The AHS provincial Chronic Disease Prevention (CDP) team within Healthy Living, Population, Public and Indigenous Health (PPIH) committed to developing an evidence informed three year AHS Chronic Disease Prevention Action Plan targeting the adult, 18+, population (Alberta Health Services, 2016). The chronic disease landscape is influenced by a range of modifiable factors including nutrition, physical activity, tobacco, alcohol, sedentary behaviour and chronic stress. The Chronic Disease Prevention Team has a responsibility to reduce risk for chronic disease by focusing primarily on tobacco and physical activity and sedentary behaviour. In order to make substantial changes to the chronic disease trajectory, a multi-factorial, multi-stakeholder, province-wide effort is needed. In 2015, the CDP Team released an evidence informed Action Plan which strives to reduce the burden of chronic disease on Albertans and the health system. The Action Plan is designed to find ways of fixing gaps in the system, as well as looking at the ways chronic disease prevention activities currently underway can be better coordinated and put into practice across the province.
The actions identified in this Action Plan are founded on evidence and best practices, they reflect both new and existing actions, and they address gaps, as well as universal and targeted priorities, identified through the consultative process. The Action Plan provides an opening to begin enabling a province-wide coordinated effort that addresses chronic disease prevention in Alberta. This includes strong and continual engagement with communities, supporting community action, working in partnership with the zone, AHS provincial teams, Strategic Clinical Networks (SCNs) and external partners, and increasing emphasis on targeted approaches to support resolving health inequities.
The Action Plan was developed to be an iterative, living document. Adaptations to the Action Plan are expected to reflect changing priorities, actions and resource capacity, as well as new opportunities for coordinating, developing and implementing initiatives. As the Action Plan evolves, the desired end state will be a comprehensive, care and age continuum-spanning plan for chronic disease prevention.
Immediate next steps include working with Alberta Health to expand the scope of the Action Plan to an all-encompassing provincial chronic disease prevention action plan. This expansion of scope will be done through the provincial Chronic Disease Prevention Coordinating Committee.
Chronic diseases are an epidemic, as well as the leading cause of death and disability around the world (WHO, 2104). Major chronic diseases include cardiovascular disease, cancer, obesity, chronic obstructive pulmonary disease (COPD) and type II diabetes (WHO, 2014). People with chronic diseases face a range of negative consequences includes lower quality of life, lower income and premature death (Patra et al., 2007), from 2009 to 2001 58% of all deaths in Alberta were the result of chronic disease (Predy et al, 2012; Government of Alberta, 2013).
The national rate of chronic disease is increasing by 14% each year. As the population of Alberta grows larger and individuals live longer, the impact of chronic disease on the health care system is only going to grow larger.
Treating chronic disease already accounts for the majority of our health care costs. Alberta spends more money on health care, per person, than anywhere else in Canada, and most of that money is spent treating and managing chronic diseases that are, for the most part, preventable (Alberta Policy Coalition for Chronic Disease Prevention, 2012).
In Alberta, people with chronic diseases account for nearly two-thirds of hospital inpatient stays, one-third of all visits to physicians and more than one-quarter of visits to emergency reports (Report of the Auditor General of Alberta, Sept 2014). In 2012-13, over 735,000 Albertans had one or more of hypertension, diabetes, chronic obstructive pulmonary disease and coronary artery disease, with the publicly funded healthcare services for these patients costing more than $4.5 billion that year alone. (Same reference as previous) The good news however is that much of the illness, suffering and premature death related to chronic diseases and conditions can be influenced by changing unhealthy behaviours – lack of physical activity, poor nutrition, tobacco user and drinking too much alcohol. For example, it is estimated that just eliminating only 3 of the risk factors for chronic disease – poor diet, inactivity and smoking – would prevent 80% of heart disease and stroke, 80% of type 2 diabetes and 40% of cancer.
Nutrition-related chronic disease prevention interventions, Evidence Review 2018