1. NO TIME TO WAIT The report of Ontario’s Healthy Kids Panel Presented by Dr. Susan Surry Associate Medical Officer of Health Simcoe Muskoka District Health Unit 8 October 2013

2. HEALTHY KIDS PANEL Target 20% ↓ in 5 Years Rationale Physical and mental health impacts Health care and societal costs A problem 30 years in the making Urgency to act now A bold but practical strategy Thought leader engagement Parent and youth consultation Written submissions and stakeholder meetings Review of evidence Panel deliverables to Minister Identify specific factors affecting childhood obesity (CO) rates Identify comprehensive, innovative, multisectoral interventions for sustainable CO reduction: evidence informed public accountability cost effective viability for implementation 2

3. UNDERSTANDING CAUSES & TRENDS 1.Factors affecting a healthy start Genes Physiology Sleep Mental health 2.Factors affecting the food environment and food choices Time pressures Cost Accessibility Knowledge Marketing 3.Factors affecting communities Time pressures Change in kids’ activities Cost Perceptions about safety Physical environments Social disparities  Taking a life course perspective  Preconception and the prenatal period  The first six months of life  The early years  The transition to child care or school  Entering adolescence  Late teens 3

4. STRATEGY IN BRIEF Three-Part Strategy: « What to do » practical 3-step package 1.Start all kids on the path to health 2.Change food environments 3.Create healthy communities ABCs of Successful Action « How to » advice on implementation A.Make child health everyone’s priority B.Invest in child health C.Use evidence, monitor progress, ensure accountability 4

5. PART 1: START ALL KIDS ON THE PATH TO HEALTH 1.Education of women of child-bearing age 2.Standard pre-pregnancy health check for women planning a pregnancy 3.Standardized prenatal education curriculum 4.Breastfeeding for at least first 6 months 5.Leverage well-baby and childhood immunization visits to promote healthy weights and enhance surveillance & early intervention 1.Education of women of child-bearing age 2.Standard pre-pregnancy health check for women planning a pregnancy 3.Standardized prenatal education curriculum 4.Breastfeeding for at least first 6 months 5.Leverage well-baby and childhood immunization visits to promote healthy weights and enhance surveillance & early intervention 5

6. PART 2: CHANGE FOOD ENVIRONMENTS 1.Ban marketing of  calorie-  nutrient foods, beverages and snacks to children under 12 2.Ban point of sale promotions and displays of  calorie-  nutrient foods and beverages in retail settings 3.Require all restaurants (including retail groceries) to list calories on menus 4.Encourage food retailers to adopt transparent, standard nutrition ratings 5.Support use of Canada’s Food Guide and nutrition facts panel 6.Provide incentives to support community-based food distribution programs 7.Provide incentives for food retailers to develop stores in food deserts 8.Establish universal school nutrition program (elementary and secondary) 9.Establish universal school nutrition program for First Nations communities 10.Develop a single standard food and beverage guideline (where children play and learn) 1.Ban marketing of  calorie-  nutrient foods, beverages and snacks to children under 12 2.Ban point of sale promotions and displays of  calorie-  nutrient foods and beverages in retail settings 3.Require all restaurants (including retail groceries) to list calories on menus 4.Encourage food retailers to adopt transparent, standard nutrition ratings 5.Support use of Canada’s Food Guide and nutrition facts panel 6.Provide incentives to support community-based food distribution programs 7.Provide incentives for food retailers to develop stores in food deserts 8.Establish universal school nutrition program (elementary and secondary) 9.Establish universal school nutrition program for First Nations communities 10.Develop a single standard food and beverage guideline (where children play and learn) 6

