By Ted Bruce
The cancer community has done a remarkable job of documenting the importance of prevention. They estimate that 50% of cancers are preventable and have an active campaign to encourage provincial government action on prevention. Learn more via the Canadian Cancer Society’s (BC & Yukon) Cancer Gameplan Election website.
Think about that number: 50%. Compare it to the 3% of health care we devote to public health preventive efforts.
The cancer community’s understanding and commitment to prevention is likely influenced by the remarkable story around tobacco reduction. A public health approach to tobacco reduction is a model that we can use to tackle a range of deadly and costly chronic diseases. But it comes at a price. The victories in the battle against smoking related diseases did not solely come from anti-smoking awareness and public education campaigns. In fact the amount of funding available for these types of campaigns is almost laughable compared to what industry spends marketing what we know are unhealthy products – a great deal of this marketing aimed a kids. Although we have seen prohibitions on advertising cigarettes in Canada, the food industry provides an example of the marketing battleground. The Ontario Healthy Kids Panel report No Time to Wait was unable to calculate the actual expenditure on food advertising aimed at children but they quote one study showing that “ four food ads per hour were shown during children’s peak television viewing times and six food ads per hour were shown during non-peak times. Approximately 83 per cent of those ads were for “non-core” foods and 24 per cent of food ads were for fast food restaurants.”
The Prevention Institute, a non-profit organization in the US, quoting a Federal Trade Commission Report states that the fast food industry spends more than $5 million every day marketing unhealthy foods to children. A full fact sheet on marketing foods and beverages to children is available on their website.
The tobacco battle has shown us that effective prevention programming incorporates a variety of strategies including taxation to affect price, marketing regulations, enforcement and efforts to change the environment to deter consumption. The National Collaborating Centre on Healthy Public Policy has an informative interactive timeline that is worth a look to see the long and hard fought battle over tobacco.
It is most important to understand, however, that tobacco reduction efforts required human resources for leadership, advocacy, policy development, program development and program delivery. And there are just not enough of these resources available in the public health system to do the job for the chronic disease epidemic we are facing.
Is the battle against smoking related disease and death over? Not by a long shot. Smoking rates may have come down but we know they can go lower. And sadly in some populations smoking rates are still at very high levels with estimates that some groups smoke at 2 to 3 times the overall rate. Learn more through Health Canada’s Canadian Tobacco Use Monitoring Survey.
We need to shift our thinking to support the cancer community’s prevention efforts. And we need to realize that cancer prevention is about more than tobacco. Chemicals in our environment, sedentary behaviour and poor diets are contributors to cancer. The time is overdue for a comprehensive prevention effort. Our political leaders need to have a vision for the future. Why is it good enough to prevent children being exposed to tobacco yet we tolerate an “in your face” obesity promoting environment for children. It is time to dream big and to put in place the human resources we need to realize that dream. We can all take a lesson from the efforts to prevent cancer. We need to shift to a new health and health care paradigm built on prevention.
– Ted Bruce is the past-president of the Public Health Association of British Columbia.
 Kelly B, Halford JCG, Boyland E, Chapman K, Bautista-Castaño I, Berg C, et al. (2010). Television food advertising to children: A global perspective. Am J Public Health. 2010;100(9):1730-5