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alPHa Annual Conference 2013
June 2-4, Radisson Admiral Toronto
The alPHa 2013 Annual Conference is accredited through U of
T as follows:
• The College of
Family Physicians of Canada – 8.5 Mainpro-M1 credits;
• Royal College of
Physicians & Surgeons of Canada – 8.5 Section 1 credits
JUNE 2, 2013
4:00 – 7:00 PM - Final Meeting of 2012-13 alPHa Board of
The final meeting of the 2012 –
2013 alPHa Board was held in the Atrium. Minutes of this meeting will be
circulated among Board members under separate cover, as well as made
available in the Board "Group”
area of alPHaWeb.
7:30 – 9:30 PM - Opening Reception
Delegates to the alPHa 2013 Annual Conference were
invited to attend an opening reception at The View, where they had an
opportunity to enjoy spectacular views of the downtown Toronto waterfront
while munching on shrimp canapés and skewers of some kind of meat.
MONDAY, JUNE 3, 2013
– 8:00 AM- Breakfast & Registration & Exhibits
8:00 – 10:00 AM Annual Business Meeting & Resolutions
The alPHa Conference kicked off
with the Annual Business Meeting, where members received annual reports from
alPHa’s President, Executive Director, Treasurer, Section Chairs and
Affiliates; as well as reports on actions on last year’s Resolutions. Each of
these was distributed prior to the meeting and can be read in their entirety
in the linked Agenda Package. alPHa’s Annual Report was also distributed and
is likewise attached.
alPHa Vice President Mary Johnson
then provided an update on the early stages of alPHa’s Strategic Plan.
"As alPHa’s Vice-President, I am very
pleased to provide the Association membership with an update on the Board’s
strategic planning this year. Since December, alPHa’s Board has been engaged
in strategic discussions about alPHa’s future directions.
Since the outbreak of SARS in 2003, it has
been recognized that the public health sector in Ontario needed to be
strengthened. Funding sources have shifted and important new resources like
Public Health Ontario have been put in place.
been a stronger focus on health promotion, with a new ministry created and
then collapsed to a division within the ministry of health and long-term
care. There’s been recognition of the role public health plays in reducing
health inequities with the inclusion of the social determinants of health
into the Ontario Public Health Standards, and the importance of early
childhood development has been recognized.
while public health sits within the Ministry of Health, many of the issues
that receive public health focus sit under Ministries like education,
environment, and children and youth services.
has meant that alPHa’s resources have been stretched to develop relationships
with more partners and track provincial activities in more Ministries.
strategic discussions have included what this slide from a Ministry of Health
presentation describes as a triple challenge:
The cost of health care has been
growing at an alarming rate, due in no small part to the growth in the
incidence of chronic diseases in Ontario
The resulting fiscal challenge for
the provincial government is only getting larger, as the population ages
At the same time, that growing
demographic is demanding higher quality care
challenges are being addressed by Ontario’s Action Plan for Health Care that
includes the priority of keeping people healthy. For the first time, we have
a provincial government that is focused both on the health care system AND on
keeping people healthy. Everyone in this room knows that this is a primary
objective of the work we do in public health – we understand what makes people healthy and what keeps
we also know that public health’s role and value needs to be better
understood by provincial and municipal governments.
is where we would like to focus the work of alPHa. We want alPHa’s members,
the public health units of Ontario, to be recognized as provincial and local
leaders in keeping people healthy to attract the resources that are needed
for us to have a greater impact on the health of the communities we serve.
Board sees that we have a great opportunity to position the association to
promote the role and value of public health. We are considering a number of
actions to that end that are outlined in the 2-page document that has been distributed.
In addition to those action items we are looking at alPHa’s governance
structure and asking some difficult questions that we believe need to be
asked if alPHa is to best serve its members into the future. We believe the
association is doing good work now, but we also recognize that we have
limited resources and need to prioritize.
I invite you to read the 2-page summary we’ve provided and to participate in
the consultation process that will be taking place over the summer and fall.
It is important for us to hear from alPHa’s members about what is most
important to them, as well as how the Association can best serve their needs.
STRATEGIC PLANNING UPDATE (Slide Deck)
STRATEGIC PLANNING UPDATE (Handout)
Following this presentation, Linda Stewart then
introduced and thanked the 2012 - 2013 alPHa Board members, highlighting the
contributions of outgoing Vice President Mary Johnson, COMOH Chair Penny
Sutcliffe, Boards of Health Section Chair Al Edmonson and President Dr. Paul
Parliamentarian Dan Lynch was then introduced to oversee
the Resolutions session. Six
resolutions were considered by the alPHa membership this year, which address
tobacco, oral health, breastfeeding, gambling and physical activity. One was referred
to the Board of Directors, and the others were passed with some amendments.
