document, Understanding the Relationship between Public Policy and Food Security in Nova Scotia: A Background Paper and Policy Lens, please visit: http://www.gov.ns.ca/hpp/repPub/LensDocument.pdf

Nova Scotia Participatory Food Costing Initiative - Food security is an underlying factor in health disparities and one of four priority areas within Healthy Eating Nova Scotia (2005).  The broad goal of the Participatory Food Costing Initiative is to work collaboratively with partners in all sectors to improve food security in Nova Scotia. Annual food costing conducted by trained low-income women in a random sample of grocery stores has provided up-to-date evidence on the cost of eating a healthy diet in NS.  Results from the 2007 food costing indicate that a basic diet costs more in rural areas than in urban areas, and more in smaller grocery stores than in large grocery stores. The results were incorporated into affordability assessments that indicated that a reference household of four people (2 adults, 2 children) relying on income assistance was food insecure, while the same household where the adults worked for minimum wage (one full-time and one part-time) was at risk of being food insecure.  The food costing initiative shows that food security is a policy issue spanning multiple sectors and jurisdictions, and that collaborative and cross-jurisdictional approaches are needed to address the root causes of food insecurity. The report from the 2007 food costing initiative is available at: http://www.gov.ns.ca/hpp/repPub/food_costing_study.pdf

Ontario

CATCH Kids Club, targeted for children 6-12 years of age, is an after-school program supported by the Public Health Agency of Canada, the Ontario Ministry of Health Promotion and YMCA Ontario. CATCH Kids Club targets children in low-income neighbourhoods and focuses on providing a safe and enjoyable after school experience involving physical activity and healthy eating programs. YMCA Ontario and Boys and Girls Clubs (Ontario) manage the program in community facilities throughout Ontario.

Raise the Bar is a project of the Canadian Society for Exercise Physiology geared to assist elementary and secondary school teachers and officials augment intramural sport and physical activity programs in their schools. Training workshops for teachers and students and online resources are provided to school boards and schools across the province.

The Aboriginal Community Recreation Activator (ACRA) program aims to increase the capacity of First Nations to deliver community sport and recreation opportunities and is geared specifically for remote/isolated communities. The 15 participating First Nation communities have hired full-time recreation specialists to act as a catalyst in the community to plan and coordinate the delivery of recreation and physical activity programming.

Federal Government

Income-Related Household Food Security in Canada.  A range of sources have consistently shown that a significant number of Canadian households experience financial challenges in acquiring adequate food on a regular basis.  The Canadian Community Health Survey Cycle 2.2, Nutrition (2004)–Income-Related Household Food Security in Canada, released last year by the Office of Nutrition Policy and Promotion, Health Canada, confirms that, in 2004, many Canadian households experienced food insecurity due to limited financial resources. Although most Canadian households had consistent access to food, more than 1.1 million households (9.2%) were food insecure at some point in the previous year. In these households, at least one adult or child experienced multiple conditions characteristic of food insecurity because there was not enough money to buy food. The prevalence of food insecurity was higher in households with certain characteristics including those:

• with lower income adequacy,
• with social assistance as their main source of income,
• not owning their dwelling,
• led by a lone parent, especially a female lone parent, and
• households considered Aboriginal (off-reserve).

Specific factors associated with food insecurity may vary from household to household, however, addressing basic social determinants of health for vulnerable groups is essential in reducing food insecurity in Canada.  For the full report visit:
http://www.hc-sc.gc.ca/fn-an/surveill/nutrition/commun/income_food_sec-sec_alim-eng.php

WHO Commission on Social Determinants of Health - Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health
The final report of the WHO Commission on Social Determinants of Health (CSDH) was released by WHO Director General, Margaret Chan and Commission Chair, Sir Michael Marmot, at a press conference on August 28th, 2008, in Geneva. The WHO CSDH was a three-year initiative that aimed to reduce health inequalities within and between countries through global knowledge synthesis, policy development and action, and civil society engagement.  Canada, through PHAC leadership and partnerships with Health Canada’s First Nations and Inuit Health Branch and the International Development Research Centre has been an active and well-respected contributor to the WHO CSDH since its inception in March 2005.  

The Commission makes three overarching recommendations to tackle the "corrosive effects of inequality of life chances":

1. Improve daily living conditions, including the circumstances in which people are born, grow, live, work and age.
2. Tackle the inequitable distribution of power, money and resources – the structural drivers of those conditions – globally, nationally and locally.
3. Measure and understand the problem and assess the impact of action.

The Public Health Agency of Canada will work with its colleagues in relevant government departments, in provincial/territorial governments, academia and non-governmental organizations to discuss what the report means for Canada and what can and should be done collectively and independently to respond to the recommendations.

