Canadian Policy Makers Research Articles

Free sugars in the Canadian diet: a research summary and future directions for food policy.

Until recently, most dietary guidelines and related food policies in Canada focused on total sugars, but recent evidence suggests that free sugars are of greater public health concern. Starting in 2017, our research group received federal funding to fill critical gaps related to free sugars and health. In this commentary, we describe our work related to tracking free sugars in the Canadian food supply and simulating the diet and health impacts of product reformulation. We then summarize how our work has influenced policymaking in Canada with examples of our knowledge translation efforts, and provide a future research and policy agenda based on our findings. Overall, there is significant room for Canadian food policies to target free sugars reductions in food and diets to address overconsumption of this nutrient of public health concern.

Words not deeds: the weak culture of evidence in the Canadian policy style

Abstract The Canadian policy style has been described as one of overpromising and underdelivering, where heightened expectations are often met by underwhelming outcomes. Here, we examine the evidentiary style of Canadian policy-making which undergirds and reflects this policy style, particularly the nature of the policy advisory system that contributes to this pattern of policy-making. We do so by assessing how the different components of the advice system, which include academics, consultants, and policy professionals within the public service, are structured and relate to each other within the overall dynamics of information management and policy formulation in the governments of Canada. Using examples from recent efforts to revitalize Canadian government, the paper argues that the federal government in particular shows a pattern of the predominance of non-innovative academic “super-users,” distributed policy shops, and process-oriented analysts and consultants who combine with attributes of federalism and partisan budgetary politics to drive a distinctively fragmented and procedurally-oriented federal policy-making process. In these processes, evidence is often secondary to political posturing and short-term electioneering in program creation and execution, contributing greatly to the national policy style set out above.

Balancing acts:

While Canadian policy makers are considering expanding school food programs in Canada, parents remain primarily responsible for packing lunches. Although women perform disproportionate amounts of foodwork, including feeding their children on school days, little research has investigated mothers’ experiences of packing school lunches in Canada. Drawing on 14 interviews with mothers of elementary-aged children in British Columbia, this study explored how mothers experience and make meaning of packing school lunches. Mothers described lunch packing largely as an individualized responsibility for children’s nutritional health and general wellbeing. Mothers strived to enact largely unattainable ideals about packing a “good” school lunch and engaged in diverse forms of physical, mental, and emotional labour to do so. When mothers were perceived to fall short of elusive lunch packing ideals, mothers judged themselves and other mothers, and also reported feeling scrutinized by other parents, teachers, and their children. While assuming the bulk of labour related to school lunch work, mothers also forged connections with their children through lunch packing, which they viewed as emotionally meaningful and a symbol of their care, love, and parental responsibility. These findings show that mothers’ experiences with lunch packing are complex and wrapped up in notions of “good” mothering and feeding ideals. For mothers, a “balanced” lunch requires not only a nutritionally adequate meal, but also involves balancing various forms of labour and contradictory emotions about food work. Understanding mothers’ experiences of lunch packing is pivotal for successfully developing school food programs that meet the complex expectations of Canadian families.

Balancing acts:

While Canadian policy makers are considering expanding school food programs in Canada, parents remain primarily responsible for packing lunches. Although women perform disproportionate amounts of foodwork, including feeding their children on school days, little research has investigated mothers’ experiences of packing school lunches in Canada. Drawing on 14 interviews with mothers of elementary-aged children in British Columbia, this study explored how mothers experience and make meaning of packing school lunches. Mothers described lunch packing largely as an individualized responsibility for children’s nutritional health and general wellbeing. Mothers strived to enact largely unattainable ideals about packing a “good” school lunch and engaged in diverse forms of physical, mental, and emotional labour to do so. When mothers were perceived to fall short of elusive lunch packing ideals, mothers judged themselves and other mothers, and also reported feeling scrutinized by other parents, teachers, and their children. While assuming the bulk of labour related to school lunch work, mothers also forged connections with their children through lunch packing, which they viewed as emotionally meaningful and a symbol of their care, love, and parental responsibility. These findings show that mothers’ experiences with lunch packing are complex and wrapped up in notions of “good” mothering and feeding ideals. For mothers, a “balanced” lunch requires not only a nutritionally adequate meal, but also involves balancing various forms of labour and contradictory emotions about food work. Understanding mothers’ experiences of lunch packing is pivotal for successfully developing school food programs that meet the complex expectations of Canadian families.

