HESA Committee Meeting

     I call the meeting to order.

    Welcome, everybody, to meeting number 146 of the Standing Committee on Health.

    We're pleased to welcome Mr. Peterson today to talk about his motion. We're looking forward to his opening remarks.

    We have only 30 minutes for this part, so Mr. Peterson, the less you have in your opening statement, the more chance we have to ask you questions, but you have 10 minutes if you want them, starting now.

    Thank you, Mr. Chairman.

    I appreciate that the question round is usually where more lucid information is gathered, so I'll just make a brief statement.

    First of all, I'll just thank the committee for undertaking this study. I know at this time of year, when it comes to committee schedules, there is not a shortage of work to be done, so I appreciate the effort that this committee has made to ensure that what I think is an important study will be undertaken.

    I'll give a bit of the background of why I thought this would be an important private member's motion to bring to the House. I gave my speech in the House, as of course you do when you're moving a private member's motion, and I'm not going to reiterate all of that. That's available, of course, for the public record.

    Just from a personal standpoint, I am now the father of two young boys and I am abundantly aware of how it's becoming increasingly difficult to get children—not just my children, but the cohort of their friends and their peers—to be as physically active as perhaps those of my generation were in our youth.

    I had the good fortune of being the son of a phys. ed. teacher when I was growing up, so I grew up with, I think, a keen awareness of the importance of physical activity, the importance of play and the importance of just being active as a child. At the time, you don't appreciate it and you don't necessarily even realize what's going on. In hindsight and as I looked back and as I undertook the research I did to bring this motion forward, I realized how important that was in my development as a child and in my college years, and in the development of my peers, and how fortunate I was to have that environment and that upbringing.

    My father, unfortunately, passed away the year of the election, 2015, just before I was elected, so he never got to see me become a member of Parliament, but a small part of me dedicates this motion to his legacy. That's why it's important from a personal level that I'm doing this, but it's also important on a universal and a national level.

    As I spoke to stakeholder groups across the country, and even in my local community—we all have great recreation and physical activity groups in our local communities—I heard the acceptance that the level of physical activity of youth is such a key determinant of future outcomes and is so important, yet everyone agreed with me that we're not doing enough.

    There seems to be a consensus that more needs to be done and that this is an important undertaking and that it's an important goal to have children and youth physically active, yet we're not getting to where we should be in this area.

    I then of course continued on my research, and the Participaction report card happened to come out just a few months before I introduced the private member's motion late last year, I believe. We're failing, and the metrics are right there in black and white. I don't need to go over them. I know that Participaction will also be here on this study, I think later today or tomorrow, and they can obviously speak much more eloquently about those results.

    It's clear to any objective observer that we're not doing enough and we're failing our children. As the research starts to evolve, pointing to the importance of mental health in our children and what role physical activity plays in ensuring mentally healthy children as well as physical health, I think it becomes even doubly more important than it was even in our understanding 10 or 15 years ago.

     Physical activity was always seen to be important to have healthy bones, healthy muscles, a healthy weight and in reducing physical impairments like diabetes and things like that, but now we're becoming more and more aware of the important role physical activity in youth has on mental health and resilience to bullying and the ability to handle stressful situations.

    All this stuff, it seems to me, would be a very positive solution and a way of ensuring that our next generation of children is healthy and capable and strong and resilient, and I don't think, as a federal government—or frankly, as provincial governments or even at the municipal level, that we're doing enough to make sure that we have all around healthy children.

    I think some of the solutions are right in front of us. I know I'm going to have a lot of questions—and I can expand on a lot of this—but the ultimate goal of this private member's motion was just to promote and support physical activity of young Canadians, and it's as simple as that. What recommendations—concrete, specific, precise recommendations—can this committee make to the federal government in an effort to ensure that goal is reached?

     The goal is simply that every child should be physically active. It's as simple as that.

    The question is simple. The answer, obviously, is more complex.

    That's where I come from on this motion.

    As I said, I have two young boys. We encourage them to be physically active, but they also spend more time than I would like on screens. When I was a child, that wasn't a thing. We would watch TV every now and then, but we didn't have access to content 24 hours a day on things you can hold in your hand wherever you are. I don't think we, as a society, have even begun to realize the detrimental effects of that upbringing. We need anything we can do as a federal government to ensure a healthier lifestyle, such as guidelines or whatever we can do to promote physical activity, because when they're physically active, they're not on tablets and iPads and streaming Netflix. They're doing things that presumably are more productive for them and more beneficial to their development.

    There's another thing I'd like to point out. There's also a disparity that struck me between young girls and young boys. Boys are not nearly active enough, but young girls are even less so. I would imagine there are a myriad of reasons for that, but I don't think it's at all fair, first of all, to not encourage all young people to be healthy and active, and when there is that disparity between genders, it's doubly unfair. As a federal government, we need to do what we can to ensure that young girls are as active as young boys and have the same opportunities and motivation to be active.

    You can go across a bunch of different subsectors and cultures—there are different numbers in all cultures throughout Canada—but I think we need to bring everybody up to a level that ensures healthy children for the future. The benefits are indisputable.

    With that, I'm happy to be in your hands, Mr. Chair.

    Thanks very much.

    When I first heard this motion, the thought came to my mind of going into a high school and seeing the kids all lined up, sitting on the floor as far as you could see, on both sides, banging away on their iPhones. Twenty years ago they'd have been outside doing something.

    Yes.

    Mr. Ouellette, I want to thank you for helping to put this whole thing together. This was your notion, and I give you full marks for it. I'm glad you're here.

    Ms. Damoff, you're first. You're going to split your time with Mr. Ouellette, I understand.

    I am. Thank you, Chair.

    Kyle, I want to thank you for bringing this motion forward. I was honoured to second it. It's something I feel strongly about as well. It's not just about kids playing sports. It's about them being active every single day, incorporating that physical activity into their daily activities.

    This is Bike to Work and School Week. We don't see the number of kids that should be biking and walking to school or to go to their friends' places. I think one of the reasons for that—or one that I hear all the time—is that parents don't feel their kids are safe because of a lack of sidewalks or bike lanes.

    Our government has invested billions of dollars into infrastructure projects. Within one of the streams, municipalities can apply for active transportation infrastructure, which means cycling and walking infrastructure. Many have done so. Do you think the government could do a better job of promoting that stream and letting municipalities know that it's available for them to apply for? We know that investment in active transportation infrastructure is one of the cheapest returns for the dollar that a municipality can make. Some are doing it, but others aren't.

    Do you think we could do a better job of that?

    To answer bluntly, yes. I don't think we're doing enough to create awareness. I'm not even necessarily convinced that we're doing enough in the number of investments available for that. It seems to me that the federal government could play a role in ensuring the physical infrastructure is there to promote a healthy lifestyle.

    You don't want to get into education; that's obviously provincial. There's a lot of municipal infrastructure as well, but I don't think the federal government, generally speaking, is doing enough to make people aware that there are investment dollars for infrastructure or to make those infrastructure dollars available.

    That's a concrete example of how the federal government can play a role in promoting the physical activity of youth—investment in infrastructure.

    The PTIF funding includes active transportation, but when I talk to other MPs and the people at Canada Bikes and Canada Walks, I find that people aren't applying for it.

     No, and part of it is just that as individual MPs, we all need to make our constituent groups, our stakeholders, aware of what's out there as well. I know we all do our best efforts to do that, but I think there just needs to be more promotion, perhaps.

    Okay.

    Robert, do you want the rest of my time?

    Could I just add to that?

    If you look at comparisons, you'll see that Japan is very interesting. They don't build a school more than four kilometres away from where the students live who are going there. Everybody in Japan walks to school. They're walking 20 minutes a day from home, so there and back means 40 minutes a day on average, just without anything else.

    There isn't that concept in Canada. I mean, I know there are geographic and weather differences between Japan and Canada. I'm not going to suggest that we should walk 10 miles in the snow to school, uphill both ways, but maybe one day a month we could have the walking school bus sort of concept, whereby the person who lives the farthest away stops and knocks on the next person's door, and then they knock on the next person's door. By the time the group of students gets to school, there are 15 or 20 all walking the three- or four-kilometre walk together. Then they've done exercise for a day and they promote the awareness. That's safe as well. I think something like that needs to be undertaken.

    The other issue I found, too, is that we don't let our children play outside as much as we used to. People say it's unsafe. Perhaps it is, but I think we have to make a distinction between risky and unsafe. There's risk involved in everything, right? This is the funny thing, the ironic part of this whole thing. If you talk to people from Diabetes Canada, who are doing good work raising awareness of the prevalence of diabetes, you'll hear there's I think a one in nine or one in 10 chance of contracting diabetes as a result of a sedentary lifestyle.

    The risk of getting kidnapped is less than one in 13 million, I think, in Canada, if you just look at it from a strictly odds perspective. You think you're safe; you're keeping your children inside because you think you're protecting them, when in fact you're probably doing more harm than you possibly could doing otherwise, and it's much more foreseeable harm. That's a cultural thing, and an attitudinal change is needed.

    It's changed since I was in about my teenage years. I noticed it because there were a few incidences of kidnapping locally in my neighbourhood, which made people aware of it, and people just kept their children inside.

