Tuesday, November 29, 2011

Thank you!

Dear Supporters, I don’t like losing one bit, but my mayoral campaign felt like a victory of sorts – and that’s what many people have told me since my 2011 run for Saanich Mayor.

On the numbers, we were short by about 1500 votes, yet we got nearly ten thousand people moving in a progressive direction. That’s new in Saanich! The incumbent won (as tends to happen municipally), but got less votes then he did in the previous election.

A Snap-shot of E-Day at the Cubbs HQ
In addition, we moved participation from one-in-five to one-in-four, and we got virtually all of the new voters. This shows there’s latent appetite for change, and that it can be galvanized.

We need to be more competitive in the air, where we were outgunned by costly advertising: big signs, large newspaper ads, glitzy brochures, TV advertising, and the consolidation of support a slate provides to a mayoral campaign.
Where we won was on the ground – on the doorstep, in the remarkable volunteer effort and in the community response. Not enough, but powerful and very encouraging for the future.
I’m proud of putting a real platform in front of voters. That’s never happened in Saanich before! We focused on real issues: from Uptown and civic engagement in planning our future, to transit, farming and a senior-friendly community.
The spotlight we shone on the devastation of Babe’s Honey was the push needed for the province to finally okay a ground-breaking bylaw. It had been sitting on the Ministers desk but as our campaign focused on the issue and got the media asking tough questions, change suddenly happened and now municipalities can regulate fill-dumping on agricultural land.
To those who voted for me: thank you! 45% of Saanich voted for change and that should send a strong message to those in power.

I want to especially thank each and every one of my supporters for giving me the best campaign experience in over two decades in public life. I can’t thank my all-volunteer campaign team enough for their dedication, creativity and support. And special thanks to my campaign manager, Samuel Godfrey, for his professionalism and dedication, and for skillfully orchestrating the work of our superb team.

Let me end by congratulating the newly-elected Mayor and Council. You have taken on an important and challenging civic duty and I wish you all the very best.


Sunday, September 18, 2011

We can do better in Saanich

Dear Friends,

As you know, I’m running for Mayor of Saanich and gearing up for elections that are coming up fast. It’s a big undertaking and I need your help to get there!

For more information or to find out how to get involved, please visit my campaign website! www.cubbs4mayor.ca

I’m running for Mayor because I think Saanich needs a leader who recognizes that our quality of life depends on how well we shape growth and manage our mobility.

We need to diversify our mobility choices, but instead we see a growing disconnect between land use and transportation. At our largest commercial development ever, situated on a key transit corridor at the region’s hub, transit was left out entirely. Clearly we missed a key opportunity. I believe we have to do better.

Having served as a Councilor and Saanich MLA, I’m strongly connected to this community and I share its desire to grow more sustainably. Saanich has pledged to reduce its carbon footprint, and endorsed a vision for growth based on mixed-use centres served by quality transit, cycling and walking corridors. Yet this vision seems mostly lost in translation. As your Mayor, I will work to reconnect our vision to concrete actions consistent with our growth management strategy.

While Saanich is progressive in many areas – like providing parks and playing fields – the walking environment isn’t one of them. Sidewalks are often rudimentary or non-existent, even on major roads and around some schools. Our community plans speak of priority improvements, but Saanich has been slow to move on them. As traffic congestion builds and our community ages, the need for safe, attractive walking environments only grows. I think we can do better.

Traffic and transit issues will always be prominent in Saanich, as much of the region moves through our community daily. We have no choice but to be leaders in managing impacts and diversifying choice, but too often we seem to shy away from challenges. Whether it’s safety at Sayward Road, congestion at McKenzie/Admirals, or moving forward on a rapid transit system that gives commuters an attractive choice, we seem to want to put our heads in the sand. There’s no magic bullet for transportation issues – but there are opportunities to build partnerships with senior governments to invest in alternatives that get us moving while shrinking our carbon footprint. I think we should be seizing those opportunities when they appear. I’m convinced that we can do much better!