Addressing Aging-in-Place Policy Challenges in Canada: A Call to Action.

Aging in place (AIP) has emerged as a critical priority in policy to support older adults living in their homes and communities. However, achieving equitable support for older adults demands a multi-faceted approach that embraces their choices, capabilities and lived experiences while considering that place is a dynamic concept. This commentary explores the challenges older adults may encounter while AIP and identifies technological and policy areas to explore. Drawing insights from the UK, policy makers in Canada are urged to adopt inclusive definitions of AIP, prioritize technological solutions for recognized challenges and actively involve older adults in policy development.

‘Three Whores at a christening’: The North Atlantic Triangle Beyond Suez

ABSTRACT For much of its history, Canadian policymakers conceived of Canada as operating within the North Atlantic Triangle, a descriptor of its close economic, cultural, military, and diplomatic ties with Britain and the United States. Frequently, within this triangular relationship, Canada had sought to counterbalance one side against the other. This task became increasingly difficult with the post-1940 transition of power, even as it made the counterbalancing effects of the Triangle all the more important. Examining American-British-Canadian relations in the wake of the Suez Crisis, this article traces that ongoing salience of the North Atlantic Triangle. In particular, it examines Canadian efforts to pursue their interests against the backdrop both of Britain’s decline and US hegemony and British Prime Minister Harold Macmillan’s efforts to rekindle London’s ‘special relationship’ with Washington.

Interdisciplinary Training For Future Leaders Through The Create-Redevelop Graduate Student Program

REDEVELOP is a graduate student training program funded by the NSERC-CREATE grant, starting in 2017. Its goal is to support the training of new professionals and researchers (> 100) who will be the next generation of science and engineering leaders and policymakers in Canada. The program has successfully developed a framework for operating almost completely virtually, well ahead of the world's transition to online learning due to the COVID-19 pandemic. Our psychology lab, The Individual and Team Performance (ITP) lab, has dedicated over a decade to researching and designing tools that enhance specific training and skill growth necessary for effective remote teamwork. In partnership with the REDEVELOP program, we support students in navigating the unique interpersonal and collaboration challenges posed by virtual team environments. We will discuss how a complex and multidisciplinary program succeeds in training graduate students to become stronger academics, practitioners, and communicators of knowledge.

The effect of nuclear and fossil fuel energy R&D expenditures on environmental qualities in Canada

Minimizing environmental problems and a clean ecosystem are at the top of countries’ political agendas. Although Canada is an eco-friendly country, the rapid increase in its ecological footprint (EF) and the decreasing load capacity factor (LCF) in recent years make the analysis of Canada’s environmental determinants important. In this context, the study analyzes the effects of fossil fuel and nuclear-related research and development (R&D) expenditures on the EF and LCF under the load capacity curve (LCC) and environmental Kuznets curve (EKC) conditions for the period 1981–2022, employing the Bayer-Hanck cointegration test and the Fourier-ADL approach. The findings indicate that the EKC and LCC hypotheses are valid for Canada, that fossil fuel R&D reduces the LCF, and that nuclear energy R&D contributes to environmental development. Therefore, Canadian policymakers should promote nuclear energy technologies and use the financial resources provided by economic expansion for clean energy purposes.

Bioplastics: No solution to healthcare's plastic pollution problem.

As Canadian policy-makers recognize the urgency for concerted actions to reduce plastics (e.g., Canada's involvement in the international plastics treaty negotiations, zero plastic waste strategy, and single-use plastics regulations), the healthcare sector must also consider a more sustainable plastics system. In this context, the potential for novel bioplastics to mitigate healthcare's substantial plastic waste problem must be carefully interrogated. Our analysis examines the complexities of bioplastics, highlighting the technical challenges of identifying legitimate sustainable alternatives, and the practical barriers for implementing bioplastics as substitutes for consumable plastics in healthcare. We focus on the Canadian healthcare sector and regulatory landscape with the insights gained being applicable to other sectors and countries. Given the limitations identified, the focus on reducing consumption should remain the priority.