    The concept now in the research, at the beginning of a study, is that some people use the term “free-range children”. We have to get back to the concept of free-range children. Tell them to go out and play and come home when the lights are on or when they need to eat dinner. That wasn't a novel concept when I was an eight-, 10- or 12-year-old. That was just my normal day. We've moved away from that in 30 years.

    It's interesting you mention that, because in Winnipeg, CFS—child and family services—has on a number of occasions, when kids have been playing outside in their backyard, intervened and said “Your children should not be alone” and attempted an intervention, so it is an issue with child welfare.

    Yes.

    Kyle, thank you very much for your lucid testimony. I was wondering if you could talk a little bit about families that are perhaps poorer. What level of support should governments be providing in ensuring that people have access to recreation services at the municipal level and the provincial level, instead of, for instance, providing the Olympic model, which provides elite athletes with a lot more support? How much of it should be geared toward ensuring that everyone can participate in sports?

    Well, that's a very good question. It's obviously important for everybody to have equal opportunity, but we need to make a distinction between sport, recreation and activity.

    Sport I look at as organized sport. Perhaps you pay a fee and join a team and there's some coaching involved, some training, some skills technique. That is great, obviously, and important, and a good way to be active, but you don't need to be in a sport to be physically active. This is what we need to move away from a little bit.

    Encourage people to play outside. Encourage municipalities to say, when they're developing a subdivision, that the builder has to put a park in the middle of it. It's simple things like that. Encourage children to play outside, to be active, to be physically involved, to learn how to play, learn how to catch a ball, learn how to run. You only learn these things by doing them.

    I also think that anything we can do to promote children being involved at any level is important, and anything we can do to overcome poverty as a barrier to that is important. I obviously don't have the answers as to what that could be, but certainly the income children's parents make shouldn't be a determining factor in whether they're physically active.

    Okay. Thanks very much.

    The time's up; sorry.

    Ms. Gladu is next.

    Thank you, Chair.

    Thank you, Kyle. I think your dad would be very proud that you're bringing this forward as an MP.

    Certainly this is an important issue. When we're talking about trying to make sure children have more physical activity, obviously if we look at the hours in their day, there's some of the time when they're in school and there's some of the time when they're out of school. If we talk about how to increase the activity.... I liked your idea about walking to school, because there's more than one person there, and I think parents are very concerned about having their kids walk alone, with the rise we've had in people taking children.

    Would you be in favour of having mandatory physical education in the schools right from kindergarten up to high school?

     Yes, from a personal standpoint, I think there should be physical education in every year of school, absolutely.

    It's under provincial jurisdiction, but I think the federal government could make recommendations.

    In terms of after-school activities, I was raised similarly to you: We were out until the street lights came on and then we went home. Kids played together, and it was okay for us to go to the park, because parents weren't concerned that we were out of sight, but I think your idea about building parks in the centres of subdivisions where people can keep an eye on their children is better.

    Maybe there are other measures, such as having, I hate to say, security checks, but something like that, or having safe community centres where children would be able to play.

    What do you think about that idea?

    Yes, there are probably a lot of examples of things that we're not doing that we could, and I'm sure there are people who are much more expert on it than I am. If people aren't letting their children play because they're afraid for their safety, that's a legitimate concern and it needs to be addressed in some manner, because to me that obstacle seems like one that could easily be overcome with any number of measures.

    When it comes to activities after school, it's very expensive to play some sports, such as hockey. We had the children's fitness tax credit of $1,200 for each child, and people really enjoyed taking advantage of it. It was an incentive to get people involved in fitness.

    Do you support such a measure?

    I did some research on the children's fitness tax credit as well. The finance department does its analysis, and the result was that not one more child was active because of it. That seems a little counterintuitive, but the report explains that the people who could already afford to put their children in sports were benefiting from the credit, and people who couldn't afford it still didn't have the cash, the outlay, to enrol their kids in sports.

    To answer your more general question, I agree with any tax measures that will encourage children who otherwise would not be in sports to be involved in sports, and that doesn't necessarily have to be a federal government measure. A number of private sector non-profit organizations do just that.

    Maybe there's a role for the federal government to play in encouraging that, by giving them the necessary tax benefits. I think of Canadian Tire, which is very active in my community in getting children to play hockey by providing free equipment to those who qualify.

     I think anything the federal government can do to encourage children who otherwise would not be physically active needs to be considered.

    Yes, I think that's good.

    I come from a rural place, and a lot of times there's no bus to take home after extracurricular activities after school, and a lot of times they've cut the teachers' pay to do extracurricular activities, so the teachers have to volunteer their time.

    Would you be in favour of working with the provinces and territories to try to figure out how to make sure that kids have teachers who are willing to put on extracurricular activities and that they have transportation so they can take advantage of it?

    Yes, I'm happy to support any measure that can be undertaken to promote extra physical activity. Obviously we're not foisting our will on the provinces or education boards or anything like that.

    No, no; it would just be a friendly recommendation.

    A lot of people prefer team sports, but not everyone does. How can we provide incentives for people to do individual sports, such as running?

    Yes, I know. It's most interesting. Of course every sport in Canada has a national organization of some sort, and I've met with the umbrella group that represents them all. They do wonderful work in promoting their sport to the communities and to individuals to get them involved. Obviously they want more people involved in whatever sport they participate in, and you don't even have to look at sport. I don't want to just think of sport. There are many physical activities, such as dance, of course. We have to look at a broader range of things, but any help we can give to organizations to self-promote will be beneficial as well.

    Some kids are better at different sports than others, of course, but I think there's a sport out there for every kid. It's just that they may not have been introduced to it yet, so if there's something like a “Try a Sport Day” whereby a child could try 30 sports in one afternoon just to get a taste of them, I think we should look at it.

    That's a good idea.

    How much more time do I have, Chair? It's one minute? Good.

    With respect to self-esteem, I was one of those kids who was always the last one picked for any team sport at school because I was gangly and growing at a rapid pace. Nowadays educators try to make sure to protect kids' self-esteem. Everybody who participates in track and field gets a ribbon, and that sort of thing. Do you think we need to take measures to address those kinds of situations, because there are still kids who may not be the favourites?

     I think in order for a sport to have a positive impact on children, they need to feel good about participating in it. It maybe doesn't faze some children if they're picked last, but every child is different, right?

    I think anything we can do to promote self-esteem, self-confidence and confidence in general in a child.... At the end of the sport, the activity or the recreational activity they undertake, they should feel better about themselves and not worse. Otherwise, it just defeats the purpose. There's a lot of study on this aspect and there are experts much smarter than I am on it, but a child ought to feel good after participating in physical activity; otherwise, we're failing and the process is failing.

    Very good. Thank you.

    Thank you.

    Ms. Quach, welcome to the committee.

    Thank you, Mr. Chair.

    I want to thank Mr. Peterson. No one opposes virtue and everyone agrees that young people need to move more.

    The last Parliament conducted several studies on physical activity among young people. Canadian Heritage carried out studies on girls, women and sport, and another study on Indigenous people and sport. There were also studies on processed products and the lack of physical activity among young people.

    I wonder how this motion is different and how it makes a constructive contribution to the discussion of the existing reports and recommendations. Did you find the recommendations unsatisfactory? Did the groups that you spoke to say that the common vision was incomplete or insufficient?

     Why did you decide to introduce this motion and study it in only two meetings? In two meetings, how will this motion add to what has already been done?

    I appreciate that question.

    I know that your colleague Mr. Davies raised it in the House, but this motion is very distinct from Common Vision in a number of ways.

    The Common Vision initiative does great work, and it's fantastic. I read it in its entirety and referenced it in both of my speeches and I also asked a Library of Parliament analyst to do a little report for me on the distinctions and what's missing, and there are a number of things missing.

    First of all, if you talk to stakeholders about Common Vision, most people think it's a positive step and most people agree it's great work, but some of the recommendations are not as precise, concise or concrete as they could be. It's almost more a statement of principles than it is of concrete measures, and it's much, much broader than my study.

    My study focuses on promoting physical activity in young Canadians. Common Vision is about all Canadians and focuses on a number on things, including the physical benefits of it as well. There's a little bit on the mental health benefits, but more on the physical benefits and how to get not only youth but adults and older Canadians involved as well.

    My motion is much more precise, in that it focuses on youth, and not just because of the physical benefits, but specifically, I think, on the mental health benefits. Bullying is on the rise in young people. Children need to be more resilient to bullying, and the evidence shows that physically active youth are more resilient to bullying. They're able to cope with bullying, and they are less likely to be bullies because they appreciate the team spirit. They've been in environments where they're not the most important person out there and where sports creates this sort of ecosystem in which you rely on others. The science behind it indicates that.

    This is not to disparage, dismiss or discount Common Vision at all. In fact, I think Common Vision should inform some of the recommendations that we make today. I'll leave my copy if the analysts don't have one, but it's easily accessible. You can look at that and then at the Participaction report card that came out, almost all the same time, incidentally. Participaction was one of the groups involved with Common Vision. There's some overlap because of that, of course.

    What concrete measures does your motion specifically address?

    Basically, you talked about some good initiatives, such as building schools within a four-kilometre radius, based on the Japanese model, and making sure that there are parks. However, these measures often fall under provincial or even municipal jurisdiction.

    How can the federal government take action in this area without encroaching on provincial or municipal jurisdictions, other than through funding?

     It's the same way it can in anything.

    Another incidental difference, and you'll be interested, is that Quebec is not part of Common Vision, so whatever recommendations come out of this committee will equally apply to Quebec, whereas Common Vision doesn't. Quebec didn't participate in Common Vision. It's unique.

    Do you know why?

    I think that was its own choice. I know that there's a footnote at the beginning that says that “Although Quebec is not opposed to the principles underlying [this] Vision, it has its own programs,” etc. It opted out.

    It's important for Quebeckers and your constituents, then, to have some sort of federal role in what ought to be done. I think the federal government....

    You're right. I mean, some of this is provincial and municipal jurisdiction, and we don't want to step on anyone's toes, but if that limited us, the federal government would have very little work to do in any sphere. Any stakeholder you speak to across Canada thinks there's a role for the federal government to play, and they don't think that we've played it.

    The report—

    Can you provide concrete examples? I agree with you, but what initiatives do you want the federal government to implement?

    I want the federal government.... I mean, I don't want to propose to make recommendations, but I would recommend that funding be set up and that money be spent on these recommendations. Common Vision is great because it brought together. every sport minister across the country, except for Quebec's. Why can't we do that quarterly and report to see what's being done? Why can't they have to report to Parliament on what best practices are working? Why can't we make sure that there's funding for sports organizations, recreational organizations and community organizations that ensure that more children are involved in sports? We should fund research that shows why physical activity helps the mental health of young people. None of that is being done right now, and it's a shame, because everyone is so close to knowing that this an important thing to do.

    The other thing is that they can break down silos and just share information. There are so many good groups doing so much good work, and a lot of them don't even know what the other groups are doing. Even if the federal government played nothing else but some role to connect all those groups together, I think we'd be better off now than we were six months ago or 12 months ago. There's much work to be done, and I'm not one who necessarily subscribes to the notion that “Oh, that's provincial jurisdiction, and the federal government shouldn't do it”, because it's not getting done. We need to step up.

    If I were a provincial member of a provincial parliament, I'd probably be doing the same thing and saying, “Let's do something.” However, we're all federal members of Parliament right now. The job's not getting done. It's incumbent on us to do what we can, I think, to help that job get done.

    Thank you.

    Thank you, Mr. Peterson, for bringing this to us and for helping us to understand some of the challenges.

    We're going to suspend for a minute while we invite the Public Health Agency of Canada to come up and get seated in place. We'll just suspend for a moment.

    Thanks very much, Mr. Peterson.

    Thanks very much everybody for coming together so quickly.

    We welcome now the Public Health Agency for another half-hour session. We have Ms. Gerry Gallagher, executive director, centre for chronic disease prevention and health equity; and Mr. Andrew MacKenzie, director of the behaviours, environments and lifespan division, centre for surveillance and applied research.

    You have 10 minutes to open, but if you were to tighten that up a little bit, we'd have more time for questions.

    Go ahead. You do have 10 minutes.

    Good afternoon, everyone.

    Thank you for the opportunity to be here. It's a real pleasure. I'll be giving remarks on behalf of Andrew and myself, but we'll both be available for questions afterwards.

    We're pleased to be here to address the committee regarding the Public Health Agency of Canada's role in improving the level of fitness and physical activity of Canadian youth.

    As you know, the vast majority of Canadians do not get enough physical activity. At least eight out of 10 adults and six out of 10 children and youth do not meet the recommended guidelines for physical activity. We also know that there are sharp differences by gender for the five- to 17-year-old age group: Only one in four girls meets the physical activity guidelines, compared to almost two in four among boys.

    Regular physical activity in childhood contributes to physical and mental health, as was mentioned earlier. We also know that it reduces the risk and/or delays the onset of chronic diseases later in life. These include type 2 diabetes, cardiovascular disease and many forms of cancer.

    Physical activity also provides benefits for the social development of youth, including self-confidence, academic performance and resilience.

    Now here's a little bit about our role at the Public Health Agency of Canada.

    Our role at the Public Health Agency of Canada is to help all Canadians be more physically active in safe and responsible environments. To that end, we obtain surveillance data to better understand the patterns and trends related to chronic disease, including the factors that put us at risk and those that protect our health. We gather, generate and share evidence to inform and guide stakeholder policies and programs. We design, test and scale-up interventions to promote healthy living and prevent chronic disease.

    We do this in collaboration with partners inside and outside the health sector, because everyone must play a role in this field.

     Here is a bit more about facts, specific activities and surveillance.

    The agency measures and reports regularly on the levels of physical activity, sedentary behaviour and sleep among Canadians aged five and over. We also examine patterns of physical activity where different groups of Canadians live, learn, play and work. This information from the chronic disease surveillance system and the pan-Canadian health inequalities reporting initiative is available in an online interactive platform.

    Through funding and scientific support, we also support the Canadian Society for Exercise Physiology , which you'll hear from after the break, in developing the 24-hour movement guidelines for both the early years and for children and youth. These were developed in collaboration with other national and international stakeholders and researchers.

    These evidence-based guidelines are used by parents, health and education professionals, clinicians, policy-makers and others to inform surveillance, and more importantly interventions, with youth across the country.

    The guidelines are promoted through a fun and interactive tool called “Build Your Best Day,” which encourages young Canadians to be more physically active.

Importantly, the guidelines hear from a variety of different means—sport and other forms of daily physical activity—in this notion of building your best day.

    As far as key initiatives are concerned, the Public Health Agency of Canada is working in innovative ways and with a variety of partners to increase the reach and impact of our grants and contributions investments, focusing on measurable results for Canadians who are least active.

    The agency has invested $112 million and leveraged $92 million in non-governmental funding through a program entitled “promoting healthy living and preventing chronic diseases through multi-sector partnerships”. This program funds projects that create supportive social and physical environments and address common risk factors for major chronic diseases, focusing again on physical inactivity and sedentary behaviour, unhealthy eating, and tobacco use. These are commonly referred to as the common risk factors for chronic diseases.

    One example is that the agency invested $5 million over five years on a physical activity project entitled “build our kids' success”, or BOKS for short. It happens before school, and it's a physical activity program for elementary school children to help boost their physical and mental health. We had more than 1,300 schools register for the program, and 58,000 students participated in all provinces and territories, so it's scaled up over time.

    Our evaluation results are demonstrating that children take an average of 30% more steps on these BOKS days than on other programmatic days. Interestingly, what we heard from school administrators was a reported reduction in negative behaviours in the school, which they definitely credit to the program. That means children are better able to focus and have a readiness and eagerness to start their day, and there are other benefits for specific students who may have had problems in the classroom prior to the program.

    Importantly, budget 2018 also pledged $25 million over five years to support Participaction. We'll be hearing from colleagues from Participaction shortly. That is administered through the Public Health Agency of Canada. The focus there is to increase participation in daily physical activity among Canadians through the “let's get moving” initiative. This investment aims to change social norms through long-term multisectoral partnerships and coordinated public education, as well as engagement to get Canadians to move more and sit less, more often.

    Earlier, we talked about collaboration between the federal, provincial and territorial governments. Since physical activity is a shared responsibility, the federal Minister of Health works closely with other federal ministers and with provincial and territorial ministers responsible for health, sport, physical activity and recreation through intergovernmental mechanisms.

    “A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let's Get Moving” was released in June 2018. Federal, provincial and territorial governments, as well as a wide range of other organizations and partners, developed this collaborative policy framework. It was intended as a mobilizing vision to support all Canadians and communities to move more and sit less through the different assets that different types of partners can bring to the table to advance this important challenge.

    Internationally, Canada's efforts related to physical activity are very much in line with, and contribute to, current international policy directions, because we are not the only country facing this challenge. Canada ratified the United Nations Convention on the Rights of the Child and is taking action to implement it . This includes the right to play and the right to recreation and the right to the best health possible.

    In May 2018, during the 71st World Health Assembly, Canada endorsed the global action plan on physical activity 2018-2030.

    This past September, Canada adopted the declaration at the third United Nations general assembly high-level meeting on non-communicable diseases. This term is used interchangeably with chronic diseases, which I referred to earlier. This declaration is a blueprint to accelerate action on non-communicable diseases to prevent and control them—because in many cases we know what to do to prevent major chronic diseases—and to advance our commitments to the 2030 sustainable development goals. Physical activity is a key element in advancing these commitments.

    Finally, I just wanted to say thank you to the committee for inviting us to speak about the contributions of the Public Health Agency of Canada on this important issue.

    Through data, evidence, innovation and partnerships, we look forward to building on our efforts to help all Canadian youth move more and sit less where they live, learn, play and work.

     Andrew and I will be pleased to answer any questions. Thank you.

     Thank you very much. You finished quickly. That's perfect.

    We're going to start with Ms. Sidhu. You're going to split your time, I understand, with Ms. Damoff.

    Thank you, Chair. Thank you all for being here.

    First of all, I want to thank my colleague for bringing Motion No. 206. I seconded it. I spoke on that. I'm chair of an all-party diabetes caucus. I know that obesity is a big risk factor for diseases, and I think we have a big burden on the health care system. Obesity rates are going higher and higher, as you know.

    We need to do a lot more. As you said, this is a shared responsibility between provincial and federal levels.

    What kinds of programs do you think can be set up so kids can do more physical activities? Do you think we should give incentives to recreational centres, so that when kids have time, they can go? I know school programs are great, but after school, what is there for them?

    I can start with this, and again Common Vision outlines this quite nicely. There are quite a few different real and/or perceived barriers to physical activity for Canadian youth. It can be time; it can be money; it can be safety; it can be social norms; it can be bullying. A number of these other ones are outlined in Common Vision.

    This is why the foundation is that different sectors have a role to play. Within a family environment, again, children often follow patterns that are typical for that particular family. I'll make an analogy with the food guide: the Canada food guide says it's not just what you eat, but even how you eat together as a family. We see similar patterns: families that move together tend to move together and eat together. Some of these notions are about how family environments have shifted, in many cases, over the last number of years, and how we can have supportive family environments.

    Similarly, when you think about where youth live, learn, play and work, each of those environments has a set of actors, a set of different sectors that can influence how things unfold in those particular environments, through incentives in some cases, and in other cases through disincentives, I will say, for how things play out in those different settings.

     That's why Common Vision outlines what different players can bring to the table. It was not intended as a specific implementation plan, but that work is under way now. As we speak, officials are working on the bones, the concrete steps about how we move forward, together with provincial-territorial governments and other sectors, to support that initiative.

    What I would say is we have some very encouraging results from some of the work we have done in attempting to show what works and trying to scale that up.

    I'll give another example, which is Trottibus, which was mentioned in the early remarks. We mounted a challenge a number of years ago that asked Canadians what they thought would work to increase physical activity for children and youth in Canada. The winning-prize dollar recipient, if you will, was Trottibus.

    Trottibus is a walk-to-school program. It was an adaptation of what's been used in some other countries. It didn't have the features of the Japan model noted earlier, about regulating distance to school. Within a Canadian context, in Quebec winters, sometimes communities had new arrivals to Canada. In other cases there were linguistic barriers for some of those families and children. There were really interesting results in increasing physical activity levels for those children, but importantly, there were also other benefits in terms of fresh-air time, how to dress in the winter cold, how to practise sidewalk safety. Also, those communities, in some cases, then influenced the design of the areas around their schools so that they were safer—changing sidewalk access and arranging for less car traffic outside of the school so that the air quality outside the school was better.

    We've seen some really interesting results. That was time-limited funding, but the results are quite promising, I would say, for potential applicability to other parts of the country.

    Another example I'll use is APPLE Schools. In this particular one, it isn't a school-based setting. For many of us from our era, once we got to school, we stood in line and waited for class to start. If we'd been sitting on a bus or in a car all morning, to stand there for another 10 minutes to wait for a class to start is probably not the best start to the day. They've tried to change the social norms in the school setting, to say, “Here's the lineup, but what are you going to do on your spot?” You're actually lined up, but you're moving as you get ready to enter that school. It's really thinking about, within those different settings and the actors around, what can be done.

    Perhaps I'll stop there. I have other examples I'd be pleased to raise if you'd like.

     We'll now go over to Pam.

    I only have a couple of minutes left, and I have two questions, so I'm going to skip the one I mentioned to you.

    Dr. Tam, our chief public health officer, did an amazing report called “Designing Healthy Living”. How was that, or was that, distributed to municipalities, and is there an opportunity to continue to push that report in municipalities? Those are the people who are actually doing the planning, and if we design communities to be livable, walkable and bikeable, then people will get out every day and use those facilities.

     Absolutely.

    I have the pleasure of supporting Dr. Tam as part of following up on her work on a healthy built environment. We've taken a very intentional approach in using that report to mobilize action, both across the federal family and with other levels within the country. In collaboration with the Canadian Institutes of Health Research and Infrastructure Canada, she convened 13 federal departments to talk about what each department could bring to the table to advance this issue.

    There have been a number of collaborations to advance that work. We've also had her speak at the Federation of Canadian Municipalities and the Canadian Institute of Planners—some of these non-traditional tables where you typically don't see a chief medical officer talking.

    Was it given to the Federation of Canadian Municipalities to distribute to municipalities, or did it just get there and sit with them?

    They have certainly been part of the discussions around the follow-up to that. They've also been instrumental in the development of Common Vision. I can follow up with the specifics.

    Maybe we could push them to get municipalities reading it and starting to implement it.

    Absolutely.

    I have maybe 20 seconds left. Could you talk about FitSpirit in 20 seconds?

    FitSpirit is a funded project that targets teenage girls to support them in school environments, and outside in the community, through a peer-based model, and to essentially figure out what works to get them moving in a way that does not necessarily limit them to playing volleyball or doing dance or yoga. It's a community-based approach to get young women and girls more active. It's early days, but we're really looking forward to its results.

    Thank you.

    Thanks very much.

    Ms. Gladu is next.

    Thank you, Chair.

    I'm going to continue on that line of questioning, because I noticed in the statistics that girls are twice as likely as boys to not have enough physical activity. Do we understand why?

    We do know that it changes over time. Although younger girls under five tend to be less active than boys, it's as they get older that we see a decline in physical activity. There's still a lot more to be done, but we do know that at a certain point, some girls may choose to not be as active in some of the more traditional physical activities, such as organized sport in a school setting. It may be gender biases influencing what's appropriate for girls to be doing or not doing, and similarly for boys to be doing or not doing. We've seen some of that carry over in the sporting community—in hockey, you see a lot higher participation rates for girls, but there are other areas where we tend not to see those same levels of activity.

    I would say it's an area of strong interest. I do know that some of our colleagues in the research community are looking at this issue more closely. Within our own funded projects, such as FitSpirit, we're trying to better unpack this issue. We're also trying to unpack this for a range of young people who may be along a gender continuum that is not just about being a boy or a girl and self-identify as LGBTQ, as an example. We need to be making sure that our programs are inclusive.

    Okay.

    I noted the money you are spending in “promoting healthy living and preventing chronic disease through multisectoral partnerships”. One of the examples you gave sounded really good. Could you give some other examples of what people are doing with the money?

    Sure. I'm happy to do that.

    I did speak a bit earlier about Trottibus, which had some really interesting results. The other one I'll talk about is Sharing Dance. The recipient in this project is Canada's National Ballet School.

    This project uses dance for a range of age groups, and in particular it shows boys and girls how to incorporate dance in building their physical literacy. It has both in-person and online resources. It's the notion that wherever you live, work, learn and play, you can be adapting dance to different types of circumstances.

    We have it now in Alberta, Manitoba, B.C., Ontario, Quebec, Saskatchewan and New Brunswick, with the opportunity for further scale-up. It's a 12-week program, in 42 communities, in seven provinces. We expect that it will also be reaching 120 communities in other parts of the country. As for the number of project partners, we have 100 organizations and individuals across the country.

    We feel that some youth may move more in school while others might move more outside of the school environment, because of some of the barriers we've talked about.

     The BOKS program looked like it was really successful. I especially liked the reduction in negative behaviours among the people who participated. It was in 1,300 schools. Are there any plans to expand that initiative?

     That initiative is expected to wrap up in August of 2019. Part of what we do with any of our funded projects is seek partners for sustainable funding. I don't have that report with me right here, but certainly readiness to scale up is a feature of any of our projects. It's very much a part of why we bring other partners on board at the front end.

    Do you have any information about an urban-rural divide with respect to physical activity? Are kids in the country more likely to be active because they're working on the farm? What do the statistics say?

     According to the data, there is not a significant difference between urban and rural. That was one of the first things I thought. I grew up in the country as well, and I expected that the rural kids would be more active, but according to the data, they're not.

    One of the things that can affect children's ability to be active is how much sleep they get. What kind of data do we have on the amount of sleep that children are getting? There was a mandatory eight o'clock bedtime for young children when I was growing up, and that seems largely abandoned.

    I don't have it in front of me, but there is ongoing data collection about getting sleep, and the results are showing that children are not getting enough sleep. I believe it was somewhere in the neighbourhood of 50%-60% of children who don't get enough sleep. The leading example was screen time: They were up too late on their phones, iPods or tablets.

    I've heard that they have their phones with them all night and they don't sleep. That's another problem.

    Exactly.

    How do we get children to play? When I was young, all the kids in the neighbourhood played. I don't know whether it happened organically, but the kids now seem very siloed and they don't seem to play in the same way.

    I'm not sure I can give you a straight-up answer on that. What I will say is that the research community in Canada and elsewhere is very interested in that. There is a real push for active, outdoor play as a complement to more structured activities, such as dance or sport.

    There's also an interest in animating our public spaces. It's one thing to have a nice green park down the street; it's another thing if you don't feel safe in it and/or there isn't a social environment in that park that makes it a fun and desirable place to go. There's some interesting work going on to look at some of those models, both in Canada and elsewhere.

    I was interested in the comments about how you exercise, how you get your fitness and the need for families to do things together. Are there any pilots you've invested in or things you've done that you think we should leverage across the country?

    Within our team's multisectoral partnerships funding initiative, family is often a feature of some of the funded projects. We do not currently have a family-targeted initiative, but through some of our agency's children's programs, we do support more vulnerable families for healthier environments, not only within the program but outside of it. This includes physical activity, healthy eating and social support. We see that very much as a complement to what we do.