Please see the Disposition of Resolutions for details on each and visit our
Resolutions section to view ongoing actions on the adopted ones in the coming
10:00 – 10:20 AM Break & Exhibits
10:20 – 10:30 AM Welcoming remarks
Dr. Paul Roumeliotis stood to welcome all delegates to alPHa’s 27th Annual
Conference, including members, colleagues from partner organizations, special
guests and public health and preventive medicine residents from across
Ontario who have taken a break from their studies and residencies to join
us. He also acknowledged sponsors Merck,
Public Health Ontario, the Public Health Division, Pfizer Canada, Vaccines
Division, and Mosey & Mosey Insurance for helping to make this
10:30 AM – 12:00 PM Confronting the Challenges – Panel
Featured Moderator: André Picard, Globe
& Mail Health Reporter
Panelists: Food: Dr. Brian Cook,
Toronto Public Health Tobacco: Dr. Roberta
Ferrence, Ontario Tobacco Research Unit Alcohol: Dr. Robert
André Picard is well known to many of us as a
journalist who really understands public health. He is the public health reporter at The
Globe and Mail and one of Canada’s top public policy writers. He has received much acclaim for his
writing, including the Michener Award for Meritorious Public Service
Journalism, the Canadian Policy Research Award, and the Atkinson Fellowship
for Public Policy Research. In 2005,
Andre was named Canada’s first Public Health Hero by the Canadian Public
Health Association, and he has received numerous awards and recognition from
a long list of organizations. André
lives in Montréal and joins us today to moderate our panel, Confronting the
Brian Cook is a research consultant with the
Toronto Food Strategy team at Toronto Public Health. He works with City and
community partners to research, coordinate and implement innovative projects
to increase access to healthy, affordable and culturally appropriate food.
His current projects include a mobile fruit & vegetable vending pilot,
healthy corner stores research, mapping Toronto's "food deserts"
and research on advertising to children.
Brian spoke about
how food production, distribution and consumption have changed over time and
how the public’s perception of the food system has changed as a result. He
expanded on this reality to argue the importance of the development of a
National Food Strategy, which would prioritize health and nourishment by
addressing fundamental issues such as sustainable farming, growing food that
is affordable and improving distribution channels for those who need it. He
further argued that while governments need to play an enabling role, they
cannot be solely responsible for generating innovative ideas on how to
implement such a strategy. He used specific examples that Toronto is using to
incubate new ideas such as its Mobile Good Food Market,
which increases access to healthy, affordable and culturally appropriate
foods. Also referred to Chicago’s Fresh
Food Bus as a model for something that will be rolled out in Toronto this
Senior Scientific Advisor for the Ontario Tobacco Research Unit at the
University of Toronto, Professor in the Dalla Lana School of Public Health
and Affiliate Scientist with the Centre for Addiction and Mental Health. She
has training in Epidemiology and Medical Sociology. Her research focuses on
tobacco smoke exposure, including the economic and environmental impact of
smoke-free bylaws, indoor and outdoor air quality studies including water
pipe, and third hand smoke exposure.
her talk with a summary of legislative and research milestones in tobacco
control to illustrate the significant progress that has been made on what is
known about the dangers of tobacco and what has been done to control it as a
result. She then pointed out that there remain equally significant challenges,
including low taxation in Ontario, wide availability, new products,
third-hand smoke, and most significantly, the perception that the war on
tobacco has already been won. Smoking
remains relatively widespread, but identifiable groups remain at particular risk,
such as low income, First Nations, and residents of multi-unit dwellings. She
indicated that Canada is beginning to fall behind on stemming smoking rates
and suggested that public health needs to start thinking about different
messaging, changing areas of focus and making better use of dwindling tobacco
control resources. She made some preliminary suggestions for policy levers to
Robert Mann is a Senior Scientist in the Social and
Epidemiological Research Department at the Centre for Addiction and Mental
Health. He is also Associate Professor in the Dalla Lana School of Public
Health at the University of Toronto, where he is the Addiction and Mental
Health Field Director for the MScCH program.
Alcohol epidemiology and alcohol policy issues have been major
interests of his research.
Robert gave a
brief presentation on new directions in alcohol, in light of an emerging body
of evidence that supports a shifting of attitude towards alcohol as a very
powerful substance that is prone to abuse, associated with negative health
and social outcomes. He argued that attention needs to be squarely focused on
reduction of overall consumption in general and high-risk drinking in
particular. He referred to Norman Giesbrecht’s report on the ten
dimensions of alcohol policy as a reference for control measures that
are demonstrated to be successful. He
noted that Ontario is doing reasonably well on average, but the average
itself needs work. He referred to the
fact that measures that have already been taken have saved billions of public
dollars over the past 35 years. He then suggested some particular areas of
focus (public control over alcohol retailing, pricing, availability and
public education) that should form the core of a Provincial Alcohol Strategy.
