1. Chronic Disease and Injury Prevention Making the Links Julian B. Young BA CRIM MPA Coordinator, Injury Prevention and Control Nova Scotia Department of Health Promotion and Protection Email: youngjb@gov.ns.ca CPHA Conference June 3, 2008

2. Injuries are the leading cause of death and disability during the first 45 years of life. Injuries kill and disable more children and youth than all other causes of disease combined. Addressing injury requires many of the same approaches and strategies as other disease issues. Little recognition that Chronic Disease and Injury Prevention have much in common. In case you didn’t know…

3. It is a process as much as it is an outcome. Strategic and conscious approach to meaningfully impacting root causes of social problems. Effectively working together to have a real and lasting impact. Abandoning traditional silo approach so we can resolve complex issues. Achieved when we coordinate and consolidate prevention efforts across the lifespan within settings where people work, live and play. What is integration?

4. Countless local, provincial, and national strategies. Cover almost every injury/ disease, and body part. Most strategies share similar goals/ pillars/ strategic directions (common threads): –Leadership, capacity, infrastructure, partnership –Awareness and social marketing –Surveillance, research, evaluation –Policy and advocacy –Settings based approaches –At risk populations –Community Action –Overarching factor of health disparities Context for Making the Links

5. Physical activity Diabetes Drugs and Alcohol Heart Health Healthy Eating Early Childhood Cancer Prevention Alzheimer's At Risk Populations Obesity Road Safety Healthy Aging Suicide Mental Health Resilience Seniors Falls Health Disparities Chronic Disease Brain Injury Crime Prevention Separate but related -- A Patchwork Quilt Surveillance Capacity Building Coordination Evaluation Public Policy Leadership Awareness Advocacy Community Action

6. Healthy Eating Road Safety Chronic Disease Crime Prevention Integrated – Each Strand Woven Together Surveillance Capacity Building Coordination Evaluation Public Policy Leadership Awareness Advocacy Community Action

7. Despite all these similarities, little conscious effort to build the linkages – to become more integrated. Lack of integration among these strategies: –those aimed at various types of injuries –those aimed at various chronic diseases –And…lack of integration between injury prevention and chronic disease strategies Building the Rationale

8. Need to recognize that there are strong connections between CD and IP –At the individual level i.e. risk factors for a senior falling –At the population level i.e. income and level of education CD and IP end up in competition with one another –Within the various settings (schools, workplaces, community, institutions) –For the attention of at-risk populations – we bombard them Think teens – sexual health, alcohol and drugs, injury, etc. Need to be more effective and efficient – the opportunity to prevent is limited –resources are finite –eventually, prevention may go out of style So What? Why Integrate?

9. And Stop Sending Mixed Messages…

10. Most people aren’t even thinking about it. Some people are pondering it. A few people are consciously doing it. And others don’t realize they are already doing it. Making the links– where are we?

11. Strong linkages between chronic disease and safety. Some consciously make this connection. Many of the barriers to active transport concern “safety”. The more people who do it, the safer it becomes for all. Improving fitness will ultimately impact risk of injury. Example – Active Transportation

12. Need to make a more conscious effort to recognize and make the linkages in our work: –Focus on root causes of chronic disease and injury –Healthy and safe go hand in hand…not isolated concepts Look at ways to integrate and harmonize strategies and initiatives: –End competition for resources and positioning of issues –Share target audiences using holistic approaches (i.e. risk) Structure our work and approaches around this: –Chronic disease and injury prevention teams –Stop viewing injury prevention as an add-on – weave it within existing work and strategies So What Do We Do About It?

13. Healthy People. Healthy Communities. Ultimately, we all want the same outcome: