Report to/Rapport au :
Ottawa
Board of Health
Conseil de santé d’Ottawa
Monday 7, May, 2012/le lundi 7 mai 2012
Submitted by/Soumis par :
Dr./Dr Isra Levy,
Medical Officer of Health/Médecin chef en santé publique
Contact
Person/Personne-ressource :
Sherry Nigro,
Manager/Gestionnaire
Health Promotion and Disease Prevention/Promotion de la santé et
prévention des maladies
Ottawa Public Health/Santé
publique Ottawa
613-580-2424, ext./poste 28971, Sherry
Nigro@ottawa.ca
ACS2012-OPH-HPDP
-0003 |
SUBJECT: |
OBJET : |
stratégie saine alimentation et vie active |
That the Board of Health
for the City of Ottawa Health Unit approve:
1. The
three-year Healthy Eating, Active Living Strategy (HEAL), as outlined in this
report.
2. That the Chair of the Board
of Health write a letter to the
Ontario Minister of Health and Long-Term Care recommending
that the Ministry include
in their upcoming Childhood Obesity Strategy a substantial investment in
diverse physical activity opportunities in schools and other organizations to
help youth to meet the physical activity minimum requirements.
3. That the Chair of the Board of Health
write a letter to the Ontario Minister of Education recommending:
a. That the Ministry provide direction and funding to school boards for
monitoring and reporting as it relates to the Daily Physical Activity Policy
(PPM 138) in elementary schools.
b. That the
Ministry provide direction and funding to school boards for monitoring and
reporting as it relates to the Ontario School Food and Beverage Policy
(PPM 150).
4.
That
the Chair of the Board of Health write a letter to the federal
Minister of Health and Ontario Minister of Health and Long-Term Care recommending
the development and promotion of menu labelling policies for franchises of 10 or more or at least $10 million in
revenue.
5. That
staff report back to the Board of Health in Q4 of 2013 on the progress to date.
RECOMMANDATIONS DU
RAPPORT
Que le Conseil de santé de la circonscription
sanitaire de la Ville d'Ottawa approuve:
1.
La stratégie triennale Saine alimentation et vie active décrite
dans ce rapport.
2.
Que la présidente du Conseil de
santé fasse parvenir une lettre au ministre de la Santé et des Soins de longue
durée de l’Ontario recommandant au ministère d’inclure, dans sa stratégie à
venir sur l’obésité infantile, un investissement considérable en vue de la mise
en œuvre de diverses possibilités d’activité physique dans les écoles et au
sein de divers organismes afin d’aider les jeunes à respecter les exigences
minimales en matière d’activité physique.
3.
Que la présidente du Conseil de santé écrive au ministre
de l'Éducation de l'Ontario et lui soumette les recommandations suivantes :
a. Que le ministère donne des directives et du financement aux conseils scolaires au
chapitre du contrôle et des rapports à soumettre entourant la Politique
sur l'activité physique quotidienne (PPM, 138) dans les écoles primaires.
b. Que le ministère donne des directives et du financement aux conseils scolaire au chapitre
du contrôle et des rapports à soumettre entourant la Politique sur les
aliments et les boissons dans les écoles de l'Ontario (PPM, 150).
4.
Que la présidente du Conseil de santé écrive au ministre
fédéral de la Santé et au ministre de la Santé et des Soins de longue durée de
l’Ontario recommandant la création et la promotion de politiques d'étiquetage
des menus couvrant les entreprises de dix franchises ou plus ou dont les
recettes atteignent au moins 10 millions de dollars.
5.
Que le personnel soumette un rapport au Conseil de santé
au quatrième trimestre 2013 sur les progrès réalisés à ce jour.
EXECUTIVE SUMMARY
The issue of overweight and obesity continues to be a growing health concern in Canada as well as other developed countries. In Ottawa, over 20% of youth and more than half (52%) of adults are either overweight or obese. A web of complex influencers including biological, behavioural, social, psychological, technological, environmental and economic factors are well documented in the literature and severely compound the challenge of addressing this health issue.
Unhealthy eating, physical inactivity and social, physical and built
environments are contributing factors to current rates of overweight and
obesity. There is a need to change daily
habits, social norms and physical and social environments. Trends in unhealthy
eating include inadequate intake of vegetables and fruit, increased reliance on
fast and processed foods and increased consumption of energy dense, nutrient
poor foods such as sugar sweetened beverages.
