The Daily - June 14, 2010
Five eminent
public health leaders (l-r Madeleine Dion Stout, Hon. Roy Romanow, Hon.
JakeEpp, Hon. Monique Bégin, Hon. Marc Lalonde) trace three decades of milestones at the opening plenary Sunday evening.
Centennial panel marks public health achievements
A panel of eminent Canadian public health leaders, representing more than three decades of legislative activity, traced the major milestones in the development of national health policy, as the Canadian Public Health Association opened its centennial conference in Toronto Sunday evening.
CPHA Chair Dr. Cory Neudorf recalled the group of visionary Canadians who formed the Association in September 1910, at a time when smallpox and typhoid fever were rampant. CPHA and public health “have each developed remarkably over the last century, reflecting and shaping the broader evolution of Canadian values and priorities,” he said.
Earlier, Centenary Chair Gerry
Dafoe leads participants in a
birthday chorus for CPHA’s
first 100 years.
“By the time the WHO was established in 1948, efforts to improve the health of Canadians had already demonstrated the dramatic, life-saving impact of population-wide public health measures,” she said. The public health challenges that Canada “faced and successfully addressed decades ago are now at the forefront of concern throughout the developing world,” while the 1986 Ottawa Charter for Health Promotion “set the wheels turning and prepared the way for the eventual report of the Commission on the Social Determinants of Health” in 2008.
CPHA Centenary Chair Gerry Dafoe recalled each panelist’s role in advancing the cause of public health in Canada.
As Minister of National Health and Welfare from 1972 to 1977, Hon. Marc Lalonde introduced a major overhaul of Canada’s social security system and received international acclaim for the 1974 policy document, A New Perspective on the Health of Canadians. Dafoe said the report laid out a blueprint for a prevention-oriented medical system, providing “a vision and a pathway for CPHA to grow and develop its leadership role in public health.” A New Perspective was released at CPHA’s 1974 annual conference.
“Decreasing rates of smoking in Canada by
looking at the evidence and sharing experience of what works has made a
huge contribution to chronic disease prevention across the country. The
biggest challenge ahead is involvement in the multisectoral processes
that are necessary to influence upstream effects on population health.
People have rightly pointed out that economics, housing, social policy,
and community cohesiveness are important determinants of health. But
other than pointing those things out, I don’t think public health has
really found a place for itself in influencing the agenda.”
-
Winnipeg
“It’s about bringing everybody together to
work on the various issues, rather than staying in our silos. We have
to break down those barriers. On the social determinants of health,
it’s really difficult to ask health professionals to see that education
and housing are significant issues when they’re concerned about their
clinical areas. But it has an impact on how people live, and on their
health. Sometimes we think we’re there [on the social determinants],
but really, we’re not.”
-
Ottawa
Hon. Jake Epp’s tenure as Minister from 1984 to 1989 was marked by the Ottawa Charter for Health Promotion, and by CPHA’s active involvement with the Charter, as well as its role in establishing Canada’s first national HIV/AIDS public awareness campaign. Dafoe acknowledged Epp’s “unwavering support” for the development of sexual health messaging, including a television campaign aimed at teens.
As Premier of Saskatchewan from 1991 to 2001, Hon. Roy Romanow introduced a regional health system and enacted Canada’s first child benefit program, a precursor to the National Child Benefit. He later chaired the Royal Commission on the Future of Health Care in Canada.
Madeleine Dion Stout represented the voices of Aboriginal nurses and addressed First Nations, Inuit and Métis health issues as president of the Aboriginal Nurses Association of Canada. Dafoe acknowledged her leadership roles on the National Forum on Health and the Mental Health Commission of Canada, her strong support for CPHA, and her participation in committees dealing with the recruitment of Aboriginal health professionals.
A Rainbow Coalition
By Hon. Monique Bégin
We still have a long way to go to fulfill the promise that many of us glimpsed during the first century of public health practice in Canada. And it will take a rainbow coalition of professionals and community partners to get the job done.
We’ve made extraordinary strides in sanitation and housing, in water fluoridation and immunization, in controlling infectious diseases. The world has seen a drop in infant mortality, and in the number of mothers who die during pregnancy and childbirth, although the need is still acute in our Aboriginal communities. And Canada has made great progress in reducing tobacco use.
But there is much more to be done. Canada’s challenge is to reorient and reorganize health care delivery via hospital-based medicine to an integrated model based on primary care. Every Canadian should have access to a continuum of broadly-defined health services, integrating prevention and health promotion.
Ensuring that the need for public services is met in the persistent neo-conservative political agenda is where a rainbow coalition becomes most crucial. Public health will receive the funding and attention it deserves when teachers and social workers, seniors’ associations and women’s organizations, business groups and trade unions, join with public health professionals to demand action on the socio-economic determinants that shape the health of all Canadians.
This kind of social change always comes from the bottom up. I’ve seen the power of civil society, and I know that the community is organized and vibrant.
Hon. Monique Bégin was Canada’s Minister of National Health and Welfare from 1977 to 1979, and from 1980 to 1984.
Participants set strategies on social determinants of health
Public health advocates sometimes assume that “if people aren’t listening, it’s their fault,” even though blaming the victim “isn’t acceptable in our community,” a veteran communicator told one of several discussion tables during a session on building effective platforms for action on the social determinants of health.