challenged each of the speakers to name what they think might be the most
important step that can be taken locally in addressing the respective
challenges. Brian Cook raised the idea of a Food Charter- something that is
non-binding but brings the perspectives of many people together – as the type
of thing that underlies real success. Roberta Ferrence strongly urged
scanning our own communities to look at what is being promoted. Robert Mann
suggested Municipal Alcohol Policies and to encourage MOHs to express support
for a provincial alcohol strategy.
then asked about the impact of low socio-economic status and health
inequities. Roberta pointed out that low income populations are higher
consumers of tobacco, but not by much. They are however more exposed and lack
the political power to do anything about it (e.g in low-income multi-unit
dwellings). She mentioned children as an example of a population that is at similar
risk because of the choices of their parents.
this, indicating that it is difficult for marginalized populations to find a
voice, which in turn affects policy attitudes towards food availability. The
common response now is food banks, when the actual solution needs to be
Mr. Picard then
asked what is required to change public attitudes about the various issues.
Robert referred to the promotion of the Low-Risk Drinking Guidelines while embracing the "moderationists”. He
also pointed to some areas where we have been extremely successful (e.g. drinking
and driving) that have been the result of a variety of social marketing strategies
and legislative change. Not through preaching, but by provision of
information. We can use those strategies to address things like binge
drinking as well.
similarly where tobacco is concerned, urging ongoing promotion of the real
dangers of tobacco while at the same time addressing the lingering rights and
taking advantage of the current political and media focus on the obesity
epidemic as a launching pad for a broader discussion about how food is
produced, distributed and consumed affects health.
are concerned, Brian further argued that we need to start focusing on raising
a new generation that is more aware of the food system and how it works,
which will empower them to make healthy decisions and recognize food
marketing for what it is. It needs to start in the schools, so that whole households
will have the required knowledge. When Mr. Picard asked if this might be too
much to ask of schools, Brian responded that since the food marketers
desperately want access to schools as well, it is imperative to ensure that
we are in there.
suggested that with tobacco, we may actually need to stop focusing on kids.
Adults are the ones in charge, and kids model their behaviour on them, and until
they grow up never seeing a smoker, they’re going to see it as normal
was then open to the floor, so that delegates could ask questions and make
their own observations about what we’re up against and how to overcome the
challenges. The glossy LCBO promotional materials were raised as an example
of Government spending money to promote products that are known to be
unhealthy in many circumstances. Robert agreed, but argued that as long as
the Province has sole control over this business, we have a single target for
direct advocacy on social responsibility.
Andre Picard then
turned to Brian to ask about the potential for marketing to promote healthier
foods. His response was that healthy foods are in a different category. While
he acknowledged that it may not be enough to tell people to eat healthy, he
also conceded that promoting broccoli in a glossy magazine is never going to
work as well as changing attitudes about the food system.
responded to a question about why it is that certain demographics are still
smoking by suggesting that the answer is usually found in opportunity and
normalization. In other words, it doesn’t matter who’s smoking so much as the
opportunities to smoke that keep it so visible. She cited the unintended
consequence of indoor smoking bans as an example: with so many people smoking
outside, it is now far more visible than it was. We therefore need to keep working at a whole-population
referred to marginalized segments of the population that may look to
unhealthy behaviours such as drinking and smoking to engender a sense of
belonging and importance that they don’t otherwise have, adn asked how we get
them to take up the health promotion messages when they feel that they don’t
matter. Robert Mann agreed that this is a valid question on a complex issue,
and one that needs to be kept in mind when developing strategies. Brian
observed that this question is also related to the stresses of low-income,
and it doesn’t help that the exhaustion of the poor is mistaken by those who
don’t know any better for laziness. It
is the stigma and stress that need to be tackled.
A final question
was asked about how we can compete with industry, whose marketing and
messaging capacities are well ahead of public health’s. Brian’s response was
that we shouldn’t think of industry as the competition. While it is true that
they have the upper hand in marketing, they aren’t using it for the purposes
of good or evil; they are using it to generate wealth. It’s therefore
Government’s role to put limitations on what they are allowed to do to that
end, and we should never depend on corporations to act in anyone’s best interests
other than their own.
Mr. Picard summed
up the session by pointing out that there has been lots of success on all of
these fronts, but challenges remain. He then offered a parting suggestion
that gambling might be the subject of a similar discussion in the near
12:00 – 12:20 PM
Minister Deb Matthews, Health &
Long-Term Care and Minister Teresa Piruzza, Children
and Youth Services
Roumeliotis welcomed Ministers Matthews and Piruzza to the meeting, who
are the co-chairs of the newly-struck Ministers Working Group on Healthy
Kids, which is charged with examining the recommendations
of the Healthy Kids Panel with a view to meeting the Government’s stated
goal of reducing childhood obesity by 20% over five years.
Minister Matthews started out by
stating that the Working Group is absolutely committed to the three pillars
of the Healthy Kids Panel strategy, noting the strong evidence that this is a
huge health issue. 28% of kids are overweight or obese and at risk of a host
of chronic diseases later in life, and we need to do something about that.