    Thank you.

    Thank you very much.

    We'll go to Ms. Quach for seven minutes.

    Thank you, Mr. Chair.

    I want to thank the witnesses for joining us today.

    I have several questions about Mr. Peterson's statement regarding the lack of funding and research on physical activity issues among young people in particular. According to him, several of the groups consulted said that they lacked research and evidence concerning the impact on the physical and mental health of young people.

    Do you have any research on that? Was this done after the development of the common vision? It's quite recent, but still, it has been almost a year.

    Has funding for physical activity among young people increased since then? If so, by how much? How many programs have been developed based on this vision and increased funding, if applicable?

    If not, why hasn't the funding been increased?

    I'll start by answering the funding questions. I'll then give the floor to Mr. MacKenzie for the research questions.

    Okay.

    We were very pleased with the funding because, at about the same time as the common vision, there was an investment in ParticipACTION. You'll soon be hearing from its president, Elio Antunes.

    The federal government allocated $25 million, and partners in other sectors doubled the investment. It sent a strong signal.

    Is it a new budget, or is the same budget renewed each year?

    It's an investment spread over a five-year period. It's a new investment.

    It's new.

    Yes.

    Is it the only new investment that concerns physical activity among young people?

    Yes.

    It's the only one. The investment amounts to $25 million over five years, so $5 million a year for the whole country.

    Our programming already provides a funding base for multi-sectoral partnerships that focus on physical activity, healthy eating and tobacco use. This is our core programming. However, ParticipACTION's investment has been added over a five-year period.

    Okay.

    Are there specific measures for disadvantaged regions, rural areas, Indigenous communities and vulnerable populations?

    We have open programming. The projects often focus on groups where there's less physical activity or a lack of healthy eating. Even though the program is open, this is often the case. Boys and Girls Clubs of Canada is one example. Kid Food Nation is another example. The UpLift partnership, for which the funding was announced last week in Nova Scotia, will benefit every young person in that province and will increase physical activity and healthy eating. It's not a targeted program per se.

    Okay.

    I have one last question about funding.

    As my colleague told me, Quebec didn't participate in the 2018 common vision. Has Quebec still received funding equivalent to the funding provided to the other provinces and territories to improve physical activity programs for young people?

    We don't only provide money to the provinces as part of our programming. The money is for the projects. This doesn't involve a transfer of money to the provinces per se. The common vision wasn't a transfer of money to the provinces. It's a policy framework. Other funding projects align with the common vision theme.

    Okay.

    I'll move on to you, Mr. MacKenzie.

    A number of community groups in my constituency work with young people in particular, including youth centres. These groups say that they don't have enough funding to work with young people in the area of physical activity.

    You talked about how screens affect inactivity among young people. Nancy Ashton, who works at the Centre de la petite enfance Abracadabra, said that the impact has been devastating. She said that it has created delays and issues in terms of motor skills, but also in terms of the cognitive abilities of young people.

    Is there any research on this subject to determine how to proceed? Have strategies been developed for parents to help them handle screens?

    There are also more and more screens in schools.

     There is extensive research ongoing. Your question has two pieces to it. One piece of it is how parents can discourage the kids from using the screen time too much. The other one is about the long-term health consequences. I'm going to break it up into those two pieces.

    On the first question, there are older studies that are continuously being updated that followed children from 1994 through 2011. Now they've stopped interviewing them, but they're following them administratively through census, education, the justice system, the health data system and all kinds of different data sources to look at the overall outcomes. They followed them for the first 16 years to understand how they were living their lives and how active they were. Now they're following them administratively to see where they end up, based on their earlier life choices.

    With regard to the second piece, there is ongoing research as well to try to figure out how parents can reduce the screen time of their children. I haven't seen anything that seems to be the magic solution yet. I have three teenagers myself and I would be interested in that solution, but I've seen no concrete recommendations so far.

    Some countries, such as Denmark—or other Scandinavian countries—have pilot projects involving outdoor schools.

    Is Canada considering outdoor education as well? Do we have pilot projects here or in Indigenous communities, for example, where outdoor education could have a cultural dimension?

    Last week, we announced the Upflift partnership, which I mentioned. The partnership brings together all school boards in Nova Scotia, including the board that represents the Mi'kmaq communities in the province. I gather that the adaptations are based on the school.

    In some communities, these options are being considered. I know that, in the territories, it's not funded by our teams. However, we're looking at ways to incorporate it into the education system. This is being done together with the provinces and territories.

    Okay. I have one last question.

    According to Mr. Peterson, the groups that he consulted said that the best practices for physical activity among Canada's young people aren't being shared.

    Did you develop this as part of the common vision?

    Yes. The framework is there, but the implementation is in the development stage. It's in everyone's interest to systematically share lessons learned and to know where things work for different populations or sub-populations and why they work. We've enhanced this sharing process in our programs. However, as you said, other sectors and people are also very involved. It would be good to have a more systematic approach.

    We don't have any tools right now.

     Thanks very much.

     Thank you.

    That completes our time. I want to thank the Public Health Agency for bringing this information to the committee.

    We're going to suspend for just a few minutes while we reschedule and bring in the Canadian Society for Exercise Physiology and Participaction.

    We'll suspend for two minutes.

    Thanks very much.

    We're resuming meeting number 146 of the Standing Committee on Health.

    We're very pleased to have the Canadian Society for Exercise Physiology, represented by Panagiota Klentrou, the chair. Welcome.

    Welcome also to Mary Duggan, manager.

    From Participaction, we have Elio Antunes, president and CEO. Welcome.

    We're very pleased you're here.

    We're going to start with the Canadian Society for Exercise Physiology. You have 10 minutes for your opening statement.

     Thank you, Mr. Chair.

    Thank you for inviting the Canadian Society for Exercise Physiology to address this important issue. We applaud the committee for undertaking this study and MP Kyle Peterson for spearheading this initiative.

    Our organization is the resource for translating advances in exercise science research into the promotion of fitness, performance and health outcomes. Our 6,000 members include academic researchers focused on the scientific study of exercise physiology, biochemistry and more, as well as highly qualified professionals working in rehabilitation, work physiology and high-performance sport.

    CSEP, together with stakeholders that include CHEO, Participaction and the Public Health Agency of Canada, launched the world’s first 24-hour movement guidelines for children and youth aged five to 17 years. Released in 2016, these evidence-based guidelines were the first to address the whole day, breaking it into four integrated movement behaviours: sweat, step, sleep and sit. They have been widely adopted by key partners in the sector, including the World Health Organization. More information about these guidelines is available in our brief.

    Building upon this work, CSEP is currently spearheading an update to two additional guidelines focused on adults aged 18 to 64 and older adults aged 65-plus.

    No one in this room needs to be convinced that fitness and physical activity are the cornerstones of a healthy lifestyle. More and more, we are seeing what used to be everyday natural fitness opportunities fade away. Children are driven to school, new subdivisions have limited yards and often no sidewalks, and we are even seeing municipalities banning street hockey. This, coupled with screens being more and more readily available, is a dangerous recipe for the health of all Canadians.

    Research has shown that significant health implications can be linked to childhood inactivity, including chronic diseases, metabolic disorders and more. Perhaps more alarmingly, obesity rates among children and youth in Canada have nearly tripled in the last 30 years. Approximately one-third of six-year-olds to 17-year-olds are considered overweight or obese.

    Last year the federal government, together with the provinces and territories, released the Common Vision report, a national policy on physical activity. CSEP and other stakeholders were encouraged by this event. The report set forth common goals and identified strategic imperatives.

    However, if we are to begin changing behaviours in a positive way and increasing the level of fitness and physical activity for all Canadians, we believe that concrete, long-term implementation plans are needed to achieve the goals set forth in the report. We believe that the commitment to sustained funding for the wider adoption and promotion of physical activity guidelines—including the Canadian 24-hour movement guidelines—will give more Canadians the tools they need to make healthy choices and lead to improved overall health.

    Research has shown that there are more benefits to increased physical activity and fitness than just the obvious ones, including economic and social and mental health benefits.

    CSEP believes that the federal government has a role to play to bring stakeholders together to promote the use of the healthy living guidelines in their respective regions. Encouraging collaboration and coordination among stakeholders to promote the use of these guidelines will benefit Canadians across the country.

    Like stakeholders in other sectors, CSEP was encouraged by the federal government’s commitment to creating and advocating evidence- and science-based policies. In that regard, we would also call on the federal government to support the further development of evidence-based guidelines and increased support for population health measurement tools.

     Finally, we believe that the federal government has a responsibility to demonstrate leadership to normalize physical activity in the lives of all Canadians—children, youth, adults and older adults.

    The Common Vision report notes that “physical activity has largely been designed out of our lives.” What was once a common part of daily life—physical activity—is now something that Canadians believe they can only undertake during leisure time, which can be hard to come by in our busy lives.

    We believe that with federal support and engaging traditional and non-traditional sectors, we can create a fundamental societal change that will have a profound impact on generations to come.

    In summary, in order to bring the goals outlined in the Common Vision report to life, CSEP has three central recommendations.

    The first is to commit to sustained funding for the wider adoption and promotion of the 24-hour movement guidelines.

    The second is continued support for the development of evidence-based guidelines and population health measurement tools.

