tag:blogger.com,1999:blog-58776606009659252952024-03-13T20:01:09.835-07:00DrPHealthPublic health in the Canadian context, is the set of organized services directed to prevent disease, promote and protect health. This site is devoted to analysis and stimulating dialogue on Canadian public health issues and in celebrating success in improving the population's health through long serving, sustainable, and ongoing work of dedicated public health workers.DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.comBlogger435125tag:blogger.com,1999:blog-5877660600965925295.post-14150190867184603562015-04-22T11:11:00.003-07:002015-04-22T11:11:49.220-07:00DrPHealth – time to begin to wrap up the blog site<div class="MsoNormal">
<span lang="EN-US">Over the
past 4 years, there have been over 430 posts and over 35,000 viewers. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">For the dedicated
reader, you will note that there have been no posting for the past 6 weeks. It
seems that the time has come to allow the site to remain active as there are
some very good unique resources that are not synthesized in other locations,
and many pages that are now outdated and should be viewed with a skeptical eye.
<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Just as importantly,
the main audience for this site has been public health workers in Canada. Where the first few years were predominately
Canadian readers, and in the mid-years about half; Now both Russian and US viewers outnumber the primary
target audience. While such
international interest is appreciated, it begs the question as to whether the
primary mandate is being met<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The site
was started when there was as relative dearth of on-line resources. Now there is a plethora. Blogs have popped
up, and more importantly, are better evidence synthesis sites that use rigorous
approaches. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Twitter was
merely a curiosity. Facebook was still a
personal sharing site and not the information source it has become. The growth in both to meet professional and
private needs speaks to their effectiveness. The growth of interest from the international
community also speaks to the rapid uptake of Web based systems. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Overall the
effort has been successful in communicating out. The site however was not well used for
stimulating dialogue amongt professionals.
And while there have been a smattering of guest contributions, a prime purpose
of protecting anonymity makes the site open to question for its legitimacy (a
valid concern from the media), and in many instances experts in various areas would
prefer their pieces to carry proper attribution. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Still to
come may be an important series on discrimination and health, and given the
recent events in the US, this has become even more pressing. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Your
thoughts and comments are still welcomed.
The <a href="mailto:drphealth@gmail.com">drphealth@gmail.com</a> address
remains active and monitored. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com1tag:blogger.com,1999:blog-5877660600965925295.post-79834394826472174902015-03-09T09:28:00.001-07:002015-03-09T09:28:14.149-07:00Incarceration, HIV, Hepatitis C and the lack of access to clean drug consumption supplies in Canada<i>A guest contribution from a health profession trainee. Extracted from a letter to their professional body requesting advocacy action. </i><br />
<i><br /></i>
<div class="MsoNormal">
Incarcerated populations have rates of human
immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection 15 and 39
times greater than the general population, respectively. Sharing of injection
equipment can account for a large proportion of the increased rates seen in
these populations. Due to the illegality of drugs, there are high rates of
incarceration among intravenous drug users (IVDUs). High incarceration rates
for IVDUs lead to an increased proportion of people who inject drugs within
prisons, and there is evidence showing little change in their drug use patterns
once in custody. As there is a scarcity of sterile injecting equipment relative
to drug supply and demand, high rates of needle sharing occur. A 2010 survey of Canadian inmates found that
half reported sharing needles. As well, some individuals report initiation of
injection use while in prison.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Current policy is to focus on interception of drugs before
they enter prisons. There has been less than a 1% decrease in prison drug use
during increased efforts to reduce drug entry (1998-2007). A Correctional
Service Canada (CSC) survey of prisoners found that 40% reported using drugs
since arrival at their current institution. It is evident that the current
emphasis on drug interception has not proven effective. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Prison needle distribution programs (PNDPs) have been
implemented successfully in several countries, for many years. Switzerland,
Germany, Spain, Moldava, Kyrzygstan, Luxembourg, Romania, Portugal, Iran and
most recently, Australia, have all implemented some PNDPs. Analysis of the
effectiveness of those programs reveals reduced spread of HIV and HCV, as well
as reduced needle sharing. There has been no increase in drug use or safety
issues for the prisons involved; staff at the PNDP prisons report increased
feeling of safety. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The health of incarcerated individuals rarely comes to
public awareness as these individuals are sequestered from society. In reality,
the incarcerated population is extremely fluid, particularly in provincial
