Media Clipping — Wednesday, January 22, 2003, The Halifax Herald

N.S. needs 20-year health strategy

By Jane Farquharson

ON DEC. 19, 2002, the Nova Scotia government announced the names and assignments of the cabinet members who will lead us into the next election. Of particular interest to me was the introduction of the new Office of Health Promotion headed by Rodney MacDonald. With this announcement, Mr. MacDonald's responsibilities dramatically expanded to include improving the health of Nova Scotians.

Although I was pleased to read that health promotion had been assigned its own office, I was equally disappointed to read that no new funding would be provided to support Mr. MacDonald's mandate. Less than four per cent of the Department of Health's $1.9-billion budget goes to health promotion. Given the levels of chronic disease in Nova Scotia, this is woefully insufficient. As I am sure the premier and his cabinet are aware, creating health costs money. There is very little value in establishing an Office of Health Promotion without providing that office with adequate resources.

Having worked in health promotion for the past 25 years, I am aware of the positive effects on the health of individuals, families and local communities which can be achieved by well-conceived and well-executed health promotion strategies. In countries such as Finland, where concerted health promotion strategies have been implemented over decades, the rates of death and illness within communities have decreased significantly. The development and implementation of such strategies are neither simple nor quick. The long-term return on the investment, both in time and in dollars, results in decreasing premature death and illness, and improving productivity.

Nova Scotia is at a critical stage in the decision-making process for health and wellness. The current rate of chronic illness, disability and death is not acceptable.

Considering the increasing demands on our health care system, and in particular the demands on the acute and long-term-care sectors, it is apparent that our focus on treating illness, with limited efforts toward preventing disease, is not working.

We cannot continue, as a progressive society, to treat illness without focusing on what can be done to prevent disease, which means dealing with all of the known causes of ill health, such as poverty, unemployment, lack of education, high rates of smoking, poor diet and physical inactivity.

Over the past few months, I have heard comments from government officials indicating that fundamentally, health is the responsibility of the individual. However, in my two-plus decades working in the field of health promotion in this province, I have never believed that Nova Scotians have among the highest rates of illness and disease in Canada because they do not feel responsible for their own health. While I acknowledge that everyone has a role to play in creating a healthy society, government has the primary responsibility and mandate to introduce and implement policy and legislation that supports and encourages the health of the population.

Strong leadership, direction and commitment to health through targeted and adequately resourced strategies must be government's unwavering promise to us. Such a promise must also be made beyond a four-year mandate, in order to achieve lasting results - not an easy commitment in an ever-changing world. However, it can be done with a long-term (20-year) plan that does not ask us to choose between a tax cut and our health. The unintended consequences of asking the public to vote for health (the Liberals promised to borrow $600 million for health) or for lower taxes (a Progressive Conservative promise), as we did in 1999, is to have indicated that financial success and health are mutually exclusive.

As most of us are aware, financial stability and health and wellness are not mutually exclusive issues. According to GPI Atlantic, one-quarter of our current health care costs (half a billion dollars a year) are attributable to preventable risk factors such as smoking, unhealthy eating, physical inactivity and obesity. If you factor in productivity losses due to these risk factors, costs climb to over a billion dollars.

Therefore, addressing these risk factors alone can substantially reduce the current $1 billion-plus burden on the economy.

There has recently been considerable discussion around the issue of the federal-provincial and territorial breakdown of costs and the need for the federal government to restore its portion of health contributions. There is no question that such an increase would mean a great deal to Nova Scotia. However, this does not change the fact that without heath promotion strategies to tackle the growing demands on our health system, our health budget will continue to be pushed to the breaking point. No amount of money can address the needs inevitably created by an aging population with high disease rates without an emphasis on prevention.

When voters are asked to cast their ballot by separating their concerns for health and deficit reduction, one political party will win an election; but in the end, Nova Scotians lose. We need a long-term plan that will provide for a healthier and a more prosperous Nova Scotia and a government that is committed to such a plan.

Jane Farquharson is the executive director of the Heart and Stroke Foundation of Nova Scotia.

Copyright © 2003, The Halifax Herald