Why does Alberta need a wellness foundation?
Chronic diseases such as cancer, heart disease, stroke, lung disease, diabetes and mental illness are the leading cause of death and disability in Alberta. Alberta spends the majority (over 90%) spent on the treatment and management of diseases which are largely preventable. As the Alberta population grows and ages, the number of new cases of chronic disease is expected to rise, adding more pressure to our healthcare system. A new approach to preventing chronic disease and promoting health is needed in Alberta. We know that investing in effective strategies to improve the quality of life of Albertans is good value for money. Research shows that a one dollar investment in health promotion, or efforts to help Albertans ‘stay healthy’, can be expected to result in a $4 to $5 cost savings to the health care system. Some large scale interventions have produced a return of investment of up to 50 to 1. Past efforts by government to invest more in preventing diseases and promoting health have been undermined by funding pressures in the health care delivery system. A wellness foundation would make sure the funding and focus is sustained and protected over the long-term.
What will a wellness foundation do to prevent disease and promote health?
A wellness foundation will focus on evidence-based actions that have been proven to address the root cause of a health problem before it develops (primary prevention). A foundation will not undertake activities in the areas of screening, rehabilitation, primary care or other forms of early detection or follow-up. Many risk factors for chronic disease in Alberta can be influenced. A Wellness Foundation will focus on addressing six well-established risk factors including physical inactivity, unhealthy eating, tobacco use, alcohol misuse, preventing adverse childhood experiences and injury.
A Wellness Foundation will work with a range of government departments, health agencies, community organizations and other key stakeholders to implement five key strategies including;
How much money would a wellness foundation need?
We propose that approximately $200 million annually, an amount equivalent to at least one percent of the total Alberta Health budget, be devoted to a dedicated wellness foundation. This is known as the “one-percent solution”. We recommend an initial investment of $60 million, increasing over 3 to 5 years to at least $200 million per year. This investment must also be new and separate from existing government budgets for prevention and health promotion. The goal is to increase investments in chronic disease prevention in Alberta, not reallocate existing funding for this work.
Where would this money come from?
Funding for a Wellness Foundation can be derived from an appropriation of the Alberta government’s general revenue fund or by implementing a special Wellness Levy on tobacco, alcohol products and possibly pop and other sugar-sweetened drinks. Research indicates that Albertans would support this approach to funding. In 2014, the Alberta Policy Coalition for Chronic Disease Prevention via the POWER UP! project surveyed senior decision-makers in government, schools, workplaces and media regarding investments in prevention. Ninety-five (95%) of Alberta respondents indicated they would support government action to reallocate 100% of tobacco tax revenue directly to health care and prevention. Seventy-two (72%) of Alberta respondents said they also would support the investment of alcohol revenue into these areas.
Is using money from increasing the price of tobacco or alcohol products (through a special Wellness Levy) to fund a wellness foundation a cost-effective approach for Government?
Funding for a wellness foundation must be adequate, long-term and separate from the existing health care budget. Tobacco use and alcohol misuse create a huge burden on our health care system. In addition to generating revenue for a wellness foundation, the positive impact of a levy on tobacco or alcohol products for public health will be immediate. Increasing the price of these products through tobacco taxes or increasing mark-ups on alcohol products is a proven health promotion strategy for reducing use, especially among young people in Alberta (see www.smokefreealberta.com and the Alberta Policy Coalition for Chronic Disease Prevention issue brief titled “Addressing Alcohol-Related Harm in Alberta”). In the long-term, lowering consumption of tobacco and alcohol will help reduce tobacco and alcohol-related deaths, illness and disability, and reduce the burden of chronic diseases on our health care system. The new revenue generated by a wellness levy on these products will be used by the foundation to support other evidence-based health promotion interventions to prevent chronic disease and injury and promote a better quality of life for all Albertans. In the long-term, a wellness foundation in Alberta will also reduce demands on the healthcare system. As more Albertans ‘stay healthy’, government won’t need to spend as much on costly treatments and hospital stays needed to treat preventable disease and injury.
Why doesn’t the Ministry of Health simply request a bigger budget and do more health promotion activities?
