Ontari 2018 prvincial electin issues backgrunder Dietitians f Canada Pririties May 2018 Access t dietitians in Ontari s health system Diet is the #1 risk factr fr chrnic diseases that cst Ontari $90 billin annually. 1 Ontarians require imprved access t dietitian services t cntain health system csts. - Dietitians are the nly regulated health prfessin in Ontari with specialized expertise in fd and nutritin. Dietitians translate the science f nutritin int fd chices and eating patterns t imprve health. - Rates f verweight and besity are alarmingly high and 30% f Ontarians have been diagnsed with a chrnic cnditin, but despite this, significant prprtins f Ontarians cnsume less than recmmended amunts f key nutrients. - Access t trusted nutritin advice fr healthy eating, and fr preventin and management f chrnic cnditins, is a key strategy fr cntaining health system csts. Dietitians f Canada (Ontari) recmmends cst-effective plicy measures t imprve access t Registered Dietitians at the individual and ppulatin level. We ask fr yur party s supprt fr these plicies t imprve access t evidence-based nutritin services: Imprve access t dietitians in primary care settings Dietitians have a psitive effect n utcmes and save healthcare dllars: - Dietitians wrking in primary health care can als have significant ecnmic benefits, saving the health care system $5.50 $99 fr every $1 spent n dietetic interventin. 2 - Nutritin cunselling imprves general eating behaviurs assciated with gd health such as increased fruit, vegetable, and fibre intake and decreased fat intake 3 - Lifestyle interventins including nutritin cunselling can 4 : reduce the risk f develping type 2 diabetes by up t 70% in adults at risk imprve bld pressure and chlesterl levels (after at least 3 mnths) decrease bdy weight by abut 3-6 kg (after at least 12 mnths). Enable remte access t the credible advice f dietitians all acrss Ontari thrugh Dietitian Advisry Service t prvide cnsumers and health intermediaries all acrss Ontari with easy, remte access t the credible advice f dietitians n fd and nutritin - EatRight Ontari dietitian advisry service ended in March 2018, despite numerus successes ver its 10-year peratin and reliance n the service by Public Health Units and ther health intermediaries. PAGE 1
- The ERO service addressed access barriers related t service fees, remte access, wait times, as well as prviding service t at-risk cultural grups in their language f chice. - Dietitian advisry service infrastructure needs t be sustained fr remte public access all acrss Ontari, supprt capacity building with ther health sectr health delivery, and implementatin supprt fr prvincial gvernment plicies and prgrams. If this type f service is nt sustained it places burden and resurce demands n existing health service prviders. - Telehealth Ontari has implemented sme dietitian access in 2018 it is imprtant that this be maintained Increase in the mandated dietitian time fr LTC hmes t 45 minutes/resident/mnth t enhance care fr the frail elderly - Residents mving int lng term care are mre frail and at greater nutritin risk than ever befre. - Many residents are malnurished r undernurished at the time f LTC admissin and are mre likely t have multiple chrnic illnesses and cgnitive deficits. - Nutritin interventins can prevent r delay further health and functinal decline. Supprt hspitals and primary care settings t implement malnutritin screening - Malnutritin and pr fd intake while hspitalized extends the length f stay n average 2 days--csting the hspital system $2 billin per year. - Less than a quarter f patients see a dietitian and 75% f hspital patients wh are malnurished will nt be treated by a dietitian 7. - Screening fr malnutritin identifies patients at risk s that crdinated care can be planned. - Adequate staffing and leadership fr dietitians in hspitals is critical fr patient well-being yet Ontari hspitals cntinue t dwnsize clinical nutritin services. Imprve access t dietitian services within hme care t decrease the need fr mre cstly services - Many hmecare clients that need dietitian services are nt receiving them fewer than 1% f hmecare visits are fr dietitian services 8. - Service prvider agencies have difficulty retaining qualified prfessinal staff due t the incnsistency in wrklad. - Imprved nutritin status assists with wund healing, reduces risks f falls, and imprves cntrl f chrnic cnditins. Supprt a crdinated Fd and Nutritin Strategy - Inter-ministerial and crss-sectral crdinatin is needed t advance fd and nutritin pririties in the prvince thrugh: Healthy fd access Fd literacy and skills Healthy fd systems - Plicy recmmendatins develped thrugh extensive stakehlder cnsultatin include access t dietitian services, and are available at http://sustainntari.cm/wrk/fns/ Implement incme-based slutins t reduce rates f fd insecurity - 1 in 8 Ontari husehlds d nt have enugh mney t buy safe and nutritius fd. PAGE 2
- Eliminatin f husehld fd insecurity requires secure, adequate incme fr all husehlds t be able t pay fr husing, fd and ther basic living expenses 9. - DC supprts the Ontari Dietitians in Public Health N Mney fr Fd is...cent$less campaign. Fr further infrmatin: Jennifer Buccin MEd RD Reginal Executive Directr, Nrthwest and Central Ontari Dietitians f Canada Tel: 416.642.9302 Jennifer.buccin@dietitians.ca www.dietitians.ca PAGE 3
References 1. Auditr General s Annual Reprt 2017. Public Health: Chrnic Disease Preventin. http://www.auditr.n.ca/en/cntent/annualreprts/arreprts/en17/v1_310en17.pdf 2. Hwatsn, A. Wall CR, Turner-Benny P. 2015. The cntributin f dietitians t the primary health care wrkfrce. J Prim Health Care 2015; 7 (4): 324-332 3. Dietitians f Canada. In healthy adults and adults with chrnic disease, what is the impact n health behaviur change f telehealth interventins delivered by health care prviders cmpared with usual care? In: Practicebased Evidence in Nutritin [PEN]. 2016 Jan 13. Available frm: http://www.pennutritin.cm. The PEN System: an internatinal, nline, evidence-based, peer reviewed database fr nutritin guidance. 4. Dietitians f Canada. What is the effectiveness f dietary r lifestyle interventins fr preventing r treating chrnic disease in the primary care setting? In: Practice-based Evidence in Nutritin [PEN]. 2016 Sept 12. Available frm: http://www.pennutritin.cm. The PEN System: an internatinal, nline, evidence-based, peer reviewed database fr nutritin guidance. 5. Dietitians f Canada. Ontari Primary Health Care Dietitian Wrkfrce Survey Reprt 2015. 6. Dietitians f Canada. Ontari LTC Dietitian Time Survey Reprt 2016. 7. Canadian Malnutritin Task Frce publicatins. www.malnutritinincanada.ca 8. Hme Care Ontari. Facts and Figures n Publicly Funded Hme Care. http://hmecarentari.ca/hme-careservices/facts-figures/publiclyfundedhmecare 9. Dietitians f Canada Psitin Statement n Husehld Fd Insecurity 2016. https://www.dietitians.ca/dietitians-views/fd-security/husehld-fd-insecurity.aspx PAGE 4
PAGE 5