Ontario Food and Nutrition Strategy Possibility Conversation Meeting #2 Ontario Collaborative Group on Healthy Eating and Physical Activity (OCGHEPA) November 28, 2011

Agenda for this session Welcome Update on the work of the OFNS Design Team Quick Huddle – Sense making Conversation Cafe Moving forward

What is the Vision for an Ontario Food and Nutrition Strategy? A cross-government, multi-stakeholder coordinated approach to food policy development.

Vision – Long-term Outcomes Safe, nutritious, affordable and accessible food for all Ontarians Food skills and community development Healthy eating throughout lifetime Sustainable local food and agriculture businesses Improved health economy, equity, environmental sustainability On-going monitoring, measurement and evaluation From draft logic model – could be discussed if they agree with the long term outcomes

What is the process that brought us here today? Initiated by the Ontario collaborative group on healthy eating and physical activity (OCGHEPA) A provincial collaboration of health professionals from non-profit, health and academic organizations dedicated to addressing population-based issues relating to healthy eating, physical activity, healthy weights and the determinants of health, including food access, availability and adequacy. The Canadian Cancer Society acts as a secretariat for the group. Our mission is to improve the health of all Ontarians by advancing healthy eating and active living initiatives through strategic partnerships, knowledge exchange and collective action.  Our vision for 2015 is an Ontario that supports healthy eating and active living for all. We envision Ontario becoming the healthiest province in Canada through an inclusive participatory approach that leverages the strengths, energy and resources of the various ministries within government and other important health partners and stakeholders.

Phase 1 - May 2009-September 2010 May 2009 OCGHEPA recognized the need for a more comprehensive approach in the area of food and nutrition to promote health and wellness in Ontarians. Fall 2009 – Summer 2010 Preliminary meetings and research September 2010 Created background document assessing functional areas of capacity Several nutrition and physical activity programs and activities have been proposed and/or attempted in recent years but there has been a lack of an overall food and nutrition strategy for the province. Programs and initiatives are currently offered by many different ministries and organizations within the province without the coordination of a broad based provincial action plan. Improved linkages and more multisectoral planning through an overall food and nutrition strategy may improve the outcomes of all of these programs – that is a well nourished, healthier, more productive population, and lower health care and social costs.

Phase 2 – Dialogue – Sept 2010 to Present Used results of Phase 1 analysis to identify specific priorities and recommendations. Phase 2 report produced to generate and facilitate dialogue. Recommendations discussed among Ontario government officials and staff as well as key health partners and stakeholders. Bringing key stakeholders into the process and moving towards action OCGHEPA is calling on the Ontario government to begin a cross-government coordinated approach in the area of food and nutrition to improve the health and productivity of Ontarians and lower the healthcare and social costs to the province. Why - Ontario’s health care costs reached 46% of the province’s total operating budget – $44.6 billion - in 2008-2009. By 2022, they are projected to reach 70%. Moreover, the number of Ontarians over 65, the most frequent users of the healthcare system, is expected to double to 8 million over the next 20 years. At the same time, childhood obesity has tripled since 1981 (Source: George Zegarac, Deputy Minister OMAFRA. Sparling Report, 2010). An Ontario Food and Nutrition Strategy will have economic, social and health benefits. At least 80% of premature heart disease, stroke and type 2 diabetes, and 40% of cancer could be prevented through healthy diet, regular physical activity and avoidance of tobacco products. Cost-effective interventions exist: the most successful strategies have employed a range of population-wide approaches combined with interventions for individuals. Using these approaches, Canada has already made important gains in reducing chronic disease death rates: WHO estimates that from 1970 to 2000, over 1 million cardiovascular disease deaths were averted in Canada. Source: WHO: Facing the Facts: The Impact of Chronic Disease in Canada http://www.who.int/chp/chronic_disease_report/media/CANADA.pdf Facts on Chronic Disease: Will affect 89% of all Canadians Preventable 91% of diabetes 90% of cardiovascular disease 50% of cancer Avoidance of morbidity Quality of life Reduction of health care costs - $180 B annually Source: School of Public Health University of Alberta