I’m asking for your support for Saanich Mayor this November. I believe it’s time for a change, and I’m hoping you’ll agree. My campaign website is here: www.cubbs4mayor.ca

Thank you, 


David Cubberley

Monday, June 6, 2011

Join me on Tuesday June 14....

Dear Friends,

Please join me at noon this Tuesday, June the 14th, for an important announcement about local government in Saanich.

I’m hosting an informal gathering at Rutledge Park – with refreshments, lively atmosphere…and a pithy speech.

We’re now just five months away from the next municipal election. Our choice affects every aspect of our community and region – from the importance of environmental stewardship to leadership on regional issues, from the taxes we pay and quality of services delivered to the degree of citizen engagement.

Like many, I think there’s room for improvement on the big issues facing Saanich – like shaping growth, managing traffic impacts, improving walkability, and building rapid transit.

I think it’s time for a change, because I’m certain we can do better.

Join me on Tuesday and I’ll fill you in on the details.


David Cubberley
Former Saanich Councillor and MLA

PS. Rutledge park is on Cloverdale Avenue, just East of Blanshard. Click here for a map.

Thursday, March 24, 2011

Funding the full ounce of prevention

News that our Health Ministers are ready to ‘dialogue’ on the threat of rising obesity drew groans from experts who’ve been demanding action for many years.

Canadians have been porking up for decades – nearly two-thirds of us are now either overweight or obese (O/O). Coupled with a sedentary lifestyle, this energy imbalance is causing disease and sending healthcare costs skyward.

In the twenty-five years from 1980 - 2005, O/O rose to 65% of males and 53.4% of females (up ten percent each). This growth of girth parallels a rise in our daily salt intake (fast foods) and sugar consumption (syrupy pop).

Even more alarming, in the same timeframe O/O among children aged six to seventeen has more than doubled, with girls (25%) and boys (27%) bulking up at similar rates.

One result is the meteoric rise of late-onset (type two) diabetes and its appearance among children, a development with huge implications for public health. Type-two diabetes (TTD) is a lifestyle disease resulting from the body’s inability to handle the high glycemic load dumped into it daily by processed foods.

Glycemic overload results from putting too much fatty, salted, sugary, energy-dense and nutrient-empty food into a body that’s sedentary. The result is a condition that over time ruins a person’s health, prompting outcomes like heart disease, cancer, blindness, amputations, and finally kidney failure.

In 2006, while serving as provincial health critic, I learned from a report done by our provincial health officer that there were some 220,000 British Columbians living with type-two diabetes (TTD). A mere five years later, we are already up to 338,000 living with TTD, and we are forecast to reach 548,000 by 2020!

That would be over ten percent of our population in 2020 living with a life-threatening lifestyle disease. The good news is, it’s largely preventable. The bad news is, we’re still not doing anything to prevent it.

Experts and advocates are calling for change in two general directions.

First, we need to recognize that diabetes develops from obesity and physical inactivity in combination. Our physiological decline is caused by environmental factors that are susceptible of change: too much energy in, not enough energy out.

The physical environment we inhabit needs strategic modification – we are simply too dependent on cars for transport. So much so that the way we’ve arranged our work and home lives, and our ways of getting between, makes weight gain difficult to avoid.

Modifying our built environment to enable more exercise, especially of the kind incidental to transport, is a key way to reduce population weight gain. Societies that provide more safe and appealing walking and cycling infrastructures achieve significantly higher levels of daily physical activity.

Modifying our physical environment needs to be done at a regional and local scale, led by local governments working with new funds from senior governments. Coupled with more greenspace closer to home and work, and linear greenways linking both, more people will be attracted to walk and cycle.

Think for example of the impact the Galloping Goose has had on travel choices in the Capital Region. It serves as an incubator for walking and cycling trips, both for commuting and as travel to non-work destinations.