facilities where inmates serve sentences less than two years. Disease
contracted in the prison system does not remain confined there; incarcerated
individuals are released to the community. Statistics from CSC estimate that
between 2000 and 2002, the number of individuals released into community with
HIV and/or HCV increased by 60% and 13%, respectively.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The World Health Organization (WHO) recommends that “prison
authorities in countries experiencing or threatened by an epidemic of HIV
infections among IVDUs should introduce needle sharing programs urgently and
expand implementation to scale as soon as possible”. In concert with this
recommendation, various national agencies have called directly on the
Government of Canada, CSC and the provincial correctional bodies to implement
PNDPs, including: CSC’s Expert Committee on AIDS and Prisons, the Correctional
Investigator of Canada, Canadian Medical Association and the Canadian Human Rights
Commission.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<i>Join in the call - contact your federal and provincial Ministers responsible for corrections. Clean needles are just one of the adjuncts needed in corrections facilities in order to maintain minimum wellbeing. </i>DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-22649137596447092102015-02-17T08:29:00.002-08:002015-02-17T08:29:20.175-08:00How Canada Performs: A National report card with international comparables. <div class="MsoNormal">
<span lang="EN-US">Ask any
classroom how many people like getting their report cards, and perhaps a few
stellar students will sheepishly lift their hands. Having our performance assessed is not a
favourite pastime for most of us. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">This shyness
away from grading extends to government performance as well. In a confederation, one of the strongest
roles that a central government can play is in monitoring and reporting on the
activities of its members (provinces).
However, in keeping with Canadian mentality, this is frowned upon, and
even when the federal government moved to reporting provincial performance as a
condition of the 2003 Canada Health Accord, this was vehemently rejected by the
provinces. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">In fairness,
collective performance is often influenced by so many factors outside of the
control of the responsible organization – in this case the provinces. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Tell that to
Bay Street, where performance is monitored and measured essentially in real
time. Corporate entities are continuously under scrutiny for delivery of their
outcomes, and in a day and age where triple or quadruple bottom lines are
measured, it is not limited to performance in fiscal deliverables. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Hence we
now have CIHI reporting out on health authority performance (subprovincial
level activity) <a href="http://drphealth.blogspot.ca/2012/05/health-indicators-who-is-best.html">May
2012</a> and that only occurred since MacLean’s magazine was printing the
information in previous years. Other agencies
have taken up the call with <a href="http://www.activehealthykids.ca/2013ReportCard/en/">Coalition for active
health kids</a>, <a href="http://www.unicef.org/media/files/RC11-ENG-embargo.pdf">Unicef</a>, <a href="http://www.bc.lung.ca/mediaroom/news_releases/nr_18_2011.html">Lung
association on influenza</a>, and the Canadian Pediatric Society annual report
card on children eg <a href="http://www.cps.ca/advocacy/StatusReport2012.pdf">2012
report</a>. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">So when last
week the economic think tank called the Conference Board of Canada released
their score card on health in Canada, while the provincial governments might
shudder, the media coverage was extensive.
British Columbia’s government was lapping up the highest ranking, while
those with poorer scores such as Manitoba and Newfoundland still felt obliged
to respond rather than discredit the
methodology. <a href="http://www.conferenceboard.ca/hcp/provincial/health.aspx">How Canada
performs</a>. </span></div>
<div class="MsoNormal">
<span lang="EN-US"> <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US">Where we continue
to fail is that the arms length bodies that are now holding us accountable for
performance, have minimal ability to influence the decision process that could
change the system. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">If we were
to look south of the border, CDC seems to be able to much more readily report
on state and county level health information, and ultimately influence resource
and policy decisions. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">The
Conference Board of Canada report card may be a step in the right direction and
notable that a predominately corporate entity is having such influence on
improving social outcomes. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-69569610000492694002015-02-13T01:55:00.000-08:002015-02-13T06:16:51.395-08:00HPV vaccine debate in the Toronto Star. Unmasking the dark side of the media<div class="MsoNormal">
The Toronto Star HPV saga dominated the airways beside the rage
against anti-vaccinators as initiators, propagators and disseminators of
measles. Two highly incongruent stories,
both highlighting the passionate debate around immunization. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Some might say neither with tragic consequences yet in
Canada, others will point to a mounting toil of preventable cervical cancer. Irrespective of your view, both illustrate the
challenge of bringing science to the public.
