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.
Despite denial in some circles, gun violence is a Public Health issue. The United States has the highest gun ownership rate in the world, and along with it the highest per capita rate of firearm-related murders of all developed countries. The consequences of gun violence are both physical and psychological. They take a toll on communities, families, and cost the health system over 170 billion dollars a year.
Because of the gun lobby’s power over legislatures, physicians in some states are not permitted to address the presence of guns in the home. ...continue reading
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
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
Kirsten Patrick is Deputy Editor at CMAJ
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, legally binding 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
Richard Doan is a Psychiatrist with Inner City Health Associates and Assistant Professor of Psychiatry at the University of Toronto in Toronto, Ontario
In Toronto’s first week of true winter weather, two homeless men died on the street, one in a bus shelter in the city’s most public square. He was wearing only jeans, a t-shirt and a hospital identification bracelet.
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
R Y McMurtry is Professor Emeritus (Surgery) of Western University (formerly University of Western Ontario). Dr. McMurtry was also an ADM at Health Canada 2000-02
Industrial wind turbines (IWTs) are being erected at rapid pace around the world. Coinciding with the introduction of IWTs, some individuals living in proximity to IWTs report adverse health effects including annoyance, sleep disturbance, stress-related health impacts and reduced quality of life. [i],[ii],[iii],[iv],[v],[vi],[vii],[viii],[ix],[x],[xi],[xii] In some cases Canadian families reporting adverse health effects have abandoned their homes, been billeted away from their homes or hired legal counsel to successfully reach a financial agreement with the wind energy developer.[xiii]
To help address public concern over these health effects Health Canada (HC) announced the Health Canada Wind Turbine Noise and Health Study (HC Study) 2 years ago and brought forth preliminary results November 6, 2014.
Here we briefly comment on the HC Study results and provide some historical context.
Acknowledgement of IWT adverse health effects is not new. The term “annoyance” frequently appears when discussing IWT health effects. ...continue reading
Erin Russell is Assistant Editor at CMAJ, currently attending the annual meeting of the American Public Health Association (APHA) in New Orleans
Along with CMAJ's editorial fellow, Moneeza Walji, I'm navigating my way through the more than 1,100 sessions on relevant public health topics that are on offer at the APHA conference this week. Yesterday I attended a session on the Ebola epidemic. Prior to coming to New Orleans, I was disappointed to hear that the State of Louisiana had issued a rather prohibitive public health advisory. The advisory calls on individuals who have traveled to the Ebola affected countries of Sierra Leone, Liberia or Guinea, or who may have been exposed to Ebola virus in the previous three weeks, not to travel to New Orleans. This, despite the CDC’s assurance that 1) Ebola can only be spread by direct contact with blood or bodily fluids and 2) people with Ebola cannot spread the virus until symptoms appear.
My first instinct was to blog about my frustration with fear-based policies; my disappointment that the state felt the need to over-rule the judgement of the APHA and its members; and my outrage that the 13,000 APHA conference delegates were being deprived of our right to learn about this major international public health crisis from those with first-hand knowledge of the situation. Fortunately, I didn’t get a chance to write that emotional knee-jerk reaction blog.
The APHA’s response to the State-imposed travel ban was much more diplomatic.
In it, Dr. Georges Benjamin, Executive Director of the APHA, acknowledged the APHA’s disagreement with the policy, their efforts to communicate their concerns to state and local leaders and their recognition that State has the best interests of the people of Louisiana [and 13,000 APHA conference delegates] at heart. The APHA has also made available pink ribbons ...continue reading