How does our corn-dominated food system relate to human health? Wayne Roberts, one of the holistic food movement’s original iron horses and the author of The No-Nonsense Guide to World Food, doesn’t mince words with his answer. “We have a health care system that doesn’t care about food, and a food system that doesn’t care about health.” To his mind corn is the most obvious example. It’s “the most subsidized crop in the world, and it has only negative health consequences.” The Environmental Working Group pegs U.S. corn subsidies from 1995 to 2009 at us $73 billion, or about $5 billion per year.

The trouble with corn, or at least the industrial feedstock variety grown in North America, Roberts explains, is “it’s an extremely low-nutrient food, just an energy provider, which is used in an agricultural system that does not value human, animal, or environmental health as one of its outcomes.”

Forty per cent of U.S.-produced corn goes to fatten cows, pigs, and other livestock for meat, milk and eggs. Ethanol takes about a third. And, high-fructose corn syrup (hfcs) gulps up about three per cent, with exports and “other” making up the remainder.

Citing the corn-fed, fatty meat, and HFCs-based soda-pop obesity epidemic, Stephen Macko asks, “We are overwhelmingly corn, but what price have we paid?” As a professor in the Department of Environmental Sciences at University of Virginia, Macko knew the two trillion-plus corn plants grown each year in Iowa—300 for every man, woman and child on the planet—had to be going somewhere. Macko estimates after water, the number one component in humans comes from corn. We’re essentially walking corn chips.

“Hair functions as a nuanced physical record of diet over time, much like a tape recording,” he explains. His collection includes locks from George Washington, Edgar Allan Poe, Diane Sawyer, and his favourite, Oetzi the Iceman. Through a complex process involving burning the hair to measure the isotopes released, his testing finds on average, about half the carbon in an average North American is derived from corn.

This is not surprising. In many ways corn is the perfect industrial crop. It is an abundant source of cheap interchangeable calories, and with a large amount of fertilizer, can be grown rapidly and predictably often on a one-person, one-machine farm enterprise. But Roberts is concerned that while corn may be good for the industrial food system, it is dysfunctional to human and planetary health. Its highly mechanized nature is hollowing out rural communities, its empty calories in our meat and pop is blowing up our waistlines, its fertilizer and pesticides are polluting our drinking water, and the industrialized food system it sustains— where the average molecule of food eaten in North America has travelled 4,000 kilometres—is polluting our air.

Are we eating too much corn? “There’s a saying ‘a tonne of anything looks ugly,’” starts Dr. David Jenkins. As the Canada Research Chair in Nutrition and Metabolism at University of Toronto and Director of the Clinical and Risk Factor Modification Centre at St Michael’s Hospital, he is one of Canada’s most respected nutritionists and has also worked with Loblaws to develop its Blue Menu line of healthier food products.

When corn feeds millions of cattle a day, which is inefficient because of its low nutritional value, or when a lot of corn sweeteners are added to make food interesting, “then I think you’re catering to a population that is not only growing vastly in numbers, but vastly in size. I’d say the bigger issue behind the corn story is the growth of the human population and the growth of the human appetite.”

Jenkins’ chief concern is the big picture, a planet showing signs of collapse under the weight of a burgeoning population of nine billion consumers. For him, corn is not the problem. Rather, it is one of the symptoms of the age-old Malthusian problem—too many people consuming too much. He knows his message is likely to fall on deaf ears, and he doesn’t try to mask the sense of urgency or frustration.

Our bulging corn-filled bellies are busting the health care bank. The annual health care bill in Canada is over $180 billion per year and about 12 per cent of gdp. Diet-related chronic diseases such as cancer, cardiovascular diseases, diabetes, and stroke make up two-thirds of the direct costs and will increase in the coming years.

And if children are our future, the prospects look even grimmer. For the first time in two centuries, the current generation of children in America may have less healthful and shorter lives than their parents, according to a 2005 report in the New England Journal of Medicine. While American kids are fatter than Canadians, our tots are tipping the scales at similar thresholds. Canada has one of the highest rates of childhood obesity in the developed world, ranking fifth out of 34 oecd countries. As of 2004, 26 per cent of young Canadians aged 2 to 17 years are overweight or obese, up from 15 per cent in 1978.

As a result of food-related disease, among other things, we have an outdated sick care system that will bankrupt our nation, says Carole Taylor, B.C.’s former minister of finance. We can choose to spend 80 per cent of provincial budgets taking care of sick people, we can go two-tier, or we can address the root of the problem with prevention or, in this case, food.

Bridging the silos of government so we have systems for health across all relevant ministries, including agriculture is something long advocated for by Dr. Carolyn Bennett, Canada’s Minister of Public Health from 2003 to 2006.

“Do you think we should have a strong fence at the top of the cliff, or a state-of-the-art fleet of ambulances and paramedics waiting at the bottom?” asks Bennett. Yet the health ministry has almost none of the tools required to build a fence. “The health of our population cannot be the sole responsibility of the Ministry of Health,” she says, openly confessing she wasn’t able to put her fingers on many of the crucial levers that influence health while in power. With time on the sidelines to reflect, she helped unveil the Liberal party’s national food policy this spring, marking the first time an official federal party document linked farmers to health care. “We can’t prevent disease, fight obesity or control health care costs if we don’t get more healthy home-grown food on our tables,” she said at the policy launch.“Our farmers will be central to meeting the health care challenge of the next decade.”

Federal Minister of Agriculture Gerry Ritz, unfortunately, could not offer similar insights. His email response to a query on what Canada is doing to align the agricultural system with better health outcomes said his government is focusing on making Canadian farmed products seem safe for international trade, but did not comment on the health of said products.

Dr. Franco Sassi explains we subsidize fat 50 times more than food with functional health benefits like fruits and vegetables, and in many cases subsidies actually serve to raise the price of fruits and vegetables.

As author of Obesity and the Economics of Prevention: Fit not Fat, which was presented to the oecd’s Health Ministerial Meeting in October 2010, Sassi is disappointed the agricultural ministers weren’t invited to the October meeting, because the health ministers don’t have much power over agricultural subsidies. He also says while obesity is the result of too many calories and too little activity, studies show it is cheaper to influence a person’s diet than their physical activity.

The mainstream media missed most of the interesting parts of Fit not Fat, merely mentioning our climbing obesity rate. While Canada is one of the fattest countries in oecd, there are signs our battle with the bulge may be waning, as the rate of increase in adulthood obesity has been the slowest in the oecd. Canada can also save 25,000 lives a year by implementing a suite of policy interventions, ranging from nutrition counselling to taxes to labelling—most interventions cost less than $200 million per year.

But the most interesting takeaway is that Canada may be the best guinea pig for fiscal measures that make healthy food more affordable and fat food more expensive— the only intervention recommended by the oecd that actually pays for itself. The oecd analysis considered a fat tax/thin subsidy model where fiscal measures would increase the price of foods with a high fat content by ten per cent, and decrease the price of fruit and vegetables in the same proportion—saving 8,510 lives per year in Canada at almost no cost.