She also observed that when the Panel was launched, it was to include a very
wide range of perspectives, but as work progressed, it became clear that this
issue is far more about food than it is about physical activity, and the
change in eating habits in kids over the last 30 years is at the root of the
Minister Piruzza added that good
health starts with birth and referred specifically to the important role of
the Healthy Babies, Healthy Children program in laying the foundation to the
life-course perspective of the Healthy Kids Strategy, where early
identification and intervention yield the best outcomes. She referred to the recent
steps to improve the program to ensure greater effectiveness and announced
that the new HBHC protocol will be introduced later this year.
She also mentioned the Ontario
Student Nutrition Program, which provides nutritious snacks and lunches for over
690 000 students, and to the Mental Health and Addictions strategy, which is
improving access to services such as mental health school workers for 50000
kids and their families. Both of these programs benefit from a range of local
Minister Matthews then observed all
of this is a constellation of programs and services that are aimed at keeping
kids healthy and at making Ontario the healthiest place in Canada to grow up
and grow old. She added that the Government is constantly working on the
wellness aspect of health, mentioning action on smoking rates (NRT, cessation
programs in hospitals and workplaces), legislation to ban tanning, and the implementation
of Health Links, which she hopes will bring public health perspectives more
to the forefront in discussions about Ontario’s health care system.
Both Ministers expressed profound
appreciation for the things that alPHa’s members do to support all of these
goals. They also indicated that they are mindful of the challenges that local
public health can face, and they will do their best to ensure that action on the
HKP recommendations reflect local needs.
Minister Matthews reiterated that
striking the right balance between healthy eating and healthy communities
will be important, and to that end, the following Ministries are on the
Working Group: Education, Agriculture
and Food, Tourism Culture and Sport, Aboriginal Affairs and Municipal Affairs
and Housing. She added that the more they talk, the more they realize others will
need to be brought in. They are taking this very seriously and the Premier is
a strong supporter. She then indicated that this work will need to be
informed by the local perspective, and there will be opportunities to ensure
that alPHa’s members can contribute.
Responding to a question about
changing the ratio of MOHLTC dollars spent on care vs. prevention, Minister
Matthews indicated that additional funding for vaccinations and nicotine
replacement therapies has already changed it a bit, but reiterated that money
is the primary issue right now (there isn’t any) and it is therefore now time
to come up with creative ways to get the better health outcomes that we want
with existing resources.
There were also questions about
prioritizing the HKP recommendations based on the likelihood and timing of
their implementation at the policy level. Specific inquiries were made about regulating
food content, banning marketing to children, establishing a surveillance
program (on which COMOH has already made a proposal), how the Poverty
Reduction Strategy will be linked and how opportunities for input will be
Minister Matthews responded that
prioritizing will depend in large part on what the Working Group hears from
us, indicating that local public health has led the way on many issues that
eventually became government policy. She urged public health to tell her what
is important by continuing to highlight the problems that provincial policies
can and should be implemented to address. She also noted that some of the
recommendations are contentious, and the more support she hears from public
health, the less rocky the path will be to finding solutions. This is
particularly important in a minority government situation, where it is
especially difficult enact legislation.
She added that all levels of
Government have to be involved, as there are different jurisdictions where
regulation is concerned. We can however do more on the information front,
citing the strong support that there appears to be for mandatory menu
labelling in restaurants as an example. She also mentioned the
Food Act (Bill 36) as a policy initiative that will support actions for a
healthier population. She also urged alPHa’s members not to wait for them if
it is clear that useful local action can be taken now.
Members expressed a clear desired to
participate in the collective action on the HKP recommendations, and asked
that timelines and opportunities to provide input to the Working Group need
to be clearly communicated. It was also noted that this is the type of
inter-ministerial committee that should be in place for a range of health
issues, to reflect the whole-of-government approach to health that the CMOH
proposed in her recent annual reports.
12:20 – 1:20 PM Lunch
1:20 – 3:20 PM
Michael Moss, Pulitzer Prize-winning
Journalist and Author of Salt Sugar
Fat: How the Food Giants Hooked Us. Before
coming to The New York Times, Michael was a reporter for The Wall Street
Journal, New York Newsday, and The Atlanta Journal-Constitution. He has been an adjunct professor at the
Columbia School of Journalism, and is the recipient of a Loeb Award and an
Overseas Press Club citation. He won the 2010 Pulitzer Prize in Explanatory
Reporting for relentless reporting on contaminated hamburger and other food
safety issues that, in print and online, spotlighted defects in federal
regulation in the United States and led to improved practices.
follow up Discussion with Dr. Paul Roumeliotis,
alPHa President; Dr. Vivek Goel, President and CEO, Public Health Ontario;
Dr. Robin Williams, Associate Chief Medical Officer of Health, Ministry of
Health & Long-Term Care; Kate Manson-Smith, Assistant Deputy Minister,
Health Promotion Division, MOHLTC; and Heather Thomas, Co-Chair, Ontario
Society of Nutrition Professionals in Public Health.
