Health Promotion

Health Promotion: A New Mandate for CSIM

Norm Campbell, MD, Don Echenberg, MD, Bert Govig, MD, Akbar Panju, MBChB, for the CSIM Health Promotion Committee

About the Authors

Norm Campbell is a professor of medicine at the University of Calgary, Calgary, Alberta, and the president of Blood Pressure Canada. Donald Echenberg is the immediate past president of CSIM and a professor of medicine at the University of Sherbrooke, Sherbrooke, Quebec. Bert Govig is the president of CSIM and the founder of the Coalition for the Acquisition of Sound Habits – CASH; he practises in Amos, Quebec. Akbar Panju is a past president of CSIM and the current vice-president of Health Promotion for CSIM. He is a professor of medicine at McMaster University, Hamilton, Ontario.

The CSIM Health Promotion Interest Group was founded in 2005 at our national meeting in Toronto, Ontario. It became apparent that this struck a chord with many of our members; and in 2007, the Interest Group was upgraded to a CSIM Committee. Here we review existing CSIM initiatives in the domains of preventive medicine, public health, and medical education, and we report on our progress and future plans.

Collaboration for Salt-Reducing Strategies

In 2007, based on advice from the Health Promotion Committee, we signed a Blood Pressure Canada policy statement calling for the following:

•          The food sector to reduce sodium additives to food

•          The federal government to oversee a reduction in dietary sodium through policy and education

•          Health care professional and scientific organizations to educate their membership and the public on the health risks of high dietary sodium

A great deal has happened since then. Statistics Canada prioritized the analysis of dietary sodium in the national food survey (CCHS 3.1 2005) and issued a media release stating that a large majority of Canadians consume an unhealthy amount of salt. A National Sodium Strategic Planning Committee (SSPC) of eight national health care organizations was formed to develop strategies for the health care sector to advocate for a lower intake of dietary sodium in Canada. Blood Pressure Canada has a grant from the Public Health Agency of Canada to support this objective. The Canadian Stroke Network has also embraced this initiative as its major focus for stroke prevention. The Canadian Stroke Network, the Heart and Stroke Foundation of Canada, and the government of Canada have issued several statements to the media on dietary sodium in an attempt to increase public awareness. Notably, the Canadian Stroke Network has recently created a sodium website (www.sodium101.ca), and the Heart and Stroke Foundation of Canada has revised its Health Check program to be more stringent with regard to the sodium content of foods eligible for the label. Several national organizations have organized talks, workshops, or symposia on this topic. With the support of Food and Consumer Products Canada (a major umbrella group for food manufacturers), the government of Canada has struck a Health Canada Multi-Sectoral Work Group to oversee a reduction in dietary sodium to recommended levels.

What does the CSIM need to do next? While Canadian action seems impressive, it is unlikely to have had much impact. Given that 80% of sodium in our food is there as a result of food processing, we need to continue to play an active advocacy role. We must encourage the Health Canada Work Group to report in a timely fashion and to act decisively.  

If successful, this effort could reduce cardiovascular events in Canada by 13% and save about $2 billion a year in health care expenses.

Collaboration for Improving Public Nutrition

In 2008, CSIM endorsed a healthy nutrition intervention administered by the Coalition for the Acquisition of Sound Habits (CASH), a Canadian health promotion charity. CASH promotes community organization for health, and favours an environmental approach to promoting healthy lifestyles. A randomized controlled trial study design was used to evaluate a nutrition intervention in 30 participating arenas in Quebec, Ontario, and New Brunswick. All sites were evaluated using pre-established criteria to assess various elements of the nutrition environment. The results of this study are under analysis, and the intervention has been opened up to other arenas. Currently, 47 arenas in Quebec, Ontario, and New Brunswick participate in this project, and more are added on a monthly basis. CASH, the sponsoring organization of this intervention, is currently developing similar tools for use in other settings including daycares, schools, hospitals, events, and conferences. CSIM members can learn of opportunities to participate in future interventions on our website, in our journal, and at www.soundhabits.org.

CSIM’s Healthy Meeting Policy

Our annual meeting Planning Committee has made an effort over the past 5 years to develop healthy practices. We offer more nutritious meals and snacks, and limit unhealthy food alternatives. We incorporate time for early morning runs and walks and understand the importance of dedicated time for networking, socializing, and simply relaxing.

In late 2008, after 4 years of promoting a healthy meeting on an ad hoc basis, the Health Promotion Committee created a standing policy to underscore our commitment to these objectives. We invite your comments on this statement (see below): tell us how you feel we are doing.

In the Works

Our Health Promotion Committee continues to develop new initiatives and interventions. For example, we recognize that on-call practices vary widely across Canada and have important implications both for patient safety and for physician health and well-being. Work has begun to create a national dialogue on this subject. For an update, watch this space!

CSIM Healthy Meeting Commitment

CSIM recognizes health promotion and health advocacy as a core value and skill set of general internal medicine, and we recognize the responsibility we have to our members and to society in general to promote health in every aspect of the CSIM’s activities.

CSIM commits to playing an active role in promoting healthy lifestyles at CSIM events by working in collaboration with relevant partners to create environments conducive to healthy choices. This commitment includes but is not limited to promoting access to healthy food, daily physical activity, smoke-free environments, positive social interactions, healthy sleep patterns, and work-life balance.

Where possible and appropriate, CSIM will also work to promote policies and practices that are environmentally sustainable and will attempt to use electronic forms of communication and documentation to promote active transport and mass transport and to promote recycling and the parsimonious consumption of polluting and nonrenewable resources.

Article Citation: Campbell N, Echenberg D, Govig B, Panju A. Health promotion: A new mandate for CSIM. Can J Gen Intern Med 2009;4(2):85-86