Dressed in a business suit and sturdy leather shoes, Basil Stewart stepped on the scale at his city's fitness centre and weighed in at 300 pounds.
The long-time mayor of Summerside, PEI, is down nearly 30 pounds from when he first began his weight-loss regime several months ago, and when the local newspaper started recording his progress as part of a challenge.
"My doctor told me if I don't get rid of some weight I'd be dead before I'm 100," said the 63-year-old mayor, laughing. "He also said, 'Basil, you're strong as a horse but don't forget there's lots of dead horses.' "
Joking aside, Mr. Stewart knows he has to change his habits – and he's not alone.
Earlier this month, PEI's chief public-health officer, Heather Morrison, released the first-ever report on the health of the island's 145,000 residents. The results have been a wake-up call for politicians and residents: They either need to take charge of their health, or be consumed by health-care costs.
The report found that "more Islanders are likely to be obese than Canadian counterparts," with 58 per cent classified as overweight or obese compared to 52 per cent across the country. On average, Islanders are also less physically active, have poorer eating habits and report more heavy drinking than other Canadians. One in 10 Islanders suffers from asthma, and they are also more likely than Canadians overall to suffer from chronic conditions such as arthritis, heart disease, diabetes and cancer.
Add an aging population – by 2020, one in five Islanders will be over 65 – and, unless something changes, PEI politicians fear this tiny province will go broke trying to pay its health bills.
"We really have to figure out how we can be healthier as we get older because we'll be unable to sustain our health and our health-care system if we don't pay attention," Dr. Morrison warned.
In fact, health-care costs in the province have nearly doubled in the past five years and are outpacing revenues. The health-care budget is close to $540-million – about 40 per cent of the provincial budget. And with the federal government's message that the provinces are on their own when it comes to health-care costs, the pressure to address the issue is even more intense.
Dr. Morrison cites myriad reasons for the island's poor health, including socio-economic factors. While the cost of living in PEI is among the lowest in the country, the average income of an Islander in 2009 was $29,788, compared to the national average of $36,429. For many, the cost of joining a gym or buying more fresh foods such as fruits and vegetables seems prohibitive.
Like economic status, education is also a determinant of good health – the better educated a person, the healthier they tend to be. Nineteen per cent of PEI residents did not graduate high school, compared to 14 per cent of Canadians overall, according to the report. Dr. Morrison also notes that, since the province is mostly rural, Islanders tend to drive, not walk.
She is hoping the report, which she plans to update every two years, will spark discussion among Islanders and get people off the couch.
It's certainly grabbed Health Minister Doug Currie's attention. "The status quo is not an option any more," he said. "If we continue to exist the way we are existing, we are not going to have a health-care system in the province of Prince Edward Island."
Within three years, his health-care budget "will well be exceeding $700-million," even if the province keeps increases to 3 or 3.5 per cent.
That reality moved Mr. Currie to develop a "wellness strategy" for the province, which includes input from Dr. Morrison and public-policy analysts; he hopes to see the first draft later this spring. In addition, he's speaking with groups, such as the Heart and Stroke Foundation and Cycling PEI, about collaborating on prevention and wellness.
Although he says it's clear to him that the federal government is "out of the business of health care," he hopes the Harper government will at least consider working with the provinces on wellness and prevention.
But PEI's Heart and Stroke Foundation CEO, Charlotte Comrie, says the provincial government has to take the lead. "I really believe that there is an opportunity here for partnerships with government around chronic disease management, a full partnership," she said, citing working together on afterschool programs that include nutrition education and physical activity.
Premier Robert Ghiz said more public awareness and education is key to transforming the health profile of an entire province. "You hope that through education people will start to make a difference in their lives when it comes to eating and exercise," he said. "We're not going to close down McDonald's. Everything in moderation – but it's just how do you preach that moderation."
Gord McNeilly, a former military fitness trainer who now works with Charlottetown's UFIT Inc., says the message is already out there. His classes are full, people are asking questions about nutrition and the need to exercise, and women are even bringing their kids to classes, providing a good foundation for the next generation. "I see more activity among people, especially mothers trying to educate their families," he said.
And then there's Basil Stewart, who, through his regular public weigh-ins, is trying to lead by example. He's challenged mayors in the other island communities to join him.
Losing weight has been a struggle, he admits. "I used to like my Pepsi and potato chips, you know, at midnight, or a baloney sandwich and glass of milk," he said. He now points out that "desserts" is "stressed" spelled backwards. He's stopped sneaking apple pie, and he's walking more.
And Mr. Stewart is attracting support not only from his own community but beyond – he's drawing inspiration from Toronto Mayor Rob Ford's efforts to lose weight.
"He called me yesterday," Mr. Stewart said. "He hopes to make it down to the Maritimes this summer, and I invited him down and said we can have a big feed of melba toast and water."