Greetings,

The following item was sent by a colleague who noted that the different
advice received about the new Canada Public Health Agency, included a
warning about over-emphasizing health promotion. They seem to miss the point
about health promotion as an approach that addresses multiple
factors/determinants that contribute to overall health, not only personal
choice. Note near the bottom of the article, that participants in one
Canadian city warned that:
"Promotion strategies tend to assume that all Canadians have the ability to
make health choices, they said. But many people do not have adequate
resources, or live too far away, to have access to a true range of healthy
choices.''

Let's have some discussion on the nature of health promotion to address
access to adequate resources, and the connection of public health and health
promotion!

Alison Stirling,
health promotion consultant,
Ontario Prevention Clearinghouse
http://www.opc.on.ca

~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *

-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: May 6, 2004 7:47 PM
May 7, 2004 Volume 8 Issue 18
*****BENNETT GETS EARFUL ON PUBLIC HEALTH AGENCY*****

Secretary of State for Public Health Carolyn Bennett has received a lot of
different advice about the new Canada Public Health Agency the government is
creating. She toured the country in March, meeting with over 300
stakeholders in "roundtable" sessions. Summaries of these meetings have been
posted on the Health Canada website.
While Dr. Bennett heard things that mirrored the contents of the Naylor
report on SARS last year, and which prompted the creation of the new agency,
she also received feedback that may cause her to take the agency in a
different direction.
All sessions talked about a need for adequate, long-term funding for public
health, and a number of sessions highlighted the disparities in public
health services between regions.
Participants in Iqaluit, Nunvaut remarked that the public health system is
only as good as its weakest link, and said Nunavut is one of the weakest
links. They said front-line workers are too busy addressing illness issues
and have little or no time for public health.
The same point was raised elsewhere. In Calgary, the minister was told to
ensure the new public health agency avoids the "tyranny of the acute."
Participants said acute health care issues tend to grab the most attention
and funds, and deprive public health of scarce resources.
The need to bolster health human resources in public health was a clear
message delivered by most groups. There was also a call for the agency to
encourage more people to specialize in public health, and ensure other
specialists are educated in the principles of population health. And it was
suggested some health professionals, like pharmacists, play a larger role.
The Toronto session came up with the idea of creating a Canadian reserve - a
cadre of health professionals licensed in all jurisdictions who can respond
to emergencies in all parts of the country. However, participants in
Edmonton said it is more important to ensure people at the local level are
adequately trained to respond to crisis situations. They said SWAT teams
sent out from a national location will not work.
Local human resource capacity in public health is more important than a
national vaccine stockpile, Regina participants warned.
A common theme in all sessions was the need for the new agency to address
the needs of different populations such as First Nations people and
francophones in English communities. "One size does not fit all," Dr.
Bennett was told.
Similarly, participants in all sessions stressed that public health
activities have to do more than deal with infectious diseases. They said the
agency needs to focus on chronic diseases too, and the root causes of
illness like poor housing. Mental health issues were repeatedly mentioned as
something the agency has to address.
It was also felt that the agency should have a public education mandate. Not
only should the Chief Public Health Officer be a "champion" for public
health, and a calming voice in times of emergency, but the agency this
person runs should engage educators and schools in communicating basic
public health messages to children.
However, participants in Winnipeg warned about over-emphasizing health
promotion. Promotion strategies tend to assume that all Canadians have the
ability to make health choices, they said. But many people do not have
adequate resources, or live too far away, to have access to a true range of
healthy choices. "Health promotion strategies risk widening the health gap
between the rich and poor," they said.
In Regina, they said the agency needs to ensure Canadians have access to
healthy choices. They said alcohol is the same price across Saskatchewan,
but milk is 5 times more expensive in northern regions.
In the coming months, the government will start broad consultations with
Canadians on how it can better protect Canadians and the type of information
and services Canadians are looking for. In the House of Commons Wednesday,
Dr. Bennett said the search to fill the position of Chief Public Health
Officer will begin next week.

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