Overall we need to build more compact, complete communities as we densify around urban nodes, and link those nodes with sustainable transport. The evidence is robust that where such infrastructures are provided, people are much more likely to walk and cycle daily. Moderate regular exercise is the single best preventive against all causes of disease and mortality.

Currently, nearly all costs for making cities more walkable and bikeable fall to the local property tax base. Transit upgrades similarly fall on local sources in the CRD (currently about 70% of all costs).

As property tax is over-stressed already, progress in retrofitting our cities for sustainable mobility is very slow. Senior governments, who collect 92 cents of every dollar of taxation, need to invest earmarked funding in retrofitting cities for walking, cycling and rapid transit use.

A second policy direction to prioritize is gradual modification of our food environment, putting new emphasis on fresh and local, and de-emphasizing salty carbohydrates and sugary drinks. There’s a compelling need to mandate reductions in salt use in industrial and restaurant foods (80% of our salt intake is from prepared foods). There should also be front-of-package labeling of calorie, sugar and salt loads in all food products.

These are both non-cost policy changes that will beneficially modify diet and enable consumers to make more discerning food choices. Recently the federal government dissolved its expert salt taskforce, which was to have developed a national salt-reduction strategy. Wrong direction Ottawa! The mandate is fitness, not fatness.

Taxation on sugar-sweetened beverages is a tool available to policy makers. It could both curb consumption and provide a revenue stream for investing in modifications of our physical environment.

But why pick on pop? Because pop is one of the bigger culprits in societal weight gain – while our consumption has ‘leveled off’ at about 72 litres a year per person, many people ingest a can or more a day (!!). A single can of pop contains 39 grams of sugar, or about ten teaspoons worth! It would take over an hour of vigorous physical activity to neutralize the calories in a single can.

Kids are prone to pop addiction. According to StatsCan research, 50 percent of 15-year-old males recalled having a soft drink in the previous 24 hours, with the average serving size being 700 ml. As Victoria’s Dr. Tom Warshawski points out, doing that just twice a week gets you to 72 litres a year.

Recent polling showed that 70% of British Columbians supported a tax on sugar if the proceeds were invested in health promotion. I’d amend ‘promotion’ to read, if the proceeds are invested in modifications to our food and urban environments so that we can make healthier, more active choices more easily.

What we don’t need is Participaction 3.0. No offense, but if you don’t create new opportunities for people to use their legs as part of daily life, you’ll never get the numbers to dance. And that goes double for cycling – without safe, convenient bikelanes and trails, people won’t feel attracted to the activity. But if you build it, they will come.

There’s a lot to learn from Europe:
  • Finland moderated its salt consumption and reduced its incidence of heart attacks and strokes dramatically.
  • Over half of Dutch and German elders get around by walking or cycling, while in the USA it’s a mere six percent.
  • In Copenhagen, nearly fifty percent of commuter travel is by bicycle, a phenomenon that has happened solely by choice with the provision of safer cycling environments.
Then there’s the great policy crossover, between what we need to do to reduce greenhouse gas emissions and what we have to do to get ourselves moving – turns out they’re identical!

Targetted investments in walking, cycling and zero-emission rapid transit will both reduce daily carbon emissions and raise daily exercise levels. Remember, every transit trip involves two short walk trips.

Our greatest challenge lies in blowing past the ingrained pessimism of professional politicians. The B.C. legislature has unanimously endorsed a strategy to address childhood obesity and physical inactivity. That was back in 2007, and the strategy has been collecting dust on a shelf ever since.

But Type Two Diabetes hasn’t stood still, adding 110,000 new victims since the politicians pledged to act. B.C.’s direct healthcare costs from TTD are rising rapidly, at $1.3-billion last year, rising to over $1.9-billion by 2015.

A public health strategy to address obesity by modifying our physical environment in ways that predispose more walking and cycling is feasible and long overdue. It would also not cost that much to implement: two capital funds earmarked for walking and cycling, each with $25-million annually to invest in cost-sharing of mobility retrofits in cities and towns.

