From Dennis Raphael - a compilation of 'letters to the editor' of the Globe
and Mail newspaper in regards to the Andre Picard article on "Keep People
Healthy In The First Place"
[posted on the Heart Health listserv, and SDOH]


By ANNE WORMSBECKER, MD
Monday, Jun 28, 2004

 London, Ont. -- The Lalonde Report is 30 years old (Keep People Healthy In
The First Place -- June 24). If time were all that was needed to engineer
change, the focus of health care in 2004 would be on preventive medicine.

Unfortunately, time, even when combined with a solid dose of talk, does very
little. Case in point: I am 26 years old -- that is, four years younger than
the Lalonde Report -- and have just graduated from medical school where
"sickness care" was emphasized and health promotion given minimal attention.

Mr. Picard has provided a reminder that we can't wait passively for change.
The time is now for physicians, policy makers and Canadian citizens to act.
We can all contribute to taking the blinders off Canadian health care, and
broaden its currently narrow field of vision to include health promotion and
disease prevention.

-------------------------------------------

By GRAHAM RICHES
director, School of Social Work and Family Studies, University of British
Columbia
 Friday, Jun 25, 2004

 Vancouver -- As voters prepare to cast their ballots, André Picard (Keep
People Healthy In The First Place -- June 24) is right to remind us of the
sage advice of the Lalonde Report (1974). The significance it attached to
the socio-economic determinants of health and to prevention and care remains
critical to Canadian's future social being.

One could go further back in history to the 1942 British report of Lord
Beveridge and his identification of the five giants of "idleness, want,
squalor, ignorance and disease" and his proposals that ushered in the
welfare state; and in Canada to the Marsh and Heagerty reports (1943),
important early influences on the creation of our own systems of health
insurance and social security.

It was the minority governments of Lester Pearson in the 1960s supported by
the NDP that ushered in Canada's golden era of health and welfare-state
development.

Of course, no politician today wants to talk about welfare states and
particularly not during elections. However, Beveridge's concerns regarding
idleness (unemployment), want (hunger and poverty), squalor (homelessness),
ignorance (unaffordable education/high student debt load) and disease
(obesity, chronic illnesses) remain critical issues for millions of
Canadians.

If these basic needs are to be addressed in compassionate, efficient and
socially just ways, the grander vision of a newly recreated and re-thought
welfare state with the full participation of civil society must be realized.

History at least suggests that the election of a minority government on
Monday could move us in such a direction, unless, of course, it is one that
might tear the country apart.

-------------------------------------------

 By IRVING ROOTMAN
professor and Michael Smith Foundation for Health Research Distinguished
Scholar
 Saturday, Jun 26, 2004

University of Victoria -- I would like to congratulate The Globe and Mail on
an outstanding article by André Picard (Keep People Healthy In The First
Place -- June 24). This is an important reminder to the public and
politicians during this run-up to the election that putting more money into
health care is not going to solve all our health problems in the long term.

We also need to heed the message of the Lalonde Report to address the causes
of ill health through increased efforts in health promotion and disease
prevention.
---------------------------
 By DENNIS RAPHAEL,
associate professor and undergraduate program director, School of Health
Policy and Management, York University
 Saturday, Jun 26, 2004

Toronto -- Graham Riches (The Five Giants -- letter, June 25) is absolutely
correct to point out that the primary determinants of health are not health
care or even lifestyle choices as much as the provision of an adequate and
humane social safety net associated with the welfare state.

The main question to be answered is why -- considering that Health Canada
has systematically churned out this information in the form of various
reports and documents since 1974 -- have governments, policy-makers and the
media paid so little attention to these messages?

-----Original Message-----
Sent: June 24, 2004 3:22 PM
Subject: Globe & Mail article 'Keep People Healthy in the first place'

From the Globe and Mail: Keep people healthy in the first place
 By ANDRÉ PICARD PUBLIC HEALTH REPORTER Thursday, June 24, 2004 - Page A19
http://www.globeandmail.ca/servlet/ArticleNews/TPStory/LAC/20040624/HPICARD2
4/Health/Idx>

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