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Prevention System Quality Index 2015 Prevention System Quality Index An inaugural report evaluating Ontario’s efforts in cancer prevention 2015 Prevention System Quality Index An inaugural report evaluating Ontario’s efforts in cancer prevention Prepared by Maria Chu, Marcia Bassier-Paltoo, Meaghan Boddy, Ontario; Phat Ha, Toronto Public Health; Joanne Hader, Cancer © Queen’s Printer for Ontario, 2015. Corinne Hodgson, Sheila Kalenge, Penney Kirby, Sargam Rana, Care Ontario; Jeremy Herring, Public Health Ontario; Karin ISSN 2369-0496 Caroline Silverman, Rebecca Truscott, Julie Klein-Geltink, Shawn Hohenadel, Public Health Ontario; Perry Hystad, College of Public Key title: Prevention system quality index (Print) Chirrey and Alice Peter of Prevention and Cancer Control, Cancer Health and Human Sciences, Oregon State University; Jon Kerner, Care Ontario. Canadian Partnership Against Cancer; Sharon Kirkpatrick, School ISSN 2369-050X of Public Health and Health Systems, University of Waterloo; Key title: Prevention system quality index (Online) The authors thank the following individuals and organizations Anna Koné, Cancer Care Ontario; Nancy Kreiger, Cancer Care for providing data, analytic and/or technical assistance Ontario and Dalla Lana School of Public Health, University of Permission to reproduce: and/or comments: Toronto; Rachel Kupets, Cancer Care Ontario; Chantal Lalonde, Except as otherwise specifically noted, the information in Naomi Schwartz, Mohammad Haque, Roseanna Presutti, Ontario Society of Physical Activity Promoters in Public Health; this publication may be reproduced, in part or in whole and Prevention and Cancer Control, Cancer Care Ontario. Jason LeMar, Public Health Ontario; Chris Markham, Ontario by any means, without charge or further permission from Physical Health and Education Association; Allison Meserve, Cancer Care Ontario for non-commercial purposes, provided Ontario Ministry of Health and Long-Term Care including the Public Health Ontario; Safoura Moazami, Toronto Public Health, that due diligence is exercised in ensuring the accuracy of Health Analytics Branch of the Health System Information Toronto Cancer Prevention Coalition and Ontario Sun Safety the information reproduced; that Cancer Care Ontario is Management and Investment Division; Ontario Ministry of Working Group; Jessica Moffatt, Cancer Care Ontario; Bronwen identified as the source institution; and that the reproduction Education, Education Statistics and Analysis Branch, French McCurdy, Cancer Care Ontario; Ronald Macfarlane, Toronto Public is not represented as an official version of the information Language, Aboriginal Learning and Research Division. Health; Jennifer McGowan, Metrolinx; Mary Fodor O’Brien, reproduced, nor as having been made in affiliation with, Nutrition Resource Centre, Ontario Public Health Association; or with the endorsement of, Cancer Care Ontario. The Prevention System Quality Index Advisory Group consisting Ontario Chronic Disease Prevention Management in Public of Rebecca Comrie, Charles Barone, Julie Gilbert, Wolodymyr Health; Ontario Ministry of Agriculture, Food and Rural Affairs; For permission to reproduce the information in this publication Lewyckyj and Loraine Marrett, Cancer Care Ontario. Ontario Ministry of Health and Long-Term Care; Lynn Roblin, for commercial redistribution, please contact: Nutrition Resource Centre, Ontario Public Health Association; The authors wish to acknowledge the following internal and Ruth Sanderson, Public Health Ontario; Steven Savvaidis, Communications external advisors and reviewers who provided comments on an Program Training and Consultation Centre, Cancer Care Ontario; Cancer Care Ontario earlier version of this report: Naomi Schwartz, Public Health Ontario; Robert Schwartz, Ontario 620 University Avenue, Toronto, Ontario, M5G 2L7 Kenneth Allison, Dalla Lana School of Public Health, University Tobacco Research Unit, University of Toronto; Chris Sherman, Telephone: 416-971-9800 of Toronto and Public Health Ontario; Fred Ashbury, Dalla Lana Ontario Society of Physical Activity Promoters in Public Health www.cancercare.on.ca School of Public Health, University of Toronto and Intelligent and Chatham-Kent Public Health Unit; Sudbury and District [email protected] Improvement Consultants, Inc.; Anna Chiarelli, Cancer Care Health Unit; Valerie Tarasuk, Department of Nutritional Sciences, Ontario; Ray Copes, Public Health Ontario; Lyndsay Davidson, Faculty of Medicine, University of Toronto; Jill Tinmouth, Cancer How to cite this publication: Food Security Work Group, Ontario Society of Nutrition Care Ontario; Loren Vanderlinden, Toronto Public Health; Ashley Cancer Care Ontario. 