Transit could be scaled up rapidly by dedicating existing and future carbon tax revenues, as well has having senior governments devolve some of the motor fuel taxes collected currently at the pump.

In 2006, the BC Standing Committee on Health estimated that ending the tax exemptions on candy, confections and soda pop would generate $40 - $45-million a year in new tax revenues.

This step alone could finance the investment stream for retrofitting infrastructure in our cities.

Is it time to Act Now and fund the full ounce of prevention? Or will we continue whistling Dixie instead?

John Pucher's Making Walking and Cycling Safer, Lessons from Europe is at: http://www.transporteativo.org.br/site/Banco/7manuais/VTPIpuchertq.pdf

A Strategy for Combatting Childhood Obesity and Physical Inactivity in British Columbia: http://www.leg.bc.ca/cmt/38thparl/session-2/health/reports/Rpt-Health-38-2-29Nov2006.pdf

Monday, November 9, 2009

Dignified Goodbyes

We all have to die when our time comes, that much we know. What’s unknown is the ‘when’ and ‘how’ of it, especially the ‘how long’ of dying, until it actually happens. Unless of course we decide to take matters into our own hands and effect our own end, which we’re allowed to do.

Some lucky people get to die in their sleep, something most of us hope for. I had an aunt who’s said to have sighed gently and slipped away while sleeping. I much prefer that to the image of my mother’s last weeks in a hospital bed, ravaged by a terminal cancer that wouldn’t stop tormenting her poor body. Hers was an end that wasn’t kind and might have been spared.

If to be unaware of passing away is deemed by most a good death, next best would be choosing the moment in a manner that mimicked, so far as possible, a gentle way of passing. That’s a scenario not currently available to most of us, a situation many feel we need to change.

Choosing the moment of our own dying is a right under Canadian law, if only in the sense that taking your own life is not a criminal act. Counselling or trying to convince someone to commit suicide is a crime, and so it should be in my view. Death isn’t a choice to be urged or forced upon anyone.

However, assisting someone who wishes to end life is also currently a crime, in every circumstance, for doctors or anyone else. That’s where significant change is long overdue.

Individuals today have a right to take their own life, but no right to a gentle way of doing it. Society, via controlled substances legislation and the prohibition on doctors assisting, has put a lock on all the gentle ways of dying. Individuals are left with an array of ugly methods of ending their lives.
It’s perhaps not surprising that in the USA, where hand-guns abound, this is the principal way that people take themselves out. What a repulsive option for humane, caring individuals who only wish to end their suffering!

Here in less-well-armed Canada, males opt for hanging first by far, with firearms a distant second. Females overwhelmingly opt to poison themselves. Women it seems are less able to marshal the aggression to pull a trigger or risk the agony of hanging. No one should have to.

Clearly, restricting people to ugly, uncertain choices deters some, which is what the law seems to intend. Some may see this as good because they'd like the right of suicide removed entirely. I'm not one of them, and chances are you aren't either. We want to see the right to a dignified exit enshrined in law.

For many people, current law removes the option of choosing to end life without inflicting terrible distress on loved ones. For those with terminal illness, who may be forced to endure horrific pain, loss of control, and no quality of life, the prohibition on a compassionate end seems a form of violence itself - a death sentence preceeded by indefinite torment.

Victorians know this scenario intimately through the life of Saanich's Sue Rodriguez, victim of an incurable disease known as amyotrophic lateral sclerosis (ALS). As her muscles failed and she lost control of body functions, including swallowing and speech, she petitioned the courts to allow a doctor to help her die with dignity. Clearly she was unable to exercise her right to commit suicide because she was physically incapable of doing it herself.

While the Supreme Court of Canada came close to saying yes (a five-four decision) sadly the status quo prevailed. That was fifteen years ago and nothing has changed, except public opinion. Canadians overwhelmingly support physician-assisted suicide in defined circumstances, like terminal illness, with appropriate safeguards.

