December 07, 2004

Manitoba is tackling chronic disease illness head on with a new prevention initiative, the provincial government announced today.

As noted in the speech from the throne, chronic disease is a major cause of illness, disability and death in Manitoba, especially among First Nations. As a result, the provincial government today revealed a Chronic Disease Prevention Initiative.

The initiative was announced today by Health Minister Tim Sale and Healthy Living Minister Theresa Oswald.

"Thousands of Manitobans suffer from one or more chronic diseases such as diabetes, congestive heart failure, asthma, high blood pressure and liver disease," said Sale. "It’s time to raise awareness of the impact of chronic disease by putting in place an integrated approach to addressing chronic disease prevention and management in Manitoba."

"Lifestyle factors, such as physical activity, healthy eating and not smoking, can greatly reduce the risk of developing chronic diseases like cancer, cardiovascular disease, diabetes, kidney disease, lung disease and others," said Oswald. "If action isn’t taken soon, we can expect more people to suffer from these conditions, resulting in increased demands on our health system."

The Chronic Disease Prevention Initiative (CDPI) expands on and strengthens a number of chronic disease programs already underway in the province. It supports and assists government and community activities that address the common risk factors that lead to chronic disease.

This community-driven initiative is undertaken by Manitoba Health and related departments and the Alliance for Prevention of Chronic Diseases which is made up of the Canadian Diabetes Association, Manitoba/Nunavut Region; Canadian Cancer Society; CancerCare Manitoba; Heart and Stroke Foundation of Manitoba; Kidney Foundation of Canada; the Manitoba Lung Association; Regional Health Authorities; and the regional office of the Public Health Agency of Canada.

Other programs, services and supports that build on and enhance CDPI include:

·         the Regional Diabetes Program,

·         the Renal Health Outreach Program,

·         the Western Health Information Collaborative/Chronic Disease Management Initiative,

·         chronic disease monitoring and surveillance, and

·         the Healthy Living Resource/Institute.

Sale noted a systematic and comprehensive approach to dealing with chronic diseases has been shown to improve the quality of chronic disease prevention, education, care, research and support. This approach requires preventing disease, early detection and modification of the course of disease and optimizing the outcomes.

"Many First Nations people are struggling daily with chronic disease and every effort should be made to improve health outcomes for these individuals, their families and the communities in which they live," said Chief Lorne Cochrane of the Assembly of Manitoba Chiefs.

"When large amounts of health care dollars are being spent to treat chronic diseases, we must begin to focus more on effective prevention and management," said Sale. "We need to implement policies and programs to create supportive environments that promote healthy behaviours as well as educate Manitobans on the importance of healthy eating, physical activity and smoke-free living."

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BACKGROUND INFORMATION

PROGRAM/SERVICES

·         Diabetes: A Manitoba Strategy – The Regional Diabetes Program (RDP) Framework, Chronic Disease Prevention Initiative (CDPI) and the Renal Health Outreach (RHO) have been developed in consultation with more than 1,000 key stakeholders provincewide including Aboriginal representation. Principles for action including partnerships, integration and evidence-based decision making around prevention, education, care, research and support provide the foundation for a Manitoba Diabetes and Chronic Disease Framework.

·         Regional Diabetes Program (RDP) – The Regional Diabetes Program is a comprehensive provincewide public health approach to diabetes prevention, education, care, research and support. RDP responds to the epidemic of Type 2 diabetes among First Nations people and the elderly of all populations. The Diabetes and Chronic Diseases Unit is working collaboratively with regional health authorities, the Manitoba First Nations Diabetes Working Group and the regional offices of the Public Health Agency, Health Canada (First Nations and Inuit Health Branch) and the Canadian Diabetes Association in the implementation of this program. Each regional health authority has developed a three-year implementation plan to be carried out in partnership with First Nation communities.

·         Renal Health Outreach (RHO) – The Renal Health Outreach is a component of the services that are provided in the new Garden Hill/Island Lake Interim Renal Health and Treatment Program. The RHO provides clinical care for the broad range of renal dysfunctions from early chronic kidney disease to imminent end-stage renal disease and renal health promotion through public, health care and patient education. The newly constructed nursing station in Garden Hill which opened in August 2004 includes space to house this initiative. Renal outreach clinics will be scheduled in four neighbouring communities and will be expanded to include two additional high risk northern communities. The model developed in Island Lakes has set the stage for looking at establishing similar programs for other communities in Manitoba.

·         The Western Health Information Collaborative (WHIC) Chronic Disease Management Initiative (CDM) – This multi-year initiative is part of a Primary Health Care Transition Fund multi-jurisdictional collaboration led by the Western Health Information Collaborative (WHIC). This project aligns with other national and provincial primary health care and chronic disease management initiatives to develop an innovative and sustainable Chronic Disease Management Info structure. The Diabetes and Chronic Diseases Unit, Information Systems Branch and Primary Health Care are working collaboratively to plan, implement and evaluate this initiative in Manitoba. 

·         Monitoring and Surveillance – Monitoring and surveillance provides information essential to planning, intervention, research, priority setting, policy development, issue management and risk management. Manitoba Health, regional health authorities and service providers will be required to provide continuous analysis, interpretation and feedback of systematically collected data. 

·         Resource Centre (Institute) – The Healthy Living Resource Centre evolved from a concept first presented by the Alliance for the Prevention of Chronic Disease as part of the CDPI. It is now proposed that Manitoba Health, the Alliance and other partners work together to expand the concept such that it can support a wide variety of healthy living and prevention-oriented initiatives throughout the province including physical activity, healthy eating and disease prevention and also injury prevention, tobacco and substance abuse reduction, healthy sexuality and mental health promotion.

CHRONIC DISEASE STATISITICS

·         Chronic conditions are the major cause of illness, disability and death in Canada. In 1997, there were a total of 215,669 deaths in Canada with more than 75 per cent of the deaths attributable to one of the following five chronic diseases: cancer, cardiovascular disease, diabetes, kidney disease and respiratory disease (Health Canada, 1997).

·         The total number of Manitobans living with diabetes was approximately 63,000 in 2001. Approximately 6,000 new cases are diagnosed annually. This translates into a provincial prevalence rate of 7.5 per cent.

·         Manitoba’s aging population will further drive up the number of people living with Type 2 diabetes.

·         First Nations people show a high incidence of Type 2 diabetes and chronic diseases. The rate of First Nations people living with Type 2 diabetes is approximately four times higher than the rate for all other Manitobans (greater than 20 per cent prevalence rate).

·         The rates of diabetes complications, including lower limb amputations and renal failure, are much higher in Manitoba First Nations people than in the rest of the population living with diabetes.

·         In some regions one in two First Nations individuals aged 50 and up have Type 2 diabetes.

·         First Nations people are diagnosed with Type 2 diabetes at a younger age and may have the disease for a longer duration.