Revisiting our social justice roots in population health intervention research.

Abstract

ublic health has its roots in social justice. Descriptions of public health work in the early 20 th century reveal the appalling living conditions of the poor and the inequities that were predominant at the time. Class distinctions were apparent in life expectancy, and in differential rates of access to sanitation, clean water, education, food and adequate housing. Although there have been many improvements in the overall health of Canadians during the past century, substantial inequities remain. Canadian and international reports 1,2 have implored us to take action on these inequities. In this knowledge age, when we are working to build population health interventions on a solid foundation of theory and rigorous methods, it is important to revisit the social justice roots of population health interventions and consider why, as practitioners and scientists, we have sometimes deviated from these values. Historical accounts indicate several important eras for population health interventions in Canada. The early part of the 20 th century was a period when many basic public health regulations were being put into place to improve sanitation, safely preserve food, and reduce communicable disease transmission. 3 Community health workers, who were primarily nurses, were particularly active in school settings and in conducting home visits in poor and underserved communities. 3,4 Efforts to address deplorable social living and working conditions among vulnerable populations are prominent in descriptions of these early public health programs. Early descriptive epidemiological studies documented important socio-economic differences in health status, but did not consistently interrogate underlying issues of class and power. Post World War II marked the beginning of an information era. Health education efforts were reinforced with the production of communication materials that could reach all Canadians. 5 Lt. Col.