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Chronic Disease Prevention Strategy 2020–2023

This is our second strategy for chronic disease prevention, and the first to incorporate all areas of work at Ontario Health. It builds on the accomplishments of the first strategy, which spanned 2015 to 2020.

The Chronic Disease Prevention Strategy 2020 to 2023 was developed in collaboration with our partners. It considers both provincial and regional initiatives, and harnesses our collective expertise to guide our work to prevent chronic disease and improve population health.

Improving population health is a core component of the quadruple aim framework, which depicts our approach to improving healthcare.

A circle divided into 4 quadrants: enhanced patient experience; improved population health; enhanced provider experience; improved value

To advance chronic disease prevention, we will need to tackle the difficult situations facing our prevention and health care systems, such as ongoing systemic inequities and the challenges posed by COVID-19. This strategy outlines concrete strategic objectives and actions to support these efforts.

This strategy reflects our formative stages and captures the ongoing initiatives being led across the organization. The work done over the next 3 years will set the stage for Ontario Health to realize further progress in chronic disease prevention, and ensure the best outcomes for the people of Ontario.

Dr. Linda Rabeneck

Chronic disease prevention is the key to the sustainability of the health care system and creating a healthier future for everyone in Ontario. Continuing to work with our partners across the health system to champion chronic disease prevention will be critical to improving population health in Ontario.”

Dr. Linda Rabeneck
Vice-President, Prevention and Cancer Control, Ontario Health (Cancer Care Ontario)

Dr. Andrew Pipe

Reducing the burden of chronic disease in Ontario requires leadership and a comprehensive approach. This strategy provides a plan for how Ontario Health will work with its partners to reduce new cases of major chronic diseases by minimizing exposure to modifiable risk factors, by helping to address emerging issues facing our prevention system, by supporting healthy public-policy, and by fostering healthy environments and healthy lifestyles.”

Dr. Andrew Pipe
Chair, Ontario Health (Cancer Care Ontario) Prevention Advisory Committee

Randall Conrad

As a cancer patient, I needed to find a way to learn to make healthier lifestyle choices and I found a path to wellness through Ontario Health’s prevention programs. Managing my mental and emotional states was just as important as managing my physical self. By working with my health care team, I’ve learned that I can make the right choices. The key is that I did not do it alone.”

Randall Conrad
Patient and Family Advisor

  • Dr. Linda Rabeneck

    Chronic disease prevention is the key to the sustainability of the health care system and creating a healthier future for everyone in Ontario. Continuing to work with our partners across the health system to champion chronic disease prevention will be critical to improving population health in Ontario.”

    Dr. Linda Rabeneck
    Vice-President, Prevention and Cancer Control, Ontario Health (Cancer Care Ontario)

  • Dr. Andrew Pipe

    Reducing the burden of chronic disease in Ontario requires leadership and a comprehensive approach. This strategy provides a plan for how Ontario Health will work with its partners to reduce new cases of major chronic diseases by minimizing exposure to modifiable risk factors, by helping to address emerging issues facing our prevention system, by supporting healthy public-policy, and by fostering healthy environments and healthy lifestyles."

    Dr. Andrew Pipe
    Chair, Ontario Health (Cancer Care Ontario) Prevention Advisory Committee

  • Randall Conrad

    As a cancer patient, I needed to find a way to learn to make healthier lifestyle choices and I found a path to wellness through Ontario Health’s prevention programs. Managing my mental and emotional states was just as important as managing my physical self. By working with my health care team, I’ve learned that I can make the right choices. The key is that I did not do it alone.”

    Randall Conrad
    Patient and Family Advisor

GOALS, STRATEGIC OBJECTIVES AND ACTIONS

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Goal 1:

Work with partners to champion chronic disease prevention in Ontario

 

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Ontario Health partners with many organizations for our work in chronic disease prevention. We are especially fortunate to have strong relationships with several First Nations, Inuit, Métis and urban Indigenous partners. We will continue to collaborate with our partners to make meaningful advances in chronic disease prevention in Ontario.