    The third is for the government to take steps to normalize healthy physical activity in the daily lives of all Canadians.

    In Canada, inactivity and obesity have become epidemic. It is clear that a new approach is needed to improve the overall health of Canadians.

     We know that healthy children mean healthy adults and older adults. In that spirit, we look forward to working with the federal government and other partners to bring the goals outlined in the Common Vision report to life and to meet these challenges head on.

    Thank you very much for inviting CSEP to participate in this study.

     As June 1 is National Health and Fitness Day, we encourage all MPs and all Canadians to get active and find more ways to incorporate fitness and physical activity in their lives.

    Thank you.

    Thank you.

    Now we go to Participaction, with Mr. Antunes.

     Good afternoon, Mr. Chair and honourable members of the committee. Thank you for the invitation to speak to you about the importance of supporting increased physical activity participation among Canadian children and youth.

    As I hear all the presenters, I am struck by the consistency among their presentations and the points I'm going to make, so it may seem repetitive, but I think it's important that these issues be talked about more than once. It's also quite striking for me that many of the solutions we're proposing are very consistent, and we have not compared our notes prior to today. I think there's a lot of consensus among physical activity-related stakeholders with regard to what needs to be done.

    As Canada's recognized physical activity brand, Participaction, a national not-for-profit organization, strives to help all Canadians to sit less and move more through innovative engagement initiatives such as our upcoming Canada-wide Community Better Challenge, which is being launched on May 31 as part of National Health and Fitness Day. I hope you all get involved with your communities, and through thought leadership. We are grateful for the federal government's support in these efforts, most recently through budget 2018's investment of $25 million over five years.

    I do want to clarify that this funding is targeted for all ages and not just for children and youth.

    Since 1971, Participaction has spoken out and made people aware of how our modern lives are leading to a physical inactivity crisis. As we move forward, however, our focus is on actually helping Canadians change their behaviour through a movement for more movement. By working with our various partners, such as CSEP and other stakeholders, we have tasked ourselves with making physical activity a vital part of everyday life.

    I'm not going to spend a lot of time talking about the specific initiatives that Participaction is undertaking, but I certainly can do that as part of the questions and answers afterwards.

    The evidence is very clear: Physical activity is essential to living a long, healthy and productive life. Unfortunately, 80% of Canadian adults fall short of meeting the national physical activity guidelines of 150 minutes of moderate- to vigorous-intensity physical activity per week. Physical activity has been socially engineered out of our day-to-day lives, resulting in a social climate that permits and even encourages more sedentary living.

    Children and youth are not immune to these downward trends. Only about one-third of Canadian children under 18 are engaging in enough physical activity to reap reported health benefits.

    More specifically, this equates to 62% of three- to four-year-olds achieving 180 minutes of daily physical activity per day, 60 minutes of which should be energetic play. As they enter school, just 35% of five- to 17-year-olds are getting the 60 minutes of moderate- to vigorous-intensity physical activity per day that they need.

    Worse still, as you've heard, girls are notoriously less active than their male counterparts, placing this group at an even greater disadvantage. These trends become even more alarming, as research shows that inactive children become inactive adults.

    In addition to the low levels of physical activity, sedentary behaviours are at an all-time high. Close to 76% of three- to four-year-olds and 51% of five- to 17-year-olds are currently surpassing national screen use recommendations of one and two hours per day, respectively.

    As is the case with physical activity, girls reportedly engage in higher proportions of sedentary behaviours compared to boys.

    As levels of physical activity tend to decrease with age, and sedentary behaviours increase, intervention is required early to ensure that children are establishing strong physical activity and screen-use habits at a young age to ensure healthy growth and development across their lifespan.

    The benefits of physical activity are numerous. From a physiological perspective, regular participation in physical activity is associated with many positive health benefits, such as decreased risk for type 2 diabetes, improved weight management and musculoskeletal health, improved functioning of the brain, and decreased risk for cardiovascular disease.

    Children and youth who are physically active demonstrate improved thinking and learning skills. Specifically, active kids problem-solve better. They think more clearly, retain and recall information more easily, and score better academically, particularly in mathematics, reading, language and science.

    Physically active children and youth also have an easier time developing and maintaining peer relationships.

    Regular participation in physical activity is associated with decreased symptoms of anxiety among children and youth. In terms of depression, engaging in physical activity, particularly at higher intensities, has reportedly not only improved symptoms of depression but also been shown to prevent the onset of such symptoms. Active kids also demonstrate increased self-confidence, self-worth and self-esteem, and report higher resiliency to stressful situations.

    Little evidence exists on the direct economic burden of physical inactivity among children and youth in Canada. However, adult data does exist. The Conference Board of Canada states that getting just 10% of Canadian adults to sit less and move more would increase workplace productivity and decrease absenteeism, injecting $7.5 billion into the economy. Additionally, it would reduce health care spending on chronic disease by $2.6 billion.

    Addressing the physical inactivity crisis is complex and thus requires a comprehensive and multi-faceted solution. I've heard a lot of the questions and answers, and you are very focused on what programs would work, but I would suggest to you that it has to go beyond singular programs. From a government perspective, collaboration and alignment should be enhanced across federal departments and between federal and provincial/territorial levels to develop, support and sustain physical activity efforts, including research, program implementation and evaluation. Governments at all levels should intentionally address people with the greatest need by targeting policies to eliminate disparities in participation levels.

    If we look to past successes, we see that the smoking cessation effort in Canada is one of the greatest wins from a public health perspective. Smoking was once regarded as a socially accepted behaviour. However, as evidence of its toxicity emerged, many key institutions—not just the health care system, but the education systems, business systems, community and religious institutes, and all levels of government—joined forces with a coordinated and aligned vision of decreasing the prevalence of smoking among Canadians.

    Despite many noted parallels, few learnings have been applied from this social health issue to the physical inactivity social health issue. Regardless of the strong evidence to support the detrimental outcomes of physical inactivity, not only to the health of Canadians but to productivity and the health care system as well, little progress has been made in terms of shifting the needle toward a more active society.

    Ironically, though, Canada remains a leader in the field of physical activity and sedentary behaviour research, as well as exercise science. Specific examples include the Participaction report card on physical activity for children and youth, which has now been replicated by 48 countries, as well as the 24-hour movement guidelines for children and youth and the early years developed by CSEP, which has been recently endorsed by the World Health Organization.

    Despite this recognized leadership of Canadian researchers and organizations on a global scale, there continues to be a significant disconnect between our international recognition and progress here in our own country.

    In June 2018, you heard many times from the other presenters that after several years of development, the federal-provincial-territorial ministers responsible for sport, physical activity and recreation endorsed Canada's first singular policy focused on physical activity, “A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let's Get Moving”.

    This policy framework must now be supported by a comprehensive, coordinated and appropriately resourced implementation plan. We need to ensure that physical activity is embedded into our cultural and social norms and that it receives the priority, attention and level of investment commensurate with the smoking cessation movement.

    Many recommendations have been highlighted in the literature by top national and international researchers pertaining to supporting increased physical activity participation among children and youth.

    Overall, efforts to promote physical activity in Canadian children should be started as early as possible, given that evidence suggests that physical activity patterns in early childhood continue into late childhood and adolescence.

    When developing strategies aimed at increasing physical activity, we must all focus on reducing inequalities by targeting high-risk segments of the population, such as teenage girls, racial and ethnic minorities, and low-income families.

    There is a strong positive association between outdoor time and physical activity. We need to send our kids outside and ensure that they have adequate outdoor active play opportunities in a variety of settings, such as the home, at school and at child care facilities. We must embed nature in everyday places used by children, such as schools, backyards, parks, playgrounds and city streets, thus creating natural outdoor play spaces that promote physical activity.

    Canada needs to create a culture of active transportation. This, however, may require strategies to alleviate parentally perceived safety concerns by informing them that the risks are very, very low. Physical education must be prioritized and treated as an important core subject area like others, such as science, math and reading. School curriculums should be promoting it to children and youth as a fun, inclusive and welcoming school subject. We must enhance capacity and training among educators to be able to provide opportunities for children and youth to develop physical literacy and to foster positive behaviours regarding physical activity and sedentary time outside of school hours.

    We must also provide better support to programs and opportunities geared towards the entire family being physically active together in their communities. Finding time for parents to participate with their children of all ages and to be active role models will support a culture of physical activity in the home.

    Lastly, communities should dedicate part of their capital plan to recreation facility revitalization.

     Leadership development, training and community capacity-building should also be provided for those living in rural and remote communities, new Canadians and marginalized populations.

    In closing, it is clear that the physical activity problem is a socially ingrained issue; consequently, it will not be solved quickly. However, progress is possible and critical. Our health care system is not equipped to handle the increased impacts of physical inactivity and sedentary behaviour.

    I urge this committee to consider two things. The first is to strongly endorse the development and resourcing of a federal-provincial-territorial coordinated implementation plan for Common Vision. It is time to move from common vision to common action.

    I also encourage this committee to consider endorsing the establishment of a parliamentary secretary for physical activity to prioritize and champion the physical activity agenda within government and to ensure that the support, alignment and coordination required across all levels of government and non-governmental organizations is facilitated.

    Thank you.