Dalton McGuinty played with the idea of fat taxes in Ontario in 2004, before retreating on account of the outcry that it would be a “poor tax” disproportionately hurting lower-income groups. Well, according to the oecd analysis, a fat tax combined with a “thin subsidy” would boost the fortunes of the less financially stable more so in Canada than in almost any other oecd country. Interestingly, the oecd also found implementing a food advertising regulation to limit the marketing of junk food to children, had a similar positive impact on lower income groups in Canada.

Kelly Brownell heads up The Rudd Center for Food Policy and Obesity at Yale University, and his mission is to battle obesity precisely by using a fat tax/thin subsidy combination, subsidizing produce and health promotion with a tax on sugar sweetened beverages. “Healthy food costs too much and unhealthy food costs too little,” he says. The usda estimates his proposed penny-per-ounce tax would reduce consumption by between 10 and 23 per cent. The Congressional Budget Office calculates this tax would raise $150 billion over ten years, while reducing health care costs in the U.S. by $50 billion. Brownell says there are currently 17 cities and states in the U.S. who are serious about this.

Not surprisingly, and like big tobacco before them, the front men for soda conglomerates like Coca-Cola and Pepsi are hitting back with a vengeance. The American Beverage Association has poured millions of dollars into ballot initiatives to repeal soda taxes. Refreshments Canada is no shrinking violet either.

After Corporate Knights contacted Coke about soda taxes, Justin Sherwood, Refreshments Canada’s rather jovial president, became our new best friend. He feels a soda tax unfairly singles out a single industry, and would not make a dent in obesity, as full calorie soft drinks account for just 2.5 per cent of the average calories consumed daily. When asked what he thinks of a revenue neutral approach of offsetting an unhealthy sugared-soda tax, with equivalent rebates for other options, Sherwood dismissed the idea as “social engineering on a grand scale,” while taking exception to the characterization that sugared soda-pop is unhealthy.

“All beverages can be considered healthy, like a slice of chocolate cake can be healthy, or a hamburger can be healthy. Just don’t eat it morning noon and night,” he said.

Over the course of the next two days, Sherwood diligently e-mailed no less than 16 studies showing hcfs is no better or worse than other sweeteners. Interestingly, a recent Princeton study found in some instances, rats fed kibble with hfcs gained significantly more weight than rats fed kibble with table sugar, even though their overall caloric intake was the same. After Brownell saw the reports, he pointed out that many of the authors take lots of money from industry.

Whether we’re dealing with corn-fattened beef, or the hfcs in Coke, corn is just the medium of expression for an industrial logic that caters to human weakness. The agricultural production of corn operates in the increasingly   out -of-touch abstraction that Planet Earth is a wholly-owned subsidiary of the economy. But we are finally waking up to the dementia of the commoditized food system because of the staggering costs showing up in the health care bill threatening to cripple government finances.

The people closest to the action, the farmers, are voting with their feet—fleeing the commodity pit that used to be a family farm, for greener pastures.

“We lost 10,000 farmers between 2006 and 2008, out of 120,000 farmers in the country,” says Joan Brady, National Farmers Union (nfu) National Women’s President. The combined debt of Canadian farmers is $65 billion. While the government hands out billions of dollars of farm support payments each year, it does so based on gross margins, not the nutritional value of food raised.

“The problem,” says Ross Hinther, Director of Research for nfu, “is that the farmer has no market power. The supply chain is dominated by a small number of industrial players who set prices and call the shots.”

For example, just two companies, Tyson and Cargill, control 80 per cent of meatpacking. “What is lacking is domestic marketing and physical infrastructure that supports farmers, and a misguided federal policy that is all geared to exporting food as a commodity,” Brady explains. To get things back on track, we need a paradigm shift predicated on Canadian farmers feeding Canadians first, the resurrection of the family farm, and fiscal recognition of the environmental good and services that farmers protect and generate.

President and ceo of the Canadian Agri-Food Policy Institute, David McInnes published similar thoughts in a 2009 report, “We are on track for 80 per cent of provincial budgets going to health care, and we are spending billions of dollars on farmers’ income support. We need to reconcile these two,” he says. “Our food system, human health, and ecological well-being are all connected, and agriculture can be a solution provider to all of them.”

The last word goes to behavioural economist Dan Ariely. “I think fatty, sugary foods build on some of our human weaknesses. We just like fat and sugar,” he says. “And when we design the world around us, we can do it either with a view to abuse our inherent nature, or we can try to take it into account and make it so we don’t fall victim to our worst instincts.”

The post The killer kernel appeared first on Corporate Knights.

Tall, with curly dark hair and a soft voice, Brown, a mother of three, is a member of Citizens for Responsible Development, a group of local residents concerned about the impacts of oil, gas, and petrochemical development in Alberta’s Industrial Heartland. Situated northeast of Edmonton, due south from the oil sands around Fort McMurray, the Heartland is Canada’s largest hydrocarbon processing region. It’s a vast area: 582 square kilometres sprawling over three counties, Fort Saskatchewan (pop. 18,653), and 49 square kilometres of Edmonton. More than 40 companies, including Dow Chemical, Agrium, and Shell Canada already have projects here. Now, with growing production in the oil sands to the north, industry analysts believe investment in the Heartland may soon ramp up.

Much of the proposed new development is focused on upgraders. Only one, owned by Shell Canada, is currently operating. But more are in the works. Alberta’s Energy Resources and Conservation Board (ERCB) has given regulatory approval for five upgraders. In June 2010, a proposal by Total E&P Canada for another new $8 billion upgrader went before an ERCB hearing in Fort Saskatchewan.

The spate of approvals led to the area becoming known as “Upgrader Alley.” But others wonder if “Cancer Alley” is a more appropriate moniker. In the last decade, Brown and other members of her group attended multiple ERCB hearings into new upgraders, raising concerns about cumulative impacts to air and water quality and human health in the region. “The environmental impact assessments have shown over the years that there is an increased risk of cancer and lung disease in this area,” says Brown. She gathers up the thick pile of maps, articles and scientific documents on the porch table. The ERCB ruling into the Total upgrader is a month away. “We’re waiting to see what the board will decide,” she says. “We know there are connections between blood cancers and emissions. How high do the risks have to go before someone says that’s enough?”

“The sky’s the limit,” says Neil Shelly, Executive Director of Alberta’s Industrial Heartland Association (AIHA). Before driving to Fort Saskatchewan I talk to Shelly on the phone about the Heartland’s future. “If we can get the upgrader base established,” he says, “the potential investment here is probably in excess of $60 billion.”

Roughly in the centre of the Heartland, the economy of Fort Saskatchewan was once built on farming and a jail. The rich soil on the banks of the North Saskatchewan River still grows bumper crops of potatoes and fields of wheat, while in the past the old downtown jail held prisoners from across Alberta. The year after the last man executed in Alberta was hanged here in 1960, Dow Chemical built a plant at the edge of town. Attracted by the proximity to Edmonton, the river, and CN and CP Rail, more companies moved in. The area became a petrochemical hub.

Now it’s also a nexus for pipelines going from the oil sands to the rest of North America. The AIHA, with Shelly at its head, envisions the Heartland as the site of a “chemical cluster.” Petrochemical facilities would be built in proximity. Gases like ethane—produced as a byproduct of upgrading bitumen into synthetic crude—could be transferred quickly from an upgrader into a refinery. Ethane is turned into chemicals used to make plastics and other materials. Factory could be added onto factory. “The polyester in your shirt can be made out of the oil sands,” says Shelly. “When you add in the value of other products that can be made from it, the oil could be worth $3,000 a barrel.”

