Consider the following set of priorities facing the province today: increasing population health, maintaining a healthy economy and providing healthy support for athletes, the people at the pinnacle of physical fitness and wellness.
At first glance, they appear to be in competition. Reconsider them, and you see how these priorities are connected, and how we're all working toward the same thing. Whether Olympian or ordinary citizen, everyone needs help in their pursuit of fitter, healthier, happier lives.
Recently, the Globe and Mail's André Picard reported on "grim new data" delivered in two health reports by Statistics Canada. "[F]or Canadians, being overweight---meaning 25 percent or more of their body weight is fat---is now the norm by age 36," writes Picard.
Earlier this month, a US study published in the American Journal of Preventative Medicine showed rising obesity rates to be a greater public health threat than smoking, which was falling, in that country. Based on data collected from 1993 to 2008, it hit hard across media. The CBC's health news website ran a story on it.
More telling, though, for local audiences was the CBC's sidebar, "Percentage of Canadian adults considered obese (2004)." Based on Health Canada information, Nova Scotia ranked third, behind Newfoundland & Labrador and PEI, with 24.6 percent. The national average: 23.1.
In 2000, already 10 years ago, The Canadian Medical Association Journal reported "the rate of obesity more than doubled for adults between the ages of 20 and 64. More than 37 percent of Nova Scotians now meet the medical definition of obesity, a figure 31 percent higher than the national average." The study, commissioned by Cancer Care Nova Scotia, drew on data collected between 1985 and 1997. Its aim was the economic impact of this trend, particularly health care costs: "[I]t costs the provincial government $120 million a year in direct health care costs."
Inactivity has been consistently identified as a cause of obesity and being overweight. The population, children and adults, is less healthy. Considering the non-stop news, what's the solution? Just as prescription drugs may treat a single consequence of the condition, such as hypertension, it's also not simply a matter of adopting the marketer's just-do-it mentality, while blindly repeating the schoolmarm's just-say-no nutritional mantra.
These are complex problems, challenges that run deep, requiring more reflective solutions, explains Bette Watson-Borg, president and CEO of The YMCA of Greater Halifax/Dartmouth.
"Obesity is the tip of the iceberg," she says. "It's the thing that shows that the social determinants of health, whether it's poverty or family support or access to sports, are the causes. Obesity is just the symptom."
Access to the Y's equipment, space and expertise is a major tenet of the not-for-profit's policy. "No one is turned away because of an inability to pay the full fee," says Watson-Borg.
The Y offers a Membership Assistance Program. Applicants meet with staff to work out a contribution that fits their budget. Applications are evaluated case-by-case, Watson-Borg says. Of the roughly 2,000 members at the South Park YMCA, for example, 17 percent receive assistance, according to Watson-Borg. At the Dartmouth Family YMCA, she estimates between 20 and 25 percent of its approximately 1,000 members are assisted.
Another community organization, Sport Nova Scotia, runs a variety of programs, several in partnership with or on behalf of the province. They do the latter for KidSport, which provides "financial funds to children who otherwise wouldn't be able to participate due to registration or equipment costs," says SNS CEO Jamie Ferguson.
According to the KidSport page on Sport Nova Scotia's website, up to $300 goes to each child each year in the program. In 2008, the province gave SNS more than $414,000 for the program but its latest allocation was down to $405,000.
Sport Nova Scotia also runs Support4Sport with $2.3 million generated by the Nova Scotia Gaming Corporation. "The biggest part of that goes to participation---so for recreational sport," says Ferguson.
Almost all of the roughly 160,000 members, in 55 different sports, of Sport Nova Scotia are "recreational sports enthusiasts. They play sport for fun, at a recreational level. And a lot of people don't understand that. That's the majority of work that we do," Ferguson points out, frustration evident in his voice.
Clearly, this is a sticking point with Ferguson. He's had to deal with the perception that Sport Nova Scotia is for elite, high-performance athletes only. But, Ferguson says, SNS helps develop organized sport throughout the province---for example, training and certifying coaches---it remains recreational, fun and for the health of participants.