Dr. Roumeliotis kicked off the afternoon session by
inviting Keynote Speaker Michael
Moss to give members an inside look at the investigations that
led to the writing of his new book , "Salt
Sugar Fat: How the Food Giants Hooked Us”, following which he would join some special
guests for a panel discussion.
Michael introduced himself as an investigative
journalist before anything else, and related a tale about how he was on
assignment to cover militancy in Algeria and, having discovered that his name
was on a list that clearly indicated that he was in harm’s way, followed his
editor’s advice to find something less perilous to report on.
The next issue that fell onto his desk was essentially a
story about how the food industry had "lost control of its ingredients”,
beginning with a few items about contaminated food, including a story
about a young woman whose life was changed by eating an E. coli-contaminated
hamburger. This story provided him with an emotional hook that led him to
delve deeper into how foods are formulated and to the revelation that reasonable
steps are intentionally not being taken by industry to protect the public. During
these inquiries, he spoke with microbiologist Dr. Mansour Samadpour, who,
while giving him information on the pathogenesis of E. Coli, suggested that
as tragic as contaminated food can be, a whole other dimension of the food
industry is as important to health, namely the engineering of foods to
maximize appeal and profit.
This led him to continue down the rabbit hole, finding
new surprises at every turn. He rimed off alarming statistics about the
relationship between diet and illnesses such as diabetes, gout, heart disease
and all sorts of other maladies for which obesity is a risk factor. What
surprised him most was that the food industry knew all about the links
between the way they "engineered” their foods and these negative health
He clarified that he does not see the food industry as
evil. The health impacts of eating their products is no more than a side-effect
of industry doing what it’s supposed to, namely to increase the appeal of
what it’s selling, keeping the price low, and ensuring wide distribution to generate
maximum profit. Moreover, not only does the food industry strive to make consumers
like their products; it has learned the value of striving to get us to need
more of them.
He revealed that he was permitted to look at lots of
internal documents during his research, and it occurred to him – based on
what he knew about the tobacco industry - that what is being peddled by the
industry is in essence addiction, even if it doesn’t meet the classical
definition as it applies to narcotics or tobacco. Working in their favour is
that you can’t quit food, and they can invent euphemisms such as "craveability”,
"snackability” and "moreishness” that mirror addiction but are somewhat more
He then referred to Howard Moskowitz, an
experimental psychologist who was once engaged by the U.S. Military to get soldiers
to eat. He used a strategy called "food optimization”, something that he
applied to great effect later on in the food industry. His initial job was to
find the "bliss point” for food, that is the combination and amount of
ingredients in the formulation that would make it most palatable. Engineering "bliss points” is now just as
common for bread, low fat yogurt, pasta sauce, salad dressing and all sorts
of other things as it once was in soda. This, Mr. Moss concluded, is screwing
with the biology of children, as it conditions them to expect a baseline of
sweetness in pretty much everything.
He then told of how Jeffrey Dunn, former chief operating officer of Coca-Cola North America walked
him through all of the things that Coke has done over the years to ensure
maximum distribution of its product, whose appeal is well known. He indicated that among its most successful
strategies was " up-and-down-the-street marketing”, whereby the decision to
service corner stores as the primary outlet for Coke would foster brand
loyalty among kids (a significant clientele) and ensure that big Coke-branded
trucks were constantly visible in any neighborhood. He then shared that Mr.
Dunn was among those industry insiders who experienced some regret about all
of this, and attempted to repay his karmic debt by taking the "snackability”
factor to the produce aisle in the form of the now-ubiquitous bags of baby
At the end of the day, Mr. Moss was surprised not only
by how little regulatory control there is over the food industry, but also by
the government’s complicity. To illustrate this, he played a short video that
outlined how the increasing prevalence of cheese in the American diet came
about. His conclusion was that we cannot count on government to act in our
Returning to the tobacco analogy (one about which the
food industry is particularly nervous), he reminded that tobacco giant Philip
Morris has become a food giant (owning both General Foods and Kraft), and it
applies all of its clever tobacco marketing and promotional strategies to its
food concerns. In addition to that, it
already had the experience of losing the public trust as more and more
evidence came forward about the dangers of tobacco. In a clever move to
regain that trust, the tobacco industry voluntarily submitted to
regulation. This strategy is the
subject of the now well-known preamble to Mr. Moss’s book, where a food
industry executive drew a parallel between the food and tobacco industries
for the first time in the 1990s.
