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Tuesday, 22 May 2012

Flu report card launched by the Lung Association fails grade.

A few weeks ago the lung associations from BC and Quebec released a report card on influenza in Canada BC Lung association link.  Last Friday the American Public Health Association picked up on the report card and gave Canada an overall failing grade.  APHA link.

On the surface, it made for good media coverage and much mileage CBC report on report card.  Probably made the folks in BC feel good, and provided fodder for Quebecers to tighten up their influenza vaccination program.

Here’s where the critical public health mind needs to go to work and read the fine print.  You can find on the original release that the study was based on a 3 day telephone blitz of 1019 residents for Canada.  It provides some level of stability on a national level, but start breaking that down into provincial data, and your confidence intervals are such that even the difference between BC and Quebec likely becomes not-significant. And then to draw a conclusion about recall on influenza like illness to suggest that certain provincial policies are better than others is a bit of a stretch.

Of course, look to the Canada community health survey for more accurate data – buried in reams of paper and not user friendly.  From 2007/08 (please let us know if there is comparable data for 2010 yet available anywhere).  Turns out that total population coverage rates has Canada at 30.5%, Nova Scotia doing the best at 38.9% and Newfoundland and Labrador in the basement at 23% (BC at 29.3% and Quebec at 25.2%). 

Ok, the years aren’t comparable and we did have a little H1N1 in between the surveys, but the rigour of the CCHS survey and the overall differences between this and the Lung Association must be noted. Likely no harm done other than the APHA headline that suggests Canada has a failing grade collectively and it would be interesting to see some international comparisons.   

Of course, kudos to the lung association for doing what PHAC and Health Canada seem so reticent to do - actually compare jurisdictional data.  McLeans magazine started the trend and over the years the McLean’s rankings carry more credence than most government reports, but isn’t this something that our major health oversight folks should be doing so that we can make decisions made on solid science?  

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