Context for OFNS 8 International: WHO’s global strategy on diet, physical activity and health WHO European action plan for food and nutrition policy 2007-2012 UN Summit on Non Communicable Diseases 2011 National: CSCC Pan-Canadian Nutrition Strategy Framework for Health Promotion & Chronic Disease Prevention 2005-2015 Healthy Canada Curbing Childhood Obesity Canadian Agri-Food Policy Institute Canadian Federation of Agriculture National Food Strategy Conference Board of Canada – Centre for Food in Canada Resetting the Table – A People’s Food Policy for Canada Provinces: BC ActNow! Nutrition in Nunavut-a Framework for Action 2007 Healthy Eating Nova Scotia 2005 Eating Healthier in Newfoundland and Labrador 2006 Live well, be well New Brunswick’s Wellness Strategy 2009-2013 Ontario: CMOH Healthy Weights, Healthy Lives 2004 MHPS HEAL 2005 Menu 2020 Ten Good Food Ideas for Ontario, 2010 Planning for Food Systems in Ontario, OPPA, 2010 OCDPA ‘Make Ontario the Healthiest Province’ 2011 Vote on Food, Sustain Ontario Election Campaign 2011 CDP Blueprint (CCO PHO) 2011-1012 PanAm Games 2015 Understanding where an Ontario-based Food and Nutrition Strategy fits in the larger context of food policies. What does Ontario based strategy add to the context? 8

Actors and Stakeholders OFNS Design Team Players suggested in the OCGHEPA OFNS Discussion Paper: Ministries: Aboriginal Affairs Agriculture, Food and Rural Affairs Children and Youth Services Community and Social Services Culture Education Environment Finance Health Promotion and Sport Health and Long-term Care Municipal Affairs and Housing Food Industry and Businesses: Canadian Restaurant and Foodservice Association Alliance of Ontario Food Processors Canadian Federation of Independent Grocers Canadian Council of Grocery Distributors Food and Consumer Products of Canada Ontario Fruit and vegetable Growers Association Ontario Federation of Agriculture Christian Farmers Federation National Farmers Union Other potential stakeholders: Green Prosperity Ontario Association of Food Banks Ontario Good Food Box Network Vineland Research Group Ontario Collaborative Group on Healthy Eating and Physical Activity: Breakfast for Learning Canadian Cancer Society-ON Cancer Care Ontario Canadian Diabetes Association Dietitians of Canada Heart and Stroke Foundation Ontario Chronic Disease Prevention Management in Public Health Ontario Ministry of Agriculture, Food and Rural Affairs MHPS OPHA-Nutrition Resource Centre Ontario Society of Nutrition Prof in PH Ontario Society of Phys Activity Promoter in PH Ontario Physical and Health Education Association Parks and Recreation Ontario Sustain Ontario U of Guelph, Human Health and Nutritional Science U of Waterloo, Health Studies and Gerontology OFNS Design Team: Cancer Care Ontario Canadian Cancer Society - ON Dietitians of Canada Heart and Stroke Foundation Ontario Public Health Association Ontario Professional Planners Institute Ontario Tobacco Research Unit Public Health Ontario Sustain Ontario Toronto Food Policy Council U of Waterloo York U So far – Strategy is led by OCGHEPA – so really is a ‘health-focussed’ strategy, but to address the other components of food in ontario – need to work with the other players mentioned in the background document. Consideration of how the strategy and group will engage with the Food industry partners listed? Other food partners to consider, eg. Convenience store owners association; Catering industry for hospitals/schools/universities/etc; hospitality industry? 9

