A House Into a Home Renovating Health Care in New Brunswick
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A House into a Home Renovating Health Care in New Brunswick presented by Next NB/Avenir N-B It is time for New Brunswickers to talk to each other. Our province and our region face some challenges, which means both must confront some difficult questions. Just as our nation seeks to redefine its role in the world economically, militarily and diplomatically, so too must New Brunswick’s citizens decide for themselves their place in Canada. Next NB/Avenir N-B will do that through a series of discussion papers it will release between February 2004 and June 2005. These papers will be supported by public forums held throughout New Brunswick and will culminate with a conference in Saint John. Next NB/Avenir N-B will be a bilingual project to reflect New Brunswick’s nature and its distinction as the only officially bilingual province in Canada. Next NB/Avenir N-B is a unique opportunity to explore what New Brunswickers think about themselves, their province and its place in Canada and the world. Please join us in the conversation. To obtain additional copies of this discussion paper or to offer your comments, please visit our website at www.nextnb.ca or write to us at: Next NB/Avenir N-B University of New Brunswick PO Box 5050 100 Tucker Park Road Saint John, NB Canada E2L 4L5 (506) 648-5655 A House into a Home Renovating Health Care in New Brunswick The pork brochette was billed as a house specialty and while the accompanying rice, potatoes and garlic bread weren’t exactly in line with the Canada Food Guide, it was nice to enjoy the meal in a Campbellton restaurant where you could smell the food and not much else. To be fair, the place was more bar than restaurant and its handful of patrons were each enjoying a drink with their food and conversation. What they didn’t have were cigarettes. Last October the New Brunswick government banned smoking in all bars and restaurants, a moved that annoyed some but quietly pleased others. The majority of New Brunswickers – about 75 per cent – don’t smoke. Another 41 per cent once did but have since quit and 33 per cent have never smoked at all, according to Statistics Canada’s 2004 health indicators report. The cigarette-free air in Campbellton should eventually have an effect on more than just the habits of those who like to dine out. Over the hill and by the highway sits the Campbellton Regional Hospital. It receives the bulk of the Restigouche Regional Health Authority’s annual $57.6 million budget. However for those afflicted with the diseases caused by a lifetime of smoking, treatment often involves a trip down to one of New Brunswick’s tertiary care hospitals. Specialized cancer treatment is offered at both the Dr. Georges-L. Dumont Regional Hospital in Moncton and the Saint John Regional Hospital. The latter is also home to the New Brunswick heart centre, where people come from around the province for heart surgery and complex care. Smoking is an expensive habit, for both the smoker and the province. Heart disease plagues smokers at a rate 70 per cent higher than non-smokers and New Brunswick has the third highest mortality rate for both stroke and heart attack. A two- hour single bypass operation costs $2,100 for the doctors (one cardiac surgeon, a general practitioner and an anesthetist). Not included in that sum are the salaries for the nurses who assist, the drugs, the equipment and the hospital space. The cost increases for a multiple bypass. According to the Canadian Cancer Society, smoking causes 85 per cent of all lung cancer cases. New Brunswick has the second highest incidence rate of lung cancer in the country. A single infusion of chemotherapy costs $10.50 for adults and $15.75 for children under the age of 15. One round of chemotherapy may consist of many infusions. Smoking is the leading cause of preventable death in Canada, which means the costs of smoking- related diseases (and the additional costs to labour productivity and personal happiness) lie within the power of the individual to control. Governments seek control too – of the costs associated with our publicly-funded health system. New Brunswick’s new smoking ban is a preventive measure, introduced with the hope that it will reduce the number of smokers in the province and therefore reduce the number of sick and dying heart and cancer patients in the province’s hospitals. It is one of the changes the New Brunswick government has introduced to try and control the rising cost of health care and improve its delivery, a problem that plagues every province in Canada. There are new initiatives such as community heath centres, nurse practitioners, the New Brunswick Cancer Network, methadone clinics and collaborative care clinics with salaried physicians and registered nurses. Then there are the adjustments to existing services such as home care, nursing homes, child immunizations and hospital bed closings. These initiatives are supposed to modernize New Brunswick’s health system, improve access and, in some instances, lower the cost over time of delivering the service. It’s a massive renovation project of the government service that Canadians hold most dear. We know in our hearts that our health care system is looking a bit worn and we know that it will take more than just a few cosmetic changes to fix it up. This is no weekend project. We’ve got to shore up the foundation, reinforce the supporting beams, rewire the circuits, expand high traffic areas and reconfigure the whole place so it meets the needs of New Brunswick residents. Who are we? New Brunswickers are a product of our surroundings. To begin with, we live in our cars, trucks and SUVs. This is a province with more paved kilometres of road per capita than any other province in Canada. We’ve got 22,600 kilometres of highway, 2,900 bridges and 17 ferries – a result of our rural and suburban lifestyles. That’s a lot of asphalt and we make use of it by driving to work, putting kids on school buses and running errands around town in our vehicles. Which probably contributes to making New Brunswick residents among the least active group in Canada. Only 44 per cent of New Brunswickers are physically active, tying us with fellow loafers in Newfoundland and Labrador and giving us a 1 per cent jump on our neighbours in Prince Edward Island. We might not like to exercise, but we do like to eat and culturally, we’re fans of fast food. Moncton has the most Tim Horton’s per capita in Canada, the Dairy Queen in Fredericton is among the most successful franchises in Canada and Dixie Lee fried chicken outlets are landmarks in just about every community in northern New Brunswick. We like our fast food so much that back in 1994, when a Wendy’s restaurant opened in Saint John, the city’s burger lovers broke the chain’s North American record for sales in one month. They bought 21,000 hamburgers. For local delicacies we deep-fry our clams, wrap scallops in bacon, serve up lobster coated in mayonnaise, piled on a butter-toasted bun and we place a piece of salt pork in the centre of a potato dumpling and call it poutine rapée. All that fat has stuck around – mainly on our waistlines. New Brunswickers are in a three-way tie with PEI and Newfoundland for the title of most obese people in Canada. Unsurprisingly, New Brunswickers, along with their fellow Atlantic Canadians, have higher than average levels of diabetes. About 5 per cent in each of the four provinces has this chronic disease, compared to a national rate of 4 per cent. The diabetes rate in Atlantic Canada’s Aboriginal communities is double the non-Aboriginal rate, about 11 per cent, making it the highest rate in the country. So we know a lack of exercise, bad eating habits and smoking all contribute to ill health but what causes us to make these choices? For some of us it’s a simple lack of willpower. Eat right and exercise – those are the basic rules for staying healthy – but sticking to that plan is easier for some than others. To begin with, if you’re going to eat right, you need to know what constitutes a healthy diet. That means you need to understand the Canada Food Guide, comprehend the information on food labels and know how to cook, braise, boil, grill or sauté the food you buy when you get home. Preventative health practices such as taking a walk, gardening, playing a sport or snacking on fruits and vegetables, is a learned skill. So too is resisting the urge to cruise by a drive-thru window. Fast food isn’t just convenient; it’s cheap. To know how to balance our household’s diet and budget, someone has to show us – a parent, a teacher or a friend – or we have to teach ourselves. Education and wealth are the two most important social factors that determine how healthy we will be because first we have to understand how to properly nourish and maintain our bodies and then we have to be able to afford it. Both are a challenge in New Brunswick. Traditionally the province has placed in the bottom third of provincial rankings for both education attainment and annual income. Four years ago the aptitude of New Brunswick students came into sharp focus following an international assessment of grade five students by the Organization for Economic Cooperation and Development (OECD).