Introduction

On 27 February 2019, it was agreed that the House of Commons Standing Committee on Health (the Committee) would study M-206, which addresses the physical activity and fitness levels of Canadian youth.[1] The motion states:

That the Standing Committee on Health be instructed to undertake a study on the level of fitness and physical activity of youth in Canada and provide recommendations and report on: (a) strategies to increase the level of fitness and physical activity for youth; (b) the economic, social, cultural, and physical and mental health benefits associated with increased fitness and physical activity among youth; (c) the impact of increased fitness and physical activity in relation to anti-bullying; and (d) that the Committee report its findings and recommendations to the House no later than June 2019.[2]

During two meetings held on 27 and 28 May 2019, the House of Commons Standing Committee on Health heard from 12 witnesses as well as the sponsor of the motion, Mr. Kyle Peterson, Member of Parliament for Newmarket – Aurora.[3] In presenting his motion to the Committee for study Mr. Peterson stated, “We’re failing our children.”[4]

The Fitness Level of Canadian Youth

The Canadian Society for Exercise Physiology (CSEP) has established guidelines on how much physical activity children and youth should get every day. The CSEP has incorporated the physical activity guidelines within the broader Canadian 24-hour Movement Guidelines for Children and Youth (ages 5-17 years) (24-hour Movement Guidelines) that include physical activity, sedentary behaviour and sleep requirements.[5] These guidelines recommend that children and youth get several hours of mild to moderate physical activity every day in addition to at least one hour of vigorous physical activity on a daily basis.

Several witnesses cited statistics on the proportion of Canadian youth that meets the CSEP 24-hour Movement Guidelines provided in ParticipACTION’s 2018 report card on physical activity for children and youth.[6] The report card reveals that 35% of children and youth aged 5‑17 years meet the level of physical activity recommended in the 24-hour Movement Guidelines based on data from the 2014-2015 Canadian Health Measures Survey.[7] However, there is a significant gender disparity within this measure: 47% of boys meet the 24-hour Movement Guidelines compared to only 25% of girls.[8] Overall, this translates to a grade of D+ for physical activity in this age group. Canada’s children and youth score even lower when all three recommendations in the 24-hour Movement Guidelines are considered. That is, when sleep (between 8 and 11 hours) and sedentary behaviour (no more than 2 hours including screen time) are included in the overall measure, only 15% of Canadian children and youth are meeting the recommendations for sleep, sedentary activity and physical activity.[9] Members were told that the fitness level of Canadian youth ranks around the middle among 48 middle- and high-income countries.[10]

Physical Activity and Health

Witnesses emphasized the negative health consequences of an inactive lifestyle. Committee members were told that being physically inactive increases the risk of a number of chronic conditions including type 2 diabetes, cardiovascular disease and some types of cancer.[11] The Committee was told that the cost to the healthcare system for the treatment of chronic diseases linked to inactivity is as high as $6.8 billion annually, or 4.0% of total healthcare costs.[12]

Conversely, an active lifestyle is associated with health benefits. The Committee was told that physically active children and youth think better, learn better, are more creative and have improved social skills.[13] Members heard that physical activity has a positive impact on mental health. Physically active children and youth are less likely to suffer symptoms of depression, anxiety and are better at handling stressful situations.[14] In terms of bullying, members were told that physically active children and youth are more resilient to bullying and are less likely to become bullies themselves.[15]

Federal Role in Current Initiatives

The Public Health Agency of Canada (PHAC) is the federal agency responsible for promoting healthy lifestyles, which include physical activity alongside healthy eating and avoidance of unhealthy behaviours. The Committee was told that PHAC collaborates with other stakeholders to fulfill this responsibility. PHAC provided funding to CSEP to develop the 24-hour Movement Guidelines[16] and, in 2018, committed $25 million over five years to ParticipACTION for its Let’s Get Moving initiative.[17] Both of these initiatives include a youth component but are not specifically targeted to children and youth.