During B.C.'s 2007 Conversation on Health, physician-assisted dying was "a frequent topic of discussion related to end-of-life care". "Many participants are in favour of instituting a process to allow euthanasia or assisted suicide, suggesting this would allow people to die with dignity". The Legislature has so far taken no public position on assisted dying, despite the wishes of its citizens.

Some still believe it would be morally wrong to allow any access to a gentle, dignified way of dying. They feel any provision to enable people to die at a time of their own choosing would somehow see the elderly, the infirm and the disabled pressured into agreeing to take their own lives. Just how one leads to the other isn't stated, only that it's a 'slippery slope'. And this intense belief has tended to stymie any initiative to change the status quo.

But I think we're coming to a time of decision with regard to personal choice for a dignified ending of life. There are signs of an emerging resolve on the public's part to see the issue addressed, especially in defined situations like terminal illness. Here on the west coast, where Sue Rodriguez was a public figure, where neighouring Oregon's Dying with Dignity Law demonstrates how safeguards can work, there's strong sentiment in favour of change.

Many believe it's ethically wrong to force someone dying slowly in great pain to simply tough it out. Yes palliative care should always be available and still isn't, as should hospice, to enable those who can to hang on until disease runs its full course. But we must face what most doctors recognize: palliation of suffering may be ineffectual at the higher reaches of pain, and the agony of lost autonomy and dignity can lead people to want to go.

It's time we recognized individual choice in the matter and ensured a humane and compassionate way to exercise it.

Ask yourself, why shouldn't someone be allowed to go gently with dignity? Quelling suffering is a principal motivation of all medicine, all nursing, all palliative care. When care is no longer restorative and pain reaches unbearable levels, quelling suffering may actually mean ending life. Why shouldn't someone be allowed to make that choice without abandoning dignity?

Since 1997, Oregon has allowed individuals with a terminal illness and less than six months to live to choose their time of dying. The sky hasn't fallen, elders and the infirm aren't being set adrift on ice flows. Last year 88 people obtained a doctor's prescription for pento- or secobarbital sufficient to carry them off. A quarter didn't ever use the drug, the comfort of knowing they had an emergency exit being enough to see it through.

Eighty percent of those making the choice of assisted dying had terminal cancer. The reasons given for choosing to end their own life aren't surprising: loss of personal autonomy (95%), inability to participate in life (92%), and loss of personal dignity (92%).

Here's what Canadian ALS sufferer Virginie Bijon says of living with her terminal illness: "I keep track of the disease's progress by what I can no longer do - walk, feed myself, speak. My body is a prison." And: "I feel in prison in this useless body of mine, and the silence isolates me from those I love. I am scared for this last leg and I pray it will be short...I long for the end for my spirit will be free at last."

Virginie Bijon shouldn't be forced to dwell in prison. She isn't petitioning for the right to end her own life, but the suffering, fear and indignity of her situation argue strongly that she should have it. Anyone in her situation should have the right to a dignified ending. She may choose not to exercise it, but she should have it.

It matters to us as individuals, majoritarily, to have the right to a gentler end than gun violence, hanging, or under-the-sink chemicals. It needs to matter equally to our legislators, at every level. The time is nigh to modify the criminal code to make it legal for terminally ill people (at the very least) to have a dignified exit.

A 2007 Ipsos Reid poll showed 76% of Canadians supported changing criminal law to allow for physician-assisted dying. Last month an Environics poll, commissioned by those against assisted dying and invoking the possibility of pressure on the elderly and disabled to go, showed 61% of Canadians and 75% of Quebecers still approved of assisted dying despite concerns. Recently Quebec doctors came out 75% in favour of decriminalizing assistance in terminal cases. These polls point to a strong underlying concensus in favour of change that legislators should to pay attention to.