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Most child and youth immunization rates are slipping
gradually. HPV coverage is increasing. Both reflect choices of parents and are less
impacted by the needs or opinions of the persons receiving the vaccine. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The Toronto Star original article spoke about the dark side
of vaccination <a href="http://www.thestar.com/news/canada/2015/02/05/hpv-vaccine-gardasil-has-a-dark-side-star-investigation-finds.html">Dark
side of Gardasil</a> <o:p></o:p></div>
<div class="MsoNormal">
While not fully retracted the story, the Star has published
an op-ed piece <a href="http://www.thestar.com/opinion/commentary/2015/02/11/science-shows-hpv-vaccine-has-no-dark-side.html">Feb
11 response</a> which counters the original allegations. The publisher and
editor-in-chief have come as close as possible without actually issuing a retraction
or apology in stating the article “let the readers down” <a href="http://www.cbc.ca/asithappens/features/2015/02/11/we-failed-toronto-star-publisher-says-the-papers-hpv-vaccine-article-let-down-readers/">Feb
11 CBC coverage</a> <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Where to from here?
Vaccination decision for most childhood illnesses have an outright acceptance
currently running around 80%, that is at least four out of five parents follow
the advise of their health care provider because they are just that “their health
care provider”. A trusted source of health
information on which they depend. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The doubters and objectors for most vaccines are in a total
minority. While a very small percentage
of the population truly want to contrary, the majority prefer the comfort of
being in the majority. Each and everyone
who should receive a hero’s medal for not only trying to protect themselves,
but for the contributing to the protection of their community. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
It remains to be seen if the Star will bow to the pressures
of advertisers, readers, journalists and politicians in refraining from
stirring the vaccine pot. It seems like
a good journalistic and business decision to review its reporting. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
Anything that is provided universally is going to have its
share of coincidental events. In the
meantime, those that remember the horrors of facing these illnesses and the devastation
they have caused in our lifetimes need to speak up to and share their wisdom, and the media have a duty to be truthful in their reporting - something the Star fell short on this time. <o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com2tag:blogger.com,1999:blog-5877660600965925295.post-16236055269790602522015-02-09T08:55:00.002-08:002015-02-09T08:55:31.150-08:00Ebola control - a real public health success story that is not being told enough. <div class="MsoNormal">
<span lang="EN-US">A great global
public health success is being played out in West Africa. Perhaps overshadowed
by the challenges associated with the treatment side of the equation in
grappling with Ebola. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Treatment
however does not reduce the number of new cases, it may reduce mortality, and
there is some evidence that mortality rates are decreasing from an initial 50%
and down to about 40%. Good news for all
those involved in treatment. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">But the
real story lies in the prevention of cases.