“We have accepted failure and rationalized it,” the participant said, “instead of understanding that we’ve failed to communicate effectively what’s in their interest to listen to.” During the session, different groups discussed:
- How to identify health equity issues, such as inequitable health outcomes for different neighbourhoods and populations;
- How to mobilize different partners around health equity issues;
- How effective cross-sectoral collaboration has made a difference at the local level;
- How to build cross-sectoral action and collaboration into the public health response on housing, health literacy, and food security, and other social determinants of health;
- What senior levels of government can do to enable and encourage intersectoral action;
- How to translate health inequality statistics, and the complexities around social determinants, into concrete issues that will galvanize public and community action.
Bed bugs return as a “very nasty problem”
Bed bugs have made a comeback in recent years, becoming a “very nasty problem which causes a lot of morbidity and marginalization,” Dr. Tom Kosatsky of the National Coordinating Centre for Environmental Health told a breakout session Sunday morning.
“One of the greatest achievements
has been the fight against the tobacco industry, and some of the
success stories that have sprung up around that issue: anti-smoking
legislation, smoke-free environments, and the steady decline in smoking
in North America over the last 40 to 50 years. Ahead, I see targeted
interventions toward those people who are still reluctant to give up
smoking.”
- Thunder Bay
“There is growing
recognition of the health issues among Aboriginal and Inuit people in
Canada, and greater understanding of the inequities they face in
chronic disease treatment and prevention. They’re a vulnerable
population, and a lot has happened. This is their country, and they’ve
faced oppression for centuries. This conference shows that the rest of
the country is here for them, even if we’re not of Aboriginal
descent.”
- Hamilton
The prevalence of bed bugs has waxed and waned since the early 1900s, and Stuart attributed the recent increase to the withdrawal of several chemical control products, including organophosphates. He cited several factors that make bed bugs a difficult control challenge: They are often hard to detect, can readily detect and avoid many chemicals, and are easily reintroduced and spread following treatment. Adults can live over a year without feeding, and they are now beginning to show resistance to insecticides.
Second-hand sales are a common mode of transfer, and travellers often bring them home. In one survey, a major pest control company in the U.S. reported that 24% of 700 hotel rooms had active infestations. In 19.7% of those cases, the infestations had spread to at least one secondary room.
The prevalence of bed bugs has raised concerns for home care workers who are less than eager to carry them home. Stuart said visiting practitioners should meet clients outside known infested areas and refrain from bringing bags, purses, or coats to areas where bed bugs are present.
Canadians live 30
years longer today than they did 100 years ago, and 25 of
those years are attributable to advances in public health. The ‘This is
Public Health’ Expo celebrates the profession’s 12 Great Achievements
of the last century and the often invisible practitioners who made them
happen, chronicling “the really profound changes that public health has
made in Canadian society,” said CPHA Centenary Director Sylvia Fanjoy.
Beginning with the slum conditions of the early
20th century, the expo traces decades of
struggle against infant mortality and contagious disease, as well as
signature achievements like tobacco control, better nutrition, and an
emphasis on exercise and active living.
The CPHA Centenary Expo: This is Public Health is open today
and tomorrow on the Lower
Concourse. |
Chemical residues raise water quality concern
Anne Rochon Ford, co-director of the
National Network on Environment and Women’s
Health
A staggering range of pharmaceutical and personal care products can be found in groundwater and drinking water, raising concerns about their health effects and their interaction with water treatment products like chlorine.
“Nobody is talking about how we deal
with violence, exploitation, or occupation. It’s disappointing, in this
era with the potential to do so much good, that so much bad is
happening. Someone said it’s the Age of Endarkenment. Afghanistan was
invaded ostensibly because of some bad guys, but mainly, as I
understand it, to make way for an oil pipeline. It seems like a lot
more people died during the occupation of Iraq by the United States
than Saddam managed to eliminate. But I didn’t see anybody rushing to
the Sudan, where the total mortality impact of the conflict was more
than 10,000 deaths per million population. Public health should be
collecting the evidence to show the impact of this process of taking
control of natural resources, because the impact on health is enormous.
But it can be very dangerous work...”
- Interior British
Columbia
Rochon Ford cited Canadian case studies that looked at lead, nitrates, trichloroethylene (TCE), and tritium in water. For people who live downstream from a refinery, or close to the Alberta tar sands, “there are ways in which you will be affected differently than others,” she said. Urban water systems may contain lead from aging water pipes, or a higher concentration of drugs and personal care products. Rural wells may be contaminated by agricultural runoff or industrial contaminants.
“Toxic effects can be cumulative, and health problems may only emerge after long-term exposure,” she said. Vulnerability is greatest for fetuses, newborns, infants, and pubescent children.
Rochon Ford said drinking water guidelines are based on adult male physiology, just as pharmaceutical clinical trials have typically been based “mostly on males of a certain age.” As a result, “we don’t actually know what the comparable is for women.” This research gap makes women vulnerable, due to their biological differences from men and the cultural roles often assigned to them by gender.
Program Update
Congratulations to University of Ottawa student Sara Torres, who won the draw for three nights’ free hotel accommodation during the conference.
The Daily is the official newsletter of the Centennial Conference of the Canadian Public Health Association, June 13-16, 2010 in Toronto. Views expressed are those of the individuals and organizations cited.
Editor in Chief: Judy
Redpath, CPHA
Editorial and Production: The Conference
Publishers, www.theconferencepublishers.com
Photo: Bard Azima,
LivingFace Photography