For the full report and executive summary, please visit: http://www.who.int/social_determinants/final_report/en/index.html

The Chief Public Health Officer’s Report on the State of Public Health in Canada
The CPHO’s first report on the State of Public Health in Canada was released in June 2008 and focuses on inequalities and health. The Report identifies Canadians’ income, education, environment, health behaviours (including diet and exercise), and social supports from family, friends and communities among the variety of factors determining how healthy we are. The Report’s recommendations include:

• build recognition among Canadians of the importance of disease prevention and health promotion;
• build on public policies in key support areas that will ensure Canadians have equal opportunities for health and well-being; and
• understand that economic and social environments are linked to health.

To access the full report, please visit: http://www.phac-aspc.gc.ca/publicat/2008/cphorsphc-respcacsp/index-eng.php 

Canada's Physical Activity Guide (for adults) was funded by Health Canada and it was developed and released by Health Canada and the Canadian Society for Exercise Physiology (CSEP) in 1998. It was followed by age-specific versions for older adults (55 years +) in 1999, and for children (6 to 9 years) and youth (10 to 14 years) in 2002. The Guides are an excellent resource to help you make wise choices about physical activity. Choices that will improve your health, help prevent disease, and allow you to get the most out of life. Get active your way…at home, at work, at school, at play and on the way…everyday!! Visit www.paguide.com where you can get Physical Activity Guides for adults, older adults, children and youth.

The Public Health Agency of Canada funded the Canadian Society for Exercise Physiology to undertake a scientific review of the physical activity guidelines, and to publish the results in a special joint issue of the Canadian Journal of Public Health and the Journal of Applied Physiology, Nutrition & Metabolism. An International Consensus Conference on physical activity guidelines will be hosted by CSEP in Kananaskis, Alberta in January 2009, with funding from PHAC. 

Healthy Living Campaigns

January 15^th- February 27^th, 2009 - WinterActive is a partnership between the Government of Canada and the provinces and territories and supports the objectives of the Integrated Pan-Canadian Healthy Living Strategy by promoting the benefits of physical activity, healthy eating, living smoke-free and sport participation. Community groups are encouraged to organize, register and promote their WinterActive events at www.winteractive.ca which will also provide a wealth of tips and resources. Incentive prizes are awarded to both event organizers and participants.

Key Dates and Events

November 17^th-19^th, 2008, Vancouver, BC – Second International Diabetes in Indigenous Peoples Forum: International Best Practices brings together an interdisciplinary group of professionals who work in the field of Indigenous peoples’ health. Presenters from Australia, New Zealand, Canada and the United States will review relevant developments in the etiology, prevention and treatment of diabetes and related conditions among Indigenous people with a focus on the sharing of international best practices. For more information visit: www.interprofessional.ubc.ca or e-mail ipconf@interchange.ubc.ca

November 24^th-26^th, 2008, Ottawa, ON – Chronic Disease Prevention Alliance of Canada  National Conference. Integrated Chronic Disease Prevention: Taking Action Together -This conference builds on the previous two conferences and focuses on how individuals, organizations, strategies and sectors can collaboratively act on the root causes of chronic disease in Canada. For more information, please visit: http://www.cdpac.ca/conference/content.php?sec=1

November 25^th, 2008, Toronto, ON - Gender Inequities in Health: What can we do to close the gap?  Men and women have different needs and challenges in getting health care.  Men and women are treated differently when they access care.  What causes inequities? Biology? Bias? Poverty? Health care delivery?  How can scientific evidence inform practice and policy to help us close these gaps?  Join leading scientists for discussion and debate 5:30 p.m. at the Gladstone Hotel, 1214 Queen Street West, Toronto. Refreshments and free admission. RSVP to j.kopelow@sympatico.ca

June 7^th-10^th, 2009, Winnipeg, MB - Canadian Public Health Association (CPHA) 2009 Annual Conference: ‘Public Health in Canada: Strengthening Connections’.  There is a current call for Abstracts for the 2009 conference with a submission deadline of December 17^th, 2008. The conference theme will provide a forum for sharing progress and will focus on strengthening the connections among research, policy and practice, and the numerous partnerships within the health sector and beyond. For more information visit: www.cpha.ca

Potential Funding Sources

The Canadian Institute for Health Research (CIHR) Partnerships for Health System Improvement (PHSI) Program supports teams of researchers and decision makers interested in working together to conduct applied and policy-relevant health research that is useful to health system managers and/or policy makers and strengthens the Canadian health care system.   The PHSI program welcomes any health services, health systems and policy research questions as long as they respond to decision maker/knowledge user identified needs.  Many issues related to health disparities would be relevant for a PHSI grant, particularly those warranting a partnered, applied and policy-relevant approach.  PHSI teams are supported by a mix of CIHR and partnership contributions (the latter of which may be in-kind or cash and are negotiated directly between the applicant and the partner in question); teams can apply for up to $500,000 per grant (including CIHR and partnership funding) for a maximum of three years.  The PHSI program will be launched in December 2008, with applications due in April 2009.  It will be launched again in June 2009 (with applications due in October 2009), and annually thereafter.  A new addition to the PHSI program – Partnership Development Funds – will be launched in December, April and June of each year.  Please visit CIHR’s PHSI website for information on important dates: http://www.cihr-irsc.gc.ca/e/34347.html
Or contact Christopher.McCutcheon@cihr-irsc.gc.ca or meghan.mcmahon@utoronto.ca for more information.

