What is Healthy Together Now?
Healthy Together Now is a government-funded, community-led initiative to prevent chronic disease in Manitoba. It began as a five-year pilot project called Chronic Disease Prevention Initiative (CDPI), and about half-way through this period it became known as “Healthy Together Now,” with Chronic Disease Prevention Initiative as a subtitle.
The vision of Healthy Together Now is to improve the health of Manitobans. The original vision was to accomplish this by focusing on three common risk factors for chronic disease: smoking, physical inactivity and unhealthy eating. The initiative would publicize these risks and offer support for changing behaviours associated with them. As the program evolved, some communities added a fourth “pillar” – mental wellbeing – as another important health factor underlying all the others.
Healthy Together Now came about as a result of the growing awareness of the burden of chronic diseases on Manitoba society. Chronic diseases such as heart disease, stroke, cancer, diabetes and obesity are major causes of illness, disability and death in Manitoba. Six out of ten Canadians are living with at least one chronic disease.
To build a case for the initiative, data on chronic disease and its risk factors in Manitoba was gathered. Manitoba had the highest rate of smokers in Canada, and the percentage of Manitoba adults who were obese exceeded national averages. In 1996, cancer, circulatory and respiratory disease deaths accounted for almost 50 per cent of the potential years of life lost in Manitoba, once again exceeding national percentages.
In September 2002, a CDPI Planning Committee was established, consisting of key decision-makers representing federal and provincial government, non-government organizations and regional health authorities. This group had met previously to discuss the development of an initiative for chronic disease prevention modeled on the Heart Health Project. Eventually a funding proposal was developed and submitted to the Public Health Agency of Canada, and a project charter was developed. The planning committee disbanded in November 2004 when a federal partnership was secured and Manitoba Health took the lead for CDPI.
The five-year demonstration project was jointly funded by Manitoba Health and Healthy Living and the Public Health Agency of Canada to March 2010. By the end of the five years, Healthy Together Now/CDPI had been implemented in 10 Regional Health Authorities involving 83 communities including 21 First Nation and 7 Métis communities. Approximately 330,000 Manitobans were reached and well over 100,000 participated directly in the programs.
How it works
A Joint Management Committee (JMC), with representatives from all participating health authorities and from provincial and federal governments, provides policy direction, overall project planning, communication and accountability. An Evaluation Committee monitors results and a Training Committee ensures adequate training for program leaders.
In the charter, regional committees were envisioned to be consistent structures in each RHA. Even though local adaptations changed that structure somewhat as the program unfolded, the intent of the regional committees remained. The committees provide regional-level planning and implementation, direction and oversight.
Combined provincial and federal funds flow from the provincial government via funding letters to the regions. The regions provide in-kind funding in personnel and other resources. Participating communities develop action plans to address the risk factors that affect their community. They work with their RHAs, local stakeholders, community organizations, schools, municipalities and individuals to identify health promotion and chronic disease prevention activities focused on tobacco reduction, healthy eating, physical activity and mental wellness. Partnerships with existing organizations and programs are encouraged. These plans are evaluated and if accepted, the resulting programs are monitored by both the regional and provincial committees. The regions are accountable for the government funds and the communities are accountable to their region.
Healthy Together Now projects are:
Community led: Community members identify, initiate and lead projects.
Evidence informed: Evidence is used to plan and design each project and to measure its effectiveness.
Integrated: CDPI aligns and blends with existing programs to add value and enhance their reach.
Focused: Projects target priorities or disadvantaged populations as identified by communities.
Sustainable: Strong partnerships and community ownership promote lasting effects.
In 2009 Healthy Together Now was awarded the Tommy Douglas Celebration of Medicare Award for Excellence in Interdisciplinary Achievement in the Area of General Disease Management. Numerous other groups and individuals have received various provincial and regional awards for their work in Healthy Together Now.