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Call to Action

CPHA 2008 Annual Conference

 

Reducing Health Inequalities
Through Evidence and Action

Call to Action

The Process

In October 2007, a national Steering Committee was established to develop the scientific program for the CPHA 2008 Annual Conference. From its very first meeting, the Steering Committee was committed to ensuring that the conference program include a Call to Action addressing health inequalities in Canada.

While our mandate was clear, it was essential that CPHA not develop preconceived ideas about the Call to Action. The latter needed to be informed by the public health community and be the holistic outcome of the conference program. CPHA had to listen carefully to what plenary speakers, presenters and delegates had to say and develop a Call that responded accordingly. A team of professional writers was engaged to synthesize the content from the plenary and thematic sessions, and conference delegates were invited to contribute their thoughts through a “Call to Action” message board—the first of its kind at a CPHA Conference.

Voices from the Conference

We heard about how health inequalities shape peoples’ lives and affect their lifespan. We were reminded that the “social gradient” exists within and across both rich and poor countries. Delegates once again discussed the fundamental determinants that affect health and human development.

The overriding sentiment that we heard and felt during the conference was the sense of impatience. From every session of the conference, we heard a very clear message: we have the knowledge; we have the conceptual frameworks for understanding that knowledge; we know a lot of what needs to be done. We need to take action, now!

A number of common themes and principles emerged through the conference. These included the need to:

  • break down silos and collaborate more closely, within public health and within the health and health care sectors;
  • communicate and collaborate with other sectors—housing, transportation, energy, environment, municipalities, finance and economics, international trade and trade institutions—whose activities affect health outcomes and have an influence on health inequalities;
  • recognize that a great deal of important, innovative work on health inequalities has been going on for a long time, and the importance of joining forces with these groups who are already leaders in their fields, respectful of their experience and commitment;
  • work across the continuum of universal and targeted policies and interventions;
  • build resiliency and innovation into public health functions, systems and practice;
  • gather and evaluate evidence more effectively, including measuring the impact and telling the story of the front-line activity;
  • demonstrate the economic benefits and cost savings associated with healthy public policy and practice. Our primary purpose will always be to save lives and build futures, not to save money. But there is a need to win the confidence, support, and interest of stakeholders whose interests lie beyond the realm of health, by preparing facts and arguments that establish common ground;
  • translate our complex message on health inequalities into sound bites that are irresistibly simple and catch the public’s and decision-makers’ imagination;
  • recognize the impact of Canada’s footprint on global health, as well as the impact that global health issues have on Canada; and
  • make social justice and equity central pillars of our work.

There are also a number of broader threads that connect the varied activities in our own organizations, sectors, and jurisdictions. These include:

  • recognizing that prevention, care, support and treatment work hand in hand;
  • understanding the need to serve the full range of at-risk and vulnerable populations, and recognizing that Canada is one of the countries where Indigenous populations require particular attention;
  • committing to harm reduction as a proven, evidence-based effective strategy for public health and community safety;
  • recognizing the broader determinants such as education and early childhood programs, employment and income, housing, literacy, and a clean, healthy environment which are too often left out of the health equation;
  • creating a “virtuous circle” from policy to practice and back to policy, that links research and theory with the front line and which builds public health capacity and promotes broader awareness of the determinants of health;
  • understanding that public health initiatives are most effective with the combination of community buy-in, policy leadership, effective collaboration, and adequate funding;
  • crafting specific interventions that address local issues and priorities, while drawing on the widest possible community of partners and stakeholders; and
  • learning from our historic successes in areas like tobacco control.

It has taken a long time to reach this point: it has been 30 years since the Alma Ata Declaration on the principle of Health for All; nearly 22 years since the Ottawa Charter for Health Promotion; 12 years since the Halifax workshop on intersectoral action for health; and 2 years since Monique Bégin spoke in Vancouver, where she described Canada as the “land of pilot projects”, and challenged us all to do more.

During the conference we’ve heard why this is the right moment for practical, coordinated action. In the coming months, several key reports will be released, including the:

  • first Chief Public Health Officer’s Report;
  • report of the WHO Commission on Social Determinants of Health; and
  • Senate Subcommittee report on population health.

These landmark documents will provide us with the opportunity to move health inequalities onto the political agenda. There is growing public recognition of health inequalities and the need to address them and, as public health practitioners, we will no longer accept inaction. We owe it to ourselves and our fellow citizens to make the most of this opportunity.

Making it Practical

CPHA is eager to fulfill its role as a convenor and a catalyst in collaboration with organizations that have been working in this area for a very long time.

We know that public health priorities are as unique as the communities whose needs they address. There is no single prescription, no magic bullet that will address health inequalities for all Canadians, or for the global community. Each of us must be prepared to embrace this complexity by adopting local, regional, national, and international strategies that engage with the broadest possible combination of communities, institutions, partners, and stakeholders. These strategies also need to reach out beyond traditional health or public health disciplines to build an understanding of the tangible, measurable value to be gained through a focus on health inequalities. We must report progress, share best practices, pool knowledge, and monitor the impact of policies and programs aimed at reducing health inequalities.

We recognize the need to educate Canadians about the importance of the social determinants of health and to engage them in building momentum and political will for action.

We know that you are looking to CPHA for coordination and common messaging, and to be a clearinghouse for ideas, best practices, and news of local initiatives. We have listened and we are ready to accept this challenge. We also know that the time for action is now.

This is a moment of magnificent impatience.

We must harness the urgency and the call for immediate action, the vision and the hope expressed at the 2008 Annual Conference and we must transform it into lasting movement for change. We find ourselves living in a country where structural injustices have been allowed to take root. This is not our vision of Canada. It is truly time to take leadership and get on with the job of translating our vision into practical, sustainable results. We must help our friends and families, our neighbours and colleagues, to understand the deep health inequalities in Canada and the role of public policy in perpetuating them.

We listened as conference participants articulated their vision for Canada. To support that vision becoming a reality, CPHA is committed to:

  • convening a forum for practitioners, partners, and stakeholders to share their experience, knowledge, and best practices;
  • serving as a clearinghouse for pan-Canadian coordination and communication, while supporting and strengthening existing efforts;
  • taking every opportunity to expand the circle of concern for health inequalities beyond public health and the broader health sector;
  • providing timely analysis emphasizing the implications for Canada of the reports of the Chief Public Health Officer of Canada, the WHO Commission on the Social Determinants of Health, and the Senate Subcommittee on Population Health, and help ensure their meaningfulness for Canadians;
  • providing a venue for provincial/territorial public health associations, medical officers of health, our members, students and other key collaborators to coordinate messages and actions;
  • devising new, more effective ways of building broad public awareness and engagement, by telling the story of health inequalities and connecting it to the fundamental values of fairness and social justice that motivate most Canadians;
  • using the sense of urgency to help build a significant social movement; and
  • positioning the 2009 Annual Conference (7-10 June 2009, Winnipeg, Manitoba) as a forum for sharing our progress on addressing health inequalities, and assembling ideas and experience from the field.

We Want To Hear From You

Please send feedback, comments and discussion on the Call to Action, as well as proposed strategies of achieving our goals.