BC Healthy Communities (BCHC), an initiative funded by the BC Ministry of Healthy Living and Sport, provides one-time-only Seed Grants to BC communities to improve community health and well-being. Since the program’s inception in 2005, BCHC regional facilitators have worked many BC communities to reduce local and regional health inequities. The next call for seed grant applications will be announced in early November 2008. For more information, please visit: http://www.bchealthycommunities.ca/Content/News/Index.asp or contact Natalie Laframboise at 250-356-0892 or bchc@bchealthycommunities.ca

The Union of BC Municipalities (UBCM), through the Community Health Promotion Fund (CHPF), administers grants on behalf of the BC Ministry of Health to support health promotion and chronic disease prevention activities in BC communities. To date, more than 120 projects have been funded. The CHPF supports the goals of ActNow BC - leading the way in North America in healthy living and physical fitness and building community capacity to create healthier, more sustainable and economically viable communities. UBCM is now inviting a fourth and final round (under the current funding) of applications from local governments. Facilitators from BC Healthy Communities will be available to assist some successful applicants to plan for and undertake their pilot projects – at no cost to the applicant. For more information on the Community Health Promotion Fund, please visit: http://www.civicnet.bc.ca/siteengine/activepage.asp?PageID=244

Green Communities Fund Call for applications: sustainable transportation projects - Eligible applicants can request up to $2 million in low-interest loans and $400,000 in grants for capital projects that facilitate shifts to sustainable modes of transportation.  For more information visit: http://www.sustainablecommunities.fcm.ca/GMF/Transportation-call-for-applications-2008.asp

Funding Opportunity for a Team Grant in Physical Activity, Mobility and Health - The Canadian Institute of Health Research's Institute of Musculoskeletal Health and Arthritis and partners with a shared interest in improving our understanding of physical activity, mobility and health will jointly launch a Request for Proposals for the Physical Activity, Mobility and Health Team Grants under this theme.  For more information visit: http://www.cihr-irsc.gc.ca/e/36773.html

Research and Resources

Inequality in the Built Environment Underlies Key Health Disparities in Physical Activity and Obesity.  For the full article visit: http://pediatrics.aappublications.org/cgi/reprint/117/2/417

WHO Commission on Social Determinants of Health - Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health.  For the full report and executive summary, visit: http://www.who.int/social_determinants/final_report/en/index.html

The Chief Public Health Officer’s Report on the State of Public Health in Canada.  The CPHO’s first report on the State of Public Health in Canada focuses on inequalities and health. For the full report, visit: http://www.phac-aspc.gc.ca/publicat/2008/cphorsphc-respcacsp/index-eng.php    

Chronic Disease Prevention Alliance of Canada – Poverty and Chronic Disease: Recommendations for Action. For the full report, visit: http://www.cdpac.ca/media.php?mid=457

Public Health Agency of Canada – Article from the Chief Public Health Officer “Add Good Health to Back to School List”.  For the full article visit: http://www.phac-aspc.gc.ca/cpho-acsp/articles/20080904-eng.php

Approaching Health Disparities From a Population Perspective: The National Institutes of Health Centers for Population Health and Health Disparities
Richard B. Warnecke et al. American Journal of Public Health 98, 9 (Sep 2008): 1608-1615
doi:10.2105/AJPH.2006.102525 For the full article visit:  http://www.ajph.org/cgi/content/full/98/9/1608

The Public Health Approach to Eliminating Disparities in Health
David Satcher and Eve J. Higginbotham, American Journal of Public Health 98, Suppl 1 (Sep 2008): S8-S11.  For the full article visit: http://www.ajph.org/cgi/content/full/98/Supplement_1/S8

Tackling Health Inequalities An All-Ireland Approach to Social Determinants
Compiled by Clare Farrell, Helen McAvoy, Jane Wilde and Combat Poverty Agency
Preface by Sir Michael Marmot, Dublin: Combat Poverty Agency in association with the Institute of Public Health in Ireland, 2008.  For the full article visit:
http://www.publichealth.ie/files/file/Tackling%20health%20inequalities.pdf

Report from the National Diabetes Surveillance System: Diabetes in Canada, 2008
http://www.phac-aspc.gc.ca/publicat/2008/ndssdic-snsddac-08/

National Diabetes Fact Sheets
http://www.phac-aspc.gc.ca/publicat/2008/ndfs-fnrd-08/

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