Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology
Issue 36 - Evidence - June 3, 2015
OTTAWA, Wednesday, June 3, 2015
The Standing Senate Committee on Social Affairs, Science and Technology met this day at 4:19 p.m. to continue its study on the increasing incidence of obesity in Canada: its causes, consequences and the way forward.
Senator Kelvin Kenneth Ogilvie (Chair) in the chair.
[Translation]
The Chair: Welcome to the Standing Senate Committee on Social Affairs, Science and Technology.
[English]
I'm Kelvin Ogilvie from Nova Scotia, chair of the committee. I invite my colleagues to introduce themselves.
Senator Eggleton: Art Eggleton, Ontario, Deputy Chair of the Committee.
Senator Raine: Nancy Greene Raine, British Columbia.
Senator Enverga: Tobias Enverga, Ontario.
Senator Nancy Ruth: Nancy Ruth, Ontario.
Senator Stewart Olsen: Carolyn Stewart Olsen, New Brunswick.
Senator Seidman: Judith Seidman, Montreal, Quebec.
The Chair: I remind us, for the benefit of those seeing us from afar, that today we are continuing to examine and report on the increasing incidence of obesity in Canada: causes, consequences and the way forward.
I'm delighted that we have two sets of witnesses with us today. They have agreed to the order in which they will present. As a result, I invite Craig Larsen, Executive Director, and Manuel Arango, Member, Board of Directors, from Chronic Disease Prevention Alliance of Canada to present first. Mr. Larsen, please proceed.
Craig Larsen, Executive Director, Chronic Disease Prevention Alliance of Canada: Good afternoon. Thank you for inviting CDPAC to appear on this important topic because obesity really is one of the major risk factors for many chronic diseases.
CDPAC is an alliance of 12 national health organizations committed to the promotion of healthy living for chronic disease prevention. In recognizing that the major risk factors for many chronic diseases are the same, we began working together about 12 years ago to tackle the root causes. Our key activities are advocacy for evidence-informed policies and programs, mainly at the federal level. We also work to mobilize knowledge about what works via our national conferences, webinars and scale-up of evidence-based projects and interventions.
Today, I would like to focus on three issues where we feel that government action would make the greatest impact on obesity.
The first issue: While CDPAC functions as a collaborative forum for major health NGOs and health care provider organizations, we recognize that we alone can't solve the complex puzzles of unhealthy weights; and complex issues such as obesity are not an individual problem simply rooted in lack of knowledge or willpower.
Twenty-five years ago, the Ottawa Charter called for a whole-of-government and whole-of-society approach to ensuring conditions for good health.
More recently, Canada's federal/ provincial/territorial Declaration on Prevention and Promotion stressed the importance of adopting a whole-of-government and whole-of-society approach.
Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework to Promote Healthy Weights embodies a clear emphasis on multi-sectoral collaboration.
The United Nations Declaration on Non-communicable Diseases, unanimously endorsed by member states in 2011, also calls for comprehensive and integrated action by all stakeholders, including industry.
Two great examples of success in this regard include the Public Health Agency of Canada's multi-sectoral partnerships approach to funding. Health Canada, through the Canadian Partnership Against Cancer, funds a globally unique funding program called Coalitions Linking Action and Science for Prevention, CLASP. I can talk about those later if you're interested in why they are such great successes.
There are three major barriers to a more fulsome integration of efforts on issues such as obesity, all of which CDPAC believes governments should play a leadership role in overcoming. First, there is a lack of shared understanding across sectors about the roles their respective actions, policies and programs play in contributing to obesogenic environment. Second, few jurisdictions in Canada consistently apply a health-impact-assessment lens to the planning, implementation and evaluation of policies and programs. Third, by and large, governments don't really function in a way that enables cross-sectoral collaboration to become standard practice.
Additionally, we really are missing an effective all-of-government platform to help define "common purpose" and accelerate progress on obesity. The provinces and territories have a wealth of evidence-based policies and programs designed to support healthy living or healthy weights, but they're not being developed in a nationally coordinated way. Solo efforts by various governments result in redundant work and inconsistencies, which can be confusing to the public and stakeholder groups that have to work across jurisdictions. The federal government should function as a convener and a catalyst for proactive, action-oriented, issue-specific teams engaging all levels of government.
The second issue I'd like to talk about is marketing and advertising to children. The scientific literature is clear: The vast majority of foods and beverages marketed to kids are high in fat, sugar and salt; marketing to kids works as it influences their food and beverage preferences and choices; unhealthy food and beverage choices contribute to childhood obesity; and unhealthy weight in childhood almost always tracks into adulthood.
Quebec's Consumer Protection Act is the only law in Canada that prohibits commercial marketing directed to kids. It has been effective within francophone communities, but where English is spoken, it has not been particularly good at protecting against cross-border diffusion of marketing from U.S. broadcasters.
Industry's self-regulatory approach to marketing to children in Canada, known as the Canadian Children's Food and Beverage Advertising Initiative, CAI, is insufficient. The standardized nutritional criteria that will be implemented by the end of this year will affect less than 2 per cent of the products currently advertised to kids. The CAI fails to make any serious attempt to keep tabs on web-based marketing to kids, which is where the majority of marketing to kids is taking place.
Any measures taken to protect children from marketing and advertising must respond to the rapidly expanding array of digital marketing techniques being used by fast food, snack food and soft drink companies to target kids. Clearly, this is a really difficult challenge. It will likely require not only coordinated domestic efforts, but international ones as well. The issue is too important for us to sit back and do nothing. Can the Government of Canada position itself for global leadership on marketing to kids?
The third issue: sugary beverages and their links to childhood obesity. Given the strength of the beverage industry and society's addiction to sugar, this is another difficult but critical issue. Here are a few important points to consider, some of which were made by my colleague Mr. Arango during his previous appearance before this committee:
There is a growing body of evidence linking sugar to obesity and other adverse health outcomes; sugary drinks are the largest source of sugar in our diet, carrying a lot of energy but little or no nutritional value; marketing by the beverage and fast food industries has normalized consumption of "biggy-sized" sugary drinks on a daily basis; and sugary drinks are now considered to be a leading driver of obesity.
CDPAC thinks that an economic intervention by governments, such as a manufacturers' levy on sugary drinks, could generate revenue to help fund counter-measures, such as healthy living education campaigns.
In conclusion, marketing to kids is leading children to make unhealthy choices. Overconsumption of sugary drinks is a major contributor to unhealthy weights. Obesity is a complex phenomenon and will require a multi-pronged intervention involving all of government and all of society with federal government leadership.
The Chair: Thank you, Mr. Larsen.