Objectives and actions by 2023

Work with Ontario’s chronic disease prevention partners to align and address common priorities

  • Engage Ontario’s leaders in chronic disease prevention through advisory committees, partnership tables, non-governmental organizations and health networks to implement the Chronic Disease Prevention Strategy 2020 to 2023.
  • Share information and collaborate on joint projects and common priorities with chronic disease prevention partners.
  • Develop new and strengthen existing partnerships.

Engage multiple sectors and levels of government to integrate health considerations in public policy development

  • Engage with ministries across the government.
  • Collaborate with public health groups, including Public Health Ontario, local boards of health and professional public health associations.
  • Submit consultations, reports and other guidance to governments and policy-makers.
  • Lead health initiatives for workers through the Occupational Cancer Research Centre in collaboration with occupational health and safety partners.

Work with and support partners to address chronic disease risk in First Nations, Inuit, Métis and urban Indigenous people

  • Implement actions to address chronic disease as part of the strategic priority on prevention in the First Nations, Inuit, Métis and Urban Indigenous Cancer Strategy 2019 to 2023.
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Goal 2:

Promote chronic disease prevention policies and programs

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System-level policies and programs can significantly reduce the risk of chronic disease. Therefore, we will promote policies and programs that aim to reduce the risk of chronic disease.

Objectives and actions by 2023

Provide evidence-based advice to governments on policies and programs for preventing chronic disease

  • Develop evidence syntheses and recommendations on existing and emerging topics in chronic disease prevention. 

Promote policies and programs that increase health equity

  • Promote using tools and resources that support health equity education and assessment, such as the Indigenous Relationship and Cultural Safety courses.
  • Build Ontario Health’s capacity to assess and address health equity in our workplace and in the work we do. 

Monitor policies and programs related to chronic disease prevention

  • Publish Prevention System Quality Index (PSQI) reports to monitor and inform Ontario’s efforts in prevention, including a report on effective policies and programs related to mental health and addictions.
  • Monitor the prevalence of chronic disease risk factors, including socio-demographic risk factors, and cancer screening program performance.

Promote healthy environments in public workplaces

  • Develop a framework for increasing access to healthy food in retail outlets (e.g., food kiosks and cafeterias) at hospitals.
  • Support a healthy workplace at Ontario Health.
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Goal 3:

Undertake primary, secondary and tertiary prevention

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Primary prevention aims to prevent chronic disease by reducing exposure to risk factors. Secondary prevention aims to improve health outcomes by finding diseases early through screening. Screening is testing done on people who have no symptoms and generally feel fine. It can find conditions early when treatment has a better chance of working. Tertiary prevention aims to lessen the effects of a disease, slow its progression and reduce the risk of recurrence.

We will maintain our existing programs across the prevention continuum throughout COVID-19, and where possible, continue to grow and strengthen these programs.

Objectives and actions by 2023

Broaden the reach of Ontario Health’s prevention programs

  • Continue to expand prevention programs to reach new populations.

Strengthen Ontario’s screening and early detection programs

  • Resume operations of our screening and early detection programs beyond COVID-19.
  • Strengthen the organized cancer screening programs in alignment with evolving evidence-based recommendations.
  • Implement human papillomavirus (HPV) testing as the recommended screening method in the Ontario Cervical Screening Program.
  • Continue to implement the glomerulonephritis model of care across Regional Renal Programs. 

Undertake initiatives in prevention and screening to reduce health inequities

  • Support chronic kidney disease risk screening in First Nations communities.
  • Plan and carry out initiatives to address inequities in cancer screening program participation.

Inform people in Ontario about how to reduce their risk of chronic disease

  • Promote the use of digital and other tools, such as My CancerIQ, by the public.
  • Continue to inform and provide educational tools to First Nations, Inuit, Métis and urban Indigenous communities to support commercial tobacco cessation, protection and prevention.
  • Undertake awareness campaigns and publish evidence-based knowledge products that provide the public with information on reducing their risk of developing chronic diseases.