7. PART 2: CHANGE FOOD ENVIRONMENTS 1.Ban marketing of  calorie-  nutrient foods, beverages and snacks to children under 12 2.Ban point of sale promotions and displays of  calorie-  nutrient foods and beverages in retail settings 3.Require all restaurants (including retail groceries) to list calories on menus 4.Encourage food retailers to adopt transparent, standard nutrition ratings 5.Support use of Canada’s Food Guide and nutrition facts panel 6.Provide incentives to support community-based food distribution programs 7.Provide incentives for food retailers to develop stores in food deserts 8.Establish universal school nutrition program (elementary and secondary) 9.Establish universal school nutrition program for First Nations communities 10.Develop a single standard food and beverage guideline (where children play and learn) 1.Ban marketing of  calorie-  nutrient foods, beverages and snacks to children under 12 2.Ban point of sale promotions and displays of  calorie-  nutrient foods and beverages in retail settings 3.Require all restaurants (including retail groceries) to list calories on menus 4.Encourage food retailers to adopt transparent, standard nutrition ratings 5.Support use of Canada’s Food Guide and nutrition facts panel 6.Provide incentives to support community-based food distribution programs 7.Provide incentives for food retailers to develop stores in food deserts 8.Establish universal school nutrition program (elementary and secondary) 9.Establish universal school nutrition program for First Nations communities 10.Develop a single standard food and beverage guideline (where children play and learn) 7

8. PART 3: CREATE HEALTHY COMMUNITIES 1.Develop a comprehensive social marketing program 2.Join EPODE – launch in at least 10 communities 3.Make schools hubs for child health and community engagement 4.Create healthy environments for preschool children 5.Develop the knowledge and skills of key professionals to support parents 6.Speed implementation of the Poverty Reduction Strategy 7.Continue to implement the Mental Health and Addictions Strategy 8.Ensure families have timely access to specialized obesity programs 1.Develop a comprehensive social marketing program 2.Join EPODE – launch in at least 10 communities 3.Make schools hubs for child health and community engagement 4.Create healthy environments for preschool children 5.Develop the knowledge and skills of key professionals to support parents 6.Speed implementation of the Poverty Reduction Strategy 7.Continue to implement the Mental Health and Addictions Strategy 8.Ensure families have timely access to specialized obesity programs 8

9. PART 3: CREATE HEALTHY COMMUNITIES 1.Develop a comprehensive social marketing program 2.Join EPODE – launch in at least 10 communities 3.Make schools hubs for child health and community engagement 4.Create healthy environments for preschool children 5.Develop the knowledge and skills of key professionals to support parents 6.Speed implementation of the Poverty Reduction Strategy 7.Continue to implement the Mental Health and Addictions Strategy 8.Ensure families have timely access to specialized obesity programs 1.Develop a comprehensive social marketing program 2.Join EPODE – launch in at least 10 communities 3.Make schools hubs for child health and community engagement 4.Create healthy environments for preschool children 5.Develop the knowledge and skills of key professionals to support parents 6.Speed implementation of the Poverty Reduction Strategy 7.Continue to implement the Mental Health and Addictions Strategy 8.Ensure families have timely access to specialized obesity programs 9

10. FROM STRATEGY TO ACTION A.Make child health everyone’s priority Cross ministry cabinet committee chaired by Premier Engage partners outside government/champions Empower parents, caregivers and youth Leverage and build on what we already have B.Invest in child health Maintain current fundings levels Leverage and repurpose government funding Commit at least $80m/y in new funding Establish a public-private philanthropic trust fund - innovation C.Use evidence, monitor progress, ensure accountability Develop a surveillance system (weights, risk factors, protective factors) Support research on causes and interventions Monitor the implementation and impact of strategy Report annually to the public on progress 10

11. “TO DO LESS WILL NOT BE ENOUGH” In year one, Ontario should meet at least the following milestones:  Establish cross-ministry committee and develop a plan  Introduce preconception health visit concept  Ban advertising to children under 12, and point-of-sale displays of sugar-sweetened beverages  Expand some of the existing healthy eating and physical activity programs that have been shown to be effective  Involve at least ten communities in EPODE  Establish indicators and a reporting strategy

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13. “TO DO LESS WILL NOT BE ENOUGH” In year one, Ontario should meet at least the following milestones:  Establish cross-ministry committee and develop a plan  Introduce preconception health visit concept  Ban advertising to children under 12, and point-of-sale displays of sugar-sweetened beverages  Expand some of the existing healthy eating and physical activity programs that have been shown to be effective  Involve at least ten communities in EPODE  Establish indicators and a reporting strategy

14. THERE IS NO TIME TO DELAY “The need is grave and compelling. If nothing changes, one in three children in Ontario will be overweight or obese. More children will develop weight issues that will lead to serious health problems in their 30s and 40s, and affect their quality of life. The cost of obesity will overwhelm our health care system.” No Time to Wait: The Healthy Kids Strategy, p.53 14