2015 Prevention System Quality Index: Professionals in Public Health; Paul Demers, Occupational Cancer Wettlaufer, Centre for Addiction and Mental Health; Barb Willet, an inaugural report evaluating Ontario’s efforts in cancer Research Centre, Cancer Care Ontario; Elizabeth Finlan, Food Health Nexus and Ontario Chronic Disease Prevention Alliance; prevention. Toronto: Queen’s Printer for Ontario; 2015. Security Work Group, Ontario Society of Nutrition Professionals Sherry Zarins, Ontario Lung Association. in Public Health; John Garcia, School of Public Health and Health Thank you to Jenny Lass of Prevention and Cancer Control, This report and associated supplemental materials are available Systems, University of Waterloo; Norman Giesbrecht, Centre for Cancer Care Ontario for copy editing this report. at: cancercare.on.ca/PSQI Addiction and Mental Health; Natalie Greenidge, Public Health Forward Foreword The 2015 Prevention System Quality Index (PSQI) through the elimination of modifiable risk factors, through structured consultation with partners and report begins Cancer Care Ontario’s (CCO’s) annual such as tobacco use, excess alcohol consumption, stakeholders emerge, and selection criteria are applied. monitoring and evaluation of the cancer prevention physical inactivity and unhealthy eating, as well as system in Ontario. The PSQI reports on the effects of harmful environmental and occupational exposures, The PSQI seeks to build on existing population system-level policies and programs in Ontario, which including pollution and ultraviolet radiation. Ontario’s health monitoring of individual cancer risk factors, encompass all large-scale initiatives taking place organized cancer screening programs also play an and increase attention on the system-level policies across the province. The PSQI identifies achievements, important role in the prevention of cervical and and programs that influence cancer prevention in as well as gaps at the system level to encourage some colorectal cancers and the early detection of Ontario. By creating a single resource for policy- system improvement. breast cancer. makers, planners and public health and health professionals that provides information on a range This focus on system-level policies and programs The indicators in this report measure the system- of cancer risk factors and exposures, the PSQI stems from evidence showing that healthy public level effects of these risk factors and exposures, supports the development of policies and broad- policy and community-wide programs facilitating which were selected based primarily on current data scale programs that could make the healthy healthier individual choices are more effective in availability and validity, followed by a summary of choice the easier choice for Ontarians. reducing the prevalence of modifiable risk factors at current policies, programs and implementers that a population level than trying to change behaviours have a role in influencing cancer prevention in Linda Rabeneck, MD MPH FRCPC one person at a time. It also recognizes that all levels Ontario. In future PSQI reports, new indicators will Vice President, Prevention and Cancer Control of government, a range of government ministries likely be developed as opportunities for enhancements Cancer Care Ontario and divisions, policy-makers, decision-makers and sectors have a role in influencing cancer prevention. Four of the seven risk domains that CCO has chosen to examine — tobacco use, excess alcohol consumption, physical inactivity and unhealthy Healthy public policy and community-wide programs eating — are shared with major chronic diseases facilitating healthier individual choices are more effective other than cancer. Cancer, cardiovascular disease, chronic respiratory disease and diabetes are responsible in reducing the prevalence of modifiable risk factors at for two-thirds of all deaths in Ontario, so targeting a population level than trying to change behaviours one their common risk factors has the potential to improve overall health in Ontario. Research has shown that at person at a time. least 50 per cent of all cancer cases can be prevented Prevention System Quality Index Report 3 Table of contents Foreword 3 Alcohol programs and program 30 Ultraviolet radiation 54 Index of tables and figures 5 implementers in Ontario Tanning bed use 54 Highlights 6 Discussion and future directions 31 Ultraviolet radiation policies and 56 policy implementers in Ontario Introduction 10 Healthy eating 32 Ultraviolet radiation programs and 56 The need for improved cancer prevention 11 Household food insecurity 33 program implementers in Ontario Cancer Care Ontario’s Prevention 12 Cost of a Nutritious Food Basket 37 Discussion and future directions 57 System Quality Index Healthy eating policies and policy 37 The PSQI framework 13 implementers in Ontario Cancer screening
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