    Thanks very much. You packed a lot into 10 minutes.

    We're going to start our question period with seven minutes for Ms. Damoff.

    Thank you.

    My first question is to both organizations.

     Active and Safe Routes to School has talked about how the number of kids walking and cycling to school has gone down. I think it's about one in three now.

     Is stranger danger real, and how can we get parents to get over their fear of sending their kids to walk and bike to school? It's what we hear so often, yet kids are just as safe today as they were 35 years ago, if not more so.

    We also know that if more kids are walking, the busier the streets will be and the better it is for all of them. How can we educate parents around building that daily physical activity of going to and from school?

    I'm an exercise physiologist, so you're going to have to take my word. I don't have specific research in this matter, nor do I think that something has been tried very consistently across municipalities, but we know countries like Japan don't allow schools to be built further away than walking distance to school.

    In most municipalities, and I'm from Oakville—

    Me too.

    —many schools are not within walking distance. Parents are rushed in the morning because space and time are the two biggest barriers. When they don't have time to walk to school for half an hour, obviously they will get the kids in the car and drive to school. I think one issue is the distance to school—

    As a federal government, we don't control that, though.

    That's true. That's why I think it was clear among us that it has to be a coordinated effort by municipalities and that the federal government can be the leader, the one that takes the message out and encourages and brings stakeholders together.

    Perception or reality is a very interesting question. It is a reality because the number of cars is the danger on the street.

    Yes, for sure.

    I have some practical responses to that, but at the end of the day, physical activity needs to be valued by our society. Parents should see driving their kids to school as socially unacceptable.

    Right now it's expected. If you walk your kids to school, people ask why you aren't driving them. As a society—and I think this is where the federal government could play a strong leadership role—we need to ingrain the value of physical activity into our social and cultural norms. If we do that, then as they're building cities, city planners will think about that, because they will value physical activity. When schools are being built, our leaders will think about where they're being built, because they will value the role physical activity plays in the health of our children and youth.

    This is a significant issue that I think needs to be addressed. We need to ingrain the value that physical activity plays in our society. We need to work with the media. I think a lot of this danger is perceived because we hear things today a minute after they happen, whereas before we didn't. I think we need to work with our media partners to ensure that the messages are somewhat balanced.

    We also need to work with our community leaders, such as the children's health services that are saying kids shouldn't be outside playing by themselves. Again, that goes back to not valuing physical activity within our culture.

    We also need to work with our school administrators, because even if you have a great walking school bus or wheeling program to schools, if the school doesn't have a safe place for you to lock your bike, kids are not going to wheel to school.

     Yes.

     How many schools have policies that prevent bikes or skateboards from coming to schools? I think that again it comes back to valuing the role that physical activity plays. We need to work with our workplaces to ensure that we have some employee policies that allow parents to maybe start their days later and walk their children to school. Again, I think this is a societal issue, and if we valued physical activity, we would have very creative solutions to address it.

    You and I have talked about federal infrastructure before. We have billions of dollars available for infrastructure, which is going to municipalities to be able to do not only recreation centres, but.... I think we need to do more around walking and cycling, using the infrastructure that's there. However, municipalities don't know about it.

    Is there a role that we could play—I was asking Kyle about this as well—to ensure that municipalities are aware of the value for them in investing in that active transportation infrastructure?

    It's highlighted in Common Vision, under “Spaces and places”, as a key component, a key area of focus.

    What we don't have is an implementation strategy to work with our municipal leaders to make them aware of the opportunities to address these issues and then to work and facilitate partnerships at a local level to make it happen.

    We need the implementation part of it.

    Common Vision—and I think Mr. Peterson said this—is very vague, and it is meant to be vague. It's a national policy framework.

    However, we need now to put that policy into action, and I think that right now there's a bit of a gap in leadership between the federal and the provincial and territorial governments. I think someone just has to step up to the plate and make it happen. Certainly the sector has been saying for a while that we need an implementation plan. I would suggest, though, that an implementation plan without resources won't go anywhere, so we need a well-resourced implementation plan.

    The roles that I see the federal government could play around research education programs and the infrastructure.... It sounds like we have enough research.

    I'm not sure about that.

    Okay.

    The way research funding is directed is mainly through the tri-council, and unless it's focused on specific diseases, it's not going to be as easily funded as when it does include chronic diseases. However, keeping people healthy doesn't always get the same amount of funding, or it doesn't get funded as often.

    I think it's what Elio says: How do we value, as a society, physical activity and health? I mean staying healthy, not just curing the diseases. It's also promoting how we can keep our population healthier so that they don't need the disease prevention.

    Time's up. Thanks very much.

    Now we go to Mr. Webber for seven minutes.

    Thank you, Mr. Chair.

    Thank you for being here today.

    Mr. Chair, I propose that we suspend and have maybe a 25-jumping-jacks body break at this point in time—

    You go ahead. You start without me, and I'll catch up.

    Can I put a motion forward that we do this?

    A voice: No.

    Mr. Len Webber: Twenty-five. Let's go, everyone.

    Voices: Oh, oh!

    An hon. member: I'd like to put on the record that we're actually going to be doing jumping jacks.

    Mr. Len Webber: Twenty-five, everyone. All right. Let's go. Go borrow some music.

    One, two, three, four, five, six, seven, eight, nine, 10, 11.... Let's stop at 12.

    Voices: Oh, oh!

    Mr. Len Webber: Okay.

    Thirteen.

    Voices: Fourteen, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25.

    All right.

    How much time do I have left?

    Time's up.

    I'm joking.

    Okay, we'll start all over again. Press zero.

    Thank you.

    Thank you again for being here today.

    I'm just going online here, Elio, to take a look at your organization, Participaction. Are you currently a non-profit organization?

    We're a national non-profit charitable organization.

    Do you rely mainly on government funding, or are there other revenue avenues?

    About 30% of our funding is relied upon from the private sector and through other means. Currently 70% of our funding is through federal or provincial governments.

    With regard to that point, we're very, very pleased and happy that we were in the 2018 budget for $5 million. We also get about $2 million from Sport Canada, so our total federal contribution is about $7 million. However, up until now, our funding has been very much project-based. We implement a great project, and then we have to go apply for more money for another project. I don't think that we've ever had the luxury or the benefit of having a long-term perspective on our strategy. This is now the first time that we've been able to do that. We've been given secure funding for five years. I'm very excited about the opportunity to do that.

     Sorry. I'm still catching my breath.

    I am too.

    I'm just reading through here again.

    I understand you were shut down at one time, back in 2001, due to financial cutbacks by the Chrétien Liberal government. Thankfully, back in 2007, the Conservative Harper government revived you. Thank God for Stephen Harper for that.

    Now Mr. Peterson has brought forward his motion. I think the Liberal government sees now that the issue of children and obesity is a very important area to look into. There's my election plug.

    I recall growing up with the names Hal Johnson and Joanne McLeod. They were household names, along with BodyBreak. You certainly don't hear from them anymore.

    Do you have any aspiration of bringing back Hal and Joanne or anyone similar to put together a national campaign, a minute's break on TV when two people talk about BodyBreak?

    Is there anything?

    I think that in my role as CEO, I hear two things:

    First, where are Hal and Joanne? Are they still part of Participaction? Second, whatever happened to the Canada Fitness Award program?

    Yes.

    With regard to both of those things, I would say no, we're not planning to bring them back.

    Come on. It was so successful, wasn't it?

    The Canada Fitness Award program actually wasn't that successful. It actually turned more kids away from physical activity than it turned on. It was very performance-based.

    We are looking at other programs.

    With respect to Hal and Joanne, I think the media landscape has changed and our society has changed. We're not convinced that's the right format as we go forward.

    However, with the $25 million over five years, we have implemented three key initiatives. One is a new campaign called “everything gets better when you get active”. The notion is that Canadians need to understand that physical activity is something that will benefit them now, not 20 years from now. By being physically active, you can think better, you can focus better, you can be a better parent and you can have better relationships. We're trying to ingrain this notion of the immediate benefits of being physically active. That's our campaign and our strategy over the next five years: that everything does get better when you get active.

    The second is something we're launching on May 31. You should be getting in your inboxes this week some information about the “community better challenge”. We're challenging every community across Canada to get their residents to be physically active, to track their physical activity over a two-week period and to try to identify the most active community in the country. We will then provide $150,000 to that community to support physical activity there.

    Again, a challenge in itself is not going to change behaviours, but it does create awareness and it mobilizes community organizations to work together and to value physical activity and building community.

    You might think the third is a bit odd: We've actually created a digital app. We've talked a lot about technology and the fact that technology contributes to being sedentary. We understand that, but we also understand that technology is not going to go away. With this in mind, we created a digital app that gives Canadians the targeted support and content to help them become more physically active. It customizes the content and the actual information that we provide to Canadians depending on their age, their location and their particular barriers to being physically active.

    If everyone here had the app, you would all have a different experience with it. We just launched the app in February and we have over 50,000 people utilizing it.

    The challenge is being launched on May 31. We already have about a thousand communities committed to participating.

    That is excellent.

    Very quickly, there was a commercial back in my day, too, that was on TV. It compared the health of a 30-year-old Canadian to a 60-year-old Swede.

    Have things gotten worse since? Thirty years ago we were quite active. Has it changed? Where in the world are they doing a good job? Is it still in Sweden?

