Stopping the soaring obesity rate behind a worsening diabetes epidemic in this province may take a social engineering effort on the scale of anti-smoking campaigns that cracked the tobacco habit for millions, experts on the disease say.
But Health Minister George Smitherman says his government's priority must be to improve care for the people who already have the ailment.
"I think it's really crucial that in talking about what needs to be done ... that we not forget the provincial government's got a very pressing current responsibility as well, which is looking to enhance the quality of care for about 800,000 people in Ontario that are estimated to have diabetes already," he said.
"We've got the current reality of a very large population that's got ... inconsistent access to diabetes care."
Those responsibilities for maintenance and treatment must compete with any education and prevention strategies that could ward off future cases, he said.
Smitherman said people with diabetes – who can suffer from heart disease, kidney ailments, blindness and circulatory problems – are helping clog hospital emergency rooms in the province.
And any program to decrease current emergency room wait times – a government priority – must better address the health of those patients, he said.
But some top diabetes researchers argue that generations alive today may be a lost cause when it comes to strategies to significantly slow the obesity and diabetes epidemic.
The roots of the problem, they say, are so deeply entrenched in the workings of our culture that real solutions may have to target the very young and future generations.
Smitherman said the provincial Liberals, which in the recent election promised $450 million added funding over four years for diabetes, have already done many things to combat obesity and diabetes.
He said the province has banned the sale of junk food and mandated more physical education in Ontario schools. As well, Queen's Park will double the resources spent on opening those schools to after-hours community activities.
The province, Smitherman said, is also building community health centres in 11 of Toronto's underserved neighbourhoods to steer people toward healthier living options. In addition, it is developing a provincial screening program to identify people with diabetes and those in danger of contracting the disease, he said.
"And we've created a Ministry of Health Promotion, all of this recognizing the sheer necessity to do more at the community level to alter and divert this trend line."
But Smitherman said some of the culturally based causes of rising obesity rates – key to the diabetes epidemic – are likely beyond the government's capacity to alter.
"Maybe (people) think it's possible for government to legislate how much time kids spend sitting behind a computer playing a video game or in front of a television. I think that, typically speaking, those types of government incursions into the home are a bit problematic."
As well, Smitherman said, there's little that can be done to alter the car-dependent urban sprawl communities that most experts believe are partially responsible for soaring obesity rates.
"Are they proposing to tear down Etobicoke and Scarborough and start again?" he asked.
He said urban intensification efforts, which would place more pedestrian-friendly amenities in sprawl areas, could backfire by actually eating up existing park and recreation space. "I don't really actually concur that, as a one-off solution, that (sprawl remediation) is the place to invest our energy."