I wish I could say what I learned in class prepared me for this conversation, but unfortunately, it did not.
Moments after completing an online module at home titled “Health and Homelessness” for the Community, Population & Public Health course as part of the pre-clerkship curriculum at the University of Toronto, I stumbled across who I thought was a homeless child - a small, skinny figure in a hoodie, with a Tim Hortons cup placed in front.
Most of my life’s work has been in the field of population health promotion – working to improve the health of the population. Thirty years ago the World Health Organisation launched the modern version of health promotion at a landmark conference in Ottawa. I was there as a participant and the author of one of the theme papers (on creating healthy environments).
The Ottawa Charter for Health Promotion defined health promotion as “the process of enabling people to increase control over, and improve their health”. Three key points stand out here. First, this is a process; as such, there really is no end point, no point at which we say ‘OK, we’ve done that, let’s move on’. No matter how healthy the population is, it can always be healthier.
Moreover, since the mechanisms involved were defined in terms of developing public policies that are good for health, creating physical and social environments that are supportive of health, strengthening community action for health, developing personal skills for health, and re-orienting health care systems to focus more on health, the process is clearly socio-political ...continue reading →
We live at a time of two great – and linked – transitions. The first is that about a decade ago we became an urban species, with more than half of humanity now living in urban areas. The UN reported that in 2014 we reached 54 percent urbanization, and that we will reach 66 percent – two-thirds – by 2050.
It's expected that we will add 2.5 billion people to the world’s urban population by 2050 - about 1.3 million new urbanites A WEEK for the next 35 years, almost all of them in Asia and Africa. And it won’t stop there. More than 40 countries are at least 80 percent urbanized, and that is where the world is headed. Interestingly, almost half the urban population lives in small cities, with less than 500,000 population. ...continue reading →
Canada’s Health Ministers met in Vancouver this week. All indications are that their talks were a lot about health care and funding, and very little about health itself. After all, let’s face it, our ‘health’ ministries are really ministries of illness care, there to manage a (very expensive) illness care system. And that system is there mainly to pick up the pieces once we become sick or injured or ‘unwell’ – not so much diseased as ‘dis-eased’.
Now don’t get me wrong, when the time comes when I need it, I would like a good illness care system there to look after me and – hopefully – restore me to pretty good health. And when I am too frail to manage, I hope it will be there to care for me with kindness and compassion. But wouldn’t it be better if I didn’t need it – or didn’t need it very much? ...continue reading →
Juan Carlos Chirgwin is a family doctor working at CLSC Park Extension health facility in Montreal, Canada
Now that “Canada is back” and “sunny ways” are on the horizon, as Prime Minister Trudeau has said, we in the medical community should also look to the light. True, we made progressive strides in the last half century, producing today’s medical body, which is more ethnically and gender diverse. Medicine has opened up new fields and models of thinking, notably in global health and social determinants of health. Physicians have been spokespersons for worthy causes for decades, but is our medical community paying sufficient attention to the nuclear risk?
Canada’s health ministers will meet in Vancouver on January 20, 2016. It is good to know we have a federal government that will engage with the provinces on health care. Let’s hope they will engage on health, not just health care.
Forty years ago, the Trudeau government of the day produced the fabled Lalonde report. It became the first government in modern times to acknowledge that further improvements in the health of the population would not come primarily from more health care. ...continue reading →
Dr. Michael Pollanen is the Chief Forensic Pathologist at the Ontario Forensic Pathology Service
I have recently returned from a humanitarian forensic medicine mission in Iraq. The autopsies I performed gave me some insight into how people die in Baghdad die. My observations in the autopsy room are witness to the major cost of war and terrorism on a civilian population. I concentrate on the 6 most frequent types of preventable deaths that I encountered, many of which would not occur - or would not occur to the same extent- in Canada or other parts of the Western world.
Although my mission to Iraq was focused on the application of forensic pathology to the protection of Human Rights, during my time in Iraq I was struck by the observation that Iraq is a society embedded in conflict. It was once the major cultural and intellectual centre of the Middle East. Yet due to recent wars and internal armed conflict with terrorists, Iraq now faces problems with the safety and security of the population and a widening gap between people who have and do not have access to the essentials of daily life, justice and health care ...continue reading →
I have worked in public health for most of my adult life, and am proud of my chosen profession. Not to be confused – as it often is – with publicly funded health care, public health is focused on keeping people healthy, protecting them from harm and preventing disease, injury and disability.
To be sure, we do not garner the headlines of the more flashy and usually over-hyped ‘medical miracles’; nobody ever wrote a headline about the 100 cases of an infection or cancer that did not happen. But the work we do is vitally important – at least as important as the latest ‘life-saving’ technology or drug. ...continue reading →
byBarbara Sibbald, Editor, News and Humanities, CMAJ
For the past 30 years, in poll after poll with only one exception, Canadians have declared that health care is the most important issue they face. For this election, the health issues are complex and numerous: our aging population, physician-assisted dying, mental health and pharmacare, to name but a few.
The following is a selection of CMAJ articles on health care issues that the new government will have to address, regardless of their stance during the election. ...continue reading →
Interview with Dr. Noni MacDonald, Professor of Pediatrics at Dalhousie University with a clinical appointment in Pediatric Infectious Diseases at the IWK Health Centre in Halifax, Nova Scotia. Recent evidence from Ontario suggests that vaccine hesitancy and refusal may be on the rise. In a commentary published in CMAJ (subscription required), Dr. MacDonald and colleague Ève Dubé discuss the importance of immunization surveillance and tailored interventions to address vaccine hesitancy. ...continue reading →