A private member's bill - C-384 - now before the House of Commons would legalize physician-assisted dying for the terminally ill, among other things. MP Francine Lalonde's bill proposes fully establishing rights to a dignified exit for people with unrelievable suffering, so confronts the more challenging angle of allowing nearly anyone to go when they wish.

This may give parliamentarians an excuse not to take the bill seriously, because it raises the stakes so high all at once. Legislators reluctant to discuss any right to die publicly may not rise easily to this debate.

However, there are recent signs of openness to getting this discussion out in the open at last. Conservative MP Stephen Fletcher, a C-4 quadriplegic who suffered traumatically after his disabling accident, wrote a National Post editorial entitled "Make life the first choice, but not the only choice." While he personally found a way through his living nightmare, he emerged with a strong belief that people should not be "forced to live in pain that is truly intolerable".

His key criterion is whether the prospect of a quality of life and level of dignity sufficient to sustain the will to live is attainable. If not, people should have a compassionate choice.

Stephen Fletcher's life is now bearable, yet he has a living will that directs euthanasia in certain circumstances. "Unfortunately, the euthanasia provisions in my living will may not be binding or enforceable, which is why I agree that changes should be considered to our current law".

"I do not want to be forced to live in a hell because the law does not take into account my 'unique' circumstances or because someone imposed their values on the meaning of life on me. Given the choice of existence without living or death, I would rather choose the latter and take my chances on the other side."

He concludes by saying he will abstain on Bill C-384 rather than vote against it, because while it "is flawed...I cannot vote against empowering Canadians to make deeply personal choices for themselves". Here is a brave and compassionate person advocating for personal choice in dying when pain becomes intolerable.

Another omen of change, from within the historically conservative ranks of medicine, is the recent position taken by the Quebec College of Physicians and Surgeons. The CMQ became the first medical body to urge that the criminal code be changed to allow doctors to take the lives of patients "facing imminent death".

The CMQ "embraces the point of view of the patient confronting imminent and inevitable death", who it believes should have the right to die without "undue suffering and with dignity". It clearly acknowledges that palliation cannot quell all suffering.

"We're saying death can be an appropriate type of care in certain circumstances".

Many believe it's time we had this debate in the open and feel that Francine Lalonde's Bill C-384 can be a catalyst for change. Canadians may not be ready yet to go the whole distance it proposes, but a progressive majority in the House could amend it to provide the option to the terminally ill forthwith. There's no coherent argument against enshrining this right.

The remaining provisions could be referred to an all-party parliamentary committee charged with consulting Canadians, reviewing provisions, and making recommendations to a future sitting of the House.

Canadians are, I believe, very interested in having this discussion. Bringing it out from under the blanket of silence thrown over assisted dying is long overdue. My own generation, the baby boomers, are having direct experience of protracted suffering with parents and friends. We want to see change, now, beginning with rights for the terminally ill.

Strange things can happen in a minority Parliament. Wouldn't it be a boon if something the public clearly wants done could be achieved by the majority in the House of Commons?

If you want to let your legislators know your views on physician-assisted dying, click on the attached finders and drop them a line.

Your Members of Parliament:

Your Members of the Legislative Assembly of British Columbia:

Wednesday, July 8, 2009

Prevention is the real cure

I came upon an interesting news item last week, on a day when I'd been thinking about the 'diabesity' epidemic rolling across North America and the absence of any new public health initiatives targetting this reversible 'lifestyle' disease.

"Spending on heart drugs growing fast" was the headline. A new study revealed that spending on cardiovascular drugs to prevent and treat heart attacks and strokes had jumped 200% between 1996 and 2006! Statins, a class of drug routinely prescribed to lower cholesterol, now account for 40% of the over $5-billion spent yearly on heart medications.

Prescription drug spending, by the way, is the fastest rising component of our public healthcare spending, and has been for a long time. Healthcare spending is increasingly an issue in politics, especially for parties of the right like the B.C. Liberals, who tell us we can't afford to fund the system we have today into the future.