In the last decade, much of the local farmland was re-zoned for heavy industry. But the dream of a chemical cluster remains a dream, subject to the highs and lows of a boom and bust energy economy. “In 2007 we had seven upgrader projects slated for the area,” says Shelly. “It was the gold rush days for the Heartland.” Then the recession hit. “All of our projects were cancelled except one,” he says. “Those were the dark days of 2009.”

In 2010 the Heartland is at a crossroads. In June, the Canadian Association of Petroleum Producers (CAPP) released a report projecting oil sands production could triple in the next fifteen years. Under its best-case scenario, CAPP predicts Alberta will produce 3.5 million barrels of bitumen per day, or 81 percent of total Canadian crude production by 2025. With several oil sands companies deciding it may be cheaper to ship bitumen to refineries over the border, two new pipelines are in the regulatory process. If approved, the TransCanada and Enbridge pipelines could send much of the new production to the U.S. and China.

Shelly thinks the majority of the bitumen should be upgraded in Alberta. “Shipping the raw product out is a huge loss of economic opportunity,” he says. In July 2010, the AIHA launched Refine It Where We Mine It, a public campaign advocating for more upgraders in Alberta. “We’re at a critical point,” says Shelly. While most of the approved upgrader projects are stalled, the Total project, if approved by the ERCB, could re-ignite investor enthusiasm. “We could turn Alberta into not just a producer of oil,” he says, “but a globally significant producer of petrochemical and high grade consumer products.”

“Preparing for hearings,” says Anne Brown, “has been a full time job for me for the last ten years.” She looks out the car window. We’re driving through Fort Saskatchewan, passing big box stores alongside Highway 21—Wal-Mart Superstore, Canadian Tire. Smokestacks rise from the Dow Chemical plant north of town. “It consumes your life,” she says.

In June, the ERCB hearing into the Total upgrader was held at the Lakeview Inn, just off the highway. If approved, the new plant would be built on 364 hectares between Dow Chemical and the Shell-Scotford refinery and upgrader. At full capacity, the upgrader will process and convert 295,000 barrels of bitumen a day from Total’s oil sands projects, including Joslyn and Surmont. In an environmental impact assessment report submitted to the three-member ERCB panel, Total claimed the project would have “no unacceptable environmental, health and socioeconomic effects.”

Brown shakes her head. We’re driving past Dow Chemical factories near the highway, a twisted matrix of steel and pipe, spewing plumes of white smoke into the air. “The people have lost trust,” says Brown. At the Total hearing, she and members of her group again brought forward concerns about inadequate air quality monitoring and the cumulative impacts of existing petrochemical facilities. “We know of chemical spills, releases, fires that have happened,” she says. If the other plants that have been approved come on line, with another new facility, Brown fears their “problems will be much larger and more people will be affected.”

Independent scientists were called to testify at the hearing. Dr. Michael Edelstein, an environmental psychologist at Ramapo College of New Jersey, examined the emergency response plan for the Total upgrader. A key component of the plan is an approach called Shelter in Place. If a chemical release occurs, residents are instructed to go inside, close all windows and doors, shut off vents and fans, seal an inside room with duct tape at the base of the door and breathe through a wet towel to filter the air.

“It’s a very limited concept,” said Edelstein, on the phone. “The regulatory process is set up to address a catastrophic event which might be lethal. But people can die from things that are cumulative. The consequences may happen over a long period of time. It falls under the radar, and citizens are essentially left to fend for themselves.”

At the hearing, Dr. Stuart Batterman, a public health expert from the University of Michigan, presented statistics compiled by Alberta Health Services and the Alberta Cancer Board. They showed Fort Saskatchewan has the highest rate of emergency room visits in Alberta, and the highest rate of hospitalizations of young children and seniors. Not only that, but compared to the rest of the province, rates of hematopoietic, or blood cancers, such as leukemia, are elevated among males in the region.

“These trends do not appear to be due to chance,” wrote Batterman in his 2010 report. Though the cause of the higher cancer rate is uncertain, he noted that benzene, styrene and naphthalene are among the carcinogens emitted from upgraders and refineries. Peer-reviewed studies from other jurisdictions, he wrote, provide “epidemiological evidence linking refinery emissions and hematopoietic cancers such as leukemia.”

“In the Heartland,” he said, “these types of cancers among males look like they’re moving beyond the statistical variation range into something that looks unusually high.” Total’s assessment, he noted, contains “omissions” and “biases” that downplay the risks to air quality and human health. “This type of facility typically has pretty high emission rates from fugitive emissions,” he said. “There are potentially tens of thousands of sources, and none of them are monitored on a regular basis. Total’s estimates of emissions from fugitives seem very low.” In the absence of a comprehensive regulatory approach to deal with cumulative impacts, he added, “I think the air quality and the health impacts will get worse.”

Industry disputes the level of risk posed by the upgrader. Ahead of the ERCB decision, Total E&P Canada president Jean-Michel Gires went on CBC Radio and said Total will minimize environmental impacts. “You don’t [minimize impacts] by random,” said Gires, noting that the company was ranked first in the oil and gas sector worldwide on the Dow Jones Sustainability Index. “You do that by system, you do that by commitment, you do that by technology, you do that by training of your people, you do that by involving your contractors.”

Cumulative impacts from current and future petrochemical facilities are inevitable. Yet industry promoters like Neil Shelly say the Alberta government does have a cumulative effects management program in place, and the risks can be contained. At the same time, the long-term vision for the area will be an exclusively heavy industry zone, according to Shelly. Companies have bought out many of the farmers in the area. For those left, the AIHA started the Land Trust Society, a program funded by the capital costs of new upgrader construction. While those in the program are barred from participating in future hearings, remaining landowners are given the opportunity “to relocate outside the area and enjoy the similar type of country living that they were when this was pretty virgin country.”

As the oil sands grow, the Heartland aims to capitalize. Chemicals that may be produced here in future are used as the building blocks for cars, houses, clothing, food packaging, the plastics in cell phones, iPods and computers: a modern world built on oil. On the phone, Dr. Edelstein said it all comes with a cost, a “landscape of fear” that envelops residents living near petrochemical infrastructure. “If you are going to make people into victims in order to achieve larger objectives,” he said, “you need to face the fact that you’re doing that, and deal with it, not pretend it doesn’t happen.” The situation “is a double bind—no matter what choice we make it’s the wrong one.”

North of Dow Chemical, as smokestacks rise above spruce trees, a back road twists and turns through the boreal forest, passing fields grown thick with grass. “These were all small farms,” says Anne Brown, pointing at properties bought out by petrochemical companies. She points ahead. “This is going to be Total’s site,” she says. “You’ll see the sign on the corner.” We drive on towards an empty field.

The post The double bind appeared first on Corporate Knights.

Over 300,000 citizens over the age of 65 call the City of Toronto home. Five per cent of these seniors live in collective dwellings, including nursing, or long-term care homes—a demographic many of us will someday occupy.