Now we have, from Québec en Forme, Sylvain Deschênes, Director, Mobilization, Mobilization and Knowledge Transfer Management.
[Translation]
I invite you to make your presentation, Mr. Deschênes.
Sylvain Deschênes, Director, Mobilization, Mobilization and Knowledge Transfer Management, Québec en Forme: Good afternoon, and thank you for having invited Québec en Forme to meet with you. It is a privilege for us to come and talk to you about an initiative that was launched in 2002 in Quebec, known as Québec en Forme. Québec en Forme is quite an innovative and unique project in Canada, and even throughout the world.
You have two documents before you; the large document is a comprehensive package that contains a lot of information, and you have an English version of it. However, I will focus on the written documents, which are in French only.
Québec en Forme is the result of a partnership between the Government of Quebec and the Fondation Lucie et André Chagnon. A first phase was rolled out in 2002, an experimental project that went from 2002 to 2006. Afterwards, from 2007 to 2017, we had a 10-year mandate, during which we were to work with children from birth to 17, to promote two healthy lifestyle habits, good nutrition and an active lifestyle; so, beyond physical activity, our mandate was to see to it that children moved.
The mission of Québec en Forme is to mobilize all of Quebec society to get behind adopting and maintaining a physically active lifestyle and healthy nutrition, both of which are essential to further the full development of young Quebecers.
Our vision: we want to see young Quebecers eat properly and have a physically active lifestyle, two life habits that are recognized by local communities and all of society as being elements that are essential to development and to educational success. I will talk about local communities a bit later.
We have three objectives at Québec en Forme; the first is to mobilize communities. Right from the outset, in 2002, our objective was to mobilize the community to deal with obesity among the young. This is a societal problem and we all know the African proverb according to which to raise a child, you need a village. In order to face such an important problem as excessive weight and sedentarity among youth, you need a village, you need society.
We focused on mobilizing communities and in order to do so, we spoke about four pillars, which are the health care environment, education, municipal government, and community organizations and early childhood education.
Right from the outset, we set up issue tables, local partner groups that can be made up of 10, 30 or 40 partners from the municipal environment, the health care field, education — principals, physical education teachers, et cetera. These people get together to put in place various action plans for young people from zero to 17 years of age, to further those healthy lifestyle habits. We feel that the mobilization of communities is an essential tool, and this is aligned with the WHO perspective that it is on the ground that things happen, and it is there that we must mobilize people if we want to bring about change in our society.
The second step was to change the environments. Here I am speaking about physical, sociocultural, political and economic environments. That is really important, and at Québec en Forme, together with all of Quebec society, we talk about creating a favourable environment. What is a favourable environment? It is giving people the opportunity to make healthy choices. If someone is in front of a vending machine and there is no healthy choice, he will choose the Coke or some sweet beverage, whereas if there are healthy choices such as apple juice or vegetable juice with a low salt content, the person will have the opportunity to make a healthy choice. If I go to the municipality on weekends and all the doors are closed, there is no access; I cannot make healthy choices. When we talk about favourable environments, it is essential that people be mobilized to achieve this, and that is why we work with decision-makers. The mayor of a municipality, or a municipal councillor, for instance, has the power to change things; the principal of a school, the director general of a school board, can make changes; the same is true for an organizer who works with families.
In order to further favourable environments, a few years ago we hired an ambassador for healthy habits in Quebec, Ms. Sylvie Bernier, a former Olympic diving champion whom you surely know. She is our spokesperson in Quebec to promote healthy lifestyle habits, and she tours the various regions to meet with decision-makers and try to bring about changes to policies and habits to make environments more favourable.
The third objective of Québec en Forme is transforming societal norms, and as mentioned here, basically, it is to get people to transition from the attitude that "We have to eat well and move well" to the attitude that "It is normal to move well and eat well." Since 2002, after more than 13 years of work, we can see that there has been a lot of development on this social norm; people are moving a lot more, eating better and paying attention to what they eat. The battle has not been won; there is still a lot of work to do, but we can see this basic shift.
I want to talk to you quickly about approaches, and I will present some statistics a little later. We are everywhere in Quebec, and so we have a population-based approach that reaches young people. We also have an ecological approach: the child is important, but his or her family and community are equally important, and we have to be able to work with young people, their families and their environment. Once again, this is an approach that works through and for the community. We strongly support the World Health Organization approach to mobilize communities.
If you move to the next page of your document, you will see the statistics. Québec en Forme has involved 164 communities in Quebec, throughout all of the regions of the province. We have the participation of over 30 aboriginal, Inuit, Cree and first nations communities in various parts of Quebec. Through Québec en Forme, 5,500 similar-minded projects, and 4,000 partner organizations have been mobilized in Quebec. We also have 17 regional action plans. We invest a great deal at the local level, that is to say close to $24 million a year on the ground. We have regional partners, which means close to $4 million invested in regional tables to support our local partners, both in training and the development of expertise, assessment and communication. We also have close to 32 national projects; at the end of the document you will find a list of all the national projects that are funded through Québec en Forme.
A societal campaign for and by youth was launched to reach young people from 9 to 13, under the acronym of WIXX, a name invented by the youth themselves. We know that the dropout rate for that 9-to-13 age group has diminished considerably. In addition, there is the WIXX magazine, also addressed to parents and partners. This campaign has been very effective in getting young people to move more, and for a few years now it has been funded by Québec en Forme. It will end with the expiry of our mandate in 2017.
We also have a website, veilleaction.org, which contains a lot of information for the communities, as well as components on expertise, health, science, and action. You will find the information on the next page of your document, as well as information on the national projects.
Allow me to repeat that we have a mandate for 2007-17; since we are now in 2015, we have two years remaining. The objective is that healthy lifestyle habits remain rooted and continue once the Québec en Forme mandate has come to an end. We believe in keeping things going by encouraging local groups, regions and our national and provincial partners to see to it that these healthy living habits will remain a priority in Quebec. There is in fact a text on the continuity of the project, an element we work on very hard. We would like to see the mobilization work we have done remain strong and solid after the end of the mandate of Québec en Forme, and we would like to see other funding partners take over to see to it that these healthy habits remain a priority in Quebec.
On behalf of all the partners who work daily for Quebec's children and encourage them to adopt healthy lifestyle habits, I thank you for listening, and would be pleased to answer your questions.
[English]
The Chair: I will open up the floor to my colleagues, beginning with Senator Eggleton.
Senator Eggleton: Mr. Larsen, I'll start with your presentation. You told us something that I think is quite interesting, and it's that the Canadian Children's Food and Beverage Advertising Initiative — this is the industry one — is insufficient. The standardized nutritional criteria that will be implemented by them by the end of this year will affect less than 2 per cent of the products currently advertised to kids. That doesn't sound very effective.