He observed that Industry cannot be expected to change
any of this for reasons of ethics alone. Even if their intentions are good,
the ultimate purpose of industry is profit, and until healthy products and
social responsibility are a profitable mainline business, limits will need to
be imposed. He did note that there is
lots of research being done by the food industry on formulating, marketing
and distributing healthier products, but it has not yielded enough practical
or profitable ideas. He referred to Nestle in particular as having a robust
research department of over 700 genius scientists that has not yet figured
out how to make something more appealing and profitable than a Hot Pocket. He
drew attention to our own culpability as consumers in a culture of
convenience and mindless eating.
On a positive note, he suggested that we may be at a tipping
point, as people are very concerned about what they eat, and they have access
to information to help them control it.
He added that the annual medical and productivity costs of the obesity
crisis alone should fuel the political appetite for government intervention,
without which the playing field is not level and it is not a fair fight. He then pointed out that the profit motive
vs. public good is still a compelling conflict to young people, even if
nutrition isn’t their first concern: they don’t like being deceived.
l-r: Michael Moss, Vivek Goel,
Robin Williams, Kate Manson-Smith, Heather Thomas
Panel members were then invited to the stage to have a
discussion about their reactions to the talk and to explore some positive
steps that can be taken as we learn more about what public health is up
against where the food industry is concerned.
Dr. Vivek Goel started the discussion stating
that this is a fight that needs to be taken to private spaces and corporate
board-rooms alike. He echoed the idea that corporations are not evil and that
shareholders are not a homogeneous bunch, and then noted that there are some
differences in corporate law in Canada that may proffer some advantage in
this regard. The long-term interests of corporations and their shareholders need
to be utilized – after all, corporations still need customers, and "activist
shareholders” can drive interests in the boardroom that are aimed at the
corporation’s long-term sustainability as opposed to focusing on short-term
profit. Food safety and health should
be an easy target for this.
He added that procurement policies for institutions (and
even grocers) can be an excellent tool for increasing the distribution of
healthy foods, and that the provision of more information to consumers will
help them navigate the numerous dubious health claims that appear on food
products. He observed that public attitudes are already shifting as awareness
Dr. Robin Williams drew on her experiences as a pediatrician
to illustrate that she worked under certain assumptions when it came to
childhood nutrition and healthy weights while being completely unaware of
some of the practices that are outlined in this book. With that awareness,
she strongly agreed that government intervention is going to be essential to
fixing the problem of unhealthy eating, which she characterized not so much a
public health problem as a societal one. As such, it is going to take some
time to translate all of this information into a successful strategy.
Kate Manson-Smith shared that despite considering
herself a reasonably savvy consumer; she was also largely unaware of the
deception that lurked on every store shelf.
She also appreciated the historical accounts in the book, and wondered
aloud about how the need for convenience can be reconciled with the health
imperative. She then expressed hope that this knowledge can be part of the
backdrop for strategizing on the Healthy Kids Panel recommendations. She repeated
the Minister’s advice to start acting locally to not simply educate, but to engage
and influence consumers. She also agreed that if food industry products are
part of the problem, the manufacturers need to be part of the conversation
that is aimed at solving it.
Heather Thomas offered a slightly different
perspective as a dietician who should – and does – know about food industry
tactics. For her, the questions that demand further exploration are about
what influences governments’ decisions on whether or not to intervene, and if
so, what is the extent and quality of that intervention. She raised the
specific example of questioning how certain things get on to the Canada Food
Guide, which, even though it is an important public health resource, is not
immune to nutritional criticism
Mr. Moss closed by agreeing that awareness is growing
and attitudes are shifting, and this is having an influence on the business
practices of the manufacturers. They know that the public is much more able
to identify a "PR rap” when they see it and that it doesn’t react well to
being deceived. He illustrated this by pointing out that Kraft has voluntarily
decided to provide clearer and more honest information on its own Nutrition
Facts labels; and that the industry as a whole is irritated with the soft
drink companies, as this is where the analogies with the disingenuous
marketing practices of the tobacco industry seem most fitting.
3, 2013 CONTINUED
3:50 – 4:40 PM Plenary:
Keeping People Healthy – The Missing Link Steve Foran, Motivational Speaker
Steve Foran is an electrical engineer who completed an
MBA and discovered he cared about a lot more than the bottom line. With 35 years’ experience in the service
industry, he has served demanding CEOs and little old ladies – and today he
is known as the Gratitude Guy. Steve
specializes in helping individuals and organizations master service
excellence and find greater happiness.
When he’s not doing that, he’s teaching Business Ethics at Saint
Mary’s University in Nova Scotia.
Steve has shared his simple yet innovative approach with
close to 50,000 people throughout Canada and the United States. His keynote session will offer us a unique
perspective on developing leadership capacity using appreciation and
gratitude to help us lead healthier lives and, in turn, better help others to
live healthier lives.
"HEY! Those bottles are for my son’s hockey team!”
yelled the man on the ladder upon hearing a clatter of glass below him in his
backyard. "If I put my empties out front, you’re welcome to them, but these
ones are for my son to raise money for new equipment!”
"Oh, sorry” replied the collector.