Like their city of choice, these seniors are multicultural. A 2006 City of Toronto Roundtable on Seniors report found that in 2001, two out of three were immigrants, predominantly from Europe, China, and South Asia.

But a sampling of menus from ten downtown homes revealed predominantly western-centric menus. Chicken, pork, beef, or fish paired with beans, potatoes, or creamed corn might meet the nutrition requirements, but they lack cultural diversity. With a provincial budget of $7.00 for three meals per person per day, it’s no wonder the menus aren’t exactly mosaics of choice.

Below are some photos of food prepared in various Toronto long-term care facilities. For the purposes of the article, it was clear that the kitchens brought their “A” game. These meals might be straight from the menu, but their presentation doesn’t necessarily reflect the day-to-day reality. Given more time, funding, and staff, mealtime at the nursing home could look like this every day.

This meal, or some variation, is among the most prevalent meals served across the board in long term care facilities. This comes from a home in Toronto with a large Portuguese population.

A strong staple of nursing homes, the European “meat and potatoes” food group dominates the daily dinner menu.

This particular meal was crafted by Corporate Knights based on daily menus. Oats tend to saturate the breakfast fare across the board – of course you can always substitute them for an enticing portion of cream of wheat. Bacon and eggs are generally given as an option once a week.

The above three selected meals are from a long-term care facility in Chinatown. Reflecting the Chinese majority, this particular home serves traditional Chinese fare for breakfast, lunch, and dinner.

This selection was a part of Kensington Gardens Nursing Home’s signature program “Passport Week” where staff and residents sample foods from around the globe, including Ecuador, Japan, Russia, China and Austria. The meal pictured above was the featured item on Ecuador Day. One woman asked, “Why isn’t this on the menu for the whole year?” An excellent question.

The post Food for thought appeared first on Corporate Knights.

The bills that can pile up are for more than an emergency ambulance ride. At Princess Margaret Hospital in Toronto, the social work department has seen patients lose their homes because they’re too sick to keep up with mortgages or rent. Other hidden costs affect not just the patients, but their caregivers too. Employment Insurance Compassionate Care Leave is only six weeks, so caregivers often take unpaid leave. Death is both sudden, and endless, and costs add up, like certain medications that aren’t covered by provinces, nursing help, especially when the caregiver is elderly, childcare, pricey hospital parking, or unforeseen needs like home oxygen.

The government programs and subsidies available are patchwork and labyrinthine. Although over 230,000 people die in this country every year, the federal government disbanded the End-of-Life-Care Secretariat in 2007. At a time of physical and mental exhaustion, when dealing with terminally ill family members, it’s up to individuals to figure out that Employment Insurance (EI) leave is federal, while social assistance is provincial, and then tackle the mounds of paperwork. The city’s subsidy for a “pauper’s funeral” is $2,208, though funeral home directors say that, at its cheapest, burial is a $5,000 affair.

Fear of dying might be the main problem. It’s inevitable, but no one wants to accept it. Instead, “we keep on doing these heroic measures … that are expensive, such as the fourth line of chemo that didn’t increase the quality of life in any way,” says Sharon Baxter, executive director of the Canadian Hospice Palliative Care Association.

Because planning for death is something people avoid, many Canadians die while fighting tiring battles in costly hospital beds. Accepting a terminal diagnosis can mean a more dignified death that’s cheaper for both patients and the system, says Baxter. Instead of paying for ambulances, dying patients can often stay at home with hospice workers managing their pain. But because no one will talk about it, Canadian hospices are largely run as charities. Quebec covers more hospice care than any other province—50 per cent.

Some employers are stepping into the breach. Assumption Insurance in Moncton, New Brunswick offers employees six months of sick leave with full pay. It doesn’t accumulate or carry over, but the option is always there, whether someone’s spouse is dying, or a child has a broken leg. This leave can be added onto the six weeks compassionate care offered through EI, and can be split up before and after a death to accommodate grieving.

“[Caregiver benefits] affect motivation, engagement and satisfaction,” said Assumption’s HR director Rachelle Gagnon, who is proud of the company’s extremely low turnover rate of two per cent. “It’s hard to quantify, but we feel that it’s a major factor in recruitment and retention.” That’s the argument they use to convince potential insurance customers to provide similar programs at their own companies.

Instead, costs climb, and we still avoid the issue. In the U.S., a recent study showed 25 per cent of Medicare spending goes toward the five per cent patients in their final year of life. It’s likely similar in Canada, but we don’t know for sure, says Senator Sharon Carstairs, who has focused on end-of-life issues for almost two decades. “That’s the kind of research, quite frankly, that isn’t being done.” In June, she presented Senate with an 80-page report, Raising the Bar, which urges all levels of government to begin work on an integrated strategy for dying Canadians. The response was complete silence. “I don’t understand the unwillingness to have a national strategy,” Carstairs says. Meanwhile, a full 70 per cent of Canadians don’t have access to palliative care, meaning they lack the option of homecare or hospice stay at end-of-life.

Carstairs’ report makes some ambitious recommendations, such as advocating for a $20 million palliative care capacity building fund. But her most ambitious piece of advice is the simplest. Death and end-of-life planning need to be talked about, she says, with conversations at family dinner tables and in doctors’ offices, between company presidents and elected officials. Canadians can no longer pretend that this is “a fantasy world where there is no death.”

The post Death and taxes appeared first on Corporate Knights.

Growing populations, industrial development, resource extraction, housing, and municipal boundary expansion have put extreme pressures on the water and terrestrial resources of the Okanagan-Similkameen. And for the Similkameen People, the health of the land and the health of the people are inextricably linked. The ability to move freely within the territory to gather medicines and food, and to hunt, pray, and live has been profoundly restricted by the tourism industry in the Okanagan-Similkameen Valleys.

To live in a healthy way, Indigenous people, and arguably all people, need access to the land. Yet much of the health policy debate in Canada is categorical, separating health, the environment, family, food, and recreation into isolated entities. The Indigenous perspective tends to be more holistic or community-based, incorporating all these entities into a broader concept of health. Currently, the Similkameen people are working to translate ancient teachings into contemporary community plans for improved health. In the past, the sustainable management of the environment was necessary and vital since it functioned as both the grocery store and the pharmacy. Today, indigenous communities don’t have sufficient access to today’s costly organic foods because of high poverty and unemployment rates.

Aboriginal people have three times the national average of diabetes, and are more likely to have heart disease than their non-Indigenous counterparts. What’s more, Aboriginal men can be expected to live 8.1 years less, and Aboriginal women 5.5 years less, than their non-Aboriginal counterparts. This is despite the fact that both Aboriginal and non-Aboriginal communities may be physically located in the same proximity to conventional health care facilities, such as in the case of the Similkameen People. However, unemployment, poverty, and continued health care coverage cuts by Health Canada’s non-insured health benefits program is a large part of what creates this inequality. Differences in mental health are prominent as well: tragically, suicide by First Nations people is nearly three times the 2001 Canadian rate. While there are many causal factors that can be attributed to these differences, food and lifestyle are one part of that equation. Food was once solely hunted and gathered, and healthy diets were drawn from fish, plants, and animals from the land. This stands in contrast to contemporary society’s sedentary lifestyle with high-calorie and low-quality foods making up a large part of the diet–which is indeed true for many Canadians. Most Indigenous people still supplement their livelihoods with hunting and gathering despite contemporary contexts and confines.

