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The state's role in promoting population health: Public health concerns in
Canada, USA, UK, and Sweden
Dennis Raphael and Toba Bryant

Abstract
Despite the expanding literature on the importance role public policy plays
in influencing the broader determinants of the public¡¯s health, profound
differences exist among jurisdictions in the attention placed by the State
. as represented by public health authorities and agencies upon such
activities. In this paper we examine the dominant public health models of
Canada, USA, UK, and Sweden. The Canadian and USA public health communities
are focused upon individualized approaches to risk management.
In contrast, the UK and Swedish public health scenes are more oriented
toward broader approaches to health determinants. We argue that the extent
to which governments, public health agencies and public health workers
concern themselves with public policy approaches to address broader
determinants of health depends upon the particular model of health adhered
to within each jurisdiction. And whether a health model is adopted depends
upon the ideological and political context within which a nation is
situated. Canada represents a situation where concerted effort to influence
governmental policy directions by the public health community could reap
significant benefits.

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