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 →
Interview with Valerie Tarasuk, Professor in the Department of Nutritional Sciences and cross-appointed to the Dalla Lana School of Public Health at the University of Toronto. In a research article published in CMAJ (open access), Tarasuk and colleagues found that income-related problems with access to food were associated with increased use of health care services and health care costs. Policy interventions that successfully address food insecurity would likely also reduce health care costs, say the authors.
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Viviana Goldenberg is a certified family physician practising in the United States
*disclaimer: the opinions expressed in this blog are those of Dr Goldenberg and do not represent those of the company at which she is employed
In the aftermath of the recent Charleston mass shooting, Americans find themselves looking for an explanation. This time the conversation has focused on the Confederate flag. After the Aurora and Newtown massacres, the finger pointed at “mental illness.” We choose to give a simple answer to a complex problem and move on without acknowledging the simple truth — that a racist driven by hatred or a mentally disturbed person could not have committed mass murder without a gun. It is, however, inaccurate to pass off the gun violence epidemic as nothing more than a “mental health issue.” In fact, a psychiatric diagnosis is not predictive of violence and the overwhelming majority of people with diagnosed psychiatric conditions do not commit crimes. Mass shootings, in turn, contribute but a small fraction of the 33,600 deaths attributed to guns annually in the USA. Alarmingly, those numbers increase every year. Roughly 20,000 cases are suicides but the rest are homicides, intentional shootings, unintentional shootings, and law enforcement interventions.
Domhnall MacAuley is a CMAJ Associate Editor and professor of primary care in Northern Ireland, UK
Is being sedentary the new smoking? Many have posed this question and there are some parallels between how our knowledge evolved about smoking and how it is evolving regarding sitting too much. While the hazards of physical inactivity are now well known, however, there hasn’t yet been the enormous culture change that we have seen in our attitudes towards smoking. When smoking cessation was primarily a medical issue there were modest reductions in smoking rates but it was only with societal change, political will and legislation that we see major impact. There is increasing awareness of the influence of social, cultural and environmental factors in encouraging physical activity but we have yet to see the same ...continue reading →
Dr. Moneeza Walji, editorial fellow, interviews Dr. Prabhat Jha, founding and current director of the Centre for Global Health Research in Toronto. In their commentary published in CMAJ, Dr. Jha and colleagues say that slowing tobacco sales in the next decade will depend on strengthening its implementation by increasing excise tax and improving anti-tobacco legislation. ...continue reading →
Lawrence Loh is an adjunct professor in the Division of Clinical Public Health at the Dalla Lana School of Public Health, University of Toronto
Author's note: The views expressed in the following post are the author's own.
My first job as a public health physician after my residency training was in vaccine safety at the Public Health Agency of Canada. I learned all about the systems that are used to conduct post-marketing surveillance to continuously monitor vaccine safety and protect the health of Canadians. While reviewing different reports of adverse events, I personally observed the rigorous attention that each serious report received to determine whether, based on seemingly interminable criteria and safeguards, the vaccine given could have even remotely caused the outcome of concern. ...continue reading →
Today, February 27th 2015, marks the tenth anniversary of the coming into force of the WHO Framework Convention on Tobacco Control (#FCTC10). To mark the historic treaty's first decade the WHO's Director-General, Dr Margaret Chan, gave an address in which she called the FCTC the 'single most powerful preventive instrument available to public health'. She wasn't exaggerating. I'll tell you why.
The FCTC was the first, and remains the only, legallybinding multilateral agreement ratified by WHO member states. Most of WHO's directives are delivered with the all the authority of a global governance institution but with none of the legal teeth that multilateral trade agreements, for example, enjoy. ...continue reading →
My street outreach teammates and I saw a slight, older woman who had literally been living in a box for months.* The box was about 6 feet long, 4 feet wide and 3 feet high and was covered by a blue plastic tarp. Her furnishings consisted of a few blankets. The “dwelling” was in an alleyway just behind some shops. The lady was disinterested in any form of housing or treatment and never accessed shelters: she always slept in her box. She repeatedly said that she would soon be moving to a Caribbean island. During a particularly bitter cold spell, we became concerned with her safety, and I completed a form for involuntary psychiatric assessment. The emergency department psychiatrist agreed with me that she likely had chronic schizophrenia, but the client was calm and would not take any medication. She promised the emergency department staff that she would go to a shelter if she was discharged. We made it clear that she was unlikely to do so, but after one night in emergency she was given a subway token to go to a shelter. She disappeared and was lost to follow-up. ...continue reading →