DRAFT - Ontario Food and Nutrition Strategy, 2011 High level overview of components of an OFNS Short-term Outcomes Mid-term Outcomes Long-term Outcomes Outputs Inputs Capacities 1.Planning and management (of organizations, partnerships and relationships) 2.Research and innovation 3.Knowledge exchange and capacity building 4.Goal and objective setting 5.Advocacy and policy development 6.Program development 7.Communications 8.Financial transfers 9.Evaluation and learning 10.Surveillance 11.Performance monitoring and accountability New provincial mechanism to address complex food system Provincial policies reviewed for their impact on food system including diet Systematized coordination between government and stakeholders for achieving food outcomes Safe, nutritious, affordable and accessible food for all Ontarians Provincial Government Indicators, data, information, analysis and dissemination Food skills and community development Provincial Legislation, regulatory changes, and programs to improve food content, safety, availability, accessibility, production, and sustainability OFNS owned by Civil Society and stakeholders Decreased availability and marketing of unhealthy foods and increased healthy foods Healthy eating throughout lifetime Policy, legislation, regulation, programming recommendations to support healthy, thriving food system Sustainable local food and agriculture businesses Legislation and regulation to support safe and sustainable food production Industry, Agriculture, Stakeholders Coordination between health, food production industry, agriculture and social systems Improved health economy, equity, environmental sustainability Recommendations for municipal and federal policy Based on the Smoke Free Ontario logic model – very draft Ongoing monitoring, measurement, and evaluation Dietitians of Canada statement - Ontario needs a coordinated provincial food and nutrition strategy to improve the health and productivity of Ontarians and contain healthcare and social costs to the province caused by poor health.   A Food and Nutrition strategy will also encourage and support a sustainable food and agricultural system, leading to food security and economic benefits. HSF – shied away from health related outcomes and used a developmental approach and building capacity Healthy Province – is on the political agenda Bylaws – Tobacco had a map of Ontario showing jurisdictions as bylaws were enacted – we could ID food policies and follow a similar approach Reduce reliance on rescue systems Research Equity and Life-course considerations Ongoing monitoring, measurement and evaluation DRAFT - Ontario Food and Nutrition Strategy, 2011

Moving Forward OFNS Taskforce Our goal is to work with the Government of Ontario to create a Food and Nutrition Taskforce to enable a coordinated approach to delivering food policy priorities. This taskforce would involve the participation of senior policy staff from all relevant ministries and key stakeholders from health, agriculture, environment, and business. The taskforce would provide strategic cross-sectoral perspectives to advise on the development, implementation, coordination, monitoring, and evaluation of policy and legislation related to food and food systems.

Sense Making Does the idea of a Provincial Task Force make sense? Are there better organizing approaches that we have not thought about yet? Do we have agreement on the mandate of the Task Force?

Conversation Cafe Questions: 1. How do we get some energy behind this? 2. What can we start to work together on now that will have a quick impact? 3. Who needs to be involved/ who’s missing?

Next Steps How do you want to see yourselves engaged in moving forward? Who would like to join the design team/taskforce? Next meeting

Acknowledgements…OFNS Design Team Cancer Care Ontario – Rebecca Truscott Canadian Cancer Society – ON – Florentina Stancu-Soare/Joanne DiNardo Canadian Diabetes Association – Sharon Zeiler Dietitians of Canada – Lynn Roblin/Leslie Whittington-Carter Heart and Stroke Foundation – Carol Dombrow Ontario Public Health Association – Cindy Scythes Ontario Tobacco Research Unit – Cathy Mah Public Health Ontario – Heather Manson/Michelle Murti/Mary O’Brien Sustain Ontario – Ravenna Nuaimy-Barker Toronto Food Policy Council – Lauren Baker University of Waterloo – Rhona Hanning, Jessica Wegener, Ellen Desjardins York University – Rod MacRae

Links For More Information Canadian Agri-food Policy Institute www.capi-icpa.ca Canadian Federation of Agriculture www.cfa-fca.ca Canadian Partnership Against Cancer www.partnershipagainstcancer.ca/ Chair in Sustainable Food Production, U of Guelph www.uoguelph.ca/news/2011/03/loblaw_u_of_g_a_1.html Chronic Disease Prevention Alliance of Canada www.cdpac.ca/ Conference Board of Canada – Centre for Food in Canada www.conferenceboard.ca/cfic/default.aspx Curbing Childhood Obesity – FPT Framework for Action to Promote Healthy Weights www.phac-aspc.gc.ca/hp-ps/hl-mvs/framework-cadre/index-eng.php Food & Health: Advancing the Policy Agenda – Workshop Report, March 2010 www.ivey.uwo.ca/lawrencecentre/events/PDFs/food_and_health_finalreport.pdf Joint Consortium for School Health www.jcsh-cces.ca/ Liberal Party National Food Policy www.liberal.ca/newsroom/news-release/michael- ignatieff-commits-to-canadas-first-national-food-policy/ New Democratic Party (NDP) Canadian Food Strategy www.ndp.ca/press/new- democrats-call-for-national-food-security-policy People’s Food Policy Project www.peoplesfoodpolicy.ca/home Public Health is Everyone’s Business, Dr. Arlene King, CMOH Report 2010 www.health.gov.on.ca/en/public/publications/ministry_reports/cmoh_09/cmoh_09.as px Sustain Ontario www.sustainontario.ca