Later on, you talked about the sugary beverages and their links to childhood obesity. Here you are suggesting a manufacturers' levy on sugary drinks. Would it be at the federal level that you would be proposing this?
Mr. Larsen: I think it could be at multiple levels — federal and provincial as well.
Manuel Arango, Member, Board of Directors, Chronic Disease Prevention Alliance of Canada: Sugary drink taxes could come in the form of excise or manufacturer taxes, and they can take place at both the provincial and federal levels. We encourage all levels of government to consider that.
Senator Eggleton: How would you measure what the tax is applied to? Is it the amount of sugar they put in, or is it some other method of calculation being used?
Mr. Arango: There are different ways of doing it. It can be done by a volume tax according to the amount of sugar in the product. An easier method is to apply it to drinks from a certain category that you define as "sugary drinks."
For us, there are definitions out there for "sugary drinks," such as sweetened, ready-to-serve, coffee, pop, juice, sports drinks and vitamin waters are all drinks that have free sugars in them. Those are the products that we would want captured.
Senator Eggleton: One thing you don't say here is what we have heard from others, and that is that there should be a ban on advertising. I will also ask Mr. Deschênes about this one because Quebec has that kind of plan in place.
Are you in favour of a ban on advertising to children? I don't see it anywhere. I do see you saying that, if we are going to protect children then we have to realize that there is an expanding array of digital marketing techniques. There are more platforms than just television — in other words in the electronic field. Could you go through that further?
Mr. Larsen: Yes, we certainly do. CDPAC, for many years now, when we talk with the senior folks at the Ministry of Health and the Public Agency Health Agency of Canada has been calling for a ban on marketing and advertising to kids. This is still something that we very much support.
I kind of left it that it is something that needs to be done, but it really is complicated; we understand that. I've mentioned that the Quebec Protection Act has been effective in francophone communities but, unfortunately, it wouldn't be as easy as just emulating that Quebec approach in other provinces and territories. This is because, among many issues, of this diffusion of marketing that comes across the borders from the U.S. in English. That has diminished the effect in English-speaking parts of the country.
When we get to the issue of Internet and web-based — because the kids are exposed to advertising everywhere with video games, on their phones and everything — so we realize that it will not be an easy task, but there are some examples in society where the Internet is being monitored. There are ways to do it.
Senator Eggleton: I am asking Mr. Deschênes to comment on this. Could you comment on the effectiveness of the plan in Quebec? It is a general ban on advertising. Some people advocate that it be done for sugary drinks or junk food, but the Quebec law is a ban on all advertising directed to children under age 13.
Is it working effectively? People are trying to promote their products and they will try to work their way around things. They will find another way of doing it. Tell me about that.
[Translation]
M. Deschênes: In my opinion, the upside of the law is that it prohibits publicity aimed at children. Unfortunately, as my colleague Mr. Larson pointed out, there is a great deal of publicity like that on social media in particular that targets youngsters. In my opinion that is where education should start. It is essential that we involve the schools. Children are bombarded by many ads, but still have to be able to make healthy choices. We are not against the McDonald's of this world, nor against poutine. In our jargon, we talk about food exceptions. For time to time such things are okay. The problem occurs when children eat this every day. We have to lead them to make healthy choices and in that way the legislation is very beneficial.
In Quebec we have the Coalition Québécoise sur la problématique du poids, which does a lot of lobbying to have sweet drinks taxed; sweet drinks are very popular with young adolescents. This coalition works very hard on zoning. When the policy prohibiting the sale of unhealthy food products came into effect in Quebec, many fast food outlets suddenly popped up close to high schools, particularly in poorer areas. Young people in schools have to be made aware of the beneficial effects of eating healthy foods by placing the emphasis on the attractive aspect and the diversity of healthy foods. We have to adopt a multi-strategy approach. We cannot have just one tool. There has to be legislation, and people who exert pressure and do awareness-raising with children, parents and partners. This is what will lead to concrete results. The law acts to circumscribe that aspect.
[English]
Senator Seidman: Mr. Larsen, you represent an alliance of some pretty weighty organizations in this country. You say that your key activities include advocacy for evidence-informed policies and programs. You work to mobilize knowledge about what works. What I would like to ask you is what works. You could help us because, obviously, we want to make recommendations about what works. Could you give us some examples from your long history? I think this alliance has been in effect since 2001. What could you tell us about your evidence of what works?
Mr. Larsen: Sure. Probably one of the best treasures that we have in Canada has been created by the Public Health Agency of Canada and that is the Canadian Best Practices Portal. It has done a good job of going around the provinces, territories and municipalities and using an evidence-based approach, which is an evaluative approach, to find out which kinds of things that have been done at the community and provincial levels to influence healthy living, physical activity and healthy eating. They house those on the Best Practices Portal. It is a really good go-to place for things that work.
There are a lot of other initiatives that are happening, that have happened across the country, that have not necessarily made it on to their portal, but it is a good place to look. It is easily searchable as well. I will give you some examples of a few of many things on there.
There was a program created in British Columbia, with funding originally from the B.C. government, to help teach kids how to be sugar-wise. It was called Sip Smart! I don't know if you have heard of that. One of the witnesses that you heard from earlier in the study, Dr. Tom Warshawski from B.C., was very much behind the creation of the Sip Smart! program and it really does works well. It is aimed at kids in Grades 4, 5 and 6 and it teaches them how sugar is completely ubiquitous in so many of the foods. Sometimes you don't even realize that in a typical can of pop that there are 9 to 13 spoonfuls of sugar. Can you imagine if you were at Starbucks and saw someone sitting beside you putting in 9 or 13 spoonfuls of sugar just how shocked you would be? But we don't even think about it, when we drink a regular size can of pop, let alone a biggie-sized one. The Sip Smart! program is a good example of teaching a kid in tangible, fun ways that sinks in and have knowledge that lasts.
Another companion piece that CDPAC created, with funding from the Canadian Partnership Against Cancer, is called Screen Smart! In that program, we also targeted kids in Grades 4, 5 and 6, teaching them about physical activity. You can look at Sip Smart!, which is focusing on sugary drinks as the energy in, and Screen Smart!, which was more on the energy out. You realize that if you are staying like that and you are not being very active then there's not much energy going out. Those are just two of many excellent things that are now housed on the Best Practices Portal.
I would like to applaud them because in the last few months they officially opened something called the Ways Tried and True. That is a whole set of interventions that are particularly effective in Aboriginal communities.
Senator Seidman: Thank you very much.
