The goal of the public health system in Canada is to improve the health of communities, whether that is locally, provincially, nationally, and/or globally. Historically, most significant improvements in health occurred in the realm of public health, including preventing infectious diseases and improving water quality. These areas are still vital – we don’t typically worry …
The staff at the Community Health Centre (CHC) where I work often discuss behavior change and the fact that many of our clients struggle to make changes that could affect the quality of their life. “If this client would only make some of the dietary changes as I’ve suggested…” “Despite all that we know about …
A recent Canadian Institute for Health Information (CIHI) Report obscurely titled Health Indicators 2012 revisits the topic of the impact of prevention on reduced mortality which was first profiled in the 1974 Lalonde Report – A New Perspective on the Health of Canadians. This caused me to go back and reread the 38 year old …
By all accounts, Kaiser Permanente (a non-profit healthcare insurer and provider in the United States) is one of the best performing health care systems in the world. Shouldn’t it follow then, that its health plan members fare better as a population in terms of their health status? Not quite. A few weeks ago, Kaiser Permanente …
The Interim Federal Health Program (IFHP) was established in 1957 to provide temporary coverage of medical costs for refugee claimants without financial means while they await qualification for provincial or territorial coverage. Citizenship, Immigration and Multiculturalism Minister Jason Kenney recently introduced changes to the IFHP that have prompted outcry across the country from physicians and …
Canadian health agencies continue to develop diabetes prevention and management strategies that primarily focus on “lifestyle”: poor diet, excess weight, and lack of physical activity. But the exclusive focus on “lifestyle” ignores the important role played by the social determinants of health. A recent paper entitled A toxic combination of poor social policies and programmes, …
I’ve been reading a new book called Oppression: A Social Determinant of Health, edited by Elizabeth McGibbon. The book raises the question of why we continue to have such vast health inequities in Canada, despite the volume of evidence pointing to the large role played by the social determinants of health in causing illness and …
“A 41 year-old woman with no documented medical history or family history of disease presents to you complaining of occasional chest pains on exertion. How many would order a stress test to rule-out cardiovascular disease?” asks Dr. Gary Bloch, to a captivated audience of resident physicians currently in training at an academic learning day – …
Recently Ontario Health Minister Deb Matthews made a speech to the Toronto Board of Trade in which she introduced changes to the province’s health care system. Hmmm – interesting choice of audiences. The Ontario government is preparing for an upcoming provincial budget. It is widely expected to contain drastic spending cuts as recommended by economist …
Ontario’s Minister of Health and Long Term Care, Deb Matthews, has called them “a bit of a secret in health care”. The Honorable Roy Romanow is a big supporter of them. They are Tommy Douglas’ “Second Stage of Medicare” in action. Are Community Health Centres (CHCs) the best kept secret in health care and, if …
In my last post I explored how stress, debt, and environmental destruction seem like obvious implications of consumption. But what if too-much-stuff is also the source of physical illness? John de Graaf, David Wann, and Thomas Naylor brilliantly address this issue in their book Affluenza: The All Consuming Epidemic in their depiction of consumerism as a …
As a young person just beginning my career as a physician, it is extraordinarily overwhelming to confront the disconnect between the values that created our Medicare system and the logistics of how it has evolved. Despite those incredible challenges, I am more so struck on a daily basis in practice by the manner in which …
Living on an island where most of the locals are descendants of people who have lived here for generations has given me an interest in local history and genealogy. Many of my older patients’ parents and grandparents lived to a fine old age without the modern conveniences and medical care we take for granted today …
It was sometime before Christmas and I was headed to a meeting at Queens Park when I saw the large bus shelter ad promoting how much money Ontario’s physician’s had saved the province. I knew immediately that it must be contract negotiations time again. Don’t get me wrong. I’m not cynical at all. It’s just …
I see the effects of poverty everyday in my job as a health promoter at a Community Health Centre. Many of our clients live in deep poverty conditions, relying on social assistance, food banks, and meal programs to get by each month. They have little stability, living day to day, month to month in a …
Walking through the streets of any large city, one sees many homeless people. Nearly two in three have a history of some form of mental illness. Hospitals have become the place where homeless people with serious mental illness go during a crisis, but hospitals are poorly equipped to meet their needs. How can society improve …