Public Health in Canada: What are the Real Issues?

Abstract

As a result of both bioterrorist threats in the U.S.A. and the Severe Acute Respiratory Syndrome (SARS) outbreak, public attention has focused on the preparedness of Canada’s public health system to deal with emergencies. Recent medical journal editorials have reacted strongly to the leaked release of a 2001 report, commissioned by the Council of Federal-Provincial/Territorial Deputy Ministers of Health, entitled “Survey of Public Health Capacity in Canada.” The report, now in wide circulation, reveals that public health professionals across the country have many concerns about their current state of preparedness to deal with major threats to the health of our population: acute infectious disease epidemics such as those in Walkerton and North Battleford; bioterrorist attacks; toxic spills; the rise in recent decades in rates of overweight and obesity, and associated complications, especially in young people. Missing from these discussions is an explanation of how this situation could have arisen in Canada, one of the world’s wealthier and better-governed nations. Such an analysis would help to inform policy and legislative response that is corrective and sustainable. In 2001, the authors travelled across the country, with the Canadian Institute for Health Information – Canadian Population Health Initiative (CPHI), consulting with public and population health researchers, policy-makers, program administrators and public health practitioners. These discussions, described in “Charting the Course”, are contributing to the long-term research and knowledge-exchange plans of both organizations, and have already resulted in the funding of innovative Canadian population and public health (PPH) research. However, research funding applied to public and population health problems in Canada cannot achieve its goals if the basic functioning of the current public health system is inadequate. Our consultations across the country suggest some underlying reasons for these current concerns. Let us examine these insights one at a time.