Item - 2016.HL13.3

The Board of Health: 

1.  Requested the Ministry of Health and Long-Term Care to develop a provincial surveillance system for ongoing monitoring of children's nutrition, physical activity and healthy weights, including access to primary care electronic medical records related to children's height and weight; and

2.  Endorsed, in principle, the recommendations in the report of the Standing Senate Committee on Social Affairs and Technology, Obesity in Canada: A Whole-of-Society Approach for a Healthier Canada, 2016.

Obesity in children is an important public health issue. Children with obesity are more likely to grow up to be adults with obesity, which can contribute to the development of chronic conditions/diseases, such as diabetes and cardiovascular disease. Many risk and protective factors contributing to childhood obesity begin in the preconception/prenatal period and continue throughout the lifespan. People’s behaviours are affected by individual factors, as well as interactions within the larger social and environmental context. Therefore, approaches to address and prevent childhood obesity include actions involving food environments, physical activity and broader socioeconomic environments.  Other potential actions focus on behavioural approaches in settings such as schools that aim to change individual nutrition and physical activity behaviours through social marketing, education and other activities to motivate behaviour change.

The Ontario Public Health Standards Child Health Requirement specifies that public health units are required to conduct local surveillance and monitoring of trends over time on healthy weights, healthy eating and physical activity.  Unfortunately, to date, no data source exists at the local level to meet this requirement. The Ontario Healthy Kids Strategy highlighted and recommended addressing this major gap by accessing data sources from non-public health partners such as primary care Electronic Medical Records and linking multiple data sources to improve the utility of the data (e.g., height and weight data linked with NutriSTEP® nutrition screening tool).  Currently, Toronto Public Health is involved in a pilot project to develop this database system.

This report provides a summary of the risk and protective factors for childhood obesity and outlines the initiatives Toronto Public Health (TPH) is undertaking to address this issue in the preconception and prenatal period, the early years and elementary school-age years.  This report also describes TPH’s involvement in the development of healthy public policies related to the built environment, commercial marketing to children, menu labelling and partnership initiatives (e.g., Healthy Kids Community Challenge) which can all contribute to preventing childhood obesity.  This report also highlights the need for better local surveillance and monitoring of healthy weights, healthy eating and physical activity in order to better plan, implement and evaluate childhood obesity prevention initiatives.