Community policymakers, take note: First Nations peoples are creating their own community health plans that incorporate local knowledge and understanding. Using Indigenous ways of knowing and doing, and considering this in all health policy creation, is an important way forward in moving from the categorical to the holistic. Given the ever-heated debate on health policy reform, this Indigenous perspective serves to deconstruct the way “Westerners” view health and should inform all Canadian community health policies, specifically where they affect Indigenous people.

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“I was a family physician in rural practice for over 20 years and twice I had individuals who chose to go blind rather than travel to the big city to access an eye specialist,” says Dr. Roger Strasser, founding dean of the Northern Ontario School of Medicine. “So you can hardly say the system is meeting the needs of those patients.”

Those patients were scared of leaving their community, he explains. “If you’ve never been to a big city, it’s really terrifying. People who grow up in rural areas feel comfortable there. They want to access health care [close to home].”

That’s not easy when almost a third of Canadians live in rural areas with access to one tenth of our country’s physicians. The result: rural Canadians have more illnesses and a shorter life expectancy than their urban peers. Specifically, First Nations men and women live seven and five years less, respectively, than other Canadians.

And things are about to get worse. In July 2010, the Canadian Journal of Rural Medicine (CJRM) found one in seven rural physicians are planning to move from their communities within the next two years.

Despite the fact that Canada’s urban population is growing and small towns are disappearing, rural and Aboriginal health care should not fall further through the cracks. Beyond the fact that all Canadians deserve the same access to care, rural Canada generates the country’s fuel and food supply, and as arctic sovereignty issues heat up, access to health care in the far north will be critical to keeping a population settled there.

Before nurse practitioner Renate Bennett’s small forestry community of Caledonia, N.S. banded together eight years ago to build a local health care facility, she was working out of a small trailer without heat or running water. We’re not wealthy, she says, “but people were able to find $100 because they were committed enough to having this building.” Bennett knows some communities are not as fortunate. “Sooner or later, if people can’t access primary health care in a rural community, they’re going to end up in a larger centre.”

Frieda Prince, social development worker for the Lower Similkameen Indian Band in the Okanagan Valley of B.C., agrees. “All those people in Vancouver, Toronto, and Montreal come from somewhere, usually the smaller communities. When you look at your Downtown Eastside, wherever that is in whatever community you’re in, that’s usually made up of people migrating to the larger centres from [rural] communities.”

Instead of promoting a diaspora from rural to urban centres, Dr. Strasser says the best health care solutions come from the rural communities themselves. “There is a tendency to take models from the city and somehow try to miniaturize them. Worst case scenario, it leads to a collapse of the health service.”

The urban formula for determining where to locate care facilities based on population density is one example of this collapse. When applied to rural communities, facilities are often concentrated in one area, which means surrounding districts have to travel far distances. Instead, Dr. Strasser says planners should look at integrated health services, which mix emergency, short-term, and long-term care beds in the same facility. But that means having versatile practitioners.

“Rural practitioners provide a wider range of services,” says Dr. Strasser. “They carry a higher level of clinical responsibility, in relative professional isolation.”

That isolation presents both challenges and opportunities. With fewer health providers, people get overworked and don’t last very long, says Dr. Michael Jong, Associate Professor with the Northern Family Medicine Education Program (NorFam) at Memorial University. But once there is a “reasonable” number of peers, the broad scope of practice available to doctors means they’ll stay, says the CJRM’s July survey. And there are other exciting benefits.

“[Health providers] live in the community they serve, so they have the opportunity to assist the community as a whole in improving their health,” says Dr. Strasser. “In a small town in rural Australia, the local doctor was so effective in presenting the message of the relationship between red meat, cholesterol, and heart disease the butcher shop started selling fish.”

To achieve such effectiveness, the NorFam program at Memorial trains physicians in rural areas, for rural areas. At the Northern Ontario School of Medicine in Sudbury, first-year students spend four weeks living and learning in Aboriginal communities.

That type of immersion, Dr. Jong says, is the key to successful retention. Dr. Jong came to rural Labrador from Malaysia to practice medicine in the late 1970s and having seen many doctors come and go, he has a deep understanding of the issues with a transient provider population.

“You cannot parachute someone into the community [to help you and] solve your problems. Residents say, ‘You need to be around for at least a couple of years before we trust you.’ Most people hate retelling their medical issues over and over again,” he says.

With programs that expose students to the issues, the fear of working in a rural environment is eliminated. “Most of the doctors here in Labrador were trained here, except the old guys like me.”

And rural and Aboriginal students often prefer staying close to home. The University of Lethbridge has a Support Program for Aboriginal Nursing Students (SPANS) located relatively close to the Blood and Piikani reserves. It prepares and supports First Nations, Métis, and Inuit students throughout the four-year Bachelor of Nursing Program by incorporating mentorship and the wisdom of elders. Before the program there were at most four aboriginal nursing students, and now there are 60, says Dr. Judith Kulig, SPANS’ coordinator.

A varied approach is needed not just for education, but for the doctor-patient relationship.

“We need to allow physicians a multiplicity of ways of dealing with their patients,” says Dr. Diane de Camps Meschino, a staff psychiatrist at Women’s College Hospital. One of her psychiatric patients lives two hours away and has three kids. Despite icy roads in winter, Dr. Meschino can’t treat her by telephone. “A system like that is revolting.”

While Dr. Meschino treats some patients by phone and doesn’t get paid, she criticizes, “How is a system [like] that sustainable?” Increased use of technology would help both patients and other doctors, especially those in remote areas who can’t just go next door to ask their colleague a question.

“While I was on holiday, I had a call from a doctor in a small town in Ontario, and an email from a physician in Newfoundland [looking for specialized expert advice],” she says. “If I can give that kind of information in five minutes to a doctor, it means [neither the doctor nor] the patient has to travel, and the patient gets timely care.”

Some options include telehealth programs, which use video conferencing to connect doctors with each other and with patients. There is also email consultation. In his town of Happy Valley-Goose Bay, Dr. Jong says they are piloting remote-controlled robots for surgeries.

But we need to start with the basics. “Canada has among the lowest rate of electronic health records in primary care in the industrialized world,” says Dr. Danielle Martin, Chair of Canadian Doctors for Medicare. “That’s a real barrier to patient safety,” she says, since documentation of prescriptions, allergies, and other medical history is crucial to proper treatment.

Technology alone won’t solve the problem. A different view of what it means to be healthy, however, will improve health care. The Partners in Community Collaboration (PICC) committee in Kelowna, B.C. help remove barriers to health care for the “disenfranchised” by having frontline staff discuss the specific needs of individuals in their community. While developed for the homeless, the program deals with more than just primary health care, bringing together community partners such as mental health, addiction, employment, and legal services.

Adam Wylie, chair of the PICC committee, explains the social determinants of health with an analogy. If someone has one bee sting, they’ll take care of it. If they have ten bee stings, would you have motivation to treat all of them? No, he says. We have to address multiple issues, because addressing one won’t make a difference. “[Otherwise] the issue or the pain’s still there. It still hurts.”

