Canada at Home, Work and Play
Canada is often viewed as a leader in population health. Looking back at the history of health care in Canada it can be recognized that the health of citizens has consistently been a priority for leaders. Reviewing the Canadian Public Health Association (CPHA) website, one can see how the social determinants of health have influenced government policy and the health care system at a federal level. Several milestones are listed in the History section of the website and outline a clear timeline on how education, employment, and housing conditions just to name a few all factor in the overall health of the general Canadian population.
After WWII, Canada implemented many universal funding programs aimed at improving life and health in Canada. This includes the Universal Health Care Plan known as “Medicare”. Even with these programs in place, there was still a need to refocus the priorities of health from one of solely curing medical conditions to one of prevention. One of the most influential reports in the development of this initiative came in 1974 and is known as, “The Lalonde Report”. This report challenged Canadian leaders and offered a new perspective on how social determinants, more so than health care services can lead to improvements in health. In the book, This is Public Health: A Canadian History” (P8.1), it talks about this being a time when industrialized countries began to realize that the substantial decline in mortality over the past several years was largely due to improved living standards rather than improved medical care. Health promotion became the focus for public health to not only improve health of Canadians but decrease costs associated with Health Care. Canadian’s began to hear about topics such as the environment, physical activity and chronic diseases. There was public campaigns launch about smoking and being fit. This would have been during my childhood and I can easily recall and recognize the “Particpaction” marketing campaign.
An even clearer picture about the key determinants for health, and their vital role in health came in 1986 with the launch of the Ottawa Charter for Health Promotion by the World Health Organization. They identified these to be of health: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity. They all have a role to play and influence how healthy a population can be. How can a child learn well at school if they are hungry? How does a person feel safe and secure if affordable housing is not available? Consideration of these key determinants has been a focus at a federal, provincial and regional level for the past several years. Despite these initiatives around prevention and promotion the majority of health care spending remains to focus on health care. There are health inequalities among Canadians and where you live, work and play all determine how long and well you may live. It is time to look at the system and make health equitable among Canadian’s and make improvements in order to be able to sustain our well recognized Canadian Health Care System.
I currently work in a Pediatric Tertiary Care hospital and for the Air Medical Critical Care Transport Team for the Atlantic Provinces. The health of the population I work with is directly impacted by several social DOH. Early childhood is a crucial time for optimal nutrition, education, housing, social interaction to impact future health status. For example, in Nova Scotia, children born to parents with higher education and income are less likely to be overweight and more likely to be physically active (Ling, 2013). This needs to be the focus for the future health care system in Nova Scotia. Practicing in a Critical Care transport Environment the impact of income inequalities, ability to maintain housing, affordable child care and access primary care for families is something that I experience on many missions. If rural communities were better resourced and if different government departments would work together to create solutions that prevent inequalities between urban and rural settings the future health of Nova Scotia might look brighter.
The webcast below is a great introduction to social Pediatrics. It is lengthy but informative!
References:
Canadian Public Health Association response to the World Health Organization (WHO) Commission's Report, Closing the gap in a generation: Health equity through action on the social determinants of health, 2008. Retrieved from: https://www.cpha.ca/sites/default/files/assets/briefs/cpha_who_sdoh_e.pdf
Canadian Museum of History. (2010). Making Medicare: the history of health care in Canada,
1914-2007. Retrieved from
http://www.historymuseum.ca/cmc/exhibitions/hist/medicare/medic-3h02e.shtml
Government of Canada. (n.d). What makes Canadians healthy or unhealthy? Retrieved from
https://www.canada.ca/en/public-health/services/health-promotion/population-
health/what-determines-health/what-makes-canadians-healthy-
unhealthy.html#unhealthy
Government of Canada. (2011). What determines health https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html#eviden
Lalonde M. A New Perspective on the Health of Canadians. Ottawa, Ontario, Canada: Minister of Supply and Services; 1974
Ling, N. (2013) .Social determinant's of Health. About Kids Health - Sicks Kids. Retrieved from: http://www.aboutkidshealth.ca/En/News/NewsAndFeatures/Pages/social-determinants-of-health.aspx
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts. Toronto: York University School of Health Policy and Management. Retrieved from:
http://www.thecanadianfacts.org/the_canadian_facts.pdf
National Collaborating Centre for Determinants of Health. (2018). Our work. Retrieved from
http://nccdh.ca/our-work/
Social determinants of health. http://rnao.ca/policy/projects/social-determinants-health
Lalonde, M. (1981). A New Perspective on the Health of Canadians. Retrieved from: http://www.phac-aspc.gc.ca/ph-sp/pdf/perspect-eng.pdf
This is Public Health: A Canadian History. Retrieved From: https://www.cpha.ca/sites/default/files/assets/history/book/history-book-all_e.pdf