The past 6 weeks have seen what was an average of 600 to 700 cases per
week, has dropped over 80% down to just over 100. (124 for the week leading up to February
4 <a href="http://apps.who.int/ebola/en/ebola-situation-report/situation-reports/ebola-situation-report-4-february-2015">WHO
weekly surveillance data</a>. The outbreak curve information embedded below. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIlVOADi9xF6g2I3pXWUvI6puRl0su-zIm4QihBfXKeHfYS_Iyy1ZaUvyZuoTjRxbDMrHrZpg5MORPJxqp6VeEgxUaBBV6jpYudz-OfkBSYlATP1gpkLkNemIcqiER7XYogciBQGBCrcY/s1600/EVD+-+Number+of+new+Cases.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIlVOADi9xF6g2I3pXWUvI6puRl0su-zIm4QihBfXKeHfYS_Iyy1ZaUvyZuoTjRxbDMrHrZpg5MORPJxqp6VeEgxUaBBV6jpYudz-OfkBSYlATP1gpkLkNemIcqiER7XYogciBQGBCrcY/s1600/EVD+-+Number+of+new+Cases.jpg" height="385" width="640" /></a></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">That is an amazing
story and a tribute to the public education, public guidelines, body disposal,
infection control, contact tracing, isolation procedures that have been
implemented in response to the outbreak. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Yes there
have tragically been 834 health care workers who have developed Ebola. That however is only 4% of all the cases and
the only group amenable to improved infection control in the treatment
facilities. A mere fraction of the reduced incident cases. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Noone
should understate the contribution of these health care heroes working on the
front lines. However, where are the
celebrations of those whose contribution is now saving hundreds of lives a week
through reduced incidence. It is typical of public health professionals to undersell their success and not celebrate too early, but perhaps a nod in the right direction that acknowledges their efforts to date and some support for continuing efforts are warranted. In typical fashion, the vast vast majority of aid resources are directed to the treatment and management sites, not to the public health efforts. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Thanks to the
WHO and all those who have been involved in planning and implementing the
fundamental public health interventions that have reduced this epidemic to the
point that full containment is well within reach. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Kudos to
all public health professionals who have been involved. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-5629776051938924712015-02-02T01:23:00.000-08:002015-02-02T01:23:00.051-08:00The Moose (measles) is loose again - and this time antivaxers are having the finger pointed at them. <div class="MsoNormal">
Once again the moose is loose. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Measles showed up in Disneyland in mid-December 2014. The bastion for middle class North American children,
the hallmark of all our childhood and most importantly the icon of healthy and
safe families. Yes there is something
wrong with the picture of Disneyland being the source. While only 84 cases were reported to date,
this outbreak has the makings of something that could irritate North American
for months. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Moreover this time the antivaccination movement is taking it
on the chin. Over half the cases were confirmed as unimmunized, and only 8% had
received two doses of vaccine. The
strain can also be linked back to the Philippine outbreak <a href="http://drphealth.blogspot.ca/2014/03/the-moose-is-loose-again-measles-fever.html">March
2014</a> which was traceable back to sub-Saharan Africa endemic illness that
spread to the Netherlands unvaccinated community, that spread to the
Phillippines through aid workers post the devastating November 2013 typhoon
Haiyan. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
As Mickey would say “It’s a small world after all” <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Measles is targeted for elimination, but until international
efforts of all stripes come together, this is a persistent plague that will
stay with us for decades. The reasons
behind the challenge in control were documented following another point source
spread in the US, the 2012 Superbowl <a href="http://drphealth.blogspot.ca/2012/02/measles-moose-is-loose.html">February
2012</a> that was more readily contained as the exposed population a tad older
than the typical Disneyland crowds. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
What is so notable in this event is the spread is being
driven by the unimmunized and underimmunized, for which sufficient susceptible
populations exist that transmission has the potential to sustained in the right
circumstances. The calls for tighter controls on personal choice exemptions,
increased mandatory requirements, improved documentation will once again remain
in public’s eye through the core of the outbreak. The defining event will be tragedy associated
with someone who is ill. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
So back to the demographics of the first generations at
Disneyland. Middle class, mostly likely
insured, well off enough to afford a trip to Disneyland, likely well nourished –
these are not the children that will suffer irreparable damage and death from
measles. They will recover and their
parents may be steadfast in their belief that measles is a mild illness. If, the virus spreads to a lower income
gradient, undernourished and uninsured children – it will be at arms length
from the causative agents of spread.