Approximately 80% of school age students report drinking at least one
sugar sweetened beverage in the week prior to being surveyed. Trends in
physical inactivity include inadequate amounts of daily physical activity and
over-reliance on vehicular modes of transportation. Only 10% of residents
(≥ 15 years) reported that their primary mode of transportation to and
from work was walking or cycling. At
the same time, societal preoccupation with weight, as opposed to healthy
behaviours, as well as myths related to energy balance, may contribute to the fact that 65% of Ottawa students
reported that they were trying to affect their weight either by avoiding weight
gain, trying to lose weight or trying to gain weight.
In recent years, Ottawa Public Health (OPH) has focused increased attention on working with partners in the health sector, the education sector and social service providers to promote healthy eating and physical activity in settings such as schools, workplaces and community houses, to raise awareness and build skills to change behaviours related to healthy eating and active living. There are also a number of partners and local champions working in the community to address these issues. OPH recognizes that for this work to effect sustained change it must be integrated with our existing partners as well as engaging non-traditional partners such as the food industry, municipal planners and developers.
In order to begin addressing issues related to
unhealthy eating, physical inactivity and social and physical environments, OPH
has refocused efforts for 2012 – 2014 under the Healthy Eating Active Living
(HEAL) strategy. The
HEAL builds on lessons learned from local public health practice,
emerging epidemiological reports, environmental scans, a review of best
practice literature and consultation with key municipal and community
partners.
The three main objectives of the HEAL strategy are:
In order to meet these objectives, the HEAL strategy takes a multipronged approach that provides knowledge and skill building opportunities to individuals, creates supportive environments and advocates for changes to public policies that impact healthy eating and active living.
Through the adoption of its HEAL Strategy, OPH
acknowledges the importance of the individual and social determinants of health
in helping its residents eat healthy, be active and maintain a healthy body
image.
RÉSUMÉ
Le problème de l’embonpoint et
de l’obésité demeure une préoccupation croissante en matière de santé au Canada
ainsi que dans d’autres pays développés. À Ottawa, plus de 20 % des jeunes
et plus de la moitié (52 %) des adultes font de l’embonpoint ou sont obèses.
Une foule d’éléments entrent en compte, notamment des facteurs biologiques,
comportementaux, sociaux, psychologiques, technologiques, environnementaux et
économiques. Tous sont d’ailleurs abordés abondamment dans la documentation
disponible. Leur effet conjugué aggrave le défi que représente la résolution de
ce problème de santé.
De mauvaises habitudes alimentaires,
la sédentarité ainsi que les milieux sociaux, naturels et l’environnement bâti
sont d’autres facteurs contribuant aux taux actuels d’embonpoint et d’obésité.
Il faut changer les habitudes quotidiennes, les normes sociales et les milieux
naturels et sociaux. Par mauvaises habitudes alimentaires, aujourd’hui, on
pense à une consommation insuffisante de légumes et de fruits, la dépendance accrue
sur des aliments prêts-à-manger et des aliments transformés et une consommation
accrue de produits alimentaires à forte teneur énergétique et pauvres en
nutriments comme des boissons sucrées. Environ 80 % des enfants d’âge
scolaire ont affirmé avoir consommé au moins une boisson sucrée au cours de la
semaine précédant le sondage. En ce qui concerne la sédentarité, la plus grande
partie de la population ne fait pas suffisamment d’activité physique
quotidienne et dépend beaucoup trop sur les modes de transport motorisés.
Seulement 10 % des résidents (≥ 15 ans) ont mentionné qu’ils
marchaient, la plupart du temps, pour se rendre au travail et en revenir ou
qu’ils utilisaient leur bicyclette. Concurremment, la préoccupation sociale au
sujet du poids, en opposition à des comportements sains, ainsi que les divers
mythes associés au bilan énergétique pourraient contribuer au fait que
65 % des étudiants d’Ottawa ont mentionné qu’ils ont essayé de modifier
leur poids soit en évitant d’en prendre, en essayant d’en perdre ou d’en
gagner.