Mr. Deschênes, I would like to ask you how Québec en Forme, happened? What was the genesis for it? Clearly, it is an example of a great success of the sort that Mr. Larsen spoke of, in the sense that it is multi-sectoral. It is a whole society approach.
How was it born? What led to Québec en Forme happening? It might be a best practice. It might be an example of something that other provinces or regions could use.
[Translation]
Mr. Deschênes: It is an interesting amalgamation. I should talk about Mr. André Chagnon, the president of the Fondation Lucie et André Chagnon, the former owner of Videotron. When he sold Videotron, he made $1.8 billion. He dedicated $1.4 billion to creating a foundation to help disadvantaged children in Quebec.
According to the foundation, to work to eliminate poverty, children have to stay in school and be more physically active. In order to stay in school and be successful, children have to have healthy lifestyle habits. The partnership was born from that vision. There was the Perreault report and the Ottawa charter. It is important to talk about the Ottawa charter.
Then there was the Perreault report, prepared with Mr. Chagnon's cooperation. They concluded that obesity and excessive weight is a growing scourge in Quebec, and they wondered whether the Government of Quebec and the private foundation could team up. At that time Mr. Charest was the Premier of Quebec, and a government action plan was brought in. People realized that the Ministry of Health was not the only one that could take an interest in healthy life habits, and that this was multi-departmental.
There were 75 initiatives in the 2006-12 government action plan, which involved the Ministry of Transport in connection with bicycle paths, and other ministries such as the MAPAQ regarding the whole area of nutrition, and the Ministry of the Family; at the time seven ministries were involved in the government action plan. This occurred during the second mandate; for the first mandate from 2002 to 2006, our project was really experimental. But as of 2007, we were looking at $400 million; the government invested $200 million in the project and the foundation invested the same amount over a 10-year period.
This is really interesting, because people felt that it was not just a short-term thing, but that it was possible to make a change over the 10-year period. We know that it takes about 20 years to bring about a societal change, according to the studies. We have been working at it for almost 15 years, so that is a lot, and we are very lucky to have had such a mandate. So that is how the initiative got started; it was due to an entrepreneur who believed very firmly in healthy lifestyle habits, and that there was a direct link to poverty as well.
In the beginning we only worked in disadvantaged areas, but after that we became a population-wide movement with the Government of Quebec; but we were always interested in disadvantaged communities in Quebec, because we wanted to encourage educational success.
[English]
Senator Seidman: I appreciate that. I presume that you are tracking, in some way, the effects of this program. You are collecting some type of data over time to demonstrate change in order to hope that this becomes permanent, as you said. Is that correct?
[Translation]
Mr. Deschênes: Yes. Over all of these years we have collected a lot of information. As I was saying we are now in the last phase of the Québec en Forme project, and so we want to put all of that together in order to evaluate the effects.
With regard to evaluation, people from our organization are working in cooperation with the government and the foundation so as to assess the value-added effects of all of it, determine what we can learn from all of this, and make recommendations to do things differently.
In the beginning it was experimental and we proceeded through trial and error; it was really an innovative project. The communities too proceeded through trials and errors. We developed projects, for instance, on movement among children of 4 to 6, and projects on leadership among young people in both primary and secondary school. We studied health and nutrition in public markets. We had several provincial projects, such as the Jeunes pousses program, i.e. how do we talk about sprouts to young people in schools; the Ateliers cinq épices program; the Tablée des Chefs program, which was aimed at young adolescents, to show them how to prepare food.
As for the whole area of awareness raising and training, we have identified a number of things and we have several elements. Some are talking about a book. We are working on compiling everything in the last phase of the project — over the next two years — in order to see what the outcomes are and to decide whether to keep going.
The initial objective was not to invest so much money over the long term; it was to set up a machine. It has been set up, and the communities are solid. Now we have to figure out how to breathe life into those communities as we move forward. We think that will cost much less, but some money will still be required to support the implementation in Quebec, locally, regionally and nationally.
[English]
Senator Seidman: Do you have any interim data or any results that you could share with us, perhaps once you leave, to send to the community?
[Translation]
Mr. Deschênes: I will follow up on that. The document I submitted to you sets out a number of avenues, but it is from 2008-09. So we may find other elements, and I will be happy to send the information to the appropriate person.
[English]
Senator Enverga: Thank you for your presentation. There is a lot of talk about sugary beverages and a lot of suggestions that say to reduce the size of the drink, or to put more taxes on it, or do not advertise to kids about sugary drinks, and many more things.
What was mentioned to me one time was why don't we reduce the sugary content of every drink and legislate that. Do you think that is possible? Do you think it will work as well? That is, instead of 13 spoons, maybe just a couple.
Mr. Arango: Sure, that is one definite approach. Whether it is food or drinks, if we mandate reformulation, where it is feasible, that definitely could work. A good example is with trans fats. Many countries have regulations to limit the amount of trans fats in foods. That has been shown to work. It is possible. It could be done with sugar as well.
Senator Enverga: That's great.
Mr. Deschênes, you mentioned that you have worked with First Nations and Aboriginals. How would you compare your statistics there? Do they have a better chance of being obese? What is the comparison between Aboriginals and First Nations and other kids that are not First Nations?
[Translation]
Mr. Deschênes: In the case of First Nations, studies show the prevalence of type 2 diabetes and excess weight. We see a lot of overweight people in many Aboriginal communities, where a sedentary lifestyle is very common, especially among the younger generation. The approach is the same. The only difference is that we constantly have to adapt our ways of dealing with them.
Having worked on the ground with Inuit, Cree and First Nations, I know that the language we use has to be different. They already have a sense of community, and they recognize how important young people are. We have to build on that. How can we help them? We use the same approach, a community-based one. The problems are huge. The issue is often that it is not always easy to talk about healthy habits in a community with major social issues and it is difficult to establish those concerns as priorities. But when they see that this approach can be preventive for young people, it becomes very beneficial.
We have really adapted our approach to First Nations. We do a great deal of work with Aboriginal organizations, such as the First Nations of Quebec and Labrador Health and Social Services Commission. We work a lot with Inuit and the Cree, and with organizations that help us take meaningful steps in those communities.
The same goes for the obesity issue. The only difference is in the methods we use with the community and in how we work there. We definitely have to adapt our approach to Aboriginal communities. We have done that, and the results have also been positive for them.
[English]
Senator Enverga: Can you tell us some results from your studies?
[Translation]
Mr. Deschênes: For example, there are three Cree communities near Chibougamau where youth leadership camps were organized. We work with young Aboriginals, who become future counsellors. We talk about healthy living in their counsellor training. We want them to become leaders and role models in their community. If they become role models, they will someday be parents and leaders in their community.
