References

More than 60% of British Columbians have been diagnosed with at least one chronic condition in 2023, a figure that has increased over the past two decades in part due to an aging population.

1. Smolina, K., Ramler, G., Setayeshgar, S., et al. (2024). Understanding chronic conditions in BC. BC Medical Journal, 66(5), pp. 178, 180. BC Centre for Disease Control.

Between 50% to 80% of chronic disease is preventable through lifestyle interventions such as improved diet, increased physical activity, and reduced tobacco use.

2. World Health Organization. (2015). Facing the facts: the impact of chronic disease in Canada. Preventing Chronic Diseases: A Vital Investment.

3. Government of British Columbia: Office of the Provincial Health Officer. (2010). Investing in Prevention: Improving Health and Creating Sustainability. The Provincial Health Officer’s Special Report. http://www.health.gov.bc.ca/library/publications/year/2010/Investing_in_prevention_improving_health_and_creating_sustainability.pdf

Chronic diseases account for 80% of the combined Medical Services Plan, PharmaCare, and acute care budgets in BC.

4. Government of British Columbia: Office of the Provincial Health Officer. (2010). Investing in Prevention: Improving Health and Creating Sustainability. The Provincial Health Officer’s Special Report. http://www.health.gov.bc.ca/library/publications/year/2010/Investing_in_prevention_improving_health_and_creating_sustainability.pdf

The estimated annual economic burden in B.C. from the modifiable risk factors for chronic disease—excess weight, tobacco smoking, alcohol use, physical inactivity and low fruit and vegetable consumption —was $7.8 billion.

5. H. Krueger & Associates Inc. (2015). The Economic Benefits of Risk Factor Reduction in British Columbia: Tobacco Smoking, Excess Weight and Physical Activity. www.krueger.ca

Failure to invest in prevention and address social determinants of health increases disease burden and strains healthcare resources, disproportionately affecting low-income and equity-deserving populations

6. Statistics Canada. (2013). Cause-specific mortality by income adequacy in Canada: A 16-year follow-up study. Health Reports, 24(7). https://www150.statcan.gc.ca/n1/pub/82-003-x/2013007/article/11852-eng.htm

7. Tjepkema M, Wilkins R, Long A. (2013). Cause-specific mortality by income adequacy in Canada: A 16-year follow-up study. Health Rep. 24(7):14-22. PMID: 24258280.

Less than two-thirds of BC adults (64.7%) meet physical activity guidelines (2018). Only 58% of BC youth (12–17) meet age-specific physical activity recommendations. Thirty five percent of British Columbians and 37% in Northern BC are inactive.

8. Northern Health. (2020). Position on Physical Activity and Sedentary Behaviour. https://www.northernhealth.ca/sites/northern_health/files/about-us/position-statements/documents/physical-activity-sedentary-behaviour-full.pdf.

Regular physical activity can reduce the risk of certain cancers up to 28%; heart disease and stroke by 19%; while improving mental health outcomes and reducing anxiety and depression.

9. World Health Organization. Physical Activity. https://www.who.int/health-topics/physical-activity/physical-activity#tab=tab_2.

An economic analysis by the Provincial Health Services Authority calculated that inactivity costs $1B per year, including $350M in direct healthcare costs and $673M in costs related to disability and premature mortality.

10. Provincial Health Services Authority. (2015). The economic benefits of risk factor reduction in British Columbia: Excess weight, physical inactivity, and tobacco smoking. Population and Public Health Program.

Smoking is responsible for 30% of all cancer deaths and contributes significantly to respiratory and cardiovascular diseases.

11. Canadian Cancer Society. (2024). Cost recovery fee proposal. https://cancer.ca/en/about-us/media-releases/2024/cost-recovery-fee-proposal#:~:text=Tobacco%20use%20is%20the%20leading,of%20the%20population%20aged%2012%2B

In BC, 42% of students in Grades 7-12 have tried vaping, higher than the national average.

12. McCreary Centre Society. (2020). Understanding Tobacco Use and Vaping Among BC Youth: Findings from the BC Adolescent Health Survey. https://www.mcs.bc.ca/pdf/understanding_tobacco_use_and_vaping_among_bc_youth.pdf

Nicotine exposure during adolescence harms brain development and increases the likelihood of future substance use and addiction.

13. National Institutes of Health. (2012). Nicotine Effects on the Adolescent Brain: What We Know. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC3543069/#:~:text=Importantly%2C%20nicotine%20may%20also%20lead,executive%20functioning%2C%20and%20inhibitory%20control.

Research shows vaping can be nearly as harmful as smoking for some conditions, with dual use posing even greater risks. Rather than quitting, many smokers who switch to e-cigarettes continue dual use—smoking and vaping— undermining vaping’s role as a harm-reduction tool.

14. Glantz, S. A., Nguyen, N., & Oliveira da Silva, A. L. (2024). Population-based disease odds for e-cigarettes and dual use versus cigarettes. NEJM Evidence, 3(3).

Nearly 32,600 households are on waitlists for social or affordable housing, with 47.5% waiting two or more years.

15. Statistics Canada. (2024). Almost one-quarter of a million Canadian households are on a wait-list for social and affordable housing. https://www.statcan.gc.ca/o1/en/plus/7075-almost-one-quarter-million-canadian-households-are-wait-list-social-and-affordable

B.C. has the highest rates of unaffordable housing nationally, affecting 25.5% of residents.

16. Statistics Canada. (2022). The Daily. To buy or to rent: The housing market continues to be reshaped by several factors as Canadians search for an affordable place to call home. https://www150.statcan.gc.ca/n1/daily-quotidien/220921/dq220921b-eng.htm

Green spaces reduce mortality risks by 8-12%, improve mental and physical health, and mitigate urban heat island effects.

17. Crouse, Dan L et al. (2017). Urban Greenness and Mortality in Canada’s Largest Cities: A National Cohort Study. The Lancet Planetary Health 1(7), p289-297.

Active transportation is recognized by the WHO as a ‘best buy for governments’ to improve physical activity while reducing GHG emissions and air pollution.

18. World Health Organization (WHO). (2022, June 7). Cycling and walking can help reduce physical inactivity and air pollution, save lives, and mitigate climate change. https://www.who.int/europe/news-room/07-06-2022-cycling-and-walking-can-help-reduce-physical-inactivity-and-air-pollution–save-lives-and-mitigate-climate-change

Those living in poverty in British Columbia had a food insecurity rate of 28.5% and 76% of households relying on social assistance are food-insecure.

19. Statistics Canada. (2024). Canadians are facing higher levels of food insecurity. https://www.statcan.gc.ca/o1/en/plus/6257-canadians-are-facing-higher-levels-food-insecurity

20. Statistics Canada. “Canadians are facing higher levels of food insecurity.” Statistics Canada, https://www.statcan.gc.ca/o1/en/plus/6257-canadians-are-facing-higher-levels-food-insecurity

Food insecurity is greater in rural and remote areas of British Columbia, highlighting significant disparities across different regions.

21. Government of British Columbia: Office of the Provincial Health Officer. (2024) Examining the Societal Consequences of the COVID-19 Pandemic (p. 82). https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/annual-reports/societal-consequences-ch-5.pdf https://www2.gov.bc.ca/assets/gov/health/about-bc-s-health-care-system/office-of-the-provincial-health-officer/reports-publications/annual-reports/societal-consequences-ch-5.pdf.

22. British Columbia Centre for Disease Control. (2023). Household food insecurity report. http://www.bccdc.ca/Documents/2023-10-18_HouseholdFoodInsecurityReport.pdf