Au cours des dernières années,
Santé publique Ottawa (SPO) a collaboré de plus en plus avec des partenaires du
secteur de la santé et de l’éducation et des fournisseurs de services sociaux
pour promouvoir une alimentation saine et l’activité physique dans divers
milieux comme l’école, le milieu de travail et les centres communautaires. Cet
effort vise à sensibiliser la population et à aider les gens à développer des
compétences pour changer l’attitude générale face à une alimentation saine et à
une vie active. Par ailleurs, plusieurs partenaires et des champions locaux
œuvrent déjà au sein de la collectivité afin de trouver des solutions à ces
questions. SPO reconnaît que, pour que ces efforts aient une incidence durable,
il faut que ses partenaires actuels y adhèrent, mais également d’autres
partenaires de secteurs moins traditionnels comme l’industrie alimentaire, les
planificateurs municipaux et les promoteurs.
Pour commencer à remédier aux
problèmes liés à une mauvaise alimentation, à l’activité physique et aux
milieux sociaux et naturels, SPO a réorganisé ses efforts pour 2012 – 2014 en
vertu de la stratégie Saine alimentation et vie active. La stratégie Saine
alimentation et vie active mise sur les leçons apprises dans le cadre des
diverses pratiques utilisées localement en matière de santé publique, dans les
rapports sur les données épidémiologiques émergentes, les analyses de
l’environnement, un examen de la documentation sur les pratiques exemplaires et
des consultations avec les principaux partenaires municipaux et
communautaires.
Les
trois principaux objectifs de la stratégie Saine alimentation et vie active
sont :
Pour atteindre ces objectifs,
la stratégie Saine alimentation et vie active a adopté une approche à multiples
facettes qui propose des occasions d’acquisition de connaissances et de
compétences aux personnes, permet de créer des milieux favorables et plaide en
faveur des changements aux politiques publiques qui ont une incidence sur un
mode de vie actif prônant une alimentation saine et une vie active.
Avec l’adoption de la
stratégie Saine alimentation et vie active, SPO reconnaît l’importance des
déterminants individuels et sociaux de la santé pour aider les résidents à
manger sainement, à être actif et à maintenir une image corporelle saine.
Background
The issue of overweight and obesity continues to be a growing health concern in Canada as well as other developed countries. For the first time in history, academics and researchers are predicting this generation of children could have a shorter life expectancy than their parents (1). Health conditions related to obesity, including cardiovascular disease, several types of cancer and diabetes are of public health concern for entire populations; other health conditions such as gestational diabetes and polycystic ovarian disease affect specific sub-populations (2). Obesity is also linked to increased risk for injury, reduced immunity (3), poor self-esteem, bullying and depression (4). A web of complex influencers including biological, behavioural, social, psychological, technological, environmental, economic and social factors are well documented in the literature and severely compound the challenge of addressing this health issue.
Over recent years, an intense interest in reducing
obesity has developed at all levels of governmental and non-governmental
agencies, who as a result, have released position statements and guidance
documents related to healthy eating, active living and obesity
prevention. The World Health Organization (5-6), the Ontario Chief Medical
Officer of Health (7), the Federal, Provincial and Territorial Ministers (8),
the International Society for Physical Activity and Health (9), the Canadian
Paediatrics Society (10), the Ontario Medical Association (11), Cancer Care
Ontario and Public Health Ontario (12), the Ontario Professional Planners
Institute (13) and most recently, the Ontario Government (14) which proposes a
Childhood Obesity Strategy to be released in the fall of 2012, as part of the
Action Plan for Health Care.
Despite increased awareness and a proliferation of community based interventions, obesity remains a growing health issue. Best practice evidence relating to population-level interventions to reverse the trend is limited. There are promising results with the “Ensemble Prévenons l’Obésité Des Enfants” (EPODE) in Europe (15) as well as in Nova Scotia with the Annapolis Valley Health Promoting Schools Program (16). OPH is watching with interest innovative projects sponsored by New York City that range from food carts to partnerships with bodegas, to social marketing campaigns on consumption of sugar sweetened beverages (17-19).
In recent years, OPH has focused attention on promoting healthy eating and physical activity in settings such as schools, workplaces and community houses, to raise awareness and build skills to change behaviours related to healthy eating and active living. OPH’s local partnerships include the five-year multi-agency Active Ottawa Actif initiative (20); Fuel to Xcell vending program with the City of Ottawa’s Parks, Recreation and Cultural Services; the Champlain Cardiovascular Disease Prevention Network; School Travel Planning with school boards and Green Communities Canada; and the Taking Action Together to Prevent Childhood Obesity community forum (21).