Dr. Kulig agrees. “If they don’t have a chance for a job or an education, you can tell them all you want about eating properly, but there are too many other things for them to deal with.”

To Dr. Meschino’s mind, Québec is a good example. Québec’s health policy extends beyond core public health functions and deals with “healthy public policies:” adequate income security programs, a good education system, a clean environment, adequate social housing, and community services.

In B.C., the First Nations Leadership Council and the federal and provincial governments have jointly created Tripartite First Nations Health Plan to give First Nations greater control over the design and delivery of their own health care. This represents a first in a patient-centred, collaborative approach to health care. Doug Kelly, Chief of the First Nations Health Council, says chiefs in Manitoba and Ontario are interested in a similar direction.

Unfortunately, the Lower Similkameen Indian Band in B.C. hasn’t seen the benefits of this new system, says Eliza Terbasket, health and social team leader of the Band. While she supports the tripartite concept, “There is a lack of communication. Our community hasn’t been informed. When we start setting up organizations provincially, generally the small bands like ours get the tail end.”

Dr. Strasser says there’s a common expectation the Ministry of Health will do everything without the people being directly involved.

Community collaboration and empowerment is instrumental to increasing access to health in rural and Aboriginal communities. Is Canada’s health care system designed to do this? Most practitioners would say no.

This article has been nominated for a RNAO Award for Excellence in Health-Care Reporting.

The article photo is courtesy of the Frontline Health Story Project, the goal of which is to increase awareness of the innovative ways that practitioners are helping to improve the capacity to serve Canadians facing barriers to healthcare. See more at www.frontlinehealth.ca

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“I have an HIV-positive patient who comes in for Chlamydia once a month. He says he uses protection. If you’re using protection, you’re not getting Chlamydia, and if you’re getting Chlamydia then you’re probably passing on HIV,” she says with disdain.

“He couldn’t identify the partner because it was in a bath house,” she continues. “Public Health monitors this kind of stuff, but clearly not enough.”

Dr. Anne Doig, former president of the Canadian Medical Association (CMA), agrees. “We don’t have good methods in place for proper checks and balances.”

Rosenberg, Dr. Doig, and Dr. Durhane Wong-Rieger, a patient advocate and doctor who helped Canada mitigate the tainted blood scandal in the late 80s and early 90s, believe Medicare has been broken, in part, by a lack of accountability.

Responsibility for your health rests as much with the doctor as it does with the patient.

“The good news about having doctors that are publicly funded is that you have health
care that could be accessible to everybody. [But some doctors think,] ‘You’re not my client. The government’s my client,’” notes Dr. Wong-Rieger.

In terms of checks, balances, and check ups, Dr. Wong-Rieger looks to her dentist as an example: “The part of my body [that’s best taken care of] are my teeth [because] my dentist is really accountable to me. If I miss a check up, he calls me. My doctor doesn’t do that.”

But is that because we pay for our dentists out-of-pocket?

Unfortunately, because dentistry is not covered, many people resort to walk-in clinics for tooth infections. “That doesn’t belong in a walk-in clinic,” says Rosenberg. If Medicare covered more services, wait times could be reduced because other health care practitioners, like dentists, could share the load.

Long wait times—the most common complaint about health care in Canada—are arguably caused by people misusing the system, but that’s just one part of the equation. Canada has always suffered from a brain drain that results in a doctor shortage, thereby making wait times longer.

In 2008, Statistics Canada reported 15 per cent of Canadians aged 12 or older —about 4.1 million people—did not have a regular medical doctor.

As the mother of a son with two holes in his heart, a daughter with a rare blood disorder—Thalassemia Minor—and a husband with Parkinson’s disease, Dr. Wong-Rieger understands this problem well.

Despite being a doctor herself, “we didn’t have a doctor for a year and half,” she says, so her family made use of walk-in clinics.

This was the only option available to her family—yet another aspect of the problem with wait-times and doctor shortages.

It’s a vicious circle. Walk-in clinics are reserved for patients who can’t get in to see their general physician (GP), but there are so few GPs people often rely on walk-in clinics for regular care. Also, Rosenberg says GPs are the lowest paid, while walk-in clinics provide doctors with fast, easy money, and there’s little or no responsibility to follow up with the patient.

Outside factors such as “talent poaching” are affecting the shortage, says Dr. Doig. Our doctors and nurses are extraordinarily well trained, and the problem is the U.S. loves to have our trainees.

In Canada’s failed version of talent poaching, Dr. Doig states the government and the CMA are both working towards making recertification for internationally trained physicians less difficult and cost-prohibitive. However, many are underemployed. And, she comments, “the whole planning of health human resource allocation across Canada is not well coordinated.”

This lack of coordination results in rural northern communities living without doctors in the region. Thirty-one per cent of Canadians live in rural or remote areas, but only 10 per cent of Canadian physicians practise outside metropolitan areas.

Shortages like these result in last-ditch efforts as happened in the wake of the H1N1 flu pandemic in 2009. In order to avoid criticism for inaction, the federal government sent body bags to rural native communities in lieu of medical assistance.

The doctor shortage, like so many problems facing Medicare, is not solely to blame for a body-bag-delivery health care system.The problems are multi-faceted.

If the government wants to reduce wait times, Medicare should cover alternative health care methods, says Rosenberg. “We keep bringing back patients because [doctors] want the money, but then it bogs the system down. Get [patients] out of the waiting room. Say you have someone with chronic back pain. Instead of bringing them in and medicating them, pass them along to a chiropractor or a naturopath.”

However, when patients ask that their test results be faxed to a naturopath or other health care practitioners, many doctors do it grudgingly, she says, and they charge you for the privilege.

While many would think doctors avoid alternative health care and are motivated to medicate by big pharmaceutical companies, Rosenberg clarifies they medicate to avoid accusations of malpractice.

These issues of entitlement to a free system where doctors are threatened with reports to the Royal College of Physicians—a monthly occurrence at Rosenberg’s busy downtown Toronto medical office—also play a role in the fear Canadians have about changing Medicare.

Medicare is “a political sacred cow,” says Dr. Doig. “Because it is a [fundamental social] value, it has become something that everyone’s afraid of tinkering with.”

Fear of change is yet another part of the puzzle in what’s left of Tommy Douglas’ original vision. “We haven’t lived up to [Medicare’s] potential,” says Dr. Doig.

In reference to the system, Dr. Wong-Rieger says, “It takes tragedies to get changes.”

The tragedy with Medicare lies in the external costs incurred for our “free” system: expensive medication, long wait times, and the absence of preventive health care.

According to a U.S. report from the National Library of Medicine, Economic Incentives for Preventive Health Care, if health care is to provide collaborative quality care, care management and effectively prevent and manage chronic disease, the system requires major re-engineering.

The report can be applied to Canada since few Canadian doctors deal with preventive medicine, says Rosenberg. And the Canadian Institute for Health Information reports 64 per cent of Canadians do not seek preventive health care.

In all examples cited in the report by the Library of Medicine, preventive health care addressed the gaps between the high cost of preventable disease and deaths and the actual prevention practices of health providers and consumers.