There is also the whole issue of motor development in early childhood centres, where children's psychomotor and motor skills are developed. We provide the educators and the managers with training, to help them implement certain methods. The goal is not to change things, but to sometimes to add elements of a healthy lifestyle, such as healthy eating. With children, we call that free play; it includes activities for discovering tastes and helping children discover tastes other than sweet. Children are very attracted to sugar, but can other tastes be developed? I want to repeat once again that we use education and structure to help those children establish themselves in environments that lead to healthy lifestyles.
[English]
Mr. Arango: I would add that obviously healthy lifestyle risk factors and addressing them in First Nation and indigenous communities are important. At the same time, many First Nation groups will say that their biggest problem is poverty.
Addressing the social determinants of health is also really critical. If you're poor and you don't have enough money to buy healthy food, that is a problem. Obviously, we have to ensure that there is accessible food. If you're in a northern, remote community and it's not there, that's an issue. We need policy instruments to address that, but determinants of health and poverty are critical issues as well.
Senator Raine: Thank you very much for being here and contributing to our study.
Mr. Larsen, I'd be interested in a bigger picture of what Public Health Agency of Canada is doing with their multi-sectoral partnerships, because they have had partnerships for many years with the active living section. Are these active living groups all involved in these partnerships? I'd also like to know more about CLASP. Could you expand on those two programs?
Public Health Agency of Canada indicates to everybody who hears those words that they are the federal government body that should be responsible for preventive health.
Mr. Larsen: Correct. I'll start with CLASP. It is an acronym standing for Coalitions Linking Action and Science for Prevention. This was a really creative thing that the Canadian Partnership Against Cancer started about six and half years ago when they started to conceptualize how to bring together the knowledge, evidence and the experience from the ground about what works and get that into the hands of the people who should be using it or could be using it: policy-makers, other researchers, et cetera.
They created this program called CLASP and it brings together research, policy, practice and community members in the planning of interventions and in the scale-up of things that have been shown to work. That is something that has been unique. In fact, they had done a global scan and they couldn't see anywhere else in the world where it had actually been tried.
It worked really well, so they initially funded a group of five initial CLASPs, I believe, and CDPAC was actually the holder of one of those original CLASPs, and the Heart and Stroke Foundation was with another. CDPAC was focusing on collaborative action on childhood obesity with a whole family of activities, and Heart and Stroke Foundation was leading one that was all around built environment.
That has really shown to be successful in getting these various sectors working together, sharing knowledge, planning together and working with communities and making a community-driven scale-up of things that work.
Interestingly, that then led to some work being done by the Public Health Agency of Canada around how it funds things. First they started with something called Innovation Strategy and, lo and behold, the Innovation Strategy funding model started to look a lot like the CLASP model where you had to bring together research policy and practice.
I forgot one really important part of the CLASP model. You have to be working across at least two provinces and territories and that was not easy. When they were conceptualizing the CLASP model, I didn't work for CDPAC yet. I was actually doing consulting work and, by coincidence, was consulting for the Canadian Partnership Against Cancer to help them conceptualize the CLASP model.
The feedback from across the country was that they couldn't possibly work across provinces and territories. They said it's too hard to do. It's difficult even with the cultures in universities trying to collaborate on research, let alone provinces working on this. We just can't do that. Well, we can and we did, and it's working well.
Lo and behold, the Innovation Strategy funding program from the Public Health Agency follows a similar approach and the CLASP did a renewal of their original CLASP teams. They re-funded them for additional two years and now they've just funded another batch of brand new ones that are about a year and a half into a three-year mandate.
Does that answer your question a little?
Senator Raine: It does, but it begs the question, you said they're into year two of a four-ear thing but, as I understood from Mr. Deschênes, it takes 15 to 20 years. What I keep seeing is you get a good program, it just gets going and it's moving along and then it's time to think up a new one. Then we don't get that concerted energy. It's always stop and go. Yet there are tons of really good people out there who would love to work together and keep on working until we lick this beast. How do we do that?
I suspect that Québec en Forme has a longer-term picture because that private sector foundation said they would go for a longer term.
Mr. Larsen: I'm glad you asked, because that's another unique and important features of the CLASP model, the innovation strategies and the multi-sectoral partnerships the Public Health Agency is doing. They are requiring sustainability in the planning, as well as in implementation and reporting, because of the old expression that Canada is the nation of pilot projects. We don't want to go down in history as yet another whole batch of pilot projects that look lovely for three or four or five years and then disappear.
They actually forced from the outset, including the one I was working with, how to set this up so it can keep on going, so that these initiatives can have wings and fly. They might not have the same millions of dollars that were coming in to get them started up, but once they are going and once you've got the local champions rallied around and you're showing success to local funders, municipal and provincial governments, they do step up to the plate.
Again, that was another one of those things that everybody balked at. Oh that's going to be really hard. I don't think we can do that, because we need lots of money, they say always. We have to have lots of money or else nothing can be done. We know that's not always the case. Once you show success the funders will start to open up.
[Translation]
Mr. Deschênes: Working with a private organization and a private funder was beneficial in two ways. It was thanks to them that we went with a timeframe of 10 years to achieve results. Having a 10-year timeframe from the get-go was helpful. We wouldn't have been able to accomplish everything we have in a 2- or 3-year period. It would've been impossible to put everything in place, a process that usually takes about 5 years. Years 5 to 8 are all about putting the right foundation in place, and years 8 to 10 are about examining what can be passed on to leave behind an impact. That may lead to next steps and further work, but not with the same intensity as that of the first 10 years.
The 10-year timeframe was strategic. When I signed my contract, I knew there was an end date. I wouldn't have worked in the same way had I known that, one day, I wouldn't be there anymore. Right from the beginning, I thought about how I could empower people in communities and the other partners. My approach was not to empire build but to create as many opportunities as possible. The whole strategy was based on that premise and sought to strengthen communities' ability to take action and make decisions. As Mr. Larsen pointed out, that involves developing educational tools, making Web-based tools available and conducting awareness campaigns, all with a view to capacity building so that, one day, when we are no longer around, others can step up and keep the momentum going. We may undertake additional initiatives but likely not at the same rate or intensity. Otherwise, it simply becomes routine and that isn't always a good thing.
The initiative is attributable to visionaries, and the government, with its 10-year funding commitment, is among those visionaries. The pioneers, if you will, envisioned an initiative that would last 10 years, knowing full well that societal change would take 15 to 20 years. But they decided to give themselves a 10-year timeframe, following a 4-year pilot project. And, today, we are seeing the tangible fruits of their labour. The point isn't to turn it into a permanent program but, rather, to keep the momentum going as long as possible, with a view to transferring knowledge and decision-making capacity. From the get-go, our intention was to empower people by giving them the tools to do the work.
