Longevity and Public Health - PowerPoint PPT Presentation

Longevity and Public Health

IFA Global Conference

Montreal

September 7, 2008

Carolyn Bennett M.D., M.P.

• Life expectancy ?
• ‘Long life’
• More than numerical....
• Quality of Life
• ICF.... Health and Functional Capacity

The Grey

Tsunami ?

The Grey Tsunami ?

R.O.M.P.

Collingwood

April 24, 2008

Dr. Carolyn Bennett M.P.

• MORTALITY RISK
• QUALITY OF LIFE
• Although…. If this is the first generation that may not live as long as their parents….

LIFE EXPECTANCY DOES MATTER

• Infectious Diseases
• Chronic Disease and Injury
• Mental Health
• Emergencies
• Social Determinants of Health

• Infectious Diseases
• Chronic Disease and Injury
• Mental Health
• Emergencies
• Social Determinants of Health

• 2003 - Canada… 44 died of SARS

France…14,000 died in the heat wave

• 2005 - Katrina
• 2005 - Ontario Medical Association Report

“…It’s efforts are focused on four main areas:

emergency preparedness

active ageing

injury prevention and

mental health.”

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• Naylor’s 4 C’s – November 2003
• Collaboration
• Cooperation
• Communication
• Clarity – who does what, when
• Germs don’t respect borders !!!!!

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• Diabetes
• Cancer
• Heart Disease and Stroke
• HIV/AIDS
• Falls Prevention

``if it`s measured it gets noticed, if it`s

noticed it gets done``

• Reportable diseases.... HbA1C
• Interventions....
• Minister Andy Kerr, Scotland
• Health outcomes down to postal code
• GIS

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• Men over 80 ...highest suicide rate in Canada
• Challenges – social and emotional isolation
• Body betrayal
• Physical ailments
• Mobility
• Pain
• Cognitive and sensory impairment
• Retirement
• Changes in income
• Widowhood, loss of friendships through death
• New caregiving responsibilties
• GBLT community - inclusion

• Nunavut ….ELDERS
• South of 60….ELDERLY ????

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• Hispanics: had an unusually low death rate due to heat. Hispanics at the time lived in places with higher population density, and more social cohesion.
• Elderly women: who may have been more socially engaged, were less vulnerable than elderly men

• individual-level risk factors for heat wave victims
• living alone
• not leaving home daily
• lacking access to transportation
• being sick or bedridden
• not having social contacts nearby
• not having an air conditioner !!!!

• Critics suggest many seniors were abandoned by their families heading to vacation spots for the traditional August holiday.
• The French government cut more than $150 million in elder funding earlier that year

• Health Minister Mattei stated the deaths were a “brutal revelation of a social fracture, of the solitude and isolation of the aged.”
• "Our society doesn't display enough sense of community“ said Paris Mayor Bertrand Delanoe

Soup lady should dish out factsWinnipeg Free Press, Mon Oct 3 2005Monday, October 3, 2005

Public Health Minister Carolyn Bennett says what bothers her about a flu pandemic is delivering chicken soup to victims.At last month's annual meeting of the Canadian Public Health Association, she told Canadian Press that mutual support among citizens is one of the most important elements of the response to a pandemic.Then she added: "The part that bugs me most is the bottom-up part. Does every Canadian know who their three neighbours are...and would we be able to get them the chicken soup and not get infected?"

Based on the 2007 Winnipeg International Workshop on Seniors and Emergency Preparedness Winnipeg, Manitoba, February 6–9, 2007For presentation to the United Nations Commission for Social Development.

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• “As long as citizens think of the sickness care system whenever they hear the word ‘health’, it will be very difficult to reorient the health CARE system to systems for HEALTH”

Put the

‘public’

(especially SENIORS)

back into

PUBLIC

health

"An army of useful citizens" can do what no one person can.

Dr. Ethel Percy Andrus

• 25% health attributable to health care system
• 15% biology and genetics
• 10% physical environment
• 50% social and economic environments

• Sharing risk
• getting people the health care they need when they need it
• Keeping people well not just patching them up once they get sick

“The worst thing for a physician is to help someone get well and then send them straight back into the situation that made them sick in the first place”

Knowledgeable Stakeholders

+

Committed Politicians

=

Better Public Policy

• Dramatically improves with an educated public…… health literacy
• Citizens pulling healthy public policy…. Civic efficacy

• Civic Literacy ….. individual
• Civil Society…. Community Action

A) strong fence at the top of the cliff

B) state of the art fleet of ambulances and paramedics waiting at the bottom ?

A) Clean air

B) Enough puffers and respirators

for all

A) a falls program to reduce preventable hip fractures

B) private orthopaedic hospitals and more surgeons

A) early learning, child care, literacy,the early identification of learning disabilities and bullying programmes

B) increase the budget for young offenders’ incarceration

A) assume that the 'grey tsunami' will bankrupt our health care system

B) include our aging population in the planning of strategies to keep them well

A) food banks and vouchers

B) Income security,affordable housing, community gardens and community kitchens and a national food policy

Pandemic Preparedness should focus on

• Tamiflu for all
• Working with the vets to keep avian flu a disease of birds
• Making sure people wash their hands especially the doctors and nurses
• Research on vaccines
• Community care plans for our most vulnerable

• how much they spent on the sickness care system
• the health of their citizens, leaving no-one behind

social determinantsvs.‘choose health’

The Causes of the Causes

Versus

The Causes

Sir Michael Marmot

• Infectious Disease
• Chronic Disease and injury Prevention
• Mental Health
• Emergencies
• Rx: Putting the Public back into Public Health
• Complex Adaptive Systems

• Evidence-informed practice
• Practice-informed evidence
• Courage to fund what works
• Courage to stop funding what doesn`t
• Complex adaptive systems…

Research

Practice

Policy

Research

KT

Practice

Policy

Research

KT

Practice

Policy

Political will

Research

Applied

research

KT

Practice

Policy

Politicalwill

ENGAGED CITIZENS

Research

Applied

research

KT

Practice

Policy

Politicalwill

Physical and mental energy comes from

feeling in control of your life,

having real choices,

and being involved with others

to find ways of organizing change for the better

Barbara Rogers

BONUS !!!!!!!!