Alberta Cancer Foundation

From Survive to Thrive

Like many people proactively involved in cancer prevention and treatment, Susan Flowers has witnessed the effects of the disease in her own life. “I lost two friends at young ages from cancer – one was 50 and the other 56,” she says. “That’s just way too young.”

Today, Flowers is involved in a new chronic disease prevention program called Thrive on Wellness. As manager of Family and Community Support Services and Social Planning in Cochrane, Alberta she’s in the early stages of the program’s implementation. Cochrane is one of several communities serving as pilot project areas for the program. And when it’s firmly in place, Flowers and colleagues hope that cancer rates here (and eventually in more than 140 Alberta communities) will drop as much as 60 per cent over two decades.

It’s not farfetched. In 2002, the World Health Organization released a fact sheet summarizing primary health-care initiatives in three countries that indicated dollars spent on prevention were an investment against treating some costly health conditions later. “Strategies for reducing onset and complications,” the report states, “include early detection, increasing physical activity, reducing tobacco use, and limiting prolonged, unhealthy nutrition.” The report concludes: “Small steps are as important as system overhaul. Those who initiate change, large or small, are experiencing benefits today and creating the foundation for success in the future.” It reads like a pitch for Thrive on Wellness.

Cancer reduction is a lofty goal, says Sandra Delon, who serves as the Director of Chronic Disease Prevention and Oral Health at Alberta Health Services. But it’s one that’s built on a solid foundation of research with proven examples of success. The first step, says Delon, is for society to begin thinking in terms of prevention instead of treatment. “We need to begin addressing the root causes of chronic disease,” she says. “Thrive on Wellness is geared to exactly that.”

A joint initiative of Alberta Health Services and the Alberta Cancer Foundation, the Thrive program is a province-wide effort aimed at reducing the occurrences of cancer, its causes and a host of other leading health problems. “One of the things that was discovered in the years of research that led to this project is that by tackling core health issues we could see a long-term reduction in not just one chronic disease but several,” says Delon.

Kim Raine is a professor in the Centre for Health Promotion Studies in the University of Alberta’s School of Public Health and holds a CIHR Applied Public Health Chair. Her own six-year research program, called Healthy Alberta Communities (HAC), is the model for Thrive on Wellness. “When we talk about common risk factors among chronic diseases, it’s diet, physical inactivity, and tobacco use,” says Raine. “We consume more calories than we did 20 years ago. We live in an environment where you can get 2,000 calories delivered to your car.”

Looking for ways to address these issues in 2005, Raine and her team concentrated on identifying local resources and reducing the barriers to healthy eating and physical activity. HAC focussed on Medicine Hat, Bonnyville, St. Paul and Norwood, an inner city area of Edmonton. The next step was to develop interventions in concert with community members to address local needs. “We wanted to create linkages with people and not just helicopter in some resources and leave,” Raine say. “We worked sustainability into the plan.”

Each community came up with a set of ideas. In Medicine Hat, an area where greenhouses and local agriculture are prevalent, teams developed community gardens on plots donated by the city to grow healthy food and increase the physical activity that gardening entails.

In Bonnyville, a program called Moms in Motion was created in partnership with the local recreational facility. The program purchased jogging strollers which the facility then loaned to low-income women for use in and around the facility. “So low-income women who were challenged with getting enough physical activity now had resources and didn’t require child care,” Raine explains.

In Norwood, an area with high transience and low incomes, access to affordable nutritious food was identified as a barrier to health. At the same time, people there didn’t see themselves as needing charity; the local food bank wasn’t an attractive option. With seed money from HAC, a social enterprise called the Good Food Box was created (see side bar). “It was an excellent way for people to get access to nutritious food,” says Raine.

Flowers and a number of community volunteers hope to replicate those results in Cochrane. Construction of a community kitchen is underway, soon to be the nucleus of social programs to educate on healthy eating, allow community groups to gather and prepare healthy food, and serve as a conduit for good food boxes.

As one group of volunteers focuses on food, another is working on plans for a health fair to help promote active, healthy living. Ideas include a blood pressure clinic and areas where the public can try new sports. New commuter paths are in the works. “We have beautiful bike paths for recreation, but they’re not really set up for true commuting,” Flowers says. “In the new districts they’re putting in paths that are rideable and walkable.”

Once Cochrane plans are fleshed-out, Flowers and her team will apply for grants through Thrive on Wellness, in amounts up to $20,000 in total. With the bulk of pilot programs and research behind Thrive, and the commitment of Alberta Health and Wellness, she’s confident that Cochrane can expect lower chronic disease rates in the years to come.

Raine feels the same way, and is pleased with what she sees. “This exceeds my expectations,” she says. “It’s a researcher’s dream to have a project you work on be picked up and implemented into what will hopefully become standard practice everywhere.”

Good Food Boxes

When Susan Flowers put forward the idea of creating boxes of fruit, vegetables and extras, such as healthy recipes, for distribution to Cochrane-area residents, “we received 30 letters of support from different agricultural groups,” she says.

Jessie Radies, the founder of Edmonton-based Live Local Alberta, isn’t surprised. Her experience with good food boxes dates back to the Healthy Alberta Communities project, where she helped unveil the concept in Edmonton’s Norwood community. Today Live Local Alberta delivers custom orders of fresh, healthy food to 150 families per week.

Radies’ not-for-profit program injects about $500,000 per year into the local economy. One per cent of the revenue goes toward reducing costs for low-income families and 75 per cent goes to local farmers. “If they’re eating food from us,” Radies says, “they’re eating less processed food and eating locally with less environmental impact.”

MORE: Read the WHO factsheet No. 172 about some global studies indicating the importance of integrating prevention into health care:
www.who.int/mediacentre/factsheets/fs172/en/index.html