Despite OPH
and the community’s efforts to address the issue, overweight, obesity and other
nutrition and physical activity related illnesses remain major public health
concerns in Ottawa. Negative trends persist in eating habits, the local
food environment, physical activity rates, the preponderance of barriers to
physical activity and in attitudes towards weight impacting mental health.
In spring 2011, the Board of Health set its Strategic Priorities for 2011 – 2014. Three Strategic Priorities are directly related to these health issues, specifically: 1) increasing access to healthy foods through municipal policies, 2) increasing nutrition skills in priority populations and 3) increasing active transportation as well as leisure physical activity.
These priorities and local consultations are the basis on which OPH has refocused efforts for 2012 – 2014 under the Healthy Eating Active Living (HEAL) strategy. The HEAL strategy builds on lessons learned from local public health practice, emerging epidemiological reports, environmental scans and a review of best practice literature. Based on this, OPH will focus on three factors contributing to obesity: 1) poor nutrition, 2) inactivity and 3) the societal preoccupation with weight.
The first contributing factor which the HEAL strategy will focus on is poor nutrition. Protective factors include eating regular meals, breastfeeding, meals prepared and eaten together at home and eating enough vegetables and fruit every day. Trends of increased reliance on fast and processed foods and increased consumption of energy dense, nutrient poor beverages such as sugar sweetened beverages are of concern. For example, 80% of school age students report drinking at least one sugar sweetened beverage in the week prior to being surveyed.
The second contributing factor which the HEAL
strategy focuses on is inactivity. Protective
factors include having family and peers that are physically active, living in
communities with infrastructure that support active transportation and access
to facilities to participate in physical activities. Trends of concern include increased sedentary
behaviours both at work and during leisure time with television and computers,
increased reliance on vehicular transportation and lifestyles that generally require little physical
exertion. Emerging research shows increased
risks for negative health outcomes from sedentary behaviour for periods longer
than one hour (22-23). Only 10% of residents (≥ 15 years) in Ottawa report that their
primary mode of transportation to and from work was walking or cycling.
The third contributing factor which the HEAL
strategy aims to improve is the weight centred focus that currently exists in our cultural
and social environment. It creates
confusion about the contributors of overweight and obesity and perpetuates myths
related to energy balance, what unhealthy eating is and the relationship of
obesity to physical inactivity. Weight bias has crept into cultural attitudes,
which undermines people’s ability to engage in healthy behaviours. Evidence shows that engaging in healthy
behaviours can improve one’s health status regardless of weight lost. Mental health issues, eating disorders,
social isolation and dieting are all indicators that weight should be de-emphasized
and the focus should be on the healthy behaviours that will, in turn, ensure
overall health. In Ottawa, 65%
of students reported that they were trying to affect their weight either by
avoiding weight gain, trying to lose weight or trying to gain weight.
OPH
recognizes that this is a complex issue that requires a complex response from
the whole community. There are a number of local champions and leaders in the
Ottawa community that OPH can work with on this issue. Innovative initiatives include the Ottawa District
School Board pilot project to provide non-academic credits to students who
participate in physical activity outside of school hours, and Stone Soup
Foodworks converted a chip truck at the University of Ottawa to offer local
healthy food instead. The 2012 – 2014
HEAL strategy outline revitalized and expanded partnerships and programming
response to this pressing health issue.
DISCUSSION
Best practise literature and environmental scans informed the HEAL strategy. The following themes were considered when
selecting activities:
1) Comprehensive Partnerships: OPH is leveraging
traditional partnerships from the health, education, and social service
sectors, other City departments and various workplaces, while endeavouring to
engage non-traditional partners through innovative partnerships. In building
the HEAL strategy, OPH consulted with key partners both municipally and in the
community.
3) Sustained Focus: OPH recognizes that these issues are going to take sustained efforts and resourcing over many years to see long-term change in behaviours and in social and physical environments. The HEAL Strategy will engage a critical mass of community commitment and engagement that will support the successful implementation of policies and shift social norms and attitudes.
RECOMMENDATION 1
1.
The three-year
Healthy Eating, Active Living Strategy (HEAL), as outlined in this report.
HEALTHY EATING, ACTIVE LIVING
STRATEGY (HEAL) FOR 2012-2014
The HEAL strategy has three specific objectives:
1. To decrease consumption of energy
dense, nutrient poor foods and beverages;
2. To increase physical activity
through walking and active transportation;
3. To engage the
‘whole-of-community’
to change social and physical environments.