"I had a pretty good week anyway. I was able to give more than usual to the
Steve paused the story at this
point to illustrate that we all approach the world with pre-conceived notions
of what life is and how people are. He then returned to the same characters,
some weeks later in the tale:
"HEY! I told you last month– those
ones out back are for my son” yelled the man on the ladder upon hearing a
clatter of glass below him in the backyard.
"Oh, yeah, I remember” replied the
collector. "I had a great week and the shelter got more than enough. I had
extras and thought your son could use them.”
With this story, Steve suggested
that pre-conceived notions are difficult to let go of and can be important
barriers to happiness, because it gives too much weight to the idea that it
is always the other person that needs to change – something over which we
have far less control. He further
suggested that being more than mediocre requires us to serve others as an
expression of the gratitude that we should all feel for receiving all of the
help that we do. In short, he serves because he’s grateful.
He elaborated by asking the
rhetorical question, "why did I get all of this”? The temptation can be to be
self-congratulatory and claim to be a self-made man, but the reality is very
different. Everything that we are and everything that we are able to do depend
strongly on where and when we start out, and that is simply a stroke of luck.
Why, he asked, was he born in a prosperous country such as Canada, in a good
home where food was always available and friends were always welcome? How was
it that his family, one of relatively limited means, still lived more
comfortably than even Royalty did not much more than a century ago? Why is it
that he was handed all of the things that made it possible for him to have
the life he has and to do pretty much anything he chooses to do?
Instead of searching too hard for
the answer, he has simply translated the immense gratitude he feels for
having received these gifts into a need to serve others. He likened his life
to a lake that depends on influx and outflow to stay alive.
He continued with a description of
his life as a young man who had just moved to Oshawa from the East Coast, and
following a string of bad luck, found himself homeless, jobless and in
possession of nothing more than a pocket full of ketchup. Feeling hopeless, a
friend reminded him that these were just setbacks, and that the list of
things he still had was far longer than the one of things he had lost. Focusing on what he has became the fuel for
the gratitude that still moves his need to serve.
He left the audience with a series
of questions and an assignment.
How intentional are we going to be
in our quest to be more caring, more happy, and more grateful? How are we
going to use that to serve our communities by keeping them healthy? Are we
going to keep an open mind in so doing, or are we going to hang on to our
preconceptions about people and life? Are we going to remember that
everything we do is going to make a difference?
For the assignment, he handed out copies
of his own bestseller - a blank notebook into which he asked members to write
three things that they are grateful for each day. Part 2 of the assignment is
to talk about one of those things to someone else.
With this, he hoped that members
would use gratitude as the fuel to move their own need to serve, to confront
challenges, to recognize opportunity and to be able to help people understand
that they understand both sides of each story.
6:00 – 8:30 PM President’s
Reception & Awards Dinner
As every year, alPHa uses its annual conference as an
opportunity to recognize individuals for outstanding contributions made to
public health in Ontario in the form of the Distinguished Service Award (DSA).
This year, alPHa was honoured to
present DSAs to Joan Carrothers (Ontario Association of Public Health
Dentistry), Vivek Goel (Public Health Ontario), Meighan Finlay (Ontario
Council on Community Health Accreditation) and Penny Sutcliffe (Sudbury and
District Health Unit).
Biographies of this year’s
recipients and a complete list of past honourees can be viewed by clicking
the programme at left. Full-sized photos are linked to the thumbnails below.
Carrothers with presenter Paul Sharma
Goel with presenter Paul Roumeliotis
Finlay with presenter Charles Gardner
Sutcliffe with presenter Valerie Jaeger
alPHa DSA Recipients l-r: Dr. Vivek Goel, Dr. Penny Sutcliffe, Meighan
Finlay, Joan Carrothers
TUESDAY, JUNE 4, 2013
8:30 – 10:30 AM Plenary: Strategic Plan Updates
by Public Health Ontario and Public Health Division
Dr. Vivek Goel, President and CEO, Public Health Ontario; Roselle
Martino, Executive Director, Public Health Division, Ministry of Health &
Long-Term Care; Sylvia Shedden, Director
Public Health Standards, Practice And Accountability Branch, Ministry of Health & Long-Term Care
Roselle Martino referred to the slide deck linked below
while providing an update on the Public Health Sector Strategic Plan, Make No Little Plans. She provided a recap of the plan, and drew
particular attention to the fourth slide, observing that while the health
sector partners on the diagram are obvious and clear, the partnerships with
non-health sector partners is less so. Public health is the overlap between
the two, and she indicated that there is a growing understanding that public
health’s overlap with the non-health sector may nevertheless be more
She then summarized some proposed actions and reported
that there is increasing support for the plan (including the notable fact
that other Ministries are actively looking for opportunities to be engaged in
the process where appropriate). The plan is meant to be an anchor for
discussions going forward rather than another itemization of what public
health already does. It is meant to support the pillar of "keeping people
healthy” in Ontario’s Action Plan for Health Care.
