Longevity and Public Health

1
Longevity and Public Health

• IFA Global Conference
• Montreal
• September 7, 2008
• Carolyn Bennett M.D., M.P.

2
Longevity

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

3
The Grey Tsunami ?
The Grey Tsunami ?

• R.O.M.P.
• Collingwood
• April 24, 2008
• Dr. Carolyn Bennett M.P.

4
D.O.B.?
5
??? Better measure

• 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

6
Shortgevity

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

7
Shortgevity Public Health ?

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

8
teachable moments

• 2003 - Canada 44 died of SARS
• France14,000 died in the heat wave
• 2005 - Katrina
• 2005 - Ontario Medical Association Report

9
Division of Ageing Seniors

• Its efforts are focused on four main areas
• emergency preparedness
• active ageing
• injury prevention and
• mental health.

10
Longevity and Public Health

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

11
Minister of Handwashing
12
Lessons learned from SARS

• Naylors 4 Cs November 2003
• Collaboration
• Cooperation
• Communication
• Clarity who does what, when
• Germs dont respect borders !!!!!

13

14
Longevity and Public Health

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

15
Chronic disease and injury prevention

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

16
Management 101

• if its measured it gets noticed, if its
• noticed it gets done
• Reportable diseases.... HbA1C
• Interventions....
• Minister Andy Kerr, Scotland
• Health outcomes down to postal code
• GIS

17
Longevity and Public Health

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

18
Mental Health

• 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

19
WISE and WONDERFULvsAGEISM

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

20
Longevity and Public Health

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

21
(No Transcript)
22
Survivors

• 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

23
Vulnerability study

• 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 !!!!

24
2 2003 Paris Heat Wave

• 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

25
The responsibility of civil society ?

• 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

26
??? Please save my granny ???
27
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?"
28

Based on the 2007
Winnipeg International Workshop
on
Seniors and Emergency Preparedness
Winnipeg,
Manitoba,
February 69, 2007
For presentation to the

United Nations Commission
for Social Development.
29
Longevity and Public Health

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

30
Tyranny of the Acute

• 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

31
Rx Longevity

• Put the
• public
• (especially SENIORS)
• back into
• PUBLIC
• health

32
"An army of useful citizens" can do what no one
person can.
Dr. Ethel Percy Andrus
33
Canadian Institute for
Advanced Research

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

34
Goal of Medicare

• 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

35
Sir Michael MarmotChair, WHO Commission on
Social Determinants of Health

• 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

36
Attitude 225

• Knowledgeable Stakeholders
• Committed Politicians
• Better Public Policy

37
Political Will to do the right thing

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

38
Putting the Public back intoPublic Health

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

39
Public Health 101
40
1.Do you think we should have a

• A) strong fence at the top of the cliff
• B) state of the art fleet of ambulances and
  paramedics waiting at the bottom ?

41
2. Would you prefer

• A) Clean air
• B) Enough puffers and respirators
• for all

42
3. Would you prefer that wait-times were reduced
by

• A) a falls program to reduce preventable hip
  fractures
• B) private orthopaedic hospitals and more
  surgeons

43
4.Should we invest in

• A) early learning, child care, literacy,the
  early identification of learning disabilities and
  bullying programmes
• B) increase the budget for young offenders
  incarceration

44
5.Should we

• 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

45
6. Is the best approach to food security

• A) food banks and vouchers
• B) Income security,affordable housing, community
  gardens and community kitchens and a national
  food policy

46
7. Pick the one that is NOT correct

• 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

47
8.Governments should boast about

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

48
social determinantsvs.choose health
49
The Causes of the Causes

• Versus
• The Causes

Sir Michael Marmot
50
Evolution of the Healthy Canadians Tree
51
Evolution of the Healthy Canadians Tree
52
Longevity and Public Health

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

53

• Research
• Evidence-informed practice
• Practice-informed evidence
• Courage to fund what works
• Courage to stop funding what doesnt
• Complex adaptive systems

54

Research
Practice
Policy
55

Research
KT
Practice
Policy
56
Research
KT
Practice
Policy
Political will
57
Research
Applied research
KT
Practice
Policy
Political will
58
ENGAGED CITIZENS
Research
Applied research
KT
Practice
Policy
Political will
59
Rx Civic ParticipationIts good for your health

• 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 !!!!!!!!
60
GREY POWER.....plug it in !!!!!