In order to meet these objectives, the HEAL strategy takes a multipronged approach that provides knowledge and skill building opportunities to individuals, creates supportive environments and advocates for changes to public policies that impact healthy eating and active living.
1. Decreasing
consumption of energy dense, nutrient poor foods and beverages
Decreasing
consumption of energy dense, nutrient poor foods is not simple. There are communities in Ottawa, referred to as food deserts that do not
have access to healthy and affordable food.
Unable
to easily access good quality food, those living in food deserts are often
served by corner, convenience and fast food outlets that offer cheap, unhealthy
foods high in fats, sugars, and salts. In addition, due to lack of knowledge
and skills people are not eating enough
vegetables and fruit, while increasingly rely on pre-prepared, packaged and
restaurant foods which are high in calories and sodium. In Ottawa, 55% of adults (≥ 20 years) and 49% of youth
report consuming less than 5 vegetables and fruit on a daily basis. Less than a
quarter of adults reported that they did not consume restaurant, fast food or
ready to eat foods in the week prior to the survey.
In order to decrease the consumption of energy dense nutrient poor foods OPH will:
a) Get
“back to basics” by promoting food preparation and meal routines particularly
with parents, low income families and seniors.
·
Expand programming to teach basic food and nutrition skills
such as portion sizes, meal planning, shopping and cooking skills.
·
Expand NutriStep screening with parents of young children 18
months to 5 years of age to assess eating habits and identify nutrition problems.
b) Increase
awareness of the health risks of sugar.
·
Social media campaign on
health effects of consuming sugar sweetened beverages including soft drinks,
energy and sports drinks, flavoured milks and juices.
c) Increase
access to vegetables and fruit.
·
Increase the distribution
and local availability of fresh, healthy food through vendors, street carts and
mobile markets, particularly where food deserts exist, in partnership with
local food programs in Ottawa such as the Good Food Box.
d) Promote
point of purchase strategies such as calorie and sodium labeling on menus in
places where food is served and sold including municipal facilities, restaurants
and cafeteria programs.
·
Assess community and
restaurant franchise owners’ readiness to implement menu labeling and provide
support to them for voluntary labeling.
·
Continued support for
Ontario Food and Beverage Policy (PPM 150) in schools though work with school
boards, teachers and students.
·
Participate in the Champlain
Cardiovascular Disease Prevention Network initiative on Healthy Food
Environment in Hospital Cafeterias.
2.
Increasing
active transportation and walking
The
majority of Ottawa adults do not meet the Canadian Physical Activity Guidelines
of accumulating 150 minutes of moderate-to-vigorous physical activity per week. Active transportation is one source of
physical activity that can help residents accumulate sufficient daily physical
activity.
In
order to increase walking and active transportation behaviours, OPH will:
a) Improve
neighbourhood walkability.
·
Complete Neighbourhood
Profiles including walkability assessments that identify barriers and assets
such as safe routes to school and how to access food.
·
Work with municipal and
neighbourhood groups to remediate specific problematic areas identified in
Neighbourhood Profiles.
·
Promote web-based route
mapping programs and mobile apps such as mapmywalk.com and mapmyride.com to
facilitate access to utilitarian and leisure walking and cycling opportunities.
b) Initiate
peer-led walking groups with champions in community settings and support
community-based programming to increase walking.
·
Expand Active and Safe
Routes to School initiatives to increase the number of school aged children who
use active transportation to and from school.
·
Continue support to Green
Communities Canada to implement the School Travel Planning project.
3.
Engaging
the whole of community to change social and physical environments
The
settings where we live, work and play have a major impact on our physical and
mental health. The social, physical and
built environments should make it easy and convenient for residents to eat healthily,
be active and feel good.
The
following activities are intended to progressively change our social norms, our
attitudes and our built environment:
a) Dispel
myths and adopt common messaging to shift from a weight focus to a healthy
behaviours approach.
·
Work with CHEO to train professionals from the health,
education and social service sectors to refocus messaging on the
themes of Eat Well, Be Active and Feel
Good about Yourself.
b) Influence
public policy and municipal plans through partnerships, advocacy and
surveillance.