Why federalism matters: policy feedback, institutional variation and the politics of trade policy-making in Canada and Germany

ABSTRACT Sub-federal units in federal systems increasingly participate in international trade policy-making, a domain that historically represents an exclusive jurisdiction of the federal level. A first strand of research emphasised exogenous factors, most notably the changing scope and depth of trade agreements and social contestation, to explain this trend. This study, by contrast, contributes to more recent efforts that focus on endogenous factors to elucidate variation in terms of how and with what implications sub-federal units have entrenched themselves in trade policy governance. The paper makes two contributions. First, it introduces a new theoretical argument suggesting that ideational and institutional feedback effects can explain variation in sub-federal trade policy-making. Second, the paper tests this framework by using two contrasting cases of federalism: Canada and Germany. The study shows that in Canada intergovernmental institutions facilitating sub-federal participation in trade policy-making had to be created through layering, while in Germany existing institutions were activated through conversion. Although both patterns of institutional change have empowered sub-federal units, they differ in terms of their robustness.

A machine learning approach to analysis of Canadian provincial power system decarbonization

Canada committed to reducing national greenhouse gas emissions by 40–45 % by 2030 and achieving net-zero by 2050, relying on low-carbon electrification across economic sectors. This study investigates the machine learning’s potential to analyze least-cost optimization of Canadian provincial power systems to 2050, to identify robust pathways for net-zero electricity system greenhouse gas emissions, and to provide policy insights respecting wind and solar generation, reducing emissions from natural gas generation, and expanding interprovincial transmission. Surrogate modeling is applied as sensitivities to generation technology capital costs, electricity demand, and carbon pricing to results from an existing capacity expansion mixed-integer linear optimization model. Under almost all future scenarios, six provinces develop new wind generation, with substantial deployment in Alberta (mean 27.3 GW, max. 62.7 GW), Ontario (mean 6.8 GW, max. 19.3 GW), Saskatchewan (mean 3.6 GW, max 8.9 GW) and Manitoba (mean 1.5 GW, max 3.5 GW). With the potential exception of BC, where higher-cost wind generation results in solar generation becoming the primary low-carbon electrical energy source (mean 25.2 GW), future solar generation across Canada is more limited (mean 37.1 GW) and less certain than wind generation in all other Canadian provinces. Existing natural gas generation is maintained in almost all scenarios in all provinces, providing support for maintaining these resources for reliability and reserve requirements. Very limited natural gas is developed under any scenarios, with the exception of British Columbia (mean 4.3 GW) where more than 80 % of scenarios include new natural gas capacity. Additional transmission transfer capacity is developed in most scenarios between BC-Alberta (∼60 % of scenarios), Saskatchewan-Manitoba (∼85 %), and Ontario-Quebec (∼75 %). Carbon prices, along with wind and solar capital costs, act as primary determinants of least-cost decarbonization pathways. These findings offer insights for Canadian policymakers into net-zero pathways for provincial electricity systems that remain robust despite variability in inputs.

What Do We Know about an Invisible Issue? Results of a Scoping Review of Elder Abuse and Gender and Sexual Minorities

Elder abuse occurs to older adults who are members of gender and sexual minorities (GSM). Whilst most of that abuse is similar to that experienced by their heterosexual and cisgender peers GSM older adults face particular vulnerabilities due to their life experiences and changes. In this article we report on our findings from a literature search and knowledge synthesis, conducted as part of a larger project to inform Canadian policy makers working to eliminate gender and sexuality-based inequalities. The review included literature on GSM and the experience of elder abuse produced in the previous decade (2013-23). A six-month scoping review was conducted via a staged approach including discovery layer searches; database specific searches; Google scholar and citation examination searches; and general Google searches.

National burden of rheumatoid arthritis in Canada, 1990–2019: findings from the Global Burden of Disease Study 2019 – a GBD collaborator-led study

ObjectiveThe objectives of this study were: (1) to describe burden of rheumatoid arthritis (RA) and trends from 1990 to 2019 using the Global Burden of Diseases, Injuries and Risk Factors...

