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As devastating as it is, the COVID-19 pandemic has opened the door to new ideas for preventing chronic illness and minimizing its rise.
“Just look at what has happened during the pandemic. We have seen scientists and experts come together to tackle a problem quickly,” says Dr. Linda Rabeneck, vice-president of prevention and cancer control for clinical institutes and quality programs at Ontario Health.
“We can use that same kind of energy to solve the problem of chronic disease if we come together and put our minds and resources towards this.”
Dr. Rabeneck’s comments were made during an experts’ panel discussion at a recent conference called Preventive Measures: Curbing the Rise of Chronic Illness in Canada. The conference was presented by The Globe and Mail and hosted by health reporter and columnist André Picard.
The experts, drawn from a wide range of medical and health policy disciplines, agreed that the pandemic has revealed Canada’s deep deficiencies in efforts to combat chronic illness. At the same time, the upheaval caused by COVID-19 has offered new insights and pointed to where more effort is needed.
For example, diabetes rates are going down in parts of Canada where communities are walkable and have healthy food available as opposed to suburbanized areas where people must drive for everything, says Dr. Gillian Booth, scientist, MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital.
The maps of where people are at most risk from COVID-19 correspond to lower-income and racialized communities, and this is the same pattern for chronic disease such as diabetes, says Paul Bailey, executive director of the Black Health Alliance.
“COVID has shone a light on these social determinants, and if we’re going to really make a dent, we have to go beyond the statistics and pay attention to peoples’ stories and experiences,” he says.
Dr. Booth adds: “The pandemic has us talking about the social determinants of health. We see on the news that if you live in a multigenerational household or provide an essential service, you are at greater risk.”
“These same social determinants for COVID apply to chronic diseases and we should be mindful of their impact,” she says.
Dr. Lisa Richardson, strategic adviser, Indigenous health at the University of Toronto’s Faculty of Medicine, agreed that it’s important “to look at the big picture.” The most significant factor predicting chronic illness among Indigenous people is the degree to which they have their own control. Some of Canada’s more than 600 Indigenous communities have a lot of autonomy in making decisions about health and health care; others are more beholden to outsiders, such as federal, provincial or territorial health officials, she says.
“First Nations in Canada are three times more likely to experience diabetes than other populations, yet the communities with the most degree of self-determination have the best health outcomes,” she says, adding that it makes a difference when a community makes its own decisions, such as managing its own social programs and choosing where kids go to school.
COVID-19 has also pulled back the curtain on economic disparities, enabling governments to boost spending dramatically on public health, says Jeffrey Cyr, managing partner of Raven Indigenous Capital Partners, which works with Indigenous entrepreneurs.
“It shows that, when the will is there, you can dig deep for public-health action,” he says. “Collective action by government can change outcomes for peoples’ lives, and it can build community health resilience.”
This kind of action should speed up progress on community health, he added: “It shouldn’t take 55 years to have clean water on reserves.”
Clinical psychologist Dr. Dayna Lee-Baggley, assistant professor with the department of family medicine at Dalhousie University, says “COVID has shown us how incredibly creative, resilient and adaptive we can be.”
“We made all kinds of changes almost overnight that people said would never happen,” she says, “and that gives us all kinds of possibilities for tackling not just chronic disease but also even larger issues, such as access to mental-health care.”