· Implement the Baby-Friendly Initiative™ as required as part of the Board of Health’s accountability agreement to normalize breastfeeding up to 6 months of age and complementary breastfeeding to two years of age and beyond.
·
Increase access to
healthy food through partnerships with City departments and community
organizations such as Just Foods and Centretown Community Health Centre. These activities will range from the
inclusion of nutrition requirements in food vendor permits and purchasing
policies for City facilities and programs to increased availability and
distribution of healthy foods in underserved neighbourhoods.
·
Inform key municipal
plans including, but not limited to, the Official Plan, the Transportation
Master Plan, the Pedestrian Plan, the Cycling Plan and the Parks and Recreation
Master Plan through surveillance data and Neighbourhood Profiles identifying
existing and potential barriers to active transportation in neighbourhoods.
·
Work with Safer Roads
Ottawa, a joint corporate program between OPH, Ottawa
Police Services, Public Works Department, Ottawa Paramedic Service and Ottawa
Fire Services, to promote pedestrian and cyclist safety.
·
Create healthier food
environments in municipal facilities such as child care and recreational facilities
through reviewing food and beverage procurement policies.
c) Profile
and celebrate the contributions of the community regularly and visibly to
better leverage local assets and progress.
·
Host an annual stakeholder forum for networking and
celebration of local successes to inform, inspire, and leverage contributions
from partners.
RECOMMENDATION 2
2. That the Chair of the Board of Health write a letter to the
Ontario Minister of Health and Long-Term Care recommending
that the Ministry include
in their upcoming Childhood Obesity Strategy substantial investment in diverse
physical activity opportunities in schools and other organizations to help
youth to meet the physical activity minimum requirements.
Few
(22%) Ottawa students in grades 7 to 12 reported meeting physical activity
recommendations of 60 minutes per day with some Ontario schools reporting as
few as 30% of high schools students enrolled in physical education (24). Adolescent participation in regular
physical activity is linked to higher academic performance (25), development of
lifelong physical activity habits and contributes to improved overall health and
social outcomes (26). Policy options
with incentives to attract youth to physical activity and reduce barriers to
physical activity such as access to sports equipment or programs are important
components for consideration. Opportunities identified by Active Healthy
Kids Canada (2011) include school-community partnerships and training, youth
leadership, policy and investment support (27).
RECOMMENDATION 3
3. That
the Chair of the Board of Health write a letter to the Ontario Minister of
Education recommending:
a. That
the Ministry provide direction and funding to school
boards for monitoring and reporting as it relates to the Daily Physical
Activity Policy (PPM 138) in elementary schools.
b. That
the Ministry provide direction and funding to school
boards for monitoring and reporting as it relates to the Ontario School
Food and Beverage Policy (PPM 150).
Currently the Daily Physical Activity Policy (PPM
138) in elementary schools states “School boards will
monitor the implementation of the policy on daily physical activity to ensure
that all elementary students are provided with the opportunity to be active for
at least twenty minutes each day during instructional time.” However, informal discussions with parents
and teachers suggest that the policy is not consistently implemented across
elementary schools in Ottawa.
Almost all children spend
approximately 30 hours per week at school; therefore schools are the setting
that can reach the largest proportion and greatest diversity of children. There is evidence to show that providing elementary school students with
opportunities to be physically active can have a positive impact on their
physical, mental and social well-being as well as academic achievement, and
readiness to learn (28).
Over the past
three years, the national surveillance organization called Active Healthy Kids
Canada has produced an annual Report Card
on Physical Activity for Children and Youth which calls for sustained
commitment from the Ministry of Education to ensure that children are receiving
daily, quality physical activity in the elementary school setting (29, 30,
31). One of the major concerns outlined in
these reports is the lack of accountability and evaluation of Daily Physical
Activity and Physical and Health Education in Ontario (32).
The Ministry of Education implemented the Ontario School Food and Beverage Policy (PPM 150) in September 2011. The policy states that school boards are required to ensure that all food and beverages sold on school premises for school purposes meet the requirements of this memorandum, including the nutrition standards set out in the Appendix to this memorandum, by September 1, 2011. To date there has been no formal monitoring plan put in place.
RECOMMENDATION 4
4. That the Chair of the Board of Health write a
letter to federal Minister of Health and Ontario Minister of Health and
Long-term Care recommending the development and promotion of menu labelling
policies for franchises of 10 or more or at least $10 million in
revenue.