Cost-Effectiveness of Nirsevimab for the Prevention of Respiratory Syncytial Virus Infection in Infants


 During CADTH’s search of the economic literature, 3 economic studies were identified that assessed the cost-effectiveness of a long-acting monoclonal antibody, nirsevimab, as an intervention to prevent respiratory syncytial virus in infants in high-income countries, including 1 study set in Nunavik.
 The 3 studies were conducted for different geographical locations: Canada, the US, and England and Wales. While each study conducted an economic evaluation, their approaches differed: 1 was a cost-consequence analysis and the other 2 were cost-utility analyses.
 The results from the 3 studies varied considerably, and the nirsevimab programs differed (e.g., in terms of patients eligible for immunization). In general, nirsevimab was generally more effective and associated with lower total costs than comparator programs. The results were sensitive to the modelled region, source of efficacy data, price of nirsevimab, and severity of the respiratory syncytial virus season.
 The generalizability of the identified studies to Canadian policy-making may be limited given the population compositions and cost parameters included in the models. To understand the potential cost-effectiveness of nirsevimab, a de novo economic evaluation would be required that compared nirsevimab with the existing preventive strategies employed in Canada (which may include monoclonal antibodies for infants) and is conducted in a Canadian setting.

Does resource efficiency matter for environmental quality in Canada?

In order to combat climate change, the OECD emphasized the need to minimize the environmental impact of material use, as well as promote resource efficiency and accelerate the creation of a circular economy. The present study objects to promote a new debate about Canadian environmental quality and resource efficiency. In other words, this paper aims to capture the effect of resource efficiency on environmental quality in Canada while controlling financial development, economic growth, and energy. Nonlinear ARDL bounds test results indicate the significant long-run linkage between environmental quality, resource efficiency, financial development, economic growth, and energy in Canada. Moreover, the asymmetric results underline that 1) resource efficiency mitigates environmental degradation; 2) economic growth and energy uses in Canada significantly increase consumption-based CO2 emissions; 3) financial development positively contributes to environmental stability. Therefore, policymakers in Canada make sure that circular economies and resource efficiency can help reach net zero and combat climate change.

Adding epitope compatibility to deceased donor kidney allocation criteria: recommendations from a pan-Canadian online public deliberation

BackgroundThe widening supply–demand imbalance for kidneys necessitates finding ways to reduce rejection and improve transplant outcomes. Human leukocyte antigen (HLA) epitope compatibility between donor and recipient may minimize premature graft loss and prolong survival, but incorporating this strategy to deceased donor allocation criteria prioritizes transplant outcomes over wait times. An online public deliberation was held to identify acceptable trade-offs when implementing epitope compatibility to guide Canadian policymakers and health professionals in deciding how best to allocate kidneys fairly.MethodsInvitations were mailed to 35,000 randomly-selected Canadian households, with over-sampling of rural/remote locations. Participants were selected for socio-demographic diversity and geographic representation. Five two-hour online sessions were held from November–December 2021. Participants received an information booklet and heard from expert speakers prior to deliberating on how to fairly implement epitope compatibility for transplant candidates and governance issues. Participants collectively generated and voted on recommendations. In the final session, kidney donation and allocation policymakers engaged with participants. Sessions were recorded and transcribed.ResultsThirty-two individuals participated and generated nine recommendations. There was consensus on adding epitope compatibility to the existing deceased donor kidney allocation criteria. However, participants recommended including safeguards/flexibility around this (e.g., mitigating declining health). They called for a transition period to epitope compatibility, including an ongoing comprehensive public education program. Participants unanimously recommended regular monitoring and public sharing of epitope-based transplant outcomes.ConclusionsParticipants supported adding epitope compatibility to kidney allocation criteria, but advised safeguards and flexibility around implementation. These recommendations provide guidance to policymakers about incorporating epitope-based deceased donor allocation criteria.

The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People With Type 1 and Type 2 Diabetes in Canada: Patient-Led Longitudinal Retrospective Cross-sectional Study With Multiple Time Points of Measurement.

Clinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) levels ≤7% (≤53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal. As a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes. In this patient-led retrospective cross-sectional study with multiple time points of measurement, we used generalized estimating equations to analyze the associations of age, sex, and socioeconomic status with 947,543 HbA1c results collected from 2010 to 2019 among 90,770 people living with type 1 or type 2 diabetes in Canada and housed in the Canadian National Diabetes Repository. People living with diabetes reviewed and interpreted the results. HbA1c results ≤7.0% represented 30.5% (male people living with type 1 diabetes), 21% (female people living with type 1 diabetes), 55% (male people living with type 2 diabetes) and 59% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA1c values during adolescence, and for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA1c levels than male people during childbearing years but higher HbA1c levels than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested that these results be communicated to health professionals and other stakeholders to improve the treatment for people living with diabetes. A substantial proportion of people with diabetes in Canada may need additional support to reach or maintain the guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people going through adolescence or menopause or those living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management, and policy makers in Canada should provide more support for people with diabetes to live healthy lives.