The principal causes of high cholesterol are the same culprits behind the shocking rise in type two diabetes, which snares over 20,000 BCers every year: poor diet and physical inactivity. We just eat way too much junk food, sugar and salt, and sit too long on our butts distracted by electronics rather than moving about.

Our public policy response to date is typical - we 'medicalize' the syndrome resulting from poor lifestyle choices and absorb the impact via rising healthcare costs. But we don't intervene to increase activity levels and improve dietary choices, which would effectively reduce the amount of illness showing up and over time decrease sickness spending.

Doctors are trained to issue drug prescriptions for the syndromes that precede illness, like high cholesterol. In a well-intentioned way they're trying to prevent incidents, like strokes, that cripple people for life. But these drugs enable the poor lifestyle choices to continue and healthcare walks blindly past prevention, its natural power tool. And doctors rarely prescribe more exercise and better diet.

Meanwhile, politicians of all stripes prattle on about soaring costs - whether from the perspective that we cannot afford to keep paying, or from the perspective we must find the way to keep paying. Either way, no one proposes effective interventions that would change lives and reduce the incidence of disease.

This is a curious conundrum. Take Type Two Diabetes for example - over 220,000 in BC live with TTD and its complications; more than 20,000 are added annually, and costs rise by about $75-million a year for this preventable lifestyle disease alone. Obviously this isn't sustainable, certainly not in times when revenues to the Crown evaporate due to economic recession.

We value our public healthcare system because it's there when we need it, without regard for our ability to personally pay. That's important, because sooner or later 'events' require interventions in a life to preserve and extend it.

But our healthcare providers are focussed on sickness cure, stabilizing individual lives by heroic interventions. They rarely if ever formulate plans to intervene to prevent illness from ever happening.

And yet, almost all the advances in the life expectancy of individuals have come from well-designed public health initiatives - from clean drinking water to smoking cessation. Drugs and heroic interventions still save those not protected by preventive measures, but the big gains come from prevention.

We're seeing massive growth of lifestyle diseases due to identifiable factors: eg, industrial fast foods and sedentary living. These are reversible if society, via politics, takes steps to reshape the environmental conditions that cause them.

Americans today consume on average 300 calories per day more than they did 20 years ago. If eating one additional jellybean per day adds a pound a year (or ten in a decade!), think what 300 calories a day do to manufacture obesity and predispose inactivity!

The goal should be to return the vast majority of us to a daily balance, where calories 'in' equate to energy 'out', rather than posting a continuing surplus. How we do that means looking to underlying conditions, like how our communities and the roads linking our neighbourhoods to work, school and services are designed. Or looking at the way industrial foods are formulated, using too much sugar, salt, fats and carbs, and taking steps to reduce these ingredients.

Interventions at this scale - to make daily walking, for example, more convenient and attractive, or daily diet more nutritious and less toxic - will over time reduce the incidence of 'metabolic syndrome', which precedes lifestyle diseases.

It's absolutely true that we need a pool of money to physically rejig our living spaces to predispose more exercise - but a lot of that money is already collected and misspent on the wrong priorities. Think of all the fuel taxes collected at the pump for vehicle travel - why isn't some of that earmarked for the physical redesign of our cities? What about the feds grabbing ten cents a litre plus GST - why shouldn't that be used to improve community design, promote active transport, and reduce healthcare costs over time?

Many such public health initiatives will pay for themselves over time, because they prevent illness and debility we'd otherwise pay for under health and other social programs. They also keep people working and families whole.

My blood boils when I read about escalating healthcare costs and then hear politicians rabbiting on about whether we can or can't afford to pay. How about focussing on interventions that reduce the incidence of illness - try that tack for a while instead of indulging your political ADD.

Say, if you don't have any ideas of your own, just give me a call. I and a couple of friends can generate a half dozen effective interventions pronto. Go ahead, call my bluff!

Tuesday, June 30, 2009

Thoreau's Relevance

'None are so old as those who have outlived enthusiasm.'