Access
to nutritional information, including caloric content and nutritional values
help consumers make informed decisions about their food and beverage
choices. Although some restaurants
voluntarily post nutrition information on websites and in brochures, food
retailers are not required to make the information available, unlike packaged foods. Researchers have found that restaurant patrons
typically underestimate calories and overestimate the healthfulness of menu
items. Some jurisdictions in the United States, such
as New York City and the State of California, have passed laws requiring at
least calorie labelling. In Canada supporters of menu labelling include, among
others, Ontario Chief Medical Officer of Health, Canadian Institute for Health
Information, Heart and Stroke Association, Canadian Public Health Association, Cancer
Care Ontario, Public Health Ontario and Ontario Medical Association. Although
OPH will be actively working on voluntary menu labeling locally, a significant
barrier are franchises that do not have local autonomy to participate in menu
labeling or do not have the capacity to have the nutritional analysis
done.
·
Progress in priority
partnerships such as:
o School
boards to expand Active and Safe Routes to School programming in 30 additional
schools;
o The
Champlain Cardiovascular Disease Prevention Network to develop and implement Healthy
School Age Children and Healthy Foods in Hospitals initiatives; and
o The
Children’s Hospital of Eastern Ontario Centre of Active Healthy Active Living (CHEO
CHAL) to train professionals from the health, education and social service
sectors to refocus messaging on the themes of Eat Well, Be Active and Feel Good about Yourself.
·
Improve food
environments in 17 Municipal Childcare Centres.
·
Complete community profiles
of walkability and food environments in 15 Ottawa neighbourhoods.
·
Implement food skill
demonstrations at 4 new locations for the
Food Hamper program.
·
Expand NutriStep
screening to reach 600 families with children ages 18 months to 5 years.
·
Launch social marketing
campaigns focusing on walking and sugar sweetened beverages.
·
Develop and implement guidelines
for procurement and advertising of food and beverages in municipal facilities.
·
Attain Baby Friendly Initiative™
certification.
Rural communities may have inequitable access to healthy
foods, neighborhood recreational opportunities and infrastructure for active
transportation. Tailored, locally
developed strategies will be implemented that build on local assets in rural
communities. For example, opportunities
related to agriculture and farming will be explored.
In March and April 2012, OPH completed internal and external partner consultations with key stakeholders on the HEAL strategy. Stakeholders consulted included corporate partners and community partners from the health, education and social service sectors. Partners from all sectors expressed support for the HEAL strategy.
The four Ottawa School Board were
consulted and indicated that the HEAL Strategy
aligns well with their existing work on the implementation of the
Ontario School Food and Beverage Policy (PPM 150), Daily Quality Physical
Activity Policy (PPM 138) and Health and Physical Education Curriculum. Representatives indicated that we would
pleased to continue to partner with OPH to support the HEAL Strategy.
In the first quarter of 2012, OPH staff began consulting with a number of corporate partners including the Transportation Strategic Planning, Planning and Growth Management and Ottawa Light Rail Transit to discuss active transportation.
In March 2011, OPH hosted the Taking Action Together to Prevent Childhood Obesity community forum. Local experts from CHEO, Champlain Cardiovascular Disease Prevention Network, OPH and a variety of other organizations came together to outline priority focus areas aimed at preventing childhood obesity. The outcome from this forum was a clear message that the community is ready for collaborative action.
LEGAL
IMPLICATIONS
There are no legal
impediments to the implementation of the report recommendations.
FINANCIAL IMPLICATIONS
The cost to develop the strategy has been funded within the OPH
budget. OPH is actively seeking
opportunities for strengthening funding sources. A one-time funding application for the
walkability strategy is pending response from the Ministry of Health and
Long-term Care. In addition, this area will be identified as a budget pressure
in 2013.
TECHNICAL IMPLICATIONS
There are no technology
implications associated with this report.
Ottawa Public Health, in
collaboration with community partners and City of Ottawa Departments, will
implement the Healthy Eating, Active Living Strategy, as approved by the Board
of Health. Ottawa Public Health will continue to consult all
relevant City departments, including Legal Counsel in the City Clerk and
Solicitor Department on agreements between the Board of Health and outside
organizations, as well as the implementation of the strategy. The Board of Health
Secretary will send letters to the appropriate Ministers as detailed in the
report recommendations.
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