Senator Chaput: Mr. Deschênes, I was reading your platform. As I understand it, your approach is based on two pillars: healthy diets and physically active lifestyles among youth.
Mr. Deschênes: Yes.
Senator Chaput: You build on that by integrating strategies and stakeholders. Would you agree that those are two very important pillars as well?
Mr. Deschênes: Both are essential pillars, yes. But are they the only ones? Probably not; other pillars are important as well.
Senator Chaput: Would you say they are essential in the fight against obesity?
Mr. Deschênes: Yes, because a child who is active and has a healthy diet is less likely to be overweight.
Senator Chaput: Quebec has a law prohibiting advertisers from targeting children under the age of 13. Did that law exist at the beginning of your mandate in 2007?
Mr. Deschênes: Off the top of my head, I think so.
Senator Chaput: So you were already able to work in that context.
Mr. Deschênes: Yes.
Senator Chaput: If I understood correctly, you said the Government of Quebec had a plan.
Mr. Deschênes: Yes.
Senator Chaput: Was the plan you developed with the foundation based on the province's plan, or did you develop it with other goals in mind down the road?
Mr. Deschênes: No. The government's action plan ran from 2006 to 2012. The organization's second mandate emerged in 2007 and was directly based on the government action plan in effect when Mr. Couillard was health minister. On behalf of all the province's ministries, Mr. Couillard signed the government action plan, and the act to establish the fund for Québec en Forme was passed unanimously. It was directly based on that act and that partnership with the foundation.
Senator Chaput: Very well. Now I'd like to pick your brain further. Your platform contains objectives and strategies to which local, regional and provincial partners can contribute. Let's say we add the federal government to that list. We are a federal Senate committee, so we are trying to ascertain what role the federal government should play and how it could support efforts to combat obesity in Canada.
How could the federal government contribute to a strategy to combat obesity?
Mr. Deschênes: That's an excellent question. We were talking earlier about accessible food. Certain communities, including Inuit communities on the North Shore, used to receive federal funding to improve food accessibility. When it's cheaper to buy 2 litres of Pepsi than it is a litre of milk, some families are obviously going to opt for the Pepsi. There used to be a federal program that provided communities with cheaper access to food. So, as far as policies, laws and regulations pertaining to access are concerned, perhaps the government could target public areas, as Quebec has done. Initially, some hospitals didn't have healthy eating policies.
Would it be possible, then, to implement healthy living policies in relevant organizations within the federal domain? In the case of adults, making showers available in the workplace, for instance, makes it easier for people to be physically active during the workday, thereby encouraging healthy lifestyle habits. Many companies in Quebec have made those kinds of facilities available to workers. If an employee who is a parent gets in shape, their children will see them exercising and being active. Employers can make a difference. Again, I would ask whether federal institutions have healthy lifestyle policies in place. Workplace cafeterias aren't always the most helpful in that regard. There again, it's a matter of optics.
Right off the bat, then, naïve though I may be, I would say that the federal government could do a lot of things to promote healthy living. As I said, Canada is an expansive society. So it's important for the federal government to examine how it can support provincial measures and for provinces to look at what they can do to support municipal and local measures, and so forth.
Senator Chaput: Mr. Larsen, would you care to add anything on the subject of how the federal government can help combat obesity?
[English]
Mr. Arango: Our colleague from Québec en Forme did mention a number of things that could be addressed. I would reiterate things like marketing restrictions. That is something the government can do. Government can make unhealthy food less attractive and less affordable, and healthy food more affordable, either through tax policy or agricultural subsidies.
One thing my colleague mentioned, as well, was the issue of food procurement policies. Through one of the coalitions in which I participate, we called upon the federal government to develop a healthy food procurement policy for its federal institutions. Obviously, that would not cover the whole country, just federal civil servants, but that would be a good step forward as well.
There are a number of things that the federal government can do such as affecting price, for sure and promotion — these are things that they can do.
Senator Chaput: Thank you.
Senator Nancy Ruth: I wanted to ask you all about the influence, as you said particularly in English Canada, of American television ads and how does one sustain problems? Have there been any discussions by your organizations or your province with various agencies in the United States about this issue? What were the conclusions, or what is the process you're involved in?
Mr. Arango: The issue of cross-border advertising, whether it's in tobacco or unhealthy food, food and beverage marketing, that's going to happen all over the world. However, in the case of tobacco, there is an international treaty where there is an agreement on how to address cross-border advertising. Countries can have bilateral agreements to control that.
Similarly with marketing of food and beverages to kids, that could be done eventually. The reality and the bottom line is that, even if you do have marketing and promotion coming in from other countries, there are things you can do internally within the country to limit the promotion of food and beverages through your own channels as well.
You have to do it both ways. Do internal controls and also establish agreements to limit commercial advertising coming from other countries.
Senator Nancy Ruth: The other thing I wanted to ask was around the outputs, particularly in your efforts in Quebec around gender. Is there a difference in the take-up or success of young men or young women in this and also in the Aboriginal communities? Do you do that statistic? Do you do a breakout of the community successes? Is there a gender breakout?
[Translation]
Mr. Deschênes: Not really, at the end of the day. We could tell you how many activities are happening in Aboriginal communities. We have all the statistics on what is being done, how many people are participating and so forth. But the analysis isn't refined enough to hone in on gender participation rates. We do know, however, that 10 per cent of girls between the ages of 12 and 13 who aren't active will become active once they hit 25. That's why we support FitSpirit, a Quebec organization that does a lot of outreach among girls. Things aren't always easy for girls in their teenage years, especially in coed environments. We have to work on educating girls. That is key. But we don't have any numbers specifically for Aboriginals, in terms of the female versus male breakdown.
[English]
Senator Frum: Mr. Deschênes, in this impressive package you've given us, you have two interesting statistics. First, you say one in two children in Quebec attend child care programs where 89 per cent of their time is spent on sedentary pursuits. You have another statistic for older children where you say after school, between three o'clock and six o'clock, young people spend 92 per cent of their time engaged in low intensity physical activity. We are covering the whole day there, between when they're in school being sedentary and then after school being sedentary.
From a policy perspective, which period of time is more important for governments or agencies to spend their time focusing on? Is it the time the kids are in school or daycare, or is it the after-school program? What focus is more important?
[Translation]
Mr. Deschênes: I don't think one is more important than the other. As I said, initially, you need a multi-pronged strategy, in other words, children can learn about healthy lifestyle habits in class and be physically active during recess and lunchtime.
