The healthiest campus in Canada?

Dr. Louis Francescutti doesn't hold back his opinion of Canada's health care system, he just offers it up: "It's the greatest waste of money in the country."

The system, he states simply, is built to accommodate sick people, which is more expensive and less effective than dealing with healthy people. Preventing illnesses, he says, is the best medicine.

As an emergency room physician at the Royal Alexandra Hospital in Edmonton, Francescutti sees a parade of preventable illnesses and injuries. Every day he treats patients who are, for the most part, the authors of their own misfortune.

"I take care of people who primarily don't take care of themselves, people who are not able to breathe because of smoking, or who are having strokes because they are overweight and inactive, whose injuries and illnesses are primarily the result of their own behaviours," said Francescutti, a professor of public health science in the U of A Faculty of Medicine and Dentistry.

Trained in preventative medicine at John's Hopkins, Francescutti is frustrated by the ER's revolving door and the health care system's inability to recognize, let alone solve, the problem. He sounds cynical as he rattles off the names of the federal commissions and provincial reports that have focused on health care, their names long forgotten, the veneer and promise of change in their titles tarnished.

"Everybody tells us that the current health care system is unsustainable, but they fall very short in giving you concrete steps in what needs to be done," he said.

So why, then, would Francescutti head up a U of A Senate Task Force on Wellness? Doesn't that sound like yet another dust collector? He insists the document is different.

Filed to the Board of Governors last spring, the task force report, ambitiously entitled Becoming the Healthiest University in Canada, is "the next step in taking the university community beyond rhetoric and into a mindset where we can take control of things that will make us healthy," he said.

"This is the first report of its kind that I have seen for a university, that lays out a blueprint. It isn't an airy-fairy document that says 'we should all be healthier.' It tells us what we need to do."

The report is available online at the U of A Senate website (www.uofaweb.ualberta.ca/senate/ ).

The most talked-about recommendation in the report suggested a campus-wide ban of tobacco altogether. The idea created a stir, with some calling the scheme visionary and others arguing it was Orwellian. Ultimately, the U of A Board of Governors accepted the report, but expressed reservations about how practical the smoking recommendation might be to implement.

Cigarettes kill about 45,000 people per year in Canada, and Francescutti agrees that banning smoking would be the single-most effective step the university community, and the greater community, could take to improve its health.

"I think it is just a matter of time," he said of the idea. "We may be a little ahead of our time on this one, but the university should very strongly support smoking cessation programs. The irony is that we continue to pretend everything is OK when things are not, and we continue to say wellness is important but never spend any money on it."

The report also backs a handful of initiatives including the U of A On The Move project.

The program was formed out of the U of A Faculty of Agriculture, Forestry and Home Economics' annual Empey Lecture last fall. The lecture was presented by Dr. James Hill, who is credited with developing the successful America On the Move program, and Dr. Diane Finegood, scientific director of the Institute of Nutrition, Metabolism and Diabetes with the Canadian Institutes of Health Research.

It's all part of a campus-wide movement to promote active living, said Dr. Rhonda Bell, who teaches human nutrition in the U of A Department of Agricultural, Food and Nutritional Science. Bell has used pedometers in research that resulted in the First Step Program for people with Type 2 Diabetes.

The campus community can purchase the U of A pedometers for $25 from the office of Health Promotion and Worklife Services. The devices come with instructions and maps of walking routes in the campus vicinity. The U of A On the Move website (www.onthemove.ualberta.ca/) also includes maps of indoor walking routes on campus. The website offers resources to find target heart rate zones and to determine body composition. It also allows On The Move participants to register and maintain an online log of their walking activity.

Dr. Wendy Rodgers, a professor and associate dean of research with the U of A Faculty of Physical Education and Recreation, says pedometers have been shown to help motivate people to become more active. She also sees the value of seeking informed consent from participants to access a database of how effective the program is. She's confident that On The Move could improve workplace productivity as well.

A special Week of Wellness being planned by the U of A Students' Union, the U of A Faculty of Physical Education and Recreation, and other groups on campus, also earned the task force's support. The first annual University of Alberta Wellness Week - Spring into Action, takes place March 14 - 20 at locations throughout campus. Events during the week include a skating party, comedians performing on the SUB stage, a wellness fair, the U of A's largest fitness class ever, cooking demonstrations, and an ultimate Frisbee marathon in Quad to raise money for charity.

Dr. Mike Mahon, dean of the Faculty of Physical Education and Recreation, says the idea fits with the faculty's goals to promote wellness on campus, and the task force recommendations.

"We're hoping the Wellness Fair will highlight everything from physical education and nutrition to mental wellness," he said.

Francescutti fully supports the notion that wellness includes mental and emotional well-being, and the task force, he says, hopes to reduce stress in the workplace, too, which task force committee members heard a lot about while researching their report.

"Some of what was related to us was about how we handle change at the university. We are poor at managing change. People can adapt to change if they are invited to be a part of the process. And one other thing is that a lot of managers on campus don't have the first clue how to manage. We need to have more training for faculty chairs and deans," he said. "All you have to do is teach people to show respect and dignity to their staff, allow them to grow as individuals, and give them pats on the back when they deserve them."

Other task force recommendations include making healthy snack and meal options more readily available, reviewing on-campus leases to attract businesses that offer healthier food choices, and starting a campus-wide immunization program. The task force would like to see shower and workout facilities in every building, so that people will find it easier to exercise at or on their way to work.

The task force's recommendations are now being examined by a new committee established to keep the report moving forward. Melanie Goroniuk, the U of A health promotion and worklife services manager, says a January meeting will begin the process of putting the recommendations into action.

"The idea now is to review the recommendations in the report and if they look good, say 'yes' and then try to come up with an implementation plan, and if we say 'no', then ask why not, and what do we do instead, because the issues are still important and we still need a strategy," said Goroniuk.

Goroniuk says the university's health promotion and worklife services will host a virtual office that will act as a sort of online clearing-house for wellness on campus.

"We just want to be able to share all the information with our staff members," she said.

Steps have already been taken on smoking cessation, she noted, with a $50,000 AADAC grant awarded to the university, the Students' Union, and the U of A Faculty of Physical Education and Recreation to help raise awareness around tobacco reduction. While the program is aimed at 18 - 24 year olds, Goroniuk notes that it may well affect some staff members and their family members.

It's steps like the ones outlined in the task force report, Francescutti says, that could make a big difference at the local level. The U of A, he hopes, will serve as an example for the greater community to follow.