Moreover the very agents of spread will be the most vocal on the issues
of personal choice, having dissociated themselves from any negative
repercussions. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
Good on those that are taking the antivaxers to task, its
time the collective voices speak up for the public good. <o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-30930051114161036312015-01-28T16:28:00.001-08:002015-01-28T18:05:42.095-08:00Mental Health Promotion in action: #BellLetsTalk<div class="MsoNormal">
It is one of the largest health awareness events that we
have seen in this country, and credit to Bell Canada and in particular to the
leadership of Clara Hughes. Give that
lady another medal for her astounding performance. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Mental health consumers and professionals alike have striven
to increase awareness of mental health issues in the country for decades. It has been the dogged determination of a
concerted charitable effort that has finally helped break through the barrier. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Throughout the day innumerable statistics and stories have
been posted on #BellLetsTalk, couched in a fund raiser of 5 cents per tweet for
the whole day, the attention seems to be coming from all directions and a wealth
of information in just the 140 character Tweets. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
If you have not done so, contribute a retweet, but more importantly
search on the hash tag and scan through the richness that Canadians have revealed. <i>Just after this posting, Clara Hughes announced that over 100 Million texts, tweets, likes etc had been sent. Slightly less than last year's record, but really - that is three for every Canadian, an incredible level of engagement. </i><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
We know that mental illness will affect at least one in
five, severe persistent mental illness affecting about 3% of the population,
anxiety disorders are one of the most common diseases and rarely reported or
treated. The list goes on and on – learn
more at #BellLetsTalk<o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-22411130618220257012015-01-21T07:45:00.001-08:002015-01-21T07:45:11.320-08:00Canada's children under the global spotlight. A continuing public health crisis<div class="MsoNormal">
An op-ed published on the plight of Canada’s children
deserves a quick read. Published in
Victoria of all places, renowned as a centre for retirement in Canada, the
article by University of Calgary professor Nicole Letourneau hits hard at the
neglect of Canadian children in comparison to our developed country peers. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
UNICEF rankings show how Canada stacks up against other
developed countries <a href="http://www.unicef.ca/sites/default/files/imce_uploads/images/reports/unicef_report_card_12_children_of_the_recession.pdf">UNICEF
state of child 12 2014</a> and the 2014
report focused specifically on the impact of the recession globally on hardest
hit nations and changes over the 2008-2013 period. Oddly much of Canadian
statistics are excluded from the main UNICEF report, but are found in a
companion Canadian document at <a href="http://www.unicef.ca/sites/default/files/imce_uploads/images/reports/rc12_canadian_companion_en_2810.pdf">Canadian
companion UNICEF</a> <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Canada’s performance remains dismal overall but
some good trends are noted<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Child poverty increased overall by 2% <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Children are more likely to be living in poverty
than adults and seniors in Canada<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Canada still ranks 20 of 41 countries in poverty
rates, and a whopping 16% absolute less than Norway where only one in twenty
children lives in poverty. <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->10% of Canada’s youth either not employed or in
school, however this fairs better than most countries (rank 7) <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Canada ranked 34 of the 41 countries in the
perception that children’s opportunities have declined<o:p></o:p></div>
<div class="MsoListParagraphCxSpLast" style="margin-bottom: 0.0001pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Canada ranks 32 of the 41 countries on
perceptions of increased stress on children. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Both the global report and Canadian companion are excellent
documents that detail the impacts of the recession and lessons to be learned
from global comparisons. Canada’s
performance close to dismal based on the op-ed <a href="http://www.timescolonist.com/opinion/op-ed/comment-canada-fares-poorly-on-children-s-health-rankings-1.1726537">Times-Colonist
January 11</a>.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Both documents are to be commended for lengthy discussions of
the economic rationale for supporting children, and both speak of the successes
that others have accomplished. <o:p></o:p></div>
<br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Time for Canada to step to the plate at more than the
tokenism expressed in addressing income splitting
amongst high single income earning families. <o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-5937151400200831452015-01-14T07:41:00.002-08:002015-01-14T07:42:51.971-08:00Canadian women continue to be denied a health benefit available globally. The case of politics and mifepristone <div class="MsoNormal">
<span lang="EN-US">Canadian
women are being denied a health benefit that is widely available in the US and
Europe. Why? because for some bizarre
reason, despite being on the WHO list of essential medications, despite
twenty-five years of global distribution, despite fifteen years of approval and
distribution in the US, despite political upheavals and protests in Australia
it had been banned and now approved for use, despite all this, Canadian regulators suggest that they
need “more information” before approval can be considered in Canada. </span><span style="font-family: Calibri, sans-serif; font-size: 11pt; line-height: 115%;">See
</span><a href="http://www.theglobeandmail.com/news/national/decision-on-whether-to-approve-abortion-pill-for-canadians-delayed-again/article22438908/" style="font-family: Calibri, sans-serif; font-size: 11pt; line-height: 115%;">Globe
and mail coverage of delayed decision on abortion pill</a> </div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The
Canadian regulator system tends towards precaution and conservatism and that
has served Canadians well in many instances.