According to the WHO, children should have an hour of physical activity a day, or seven hours a week. When I was working in the field, I would ask partners what could be done to build on the two hours of physical activity children received in gym class every week. The most obvious answer: get them walking to school.
Everyone used to walk to school. Today, however, very few children walk to school. Why? Because parents worry about their children's safety. Municipalities can create safe walking routes by, for instance, making sure that snow is cleared from sidewalks and paths. Quebec has a program called Trottibus, a walking school bus. Seniors and volunteers accompany children so that they can walk to school in a safe and supervised environment. If a child spends 15 minutes walking to and from school, that's 30 minutes a day.
In addition, before Québec en Forme and other partners came on the scene, children in many after-school daycare programs would do arts and crafts until their parents picked them up. But they could have been spending that time being physically active in the gym or the school yard. Monitors were there to supervise not lead children in physical activity. We asked ourselves whether it would be possible to give those monitors the training to do that.
We also introduced an activity program in schools called Acti-Leaders, where students organize and run sports activities for younger children after school. In short, to answer your question, I would say that it isn't any better to focus on one period of time over the other. The whole point is to give young people as many opportunities as possible to be active throughout the day.
Students can be active in the classroom as well. Gym teachers aren't the only ones who can get children moving. That's simply not the case. In Abitibi, schools have introduced physical activity breaks. A student stands up and calls a physical activity break; music is played and the class spends five minutes being active. Afterwards, the lesson resumes.
All of those efforts in combination, that patchwork of measures, if you will, is the key to achieving results. We need to give youth more opportunities to be active. To recap, then, it's important to get children to walk to school and to give them opportunities to be physically active in class, at recess, at lunchtime and after school.
We focus a lot on school, which is, of course, important, but the school year is only 180 days long. There are 365 days in a year, so that leaves 185 days where children are spending time in their communities, at summer camps or with their parents. How, then, do we create the conditions that are conducive to healthy living? It has to be a collective effort on the part of schools, municipalities, the healthcare system and community agencies alike. With all the stakeholders doing their part, the more physical activity opportunities children will have and the more active they will be.
[English]
Mr. Larsen: I wanted to add that I agree very much with what Mr. Deschênes said. At CDPAC, we have not picked any certain part of the school age or even the age spectrum, but we have consciously selected to work largely with children and youth because we believe — and the evidence shows — that the earlier in life you instill knowledge and skills, the more likely that will come to bear as kids get older and become young adults. They don't always act on the knowledge they have, but if it's there when the time comes, they know the right things to do.
Briefly, during my main talk I didn't mention mental health and it occurred to me that that has not come up at all yet in the discussion today. It probably has from other witnesses, but that is another important factor that comes to bear in the knowledge and skills we instill in kids. They also need the sense of mental wellness and resilience to deal with stress that is increasingly part of this modern world we live in.
Senator Frum: I'm glad you mentioned the part about walking to school. As a lot of questioners have said, we are trying to understand from a federal perspective how we can contribute to this issue. You mentioned the existing initiative of International Walk to School Month, which I don't think anyone has mentioned. We've had advocates for walking to school here before, and I'm one myself, but this is a new thing. It's happening in Quebec. As a parent, I've never heard of it in Ontario. Can you tell us anything more about it?
[Translation]
Mr. Deschênes: Basically it's a project that Québec en Forme funded for a number of years called Trottibus, where a provincial organization allowed children to walk to school safely under supervision. Another organization, Vélo Québec, created a program called On the Move in the Community; originally called On the Move to School, it became On the Move in the Community.
Again, how do we get children to walk to school? We work with schools to develop travel plans to get them there safely, by using markers to designate the route, for example. So Trottibus and Vélo Québec are both provincial organizations that have undertaken initiatives to help communities create safe routes for walking and biking.
Laval is a good example. There, the six groups worked with the city to come up with travel plans setting out safe routes that children could use to get to school year-round or go to the park on the weekend. It gave parents reassurance and made them feel more comfortable. Routes with less car traffic were chosen to give pedestrians safer walking areas. Some cities painted footsteps on sidewalks so that young people would know the safest routes to take. Children can knock on a neighbour's door if they don't feel safe. It's an example of communities stepping up and looking after their children.
Vélo Québec and Trottibus are the organizations that exist in Quebec.
[English]
Mr. Arango: I wanted to add to that in Ontario there is some work going on with active safe routes to schools. Having good policies in place to ensure that you can transport kids safely to schools is important, but you also need the infrastructure investments in place to allow that to happen.
There are a number of national organizations, part of a coalition known as the Federal Active Transportation Coalition, which has been asking the federal government to invest in infrastructure to facilitate walking, biking and public transit use. Without a sidewalk and without a path in a neighbourhood directly to a school, it's more likely that people will resort to using a car. The policies are important, but you definitely need the infrastructure investments.
This coalition has been calling upon the government to invest $250 million over three years to support investments in sidewalks, bike paths, et cetera. We'd like to see something happen, similar to what happened in the Recreational Infrastructure Canada Program. Something similar for active transportation would be fantastic.
Senator Enverga: Mr. Larsen — and perhaps Mr. Deschênes could answer, too — you mentioned that the UN NCD declaration — unanimously endorsed by member states in 2011 — called for comprehensive and integrated action by all stakeholders, including industry. Have you heard about this or what kind of action did the states or nations take? What are the successes?
Mr. Larsen: Fairly recently we started hearing progress steps, mostly in Canada. We are starting to assemble our progress in Canada and assemble that at the world stage as well. I have not seen very many details shared yet, but I'm glad you brought up the UN NCD statement referring specifically to industry as part of solution. It relates back to a question you asked, Senator Raine.
I didn't fully answer the question about the Public Health Agency's multi-sectoral partnerships funding approach, and the unique piece is that they require matched funding. Federal government funds have to be matched by the private sector, and the Trottibus is one example of those multi-sectoral initiatives.
In response to one of the earlier questions about what the federal government could do to help with obesity, it would be great to follow up with that and continue to encourage private sector to come to the table and be part of the solution.
The Chair: Mr. Larsen, could you clarify the acronym of NCD?
Mr. Larsen: I am sorry about that. The United Nations and a lot of other countries in Europe, et cetera, refer to non-communicable diseases, whereas we refer to chronic diseases.
The Chair: It was important for you to clarify the context.
Senator Raine: When you think about the equation, you've got the calories in and the calories out, and a whole bunch of interventions that are needed. We all know what they are. We are not quite sure whose job it is to initiate them, but they need everyone on board from the top down. I am happy to hear that at the Public Health Agency of Canada has that best practices — what did you call it again?
