Canadian Health Systems Miss The Boat On Obesity And Chronic Diseases

Last week the Conference Board of Canada released a not too flattering report on the status of chronic disease and obesity management in Canada.

According to the press release that accompanied this Health Report Card, which Canada receives “A” grades on self-reported health status, mortality due to circulatory diseases (primarily heart disease and stroke), and premature mortality, it receives “B” grades on mortality due to mental disorders and mortality due to respiratory diseases (which include asthma, tuberculosis, bronchiolitis, emphysema, cystic fibrosis, influenza, and pneumonia).

But, when it comes to the prevention management of three major chronic diseases, Canada’s performance is dismal compared to its 17 peers:

– Mortality due to musculoskeletal diseases—“C” grade, 11th-place ranking

– Mortality due to cancer—“C” grade, 13th-place ranking

– Mortality due to diabetes—“C” grade, 15th-place ranking (out of 17?!?)

It does not take a genius to recognize that all three of these conditions are tightly linked to obesity, which is why Gabriela Prada, the Conference Board’s Director, Health, Innovation, Policy and Evaluation is quoted as saying:

“Canada is facing a growing burden from chronic diseases such as diabetes and cancer. This burden is expected to increase due to an aging population and rising rates of obesity”.

Indeed, as the report points out:

Obesity has taken centre stage as a major risk factor for chronic diseases. Obesity is one of the most significant contributing factors to many chronic conditions, including heart disease, hypertension, and type 2 diabetes—type 2 diabetes accounts for 85 to 95 per cent of all diabetes cases in high-income countries. The share of overweight or obese Canadians continues to increase. According to calculations based on measured data, almost two-thirds of Canadians were considered to be either overweight or obese in 2008, and 24 per cent were considered to be obese. Particularly troubling is the growing share of children who are overweight. More than one in four Canadian children are considered overweight—a share that is higher than the OECD average.”

So while decision makers in Canada’s health care system may well feel that other issues are perhaps more important (or have stronger lobbies), the future of Canada’s health care system very much depends on whether or not these decision makers will eventually recognize that without significant attention to chronic diseases and obesity Canadians’ health will be unlikely to become ‘world class’.

Importantly, none of this is simply a matter of pouring more money into Canada’s health care systems. Indeed, as the report points out,

“…countries with considerably older populations than Canada’s—like Japan and Sweden—do not have more expensive health systems. In fact, Japan, which has the lowest health care spending per capita, boasts the highest life expectancy and the lowest infant mortality rate. Japan also has one of the lowest premature mortality rates, the second-lowest mortality rate due to cancer, and the lowest rates of mortality due to circulatory diseases, diabetes, and mental illness.”

The report concludes that,

Canada has no choice but to adopt a model that focuses on sound primary care practices and population health approaches—particularly preventing and managing chronic diseases—and recognizes and rewards high-quality health care services.”

As I have said before, no health care system can afford NOT to address and manage obesity.

Edmonton, Alberta