“We should be very much proactive in identifying patients ahead of time. Does this cost more? No,” Dr. Wong-Rieger says.

In Canada, the care system is just that—a system. “We expect you to adapt to the system, we don’t expect the system to adapt to you. Canada’s a great country in terms of the public services available, and yet we’re pretty stupid [about service delivery],” she criticizes.

The problems with health care lie with patient, doctor, and government—no one source is to blame.

“It’s very multi-factorial,” says Dr. Doig, referring to a lack of food policy, agricultural
policy, and proper education.

As far as education goes, for Rosenberg, Dr. Doig and Dr. Wong-Rieger, diabetes, smoking and weight problems are the most prevalent preventable health issues facing Canadians.

Just under five per cent of Canadians have diabetes. Ninety per cent of those have Type 2 adulthood onset diabetes, which unfortunately is presenting more in children all the time.

As for smoking, smokers pay more for health insurance in the U.S. In terms of body mass index (BMI), all government employees in the state of Alabama who don’t live within their BMI have one year to get fit or start paying for their insurance—currently covered by the state.

These kinds of measures may not be far off. “The Canadian public is already paying more than half of their health care costs privately. [All that’s covered] are physician services and in-hospital services. Everything else that might be covered is at the discretion of the provincial government,” notes Dr. Doig.

For Dr. Wong-Rieger, solving any problem with Canada’s health care system is a full circle trip back to accountability. “I’m not up to the point where if you smoke I’m not going to take care of you. But, if you’re given good advice and you choose not to do it—is there not a point where [the patient has to take] responsibility?”

Nurse Rosenberg sees these kinds of problems every day. Recently, a 24-year old
man, over 300 pounds, came into her office on a scooter. He told the doctor he needed his disability forms signed. “He said, ‘I’m morbidly obese and I have depression. And I just wanted a few refills for morphine, Demerol, and Tylenol 3.’”

The doctor filled out the forms, “so he could charge OHIP $150,” but would not refill the prescription.

Without having any more interaction with the patient apart from a brief discussion, the doctor signed forms to ensure this man received a monthly government cheque, and potentially sent him on to another doctor to try and get medications clearly not used for depression.

Where does all of this leave Canadians? It leaves us asking what we are sacrificing for our political sacred cow. The answer: Perhaps we sacrifice our own health because we take it for granted that Medicare will always be there and always be “free.”

For Rosenberg, “If you can’t give good reason why you’re 100 pounds overweight, or if you keep getting Chlamydia, you should pay for it. You put yourself at risk, so why should we pay the consequences? That’s why the people who need an MRI really quickly don’t get it: because someone ate themselves into oblivion and is now diabetic sitting in the ER. It’s a shitty system.”

*In order to protect her identity, Kathleen’s name was changed.

This article has been nominated for a RNAO Award for Excellence in Health-Care Reporting.

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How does our corn-dominated food system relate to human health? Wayne Roberts, one of the holistic food movement’s original iron horses and the author of The No- Nonsense Guide to World Food, doesn’t mince words with his answer. “We have a health care system that doesn’t care about food, and a food system that doesn’t care about health.” To his mind corn is the most obvious example. It’s “the most subsidized crop in the world, and it has only negative health consequences.” The Environmental Working Group pegs U.S. corn subsidies from 1995 to 2009 at us $73 billion, or about $5 billion per year.

The trouble with corn, or at least the industrial feedstock variety grown in North America, Roberts explains, is “it’s an extremely low-nutrient food, just an energy provider, which is used in an agricultural system that does not value human, animal, or environmental health as one of its outcomes.”

Forty per cent of U.S.-produced corn goes to fatten cows, pigs, and other livestock for meat, milk and eggs. Ethanol takes about a third. And, high-fructose corn syrup (HFCS) gulps up about three per cent, with exports and “other” making up the remainder.

Citing the corn-fed, fatty meat, and HFCS-based soda-pop obesity epidemic, Stephen Macko asks, “We are overwhelmingly corn, but what price have we paid?”

As a professor in the Department of Environmental Sciences at University of Virginia, Macko knew the two trillion-plus corn plants grown each year in Iowa—300 for every man, woman and child on the planet—had to be going somewhere. Macko estimates after water, the number one component in humans comes from corn. We’re essentially walking corn chips.

“Hair functions as a nuanced physical record of diet over time, much like a tape recording,” he explains. His collection includes locks from George Washington, Edgar Allan Poe, Diane Sawyer, and his favourite, Oetzi the Iceman. Through a complex process involving burning the hair to measure the isotopes released, his testing finds on average, about half the carbon in an average North American is derived from corn.

This is not surprising. In many ways corn is the perfect industrial crop. It is an abundant source of cheap interchangeable calories, and with a large amount of fertilizer, can be grown rapidly and predictably often on a one-person, one-machine farm enterprise. But Roberts is concerned that while corn may be good for the industrial food system, it is dysfunctional to human and planetary health. Its highly mechanized nature is hollowing out rural communities, its empty calories in our meat and pop is blowing up our waistlines, its fertilizer and pesticides are polluting our drinking water, and the industrialized food system it sustains—where the average molecule of food eaten in North America has travelled 4,000 kilometres—is polluting our air.

Are we eating too much corn? “There’s a saying ‘a tonne of anything looks ugly,’” starts Dr. David Jenkins. As the Canada Research Chair in Nutrition and Metabolism at University of Toronto and Director of the Clinical and Risk Factor Modification Centre at St Michael’s Hospital, he is one of Canada’s most respected nutritionists and has also worked with Loblaws to develop its Blue Menu line of healthier food products.

When corn feeds millions of cattle a day, which is inefficient because of its low nutritional value, or when a lot of corn sweeteners are added to make food interesting, “then I think you’re catering to a population that is not only growing vastly in numbers, but vastly in size. I’d say the bigger issue behind the corn story is the growth of the human population and the growth of the human appetite.”

Jenkins’ chief concern is the big picture, a planet showing signs of collapse under the weight of a burgeoning population of nine billion consumers. For him, corn is not the problem. Rather, it is one of the symptoms of the age-old Malthusian problem—too many people consuming too much. He knows his message is likely to fall on deaf ears, and he doesn’t try to mask the sense of urgency or frustration.

Our bulging corn-filled bellies are busting the health care bank. The annual health care bill in Canada is over $180 billion per year and about 12 per cent of GDP. Diet-related chronic diseases such as cancer, cardiovascular diseases, diabetes, and stroke make up two-thirds of the direct costs and will increase in the coming years.

And if children are our future, the prospects look even grimmer. For the first time in two centuries, the current generation of children in America may have less healthful and shorter lives than their parents, according to a 2005 report in the New England Journal of Medicine. While American kids are fatter than Canadians, our tots are tipping the scales at similar thresholds. Canada has one of the highest rates of childhood obesity in the developed world, ranking fifth out of 34 oecd countries. As of 2004, 26 per cent of young Canadians aged 2 to 17 years are overweight or obese, up from 15 per cent in 1978.

As a result of food-related disease, among other things, we have an outdated sickcare system that will bankrupt our nation, says Carole Taylor, B.C.’s former minister of finance. We can choose to spend 80 per cent of provincial budgets taking care of sick people, we can go two-tier, or we can address the root of the problem with prevention or, in this case, food.