This however should be called what it really is – blatant political
interference in the regulatory process.
The government will likely move to an election this year, and merely is
clearing the plate of a potential ideological embarrassment if a Conservative government
were to issue an approval, they stand to alienate the far right. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Shame on
such political pettiness that women in Canada are continued to be denied a more
comfortable and perhaps safer alternative to pregnancy termination. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Abortion
evokes a variety of emotional responses that span the continuum and have
entrenched camps at both extremes of the spectrum. The health ethics of
abortion have long been clarified with the duty to support a client in their choice. That in Canada we would continue to utilize
technologies that are antiquated and may not be as safe is astounding. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Mifepristone
is not an innocuous drug. It has a very
intended purpose that disrupts endocrinological responses and induces uterine endometrial
degeneration, essentially mimicking processes involved in normal menstruation. Its pharmacological targeting is more
appropriate than the one approved medical regime in Canada which combines the
cytotoxic drug methotrexate with misoprostol which is better known for its
gastric protection action than its use in obstetrical induction as a cervical
ripening agent and stimulator of uterine contractions. The non-medical alternative remains the
Canadian mainstay of pregnancy termination using the invasive procedure of vacuum extraction. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The technical
details aside, that politics have played into what is supposed to be a
non-political regulatory approval process fuels further concerns of the
interference politicians have played on government scientists and silencing of
their voices <a href="http://drphealth.blogspot.ca/2013/10/muzzling-science-harperism-undermines.html">The
Canadian muzzling of scientists October 2013</a> . In this case scientists should be speaking up
loudly in addition to the voices of women (and men) who are being subjected to
abuse by being denied a treatment alternative that ultimately leads to a higher
likelihood of physical attack on their bodies. </span></div>
<div class="MsoNormal">
<span lang="EN-US">I<o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">n any other
legal realm, this would be considered violence against women. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com1tag:blogger.com,1999:blog-5877660600965925295.post-67143523185811379462015-01-06T21:03:00.001-08:002015-01-07T18:33:02.902-08:00Picard hits a home run: Hospital congestion not just an influenza problem<div class="MsoNormal">
A national treasure, André Picard once again tells it like
it really is. Influenza is not the cause
of the winter bed surges – its bad management and planning. The increased volume of influenza hospitalizations
may hit a 1% surge above background levels, whereas some hospitals are looking
at over 25% excess populations above bed
numbers - and doing nothing other than blaming something over which they
perceive they have no control. <i>Jan 7 - a calculation of current admitted clients by number of beds in one are of close to 1 Million population, suggests overall impact on bed utilization is 3% - well below the reported capacity overflow for the same area. if you have local statistics, please share them and help debunk the myth</i><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Well done André – hit a knockout punch to ring a few bells. Hospitals manage very well planning for
holiday slowdowns, planning for reduced services on weekends, and coping
outside of the 8-5 work day. They even
have demonstrated marvelous capacity to respond to labour strife with strikes and
walkouts, without poorer health outcomes. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Yet, annually the surge occurs to align with the predictable
wave of influenza. And predictably the
hospitals will argue for more beds, the emergency departments will complain of
backed up patients, long wait times and poor quality care. And come April, while the rhetoric
reverberates, planning for a summer slowdown will be in full swing. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The cynics might reply with its just public health
complaining and pushing more vaccine. If public health did a better job getting
people to wash hands, cover their coughs, be immunized and even ensure that the
walking ill don’t see it necessary to use the emergency room, that the
hospitals would manage better. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Talk about victim blaming!!! <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
That a large number of people inside and outside the hospital
this year are gripping about the poor planning is a faint light that perhaps
somebody might think differently. With a
dozen years at senior executive tables and nearly 30 years in the field, this
writer’s skepticism is justifiably a learned response. As one person said, “its like the movie Groundhog
day. We just keep repeating the same
mistakes over and over and painfully slowly learn from our mistakes. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
So good on you Picard for taking the system to task. We deserve the criticism and we deserve chastisement
for our failure to learn from the past.
