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Proactive Health Promotion – An Old Idea with New Possibilities

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Since 1974, Canadians have spent approximately $1.8 trillion on health care of which only about 2% was invested in prevention.  These numbers leapt off my screen while reading a recent Globe & Mail column by André Picard.

Picard’s was recognizing the 40th anniversary of a prescient report published in 1974.  The report by the then Minister of Health and Welfare, Marc Lalonde, was called “A New Perspective on the Health of Canadians” and included a detailed “Health Promotion Strategy” that would be eerily relevant today; i.e. promote increased physical activity, strengthen regulations on the nutritional content of food, and provide support to the chronically ill and aged to help them stay in their community.

40 years hence, and today obesity and diabetes are regularly cast as epidemics. The global cost of chronic disease is expected to reach US$47 trillion over the next 20 years.  Health policy leaders commonly bemoan their inability to address the social determinants that largely determine people’s health status.  Close to half of some provincial budgets are spent on health care but only about 10% of health outcomes are actually attributable to formal health care services.  And, the Baby Boomers are just now entering their years of high health care needs.

Health IT is often held up as one of the solutions to this predicament, but we have decidedly prioritized implementing and connecting clinical systems with each other largely to the exclusion of providing any tools for people themselves.  Were he writing his report today, I wonder what recommendations Marc Lalonde would make regarding modern information technology? Would our investments align with the spirit of his report – to help people live healthier lifestyles to proactively reduce demand for health care in the future?  How would he recommend our formal health system leverage the almost 100,000 mobile apps for personal health management that are available to patient-consumers today?  Perhaps he would recommend that we invest in technologies that can help educate populations more effectively, enable collaboration with patients and their communities of support, and motivate people to live healthier lifestyles.

If Lalonde wrote his report today, would we look back 40 years from now and be glad that we began heeding his advice in 2014?  Or, in 2054 would another reporter write a fleeting column marking the silent anniversary of wise advice we ignored?  Hope is not a strategy, but my hope is that we will do a better job in the next 40 years creating what Lalonde aspired to 40 years ago: “Good health is the bedrock on which social progress is built. A nation of healthy people can do those things that make life worthwhile, and as the level of health increases so does the potential for happiness.”