The total amount spent on prevention and health promotion in Alberta is approximately 3% of the provincial health budget. Much of these limited funds are then applied to the prevention of communicable diseases in Alberta, such as vaccination campaigns. Although health departments use the remaining funding for addressing a wide range of public health concerns, the current funding amount is simply not adequate to address all possible areas of chronic disease prevention. Furthermore, this small amount of funding is not ‘protected’ and is vulnerable to shifting government priorities and increasing financial demands from the acute care system. This has meant that keeping a long-term focus on specific health strategies in Alberta has proven very difficult. Government funding for these strategies is often limited to short-term ‘pilot’ or ‘demonstration’ projects with little or no available funding to continue the work once the initial term has ended. Although there are several possible governance models for ensuring that would fit for a Wellness Foundation, Wellness Alberta believes any chosen governance model must ensure the Wellness Foundation is enabled to take a long-term funding approach and focus on the complex social and public health issues being experienced in Alberta. To be effective, a Wellness Foundation must not be constrained by government funding and political cycles. Read more on the specific governance model proposed by Wellness Alberta.
A Wellness Foundation will enhance but not duplicate the important work being done by government departments. The foundation can support government strategies by working with those successful pilot projects to expand (‘scale up and spread out’) into other places/communities in Alberta. A foundation will work to fill gaps in areas not traditionally funded by the government, and will generate evidence to support effective programming and policies which could be used for provincial wellness planning.
The funding model we are proposing will generate new revenue for funding this work, and does not reduce or impact on the current and necessary prevention funding allocated within Alberta Health, Alberta Health Services or other non-governmental organizations funded to do this work.
Is the funding and operational model being proposed for a Wellness Foundation similar to any existing models in Alberta?
The Wellness Foundation model draws from two existing models in Alberta; the Alberta Heritage Savings Trust Fund and the Alberta Tourism Levy.
The Alberta Heritage Savings Trust Fund is valued by Albertans because it demonstrates a dedicated Government commitment to our long-term financial health. Similarly, creating a dedicated, well-financed, sustainable Wellness Foundation in Alberta would demonstrate Government's commitment to our long-term physical, mental and social health. Investments in the Alberta Heritage Savings Trust Fund are protected by legislation and the Fund is overseen by an all-party standing committee. Wellness Alberta believes financial investments for the Wellness Foundation require this same assurance of public accountability, transparency and protection from the ongoing budgetary demands from the acute care delivery system and budget shortfalls in other Ministries.
The proposed funding model for a Foundation is based on the current Alberta Tourism Levy. The Tourism Levy is applied to hotel room charges in Alberta and the proceeds are used to promote tourism in Alberta. Revenue from the Wellness Levy will be reinvested in a Wellness Foundation dedicated to promoting physical, mental and social health in Alberta.
To what extent do Albertan’s support the creation of a wellness foundation?
Over the past quarter century, several key provincial government commissions and reports have explicitly recognized the good value of investments in prevention and health promotion in order to improve the health and productivity of Albertans in the long-term and lessen the demand on our health care system. A March 2012 Ipsos Reid survey found that 80% of Albertans surveyed support investing an amount equal to 1% of the health budget each year into a wellness foundation dedicated to promoting healthy living. Furthermore, 78% of those polled agreed the foundation should operate independent of the provincial health care system to ensure the funding and focus is protected over the long-term. When asked how a foundation should be funded, Albertans supported increasing tobacco taxes (79% support), alcohol taxes (68% support) and taxing pop and other sugar-sweetened beverages (65% support).
Is now the right time to set up a wellness foundation in Alberta?
If we always do what we have always done, we will always get what we have always got. It’s time to do things differently in order to significantly improve the health and well-being of Albertans and to reduce the substantial demands resulting from preventable illness on our health care system. Despite numerous reports and recommendations that call for increasing investments in preventing poor physical, social and mental health, little has changed and the chronic disease epidemic continues. The costs of this inaction have been profound. We are spending more than ever before on acute care in Alberta, and more per capita on health care than any province in Canada. The burden from preventable disease and disability is mounting and neither our public health care system, not our long-term economic productivity will be sustainable unless efforts to prevent disease and disability is prioritized and adequately funded. Support an Alberta Wellness Foundation: It’s about health. It’s about time.
Wellness foundation diagram
Strategies and focus
Return on investment
Successful foundation examples