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
In this day and age, few senior executives last more than a
couple of years – corporate history is so short that we are destined to repeat our
errors, over and over and over again and sentenced to the annual winter surge
to be taken in stride as a “normal”.
Besides, were it not for the winter surge, we would not have the numbers
on which to argue for more beds, bigger emergency departments, more, more, more…. <o:p></o:p></div>
<br />
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Thanks André. We’ll
be looking forward to your next home run. <a href="http://www.theglobeandmail.com/globe-debate/dont-blame-the-flu-for-er-congestion/article22309794/">globeandmail
ER congestion January 6 2014</a> <o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com1tag:blogger.com,1999:blog-5877660600965925295.post-57546858972827285752015-01-04T19:40:00.000-08:002015-01-05T14:08:25.602-08:002015 – What the New Public Health Year may bring. Predictions of what is hot and what is not. <div class="MsoNormal">
2015 comes with no promises, but heck – why not stick a neck
out and provide some predictions on where things are going in public health. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
For the optimist, look to:</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: Symbol; text-indent: -18pt;"><span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: Symbol; text-indent: -18pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><span style="text-indent: -18pt;">Successful trials of candidate Ebola vaccines
and the beginning of control on the West Africa outbreak. While not the biggest
public health issues, it will continue to be the dominant media attraction for at
least the first half of the year.</span></div>
<div class="MsoListParagraphCxSpFirst" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Mental Health issues will continue to receive
appropriate and perhaps even expanded attention as a public health issue, more
than just increased clinical services. <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Improved involvement of public health in
commenting on significant policy issues in some format of health assessment
with some useful tools available to support the work<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Further subtle migration of other health sectors
to areas of prevention (without necessarily involving traditional public health
experts)<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Enhanced emergence of the specialized disciplines
of public health economics and public health services research. <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Tokenism to public health controls by
implementing policy restrictions on flavoured tobacco and electronic nicotine delivery
systems (/ENDS/e-cigarettes/vaping), with perhaps some attention to food advertising to
children. <o:p></o:p></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Continued general improvements in nutrition and
diet – led predominately by market forces and social trends and not by
organized public health responses. <o:p></o:p></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<br /></div>
<div class="MsoNormal">
Social issue trends with significant long term health
benefits.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"> </span></span><span style="font-family: Symbol; text-indent: -18pt;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><span style="text-indent: -18pt;">Increased attention to the issues of ethnic and
racial discrimination as a public policy and public health issue</span></div>
<div class="MsoListParagraphCxSpFirst" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Further rhetoric on the maldistribution of
wealth – without solutions<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Attention being formally given to the issues of
Canadian youth underemployment<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Renewed attention to women’s health issues of gender
equity, domestic violence, sexual discrimination and harassment. <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Persistent downsizing of governments and limiting
growth in the health sector. <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Continued shift in public policy power to the
oil and gas megaindustries. <o:p></o:p></div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Continued migration from collective recreation
to dependence on electronic communication devices<o:p></o:p></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;"><br /></span></span></div>
<div class="MsoNormal">
For the pessimist:<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Further migration away from, and the disempowering
of the traditional public health infrastructure<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->The continued disciplinization of public health
in Canada to the detriment of the organization of public health <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Continued flailing of the explicit poverty
agenda with mere shuffling of the issues<o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Further government short selling of the future
of children in the country. <o:p></o:p></div>
<div class="MsoNormal">
</div>
<div class="MsoListParagraphCxSpLast" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Expansion of faith based tensions and
discrimination<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
And things that we might want but can expect are unlikely to