Support primary care providers in delivering prevention and screening to their patients

  • Equip primary care providers with data and tools, including digital tools, to help facilitate prevention and screening.
  • Integrate prevention and screening guidance into clinical advice documents.
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Goal 4:

Inform chronic disease prevention through research, and population health assessment and surveillance

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Through high-quality evidence synthesis, generation and dissemination, we will provide information needed for people to understand and take action on chronic disease prevention.

Objectives and actions by 2023

Improve the evidence base and understanding of chronic disease prevention

  • Conduct and support research on chronic disease causes, prevention and screening.

Strengthen Ontario Health’s data holdings and data infrastructure

  • Identify and address information gaps, and use the data holdings and infrastructure to support research, planning and surveillance.

Provide risk factor, screening and disease surveillance information that informs chronic disease prevention

  • Publish reports and knowledge products, such as fact sheets, on risk factors, including socio-demographic risk factors, and screening.
  • Publish reports and knowledge products on disease surveillance information, such as Ontario Cancer Statistics.

Provide data and evidence-based guidelines that support ongoing quality improvement in prevention and screening

  • Support quality improvement through quality standards, evaluation and reporting.

CHRONIC DISEASE IN ONTARIO

For Ontario to have a sustainable health care system, we must minimize exposures to common chronic disease risk factors and the risk of developing chronic diseases.

Chronic disease prevention plays a critical role in ensuring we can address the population health component of the quadruple aim framework.

Chronic diseases are the leading cause of death in Ontario. They are costly to treat and largely preventable.

Over 7 in 10 deaths in 2015 were due to a chronic disease. 242,054 hospitalizations in 2016 were due to cardiovascular diseases, diabetes, chronic lower respiratory diseases and cancer.

Chronic disease risk factors are common in Ontario adults, and related health care and indirect costs are substantial.

Adults in Ontario with chronic disease risk factors and related costs. See figure description for details.

Some populations in Ontario have a disproportionate burden of chronic diseases. People with low income are more likely to die from chronic disease compared to people with high income.

Health inequities in 2015. See figure description for details.

EVALUATING OUR PROGRESS

As an integrated health agency, Ontario Health has tremendous potential to advance chronic disease prevention.

Over the coming years, we will measure and monitor our progress towards implementing initiatives outlined in this strategy. We will do this by tracking key indicators for managing performance and measuring progress. Our evaluation approach will be iterative and accommodate changes that may develop over the span of the strategy.

Our achievements so far

The first chronic disease prevention strategy was developed under Cancer Care Ontario before it transitioned to Ontario Health. The Progress in Prevention: Achievements from the Chronic Disease Prevention Strategy 2015 to 2020 report highlights the achievements in chronic disease prevention under this first strategy from April 1, 2015, to March 31, 2020.

Some of these achievements include:

  • Transitioning from the guaiac fecal occult blood test (gFOBT) to the fecal immunochemical test (FIT) as the screening test for people at average risk of developing colorectal cancer. We expect this transition to lead to an increase in colorectal cancer screening participation.
  • Integrating smoking cessation programs into regional cancer centres. As a result, more people with cancer are screened for tobacco use and offered help to quit smoking.
  • Leading the development of the Occupational Disease Surveillance System. This system links provincial health databases with job information to support studies of occupational disease and inform prevention activities.

ABOUT THIS STRATEGY

This strategy was developed in consultation with several of our chronic disease prevention partners. These include the Ontario Health (Cancer Care Ontario) Prevention Advisory Committee, patient and family advisors, government agencies, not-for-profit health organizations, researchers and public health experts.

This strategy builds on our achievements to date, highlights new opportunities to strengthen our efforts in chronic disease prevention, and captures the work in chronic disease prevention across Ontario Health.

It harnesses our expertise and that of our partners to serve as a comprehensive guide for preventing chronic disease in the province and improving population health.

Acknowledgements

Many individuals and organizations across the province contributed to the development of this strategy. In particular, we would like to acknowledge the contributions of the Ontario Health Chronic Disease Prevention Strategy Working Group. We are grateful for their insights and expertise, and thank them for their efforts in advancing chronic disease prevention in Ontario.