Frequently cited by witnesses was the document outlining a pan-Canadian framework on physical activity entitled A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let’s Get Moving (Common Vision), which was released on 31 May 2018.[18] The Common Vision was prepared by a steering committee made up of sport, physical activity, recreation and health representatives from the federal, provincial and territorial governments. Intended only as a policy document, the purpose of the Common Vision is to “complement and align with other relevant policies, strategies and frameworks”[19] that exist across Canada with the goal of increasing physical activity levels of all Canadians.[20] Members heard that work is underway to convert the policy framework of the Common Vision into an implementation plan for action.[21]

Recommendations for Further Action by the Federal Government

The Committee heard about the efforts of stakeholders to improve the physical activity and fitness level of Canadian youth. For example, the Boys and Girls Clubs of Canada offers a range of structured and supervised extracurricular programs and services to 200,000 children and youth in 700 communities across Canada.[22] The organization recently launched a program called “Bounce Back League” for children who have experienced trauma that recognizes the positive impact of physical activity on mental health.[23]

Some witnesses mentioned efforts to increase “active transportation,” which refers to means of transportation that involve physical activity including walking, biking, running and skateboarding. For example, the Committee was told about the walking school bus initiative, which involves students, usually with supervision, walking to school in a group as they pick up other students along the way.[24] However, it was pointed out that many students are not within walking or even biking distance of their schools[25] and that schools are not always equipped to properly and safely store bicycles during the school day.[26]

The Committee heard about the need to “normalize” daily physical activity;[27] that it should be a normal and expected part of every day. The Committee was told that other countries have implemented strategies to normalize physical activity but that these strategies can involve different approaches. For example, in Japan, all children walk to school, in New Zealand children are expected to spend two hours a day playing outside and in Scandinavian countries the focus is on daily physical education.[28]

In terms of physical education, most children and youth attend school, therefore physical activity programs in schools are best suited to reach the largest proportion of children and youth. Canadian guidelines recommend that students get 30 minutes of high-quality daily physical education.[29] However, the Committee heard that school curricula vary across the country with provinces and territories implementing different minimum requirements for daily physical education. As little as 22% of Canadian students receive daily physical instruction.[30] It was suggested that there still may be a preference for academic achievement over physical activity, resulting in some resistance by school boards to place more emphasis on physical education in the curricula.[31]

The issue of community infrastructure was also raised during this study. Appropriate community design can encourage active transportation and outdoor play, which should lead to the normalization of physical activity. The Committee heard that the federal government, through Infrastructure Canada, provides funding for community infrastructure projects. It was noted that this program is highlighted in the Common Vision.[32]

Finally, the concept of physical literacy was frequently mentioned. Physical literacy refers to the knowledge and understanding required for individuals to value and take responsibility for their physical activity.[33] The Committee was told that physical literacy needs to be developed at a young age so that good physical activity habits can be ingrained in youth and will follow through to adulthood for a healthy life.

All witnesses agreed that the Common Vision policy framework must be converted to actionable items. Members were told that the implementation plan that is developed must take a community level approach that involves all sectors, including parents, education, recreation, sports and health services.[34]

In presenting its recommendations to the federal government, the Committee emphasizes the plea it heard, “What we can't afford is to do nothing.”[35]

Recommendation 1

That the Government of Canada ensure sufficient funding for, and endorse the development of, an implementation plan for the pan-Canadian framework on physical activity entitled A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let’s Get Moving.

Recommendation 2

That the Government of Canada appoint a “Physical Activity Champion for Youth” responsible for:

• ensuring that all relevant stakeholders are included in the group tasked with developing the implementation plan for A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let’s Get Moving;
• overseeing the implementation plan, particularly as it relates to programs, strategies and initiatives targeted to children and youth aged 5-17 years;
• reporting to the Minister of Health on the progress of the implementation of that plan; and,
• ensuring that the impact of the implementation plan is measured with respect to the performance of youth in terms of the Canadian Society for Exercise Physiology’s Canadian 24-hour Movement Guidelines for Children and Youth (ages 5-17 years).

Recommendation 3

That the Minister of Health report annually to Parliament on the status of the implementation plan for A Common Vision for Increasing Physical Activity and Reducing Sedentary Living in Canada: Let’s Get Moving and that the reports be publicly available.

Recommendation 4

That the Government of Canada commit to sustained funding for the promotion and adoption of the 24-hour Movement Guidelines developed by the Canadian Society for Exercise Physiology.

Recommendation 5

That the Public Health Agency of Canada work with the proposed Physical Activity Champion for Youth to develop and implement Canada-wide public awareness campaigns to:

• increase physical literacy among Canadian children and youth;
• promote the Canadian Society for Exercise Physiology’s Canadian 24-hour Movement Guidelines for Children and Youth (ages 5-17 years); and,
• normalize daily physical activity.

Recommendation 6

That the Government of Canada work in collaboration with the provinces and territories as well as the Federation of Canadian Municipalities to ensure that local governments are aware of available federal funding for active transportation projects through the Public Transit Infrastructure Fund.