"There are in Nova Scotia less than 80 carded athletes---athletes recognized by their national sport organization as high-performance athletes," says Ferguson. "They work with their national sport organizations and the Canadian Sports Centre Atlantic. Once they reach that level, they're off our grid."
Nova Scotia actually has 56 carded athletes, says Stephen Gallant, director of sport with the province's Department of Health Promotion and Protection. A small group in top form, they're exemplars for the rest of the recreational enthusiasts, from kids to seniors, says Gallant: "People have to have something to aspire to. Everyone's trying to get the best level they can get to." Gallant oversees a $13 million budget, but says only about $220,000 is directly related to high-performance athletics in the province.
Currently, the Department of Health Promotion and Protection has a budget of $89 million to cover a variety of responsibilities: among them physical activity, sport and recreation, communicable disease prevention and control (HPV and H1N1 vaccinations and immunizations are part of that), environmental health and addictions services.
Rick Gilbert, director of active, healthy living at the department, works with municipalities and community groups, such as Recreation Nova Scotia, the Heart & Stroke Foundation and the Ecology Action Centre on a provincial Active Transportation program. It's not exactly sport or recreation, which is what makes it unique for Gilbert. "There's a utilitarian aspect to it that really has nothing to do with leisure time," he says.
The Department of Health Promotion and Protection also administers the Healthy Living Tax Credit. Right now parents and guardians can claim up to $500 spent on equipment, registration and so on for each child 17 years old and under. Children must be registered in a sport, recreational or physical activity recognized by the department.
The then-Conservative government introduced the tax credit in 2005. In late December 2008, the Minister of Health Promotion and Protection at the time, Barry Barnet, announced the tax credit would be extended to Nova Scotians of all ages.
The expanded tax credit was to be part of the Conservatives' next budget, but then they faced defeat in the legislature in the new year. An election was triggered, installing Darrell Dexter in the premier's office.
With the NDP's first budget this past September, the tax credit expansion was deferred. The rationale: it would've taken $5.3 million out of government coffers, which would have to have been absorbed elsewhere in the Department of Health Promotion and Protection, says its deputy minister, Duff Montgomerie.
The province is in bad fiscal shape, with government wheezing under a "2009-2010 budget deficit of $525.2 million," according to a department of finance forecast update issued last month.
"Every department had a reduction," Montgomerie says. "It's going to be tougher this year." The deputy minister doubts the tax credit for all will be brought in in the next two years. "It will always be discussed," says Montgomerie. "I highly doubt they'll put it back in. It's not my decision."
Sport Nova Scotia's Jamie Ferguson understands the province's economic predicament. "We respect that but we're also going to continue to push to try to get it put back on the table," he says.
Though she's not sweating over the tax credit deferral, the YMCA's Bette Watson-Borg believes the discussion around it at least "raises awareness about the need to reduce financial barriers to access."
Every bit helps, especially for single, low-income, working and unemployed parents and guardians who want their children and themselves to be healthy. "If people are facing tough decisions about their discretionary dollars, [they're] going to be directed toward accommodation, food and child care," says Watson-Borg.
The Olympics make a fine midwinter distraction, perhaps no more so than for Darrell Dexter, who has to keep the health of Nova Scotians, the province's economy and the need to foster top athletes in mind, in balance. The premier heads west for the opening ceremonies on February 12.
Nova Scotia has a $2.8 million budget in place for the games, including a promotional Nova Scotia Day and a chance to promote tourism and business opportunities at an Atlantic Canada House Pavilion.
"That came out of existing money," confirms Montgomerie, whose department has handled the voyage to Vancouver. Indeed, a release from December 22, announcing the premier's trip makes clear the trip is "a commitment by the previous government from early this year."
Meanwhile, some Nova Scotians will commit to watching the Olympics. But they may want to reconsider after reading another CBC health story from earlier this month; this one about the findings of Australian researchers. The headline: "TV time shortens life, study suggests."