TORONTO — A new landmark report, Population Health in Canada’s Largest Cities, released today assesses differences in the cancer risks of populations in Canada’s largest cities. Led by the Canadian Partnership Against Cancer, the report finds that western municipalities overall have healthier lifestyles than their eastern counterparts, and better cancer risk profiles as a result.
Population Health in Canada’s Largest Cities presents indicators for selected cancer risk factors including tobacco use and exposure, physical activity, obesity, alcohol and fruit and vegetable consumption. The report also includes information on the percentage of Canadians in each of the featured cities reporting up-to-date cancer screening for colorectal, breast and cervical cancers.
“The Government of Canada recognizes that cancer is a major health issue for Canadians,” said the Honourable Rona Ambrose, Minister of Health. “Leading a healthier, active lifestyle plays an important role in reducing the risk of many forms of cancer. Additionally, detecting cancer early through appropriate screening can save lives.”
Typically, the prevalence of chronic disease risk factors is measured and reported at the provincial or territorial level. But there’s value in taking a close look at indicators at the local municipal level. Banning smoking on city property, or providing access to bike paths, or keeping junk food out of public schools are some ways municipal governments can influence the health of Canadians and reduce their cancer risk.
“Canadians can affect their own cancer risk by making healthier choices like eliminating tobacco use, healthy eating, and being active,” said Dr. Heather Bryant, vice-president, cancer control at the Canadian Partnership Against Cancer. “But, at the same time, we should acknowledge that public health policies play an important role in creating supportive environments for individuals to make these healthy choices. Studies like this one are intended to encourage conversations and show where we could work together effectively to benefit Canadians.”
Variation within provinces: a tale of two cities…or more
While economic, cultural and social variations have considerable influence on cancer risk, this report has shown that even cities with comparable socioeconomic profiles can have very different risk profiles perhaps partly as a result of different policy and planning. For example in Ontario, Hamilton ranks in the top ten for reduced second-hand smoke exposure in public places, while Oshawa ranks in the bottom five. Hamilton has bylaws in place to limit second-hand smoke exposure, while Oshawa does not. Similarly, Saskatoon has crafted bylaws that go beyond provincial legislation to limit second-hand smoke exposure in public places. It now has the lowest rate of exposure in the country. The rate in Regina is more than twice as high at 12%.
In Alberta, Calgary ranks in the top third of most indicators related to prevention, while Edmonton ranks in the middle or bottom third. In British Columbia, residents of Victoria report that they are significantly more active than their Vancouver neighbours but a higher proportion of them report drinking beyond the recommended guidelines relative to Vancouver residents.
In Ontario, Toronto has among the lowest rates of smoking, alcohol consumption, and percentage of people who report being overweight, or obese. But Kitchener-Cambridge-Waterloo, Hamilton and Oshawa all rank lower on these measures.
In Atlantic Canada, Halifax ranks highly for its physically active population, but as with residents in most of Atlantic Canada, it has high rates of smoking.
The variation in the prevalence of cancer-risk factors between cities may well reflect the socio-economic status of the local population, its average age, and income and education levels. But local health policies and bylaws can and do have a major impact. Most municipalities, for instance, have bylaws that seek to limit exposure to second-hand smoke in public, but some regions go further than others.
“Municipal policies play an important role in the health of Canadians. For example, Peel Region’s new Outdoor Smoking By-law removes harmful second-hand smoke from areas where children play, and entrances to libraries, arenas, community centres and other municipal buildings,” said Dr. David Mowat, Medical Officer of Health, Region of Peel. “Smoke-free places protect the health of the community, while supporting smokers who want to quit. This report sheds light on health issues common across the largest cities in Canada and creates an opportunity to leverage expertise from other cities to advance cancer and chronic disease prevention work in this country.”
Screening: fine tuning the big picture
Research shows that regular screening for colorectal, cervical and breast cancers can not only improve outcomes, but save lives. While provinces manage and deliver screening programs for colorectal, cervical and breast cancers, gauging the uptake at the municipal level can help identify where local promotion efforts could help bolster participation in these potentially life-saving tests and scans. The report shows that Edmonton, for example, has among the country’s lowest rates of women taking pap smears and undergoing mammography screening, while Calgary’s screening rates for both of these tests are among Canada’s highest. Saskatoon has substantially higher screening rates for pap tests than Regina. Yet Saskatoon’s mammography screening rate is one of the lowest in the country, while Regina has one of the highest. In Ontario, Ottawa has one of the best pap test-screening rates in the country, while Toronto has one of the worst.
“As a colorectal cancer survivor who received excellent care, I encourage anyone over 50 to be screened – early detection is important, when the disease is usually easier to treat,” said Archie McCulloch, a retired scientist from Fall River, Nova Scotia. “I’m encouraged that more Canadians are now being screened; these programs can literally save lives.”
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About the Canadian Partnership Against Cancer
The Canadian Partnership Against Cancer works with Canada’s cancer community to reduce the burden of cancer on Canadians. Grounded in and informed by the experiences of those affected by cancer, the organization works with partners to support multi-jurisdictional uptake of evidence that will help to optimize cancer control planning and drive improvements in quality of practice across the country. Through sustained effort and a focus on the cancer continuum, the organization supports the work of the collective cancer community in achieving long-term population outcomes: reduced incidence of cancer, less likelihood of Canadians dying from cancer, and an enhanced quality of life of those affected by cancer.