Top Ten Research Priorities for Psoriasis, Atopic Dermatitis and Hidradenitis Suppurativa: The SkIN Canada Priority Setting Initiative.

The Skin Investigation Network of Canada (SkIN Canada) is a new national skin research network. To shape the research landscape and ensure its value to patient care, research priorities that are important to patients, caregivers, and health care providers must be identified. To identify the Top Ten research priorities for 9 key skin conditions. We first surveyed health care providers and researchers to select the top skin conditions for future research within the categories of inflammatory skin disease, skin cancers (other than melanoma), and wound healing. For those selected skin conditions, we conducted scoping reviews to identify previous priority setting exercises. We combined the results of those scoping reviews with a survey of patients, health care providers, and researchers to generate lists of knowledge gaps for each condition. We then surveyed patients and health care providers to create preliminary rankings to prioritize those knowledge gaps. Finally, we conducted workshops of patients and health care providers to create the final Top Ten lists of research priorities for each condition. Overall, 538 patients, health care providers, and researchers participated in at least one survey or workshop. Psoriasis, atopic dermatitis and hidradenitis suppurativa (inflammatory skin disease); chronic wounds, burns and scars (wound healing); and basal cell, squamous cell and Merkel cell carcinoma (skin cancer) were selected as priority skin conditions. Top Ten lists of knowledge gaps for inflammatory skin conditions encompassed a range of issues relevant to patient care, including questions on pathogenesis, prevention, non-pharmacologic and pharmacologic management. Research priorities derived from patients and health care providers should be used to guide multidisciplinary research networks, funders, and policymakers in Canada and internationally.

Dairy concessions in Canadian trade: a discursive institutionalist account

ABSTRACT Canadian policymakers have long been protective of their dairy industry despite reducing state interventions in other sectors. Recent preferential trade agreements (CPTPP, CETA, and CUSMA), however, have shown there are limits to this insularity. These new agreements have introduced dairy access concessions at a moment of flux within the rules-based international order. Why are there dairy concessions at this moment? This article combines political economic and ideational factors to explain this shift in Canadian trade policy. Applying discursive institutionalism, we observe a collapse of the dairy industry’s discursive power over sovereignty and federalism. This discursive breakdown is a function of (1) the legacy of earlier preferential trade agreements and (2) the success of challenger coalitions in persuading actors in favour of economic liberalization. Incorporating content analysis of public statements, we characterize this discursive breakdown within both federal and intergovernmental networks.

Lobbying and nutrition policy in Canada: a quantitative descriptive study on stakeholder interactions with government officials in the context of Health Canada’s Healthy Eating Strategy

BackgroundThe political activities of industry stakeholders must be understood to safeguard the development and implementation of effective public health policies.MethodsA quantitative descriptive study was performed using data from Canada’s Registry of Lobbyists to examine the frequency and governmental target of lobbying that occurred between various types of stakeholders (i.e., industry versus non-industry) and designated public office holders (DPOH) regarding Health Canada’s Healthy Eating Strategy, from September/2016 to January/2021. Initiatives of interest were revisions to Canada’s Food Guide, changes to the nutritional quality of the food supply, front-of-pack nutrition labelling and restrictions on food marketing to children.ResultsThe majority of registrants (88%), and corporations and organizations (90%) represented in lobbying registrations had industry ties. Industry-affiliated stakeholders were responsible for 86% of communications with DPOH, interacting more frequently with DPOH of all ranks, compared to non-industry stakeholders. Most organizations and corporations explicitly registered to lobby on the topic of marketing to children (60%), followed by Canada’s Food Guide (48%), front-of-pack nutrition labelling (44%), and the nutritional quality of the food supply (23%). The food and beverage industry, particularly the dairy industry, was the most active, accounting for the greatest number of lobbying registrations and communications, followed by the media and communication industry.ConclusionsResults suggest a strategic advantage of industry stakeholders in influencing Canadian policymakers. While some safeguards have been put in place, increased transparency would allow for a better understanding of industry discourse and help protect public health interests during the policy development process.