Mr. Larsen: Canadian Best Practices Portal.
Senator Raine: So, if I were to Google "PHAC best practices," I would find a site that would let me in and start to solve this?
Mr. Larsen: Yes.
Senator Raine: We need almost a great big wall with a spread sheet on it, all the different interventions, who is doing what and where we are at, and then try to measure it. Somewhere along the line, I keep thinking: How do we motivate parents to understand that it is more dangerous for their children to eat junk food, drink pop and lie in front of the television than it is to play in the park. That is not considered neglectful parenting. However, if a parent let's their kid play alone in the park at age 7, which I did as a kid, that parent would probably be called to task over it. We need to change that.
Yes, we need to have safe parks. Maybe we should hire park rangers to invite the kids down there and have an ice cream machine with no ice cream in it. How do we attract the kids to the parks again? How do we get them outside?
I was on a plane with a man and we were talking about our grand kids. He said he was shocked. He was visiting his grandson and said, "Let's go out to the backyard and play." His grandson said, "I am an indoor boy." He refused to go out in the backyard. How do we motivate people, the parents especially?
The Chair: We want you to respond, but I want to indicate for the committee that ParticipACTION will be here next Wednesday. We will get you to take it a certain distance in response to the senator's question, and perhaps we can pursue it further at that time.
Mr. Larsen: The first thought that comes to mind is an area we are starting to see more attention given to when it comes to healthy living is the workplace for adults. We know that's important, because a lot of us spend more hours at work than we do at home with our kids. We are seeing that important setting.
When Mr. Deschênes referred earlier to the importance of having that ecological approach, we have to look at all of the age groups and all of the settings and have a multi-pronged approach. The workplace is a pretty important one, where we can get through to the moms and dads. I am encouraged to see a lot more starting to happen in the workplace.
[Translation]
Mr. Deschênes: When you work with communities, locally, and all the stakeholders are engaged, you can get an accurate snapshot of what's happening in the community. You mentioned playing in the park, but is the park accessible? Do children go there? City councillors often take for granted that, just because they've built a park in their ward, kids will use it. Maybe kids don't go there because it's a place where teenagers hang out and engage in, shall we say, less than wholesome activities.
It's important to consider all of the factors. How are the streets and parks being used? When I was young, we used to play hockey in the street. Nowadays, some municipalities prohibit street hockey. Some even prohibit kids from playing basketball in their driveways because the neighbours find it too noisy. So that's what I'm talking about when I say we need to put the right conditions in place. Those are the bylaws and policies that need to change. It's not goodwill that mayors and councillors are lacking, but they sometimes create policies in response to complaints from residents.
In some schoolyards, children aren't allowed to throw snowballs or bounce a ball against the wall. Or, if students do want to bike to school, there's nowhere for them to lock up their bikes securely.
Again, it has nothing to do with pointing fingers at anyone. It is simply a matter of bringing everyone to the table to figure out exactly what's going on and understand the bigger picture. Then it's possible to assess the situation accurately and identify potential solutions. Maybe it's possible to make parks or schools more accessible. Maybe a park monitor could be replaced with an activity leader. In the Lower St. Lawrence region, some regional county municipalities have put bins full of sports equipment in all parks. An occasional ball or hula hoop may go missing, but it's no big deal, communities simply replace them. They have made parks appealing to children, so they enjoy going there.
Fountains were removed in some places because teenagers would vandalize them and they were too costly for the municipality to repair. If there's nowhere for kids to get a drink of water, there's a problem. The focus has to be on creating the right conditions and environments. And for that to happen, all the partners and municipal representatives have to be engaged. All of those ingredients are the key to success. Though all of the measures may not work perfectly, Quebec has stepped up to address the problem, and we are seeing some great results. Communities are taking ownership and making decisions.
We were talking earlier about energy drinks and pop and the fact that some municipalities had banned them. Again, I would ask who are the people with the authority to do that. Mayors and reeves are the ones with the power to make those decisions. The public is calling for change.
We funded a project targeting food retailers. Loblaw's now offers healthier food products under the Blue Menu label. We are starting to see a societal shift and all we have to do is keep that momentum going. Clearly, it's a matter of supply and demand. If people know about the benefits of healthy eating, they will demand healthier choices, and retailers will have to adapt. It's a long-term undertaking that depends on community engagement and the involvement of society, as a whole.
[English]
The Chair: I am still trying to be easy with the term "indoor kid." It is fascinating when you think of the indoor pet, the indoor this and now the indoor kid. That is an interesting concept.
I thank you for your contributions here today. You have been taking it into a dimension we have been moving along. Early on we recognized it's a complex issue, but you have to find ways of bringing the different aspects together, from nutrition through to exercise, community and infrastructure.
Mr. Arango, when you were speaking about that issue, I was thinking that there are federal infrastructure programs that many communities have used imaginatively to help. I am aware of a village in Nova Scotia, for example, where they combined two small federal infrastructure programs — one dealing with community sidewalks and another dealing with recreational area concepts. They put together a walking park. They redid the sidewalk through the village and extended it at both ends. One walkway went up behind the school through a really nice, natural area and, at the other end of the village, the walk goes down along the river and to the park that the community already had.
It is fascinating to me, the number of people who use that walk; who walk the whole distance. We see young business women who are out in the morning running that distance. I forget exactly the distance, but it is at least 2 kilometres or more like 4 kilometres in total. All the way through the day, you can see people who are deliberately walking through that area. School kids use it to walk down to the village to pick up something to eat, as opposed to getting something out of the machines at school.
It is a simple example, I think, of what you were saying that it doesn't take, in all cases, complex organizations. It deals with the issue of safety, because it is within the community all the way through. It involves a natural area, but it is a nicely located area. Well, it was naturally located, but it happens to be right on the edge of the village and behind the school.
I think, today, what you have helped us do is to continue to look at trying to find examples and recommendations where the federal government can be involved. The federal government doesn't have to do it all, but, through certain programs, if the guidelines on how the money is to be expended are carefully structured, then it can facilitate a lot of activity.
I was also listening carefully to your comments about the length of time of an organization. Certainly we know that some of these things are short-term, but one has to be careful about building a bureaucracy because that tends to be the greatest inhibitor to innovation, as we move forward. I thought you were very helpful in terms of the way you put the structure around this. When you've got a private involvement in this kind of thing, then you can set up objectives and rules that ensure that you are moving, overall, to your objective — but give the time to move forward in that area.
I think your presentations to my colleagues have elicited responses that will help us as we begin to formulate our report. With that, I declare the meeting adjourned.
(The committee adjourned.)