    Well, actually, that commercial was probably the very first one that Participaction developed. Yes, it showed that a 60-year-old Swede was in better shape than a 30-year-old Canadian.

    We, as part of our report card.... As I mentioned, from a children and youth perspective, 48 countries are now replicating the report card. Every two years, we do an analysis across these 48 countries. I would say that Canada is probably in the middle of the pack.

    We're actually doing well in the areas of organized activity and facilities. Where we're not doing really well is in active outdoor play, active transportation and the more unstructured types of activities. I think we've been very focused on structured activity, which provides value in and of itself, but it's not making our kids more physically active.

     I live a few blocks from an elementary school, and I see parking lots full at the end of the day as parents are picking up their kids. I see bike racks empty during the day, when back in our day, they were full. You're absolutely right that we need to change society and our way of thinking, and we have to target the parents.

    Maybe we just have to create massive walking teams or squads rather than the bus, so instead of everybody having to walk their kids down to school, they meet on a corner and they walk down with a team leader. That's another way of seeing public transportation: Our feet can be transportation.

    Agreed.

    Time is up.

    Thank you for the exercise break; it felt good.

    Maybe we should have another one.

    No, not right now.

    Ms. Quach, you have seven minutes.

    Thank you, Mr. Chair.

    I want to thank the members of both organizations for joining us today.

    I have several questions.

    You both talked about programs with long-term plans.

    An initial policy is aimed at physical activity, which includes young people. You said that the $25 million wouldn't be used exclusively for young people.

    Have any countries with investments in physical activity, especially among young people, been able to serve as models and demonstrate the positive impact on the health care system, the economic system, education and productivity?

    Mr. Antunes, you provided several figures on productivity and health.

    Could Canada refer to and draw inspiration from any models?

    First of all, just to clarify, the $25 million that Participaction received is not just targeted at children and youth; it's all populations.

    The second question is interesting, and I mentioned in my notes that internationally we are looked upon for leadership. They take our ideas and they mobilize governments and create investment and implement specific strategies and programs based on a lot of the initial thinking done here in Canada.

    There are examples. We talked about New Zealand having an outdoor strategy; their focus is around getting kids outside. Some of the Scandinavian countries have focus around daily physical education. Every country approaches the issue from a different perspective. What we have found and what is common across all countries, from a children and youth perspective, is this value of physical activity within their cultural norms.

    They may approach it from different perspectives and through different programs, but it's always valued. It's not a question. In New Zealand, kids will go outside for two hours a day; that's what's expected. In Japan, kids are expected to walk and not be driven. In some of the other European and Scandinavian countries, physical education is normalized. Kids get, I think, over 60 minutes of physical education per day.

    We can approach this issue in many different ways, but we need to value it and we need to have a long-term commitment and investment to see it through.

    You both spoke of additional investments needed in the long term. How much are we talking about?

    We're proud of our $25 million. However, the people in my constituency hadn't heard anything about the common vision, and they say that they lack money. In addition, the witnesses from the Public Health Agency of Canada said earlier that there wasn't necessarily any targeted funding for rural, remote or vulnerable populations.

    The Canadian Society for Exercise Physiology has given an “F” rating for 24-hour movement behaviours, sleep, activities, and so on.

    How much should we increase the investment in physical activity among young people in Canada?

    This is not an easy question for a researcher, but I would say between $3 million and $5 million yearly could make a difference. That's only for, again, program-specific, targeted initiatives and so on. I don't know; I only know how much you can save by making everybody more active, and that's in the billions.

    It's not so much how much you spend today, but how much you invest in the future and what the return is going to be in the future from that investment.

    You have figures for the return on investment. Can you share them?

    Yes.

    What's the return on each dollar invested in the health and physical activity of young people? You spoke a little bit about it, Mr. Antunes.

     Yes. Maybe Participaction—

    There is. I don't have it with me, but I can certainly get it to you. There are return-on-investment numbers. Certainly the Conference Board of Canada has done that for adults. The data isn't as vast for children and youth.

    This is maybe where we don't align with my colleagues here. I would say that we're not looking at $3 million to $5 million to make a change in physical activity behaviours; we're looking at hundreds of millions of dollars to actually make an impact.

    If you look at the smoking cessation movement I referenced, you'll see that 30 years after the movement started—I believe in 2018—there was additional new money of $80 million on top of what was already being invested for smoking cessation and tobacco control, bringing the investment to well over $300 million. That's 30 years after the movement started. Gerry and the Public Health Agency can talk about the total investment in physical activity, but I think it's in the neighbourhood of $100 million.

    Right there, there's a disconnect. Less than 17% of Canadians smoke, but more than 80% of Canadians are physically inactive, so there's a clear imbalance of investment here. I'm not suggesting you take money out of smoking cessation and put it into physical activity, but if we value physical activity and if we understand and believe that physical inactivity will have the same type of health consequences as smoking—which the evidence suggests it is, and can, and will—then we need to step up with the same level of attention and investment. I'm talking hundreds of millions, not thousands.

    You said that there aren't enough federal programs to promote physical activity to young people and their parents. You said that the recommendations aren't being implemented. Do you have any examples and concrete recommendations? An oversight committee on the common vision was supposed to have been established a year ago. What federal programs were you talking about?

    I'm not sure that we're lacking programs. I think there are lots of great programs, and I think the Public Health Agency has invested in significant programs that are demonstrating value.

    I think what we're lacking is an overall coordinated approach. We have a policy framework that's not being actioned, and I think there is a bit of a disconnect between the federal and the provincial/territorial governments. I know this is not typical just for physical activity; I think it's probably typical for all government business when you have to work together, but I think we have to put those issues aside. We have to look at the common good will that we're all trying to achieve. We have to figure out ways to work together and not wait for the others to step up.

    My challenge to you would be the same challenge to provincial and territorial ministers whom I met with recently at their conference: We need leadership. We need leadership at a federal level and we need leadership at a provincial/territorial level. I certainly think that there is a role for the federal government to play—a significant role—but I also think that you can't do it alone. You need the provinces and territories to be there to support.

    I have one last question.

    You mentioned a common strategy and the lack of municipal infrastructure for transportation and travel. Are you in contact with the Federation of Canadian Municipalities, for example? Should the federal government work more proactively with municipalities and invest more in active living infrastructure?

    I think yes, and I guess our proposal is to establish a parliamentary secretary. The Department of Health has a huge mandate. Maybe you're the parliamentary secretary, but you have a lot of priorities on your plate. We have a minister of science and sport, which is related to physical activity but also is very specific on sport, which is what the mandate there is.

    I think there's a lack of coordination and leadership at the federal level, and I think we need a champion. Our recommendation is a parliamentary secretary who can mobilize various federal departments—health, sport, transportation, environment, citizenship and immigration, even veterans affairs—to look at physical activity supports and strategies, and also to work very intimately with the provinces and territories, which then can also work with their municipalities. I think it's sometimes very difficult for a federal government to work directly at a municipal level, but certainly if we're all working collectively with our provinces and territories, that can be easily facilitated.

     Okay. Thanks very much.

    I'm going to offer Mr. Peterson an opportunity to ask a question.

    Thank you, Mr. Chair. Thank you to our witnesses for being here. Thanks again to the committee for undertaking this study. I think it's important.

    Mr. Antunes, I have a couple of questions for you. I've read the report that you referred to often. I commend it to everybody, a Participaction report—nice colours, too. The subtitle on the front reads: “Canadian kids need to move more to boost their brain health”. That's a nice summary of where we're all coming from, or where I was coming from, when we brought the motion forward.

    In this report there is, as you know, an expert statement about mental health and self-esteem and things like that in youth. Can you elaborate a little bit on those components of the report and their importance when it comes to developing healthy young Canadians?

    In every report card that we publish, we focus on a different issue. The purpose and the challenge is to highlight that physical activity benefits many aspects of one's life.

    If you want to deal with mental health issues of youth, we should be thinking physical activity, in addition to all the other strategies. If you're thinking about peer relationships, or academic excellence, in schools, physical education is often taken away from kids as a punishment, when in fact you should be giving them more physical activity if they're misbehaving, because they're going to be more attentive and do better at school.

    The connection to brain health was really a way for us to work with non-traditional partners to engage them in dialogue around the role that physical activity plays in helping kids think better, feel better and interact better with their peers. There's a lot of information, which I would encourage you to read through. The brief we submitted goes into a lot more detail.

    It's really just a highlight of the benefits of physical activity to kids' overall brain health, both from a cognitive perspective and from an emotional and a performance perspective.

    May I add something?

    Yes, please.

    There is quite a lot of evidence lately, beyond kids, that the approach to mental health should include physical activity. There are studies right now in schizophrenia and more serious mental illnesses that show good results if you engage the individuals in physical activity. In fact, apart from being a therapy on its own, physical activity may actually increase the success of the medication. On a lot of levels, physical activity seems to be a partner in therapeutic programs for mental health in particular, across ages.

    Thank you.

    Thank you very much. We very much appreciate your contribution. It's certainly been interesting. It opens up a whole lot of areas that I wasn't aware of.

    Thank you to the witnesses, and thank you, Mr. Peterson.

    With that, we adjourn the meeting.