Bridging the silos of government so we have systems for health across all relevant ministries, including agriculture is something long advocated for by Dr. Carolyn Bennett, Canada’s Minister of Public Health from 2003 to 2006.

“Do you think we should have a strong fence at the top of the cliff, or a state-of-the-art fleet of ambulances and paramedics waiting at the bottom?” asks Bennett. Yet the health ministry has almost none of the tools required to build a fence. “The health of our population cannot be the sole responsibility of the Ministry of Health,” she says, openly confessing she wasn’t able to put her fingers on many of the crucial levers that influence health while in power. With time on the sidelines to reflect, she helped unveil the Liberal party’s national food policy this spring, marking the first time an official federal party document linked farmers to health care. “We can’t prevent disease, fight obesity or control health care costs if we don’t get more healthy home-grown food on our tables,” she said at the policy launch. “Our farmers will be central to meeting the health care challenge of the next decade.”

Federal Minister of Agriculture Gerry Ritz, unfortunately, could not offer similar insights. His email response to a query on what Canada is doing to align the agricultural system with better health outcomes said his government is focusing on making Canadian farmed products seem safe for international trade, but did not comment on the health of said products.

Dr. Franco Sassi explains we subsidize fat 50 times more than food with functional health benefits like fruits and vegetables, and in many cases subsidies actually serve to raise the price of fruits and vegetables.

As author of Obesity and the Economics of Prevention: Fit not Fat, which was presented to the OECD’s Health Ministerial Meeting in October 2010, Sassi is disappointed the agricultural ministers weren’t invited to the October meeting, because the health ministers don’t have much power over agricultural subsidies. He also says while obesity is the result of too many calories and too little activity, studies show it is cheaper to influence a person’s diet than their physical activity.

The mainstream media missed most of the interesting parts of Fit not Fat, merely mentioning our climbing obesity rate. While Canada is one of the fattest countries in OECD, there are signs our battle with the bulge may be waning, as the rate of increase in adulthood obesity has been the slowest in the OECD. Canada can also save 25,000 lives a year by implementing a suite of policy interventions, ranging from nutrition counselling to taxes to labelling—most interventions cost less than $200 million per year.

But the most interesting takeaway is that Canada may be the best guinea pig for fiscal measures that make healthy food more affordable and fat food more expensive—the only intervention recommended by the OECD that actually pays for itself. The OECD analysis considered a fat tax/thin subsidy model where fiscal measures would increase the price of foods with a high fat content by ten per cent, and decrease the price of fruit and vegetables in the same proportion—saving 8,510 lives per year in Canada at almost no cost.

Dalton McGuinty played with the idea of fat taxes in Ontario in 2004, before retreating on account of the outcry that it would be a “poor tax” disproportionately hurting lower-income groups. Well, according to the oecd analysis, a fat tax combined with a “thin subsidy” would boost the fortunes of the less financially stable more so in Canada than in almost any other OECD country. Interestingly, the OECD also found implementing a food advertising regulation to limit the marketing of junk food to children, had a similar positive impact on lower income groups in Canada.

Kelly Brownell heads up The Rudd Center for Food Policy and Obesity at Yale University, and his mission is to battle obesity precisely by using a fat tax/thin subsidy combination, subsidizing produce and health promotion with a tax on sugar-sweetened beverages. “Healthy food costs too much and unhealthy food costs too little,” he says. The USDA estimates his proposed penny-per-ounce tax would reduce consumption by between 10 and 23 per cent. The Congressional Budget Office calculates this tax would raise $150 billion over ten years, while reducing health care costs in the U.S. by $50 billion. Brownell says there are currently 17 cities and states in the U.S. who are serious about this.

Not surprisingly, and like big tobacco before them, the front men for soda conglomerates like Coca-Cola and Pepsi are hitting back with a vengeance. The American Beverage Association has poured millions of dollars into ballot initiatives to repeal soda taxes. Refreshments Canada is no shrinking violet either.

After Corporate Knights contacted Coke about soda taxes, Justin Sherwood, Refreshments Canada’s rather jovial president, became our new best friend. He feels a soda tax unfairly singles out a single industry, and would not make a dent in obesity, as full calorie soft drinks account for just 2.5 per cent of the average calories consumed daily. When asked what he thinks of a revenue neutral approach of offsetting an unhealthy sugared-soda tax, with equivalent rebates for other options, Sherwood dismissed the idea as “social engineering on a grand scale,” while taking exception to the characterization that sugared soda-pop is unhealthy.

“All beverages can be considered healthy,like a slice of chocolate cake can be healthy, or a hamburger can be healthy. Just don’t eat it morning noon and night,” he said.

Over the course of the next two days, Sherwood diligently e-mailed no less than 16 studies showing HFCS is no better or worse than other sweeteners. Interestingly, a recent Princeton study found in some instances, rats fed kibble with HFCS gained significantly more weight than rats fed kibble with table sugar, even though their overall caloric intake was the same. After Brownell saw the reports, he pointed out that many of the authors take lots of money from industry.

Whether we’re dealing with corn-fattened beef, or the HFCS in Coke, corn is just the medium of expression for an industrial logic that caters to human weakness. The agricultural production of corn operates in the increasingly out-of-touch abstraction that Planet Earth is a wholly-owned subsidiary of the economy. But we are finally waking up to the dementia of the commoditized food system because of the staggering costs showing up in the health care bill threatening to cripple government finances.

The people closest to the action, the farmers, are voting with their feet—fleeing the commodity pit that used to be a family farm, for greener pastures.

“We lost 10,000 farmers between 2006 and 2008, out of 120,000 farmers in the country,” says Joan Brady, National Farmers Union (NFU) National Women’s President. The combined debt of Canadian farmers is $65 billion. While the government hands out billions of dollars of farm support payments each year, it does so based on gross margins, not the nutritional value of food raised.

“The problem,” says Ross Hinther, Director of Research for NFU, “is that the farmer has no market power. The supply chain is dominated by a small number of industrial players who set prices and call the shots.”

For example, just two companies, Tyson and Cargill, control 80 per cent of meatpacking. “What is lacking is domestic marketing and physical infrastructure that supports farmers, and a misguided federal policy that is all geared to exporting food as a commodity,” Brady explains. To get things back on track, we need a paradigm shift predicated on Canadian farmers feeding Canadians first, the resurrection of the family farm, and fiscal recognition of the environmental good and services that farmers protect and generate.

President and CEO of the Canadian Agri-Food Policy Institute, David McInnes published similar thoughts in a 2009 report, “We are on track for 80 per cent of provincial budgets going to health care, and we are spending billions of dollars on farmers’ income support. We need to reconcile these two,” he says. “Our food system, human health, and ecological well-being are all connected, and agriculture can be a solution provider to all of them.”

The last word goes to behavioural economist Dan Ariely. “I think fatty, sugary foods build on some of our human weaknesses. We just like fat and sugar,” he says. “And when we design the world around us, we can do it either with a view to abuse our inherent nature, or we can try to take it into account and make it so we don’t fall victim to our worst instincts.”

This article has been nominated for a RNAO Award for Excellence in Health-Care Reporting.

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