Sustaining the momentum now that
the plan has been launched will be achieved in part by harnessing local
expertise, increasing collaboration within the sector and raising the profile
and understanding of what public health is and does with the public and the
policymakers. This last objective will be served by working with internal and
external partners, developing a communications plan and examining options for
Finally, she described the "tables”
that will be established to examine t early childhood development, the
built environment, public health human resources, sector infrastructure, and
the prevention of communicable and infectious diseases. A detailed
implementation plan is expected by the end of the year.
Public Health Ontario President and
CEO Vivek Goel then rose to give a summary of his organization’s strategic
plan, which is being rebooted as PHO enters its sixth year on the Ontario
public health scene.
He noted that it has now been ten years since the SARS
outbreak, an event that led to PHO’s creation. With that, he gave an overview
of the purpose of PHO in its supporting roles for local public health, the Ministry,
the broader health sector and beyond. He also noted the short time that has
elapsed since the creation of PHO with a staff of one (him) to the
thousands-strong organization that it is today. He then moved on to a
description of the inputs to PHO’s strategic planning activities, namely the
surveys, consultations and interviews that are being reviewed and considered
against the purpose and legislated
objects of the agency. The broad goal will be to facilitate continuous
external engagement and to ensure that PHO’s suite of services (i.e. the
information and tools that are required to take action on issues related to
public health) is well known and readily available to those who are meant to
benefit from them.
The Plan is expected to be launched next year.
Roselle Martino and Sylvia Shedden then returned to give
an update on Key Initiatives of the Public Health Division, namely planning
for the 2013/2014 Universal Influenza Immunization Program, administrative
improvements to Healthy Smiles Ontario, further exploration of Public Health’s
role in Health Links, operationalizing of the Performance Management
Framework, Protocol Evergreening, future considerations for Accreditation and
funding updates. The linked slide deck contains all of the necessary details
and speakers’ notes.
Roselle also reiterated that one of the Public Health
Division’s functions is to "make the case” for Public Health within the
broader Government budgeting machinery. She wanted to convey that they do a
lot of work internally to get what they can and lots of thought and rigour
goes into that process, looking at the trade offs, focusing on areas that
really do need increments and areas that may survive resource shifts. All
will be revealed by the end of June.
Responding to a question about
capital funding, Roselle indicated that there is a "community capital” line
in the broader budget, and the PHD is exploring how that line’s definition
might be expanded to cover the needs of local public health.
A caution was also raised from the
floor about the pressing need to rationalize Ontario’s publicly-funded oral
health programs rather than add yet another administrative layer (as proposed
in the slide deck). Roselle agreed, but responded that rationalization is
going to be a complex process and the measures being taken now are temporary
Concerns were also expressed about the
energy being spent on public health’s relationship with Health Links, which
is a program aimed at addressing the needs of the heaviest users of the
health care system and as such outside of the mandate of public health. Roselle indicated that she understood and
respected that view, but that the Ministry is still interested in taking this
opportunity to fully and fairly answer the question of what role, if any, public
health might play. She also clarified that this question is intended to be
answered through an understanding of what public health itself thinks its
role should be and not through having one imposed on it.
Another concern was raised about
the UIIP reimbursement inequity (i.e. that pharmacists are being paid 50%
more per dose administered than other providers) may lead community
practitioners to cease offering flu shots. Roselle answered that this is
being looked at as part of the Immunization System Review, which is expected
to be completed by September. She also assured alPHa’s members that the
significantly higher rate paid to pharmacists did not go unchallenged.
10:45 AM – 12:00 Noon - Section
Meeting for Council of Ontario Medical Officers of Health
11:00 AM – 12:00 Noon - Section Meeting for Board of Health Members
12:30 PM – 1:00 PM - Inaugural Meeting of 2013-14 alPHa Board
Meeting Materials will be distributed to members under separate cover.
They will also be made available in the Members’ Groups pages on alPHaWeb
Members click here
of Health Section Members click here
Board of Directors’ Members click here
gratefully acknowledges the generous support of the following:
Resolutions voted on by the alPHa Membership at the 2013 Annual Business Meeting.
Posted here are archived files from alPHa's past conferences, including fall and winter semi-annual meetings, our Annual Conference, as well as special-purpose and events that we have held in partnership with other organizations. In most cases, these are downloadable .pdf files that include summaries and presentations or links to external Web sites.
Collection of slide decks that have been provided by presenters that may be of interest to alPHa members. These will be primarily from alPHa symposia and conferences, but some may be included from partner events if we believe that the content will be sufficiently interesting to our members. Please note that this collection includes only materials that we have been granted permission to share. If you are looking for materials from meetings of alPHa's Sections, Board of Directors or ad hoc committees that do not appear here, please go to the associated members or group pages, where additional meeting-specific materials may be accessible to members of those groups.