happen:<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoListParagraphCxSpFirst" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Minister Ambrose taking a leadership role in
forging federal-provincial health bridges <o:p></o:p></div>
<div class="MsoListParagraphCxSpMiddle" style="margin-left: 18.0pt; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Real leadership from the Public Health Agency of
Canada and the new Chief Public Health Officer<o:p></o:p></div>
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</div>
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<!--[if !supportLists]--><span style="font-family: Symbol; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]-->Multilateral international efforts to resolve
tensions and expand peace<o:p></o:p></div>
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<br /></div>
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As with any list, DrP invites your suggestions and comments,
posted to the website or with an assurance of anonymity if directed to <a href="mailto:drphealth@gmail.com">drphealth@gmail.com</a>. <o:p></o:p></div>
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<br /></div>
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Finally, renew your resolutions in support of your vocation
as a public health professional. The list from 2012 remains as relevant today
as from three years ago. <a href="http://drphealth.blogspot.ca/2011/12/resolutions-for-public-health-workers_30.html">Dec
30 2011</a> <o:p></o:p></div>
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<br /></div>
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May 2015 fulfill your best dreams and gift you with
happiness and health<o:p></o:p></div>
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<br /></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-50320064272361385282014-12-23T08:45:00.000-08:002014-12-23T16:21:05.860-08:00Public Health year in review - top stories from the readers and writers perspectives<div class="MsoNormal">
<span style="font-family: Arial, Helvetica, sans-serif;">As the year rolls to an end what are the biggest stories in
public health over the past year? Trite
by some standards however a reflection of where we have come from in the past
12 months. The site having received its
33,000<sup>th</sup> visitor this week<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;">First your votes based on views of various postings in descending
order by number of views. The list of
most popular sites contrasts dramatically with the list of what DrP thinks
about the key public health issues for 2014 which follows<o:p></o:p></span></div>
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<span style="font-family: Arial, Helvetica, sans-serif;"><br /></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<br />
<ol>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: 7pt; font-stretch: normal;"> </span><span style="font-family: Arial, Helvetica, sans-serif;">Hookah use:
A Science Update on a widely read subject </span><a href="http://drphealth.blogspot.ca/2014/02/hookah-use-science-update-on-widely.html" style="font-family: Arial, Helvetica, sans-serif;">Feb
17</a></li>
<li><span style="font-family: Arial, Helvetica, sans-serif; font-size: 7pt; font-stretch: normal; text-indent: -18pt;"> </span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">Public health officers under duress.</span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;"> </span><span style="font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">How well do we stand up for Canadians?</span><a href="http://drphealth.blogspot.ca/2014/11/public-health-officers-under-duress-how.html" style="font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">Nov
20</a></li>
</ol>
<!--[if !supportLists]--></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-language: EN-CA;">3.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-CA;">Assessing
Minister of Health Ambrose's first 8 months in office. Not even close to a
passing grade </span><a href="http://drphealth.blogspot.ca/2014/03/assessing-minister-of-health-ambroses.html">March 5</a><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-CA;"> <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-language: EN-CA;">4.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">One year of Minister what’s-her-name? Ambrose’s first year. </span> <a href="http://drphealth.blogspot.ca/2014/08/one-year-of-minister-whats-her-name.html">Aug
13</a> <span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-CA;"><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin; mso-fareast-language: EN-CA;">5.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">Quebec's public health system under siege </span><a href="http://drphealth.blogspot.ca/2014/10/quebecs-public-health-system-under-seige.html">Oct 16</a><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-CA;"> <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">6.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">Influenza 2014 - pandemicH1N1
the sequel </span><a href="http://drphealth.blogspot.ca/2014/01/influenza-2014-pandemich1n1-sequel.html">Jan 3</a><span style="color: #222222; mso-bidi-font-family: Arial; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-CA;"> </span><span style="color: #222222; mso-bidi-font-family: Arial;"><o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpMiddle" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">7.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">Minimum wage, Living wage,
Assured Basic Income, and the shift to Part-time work </span><a href="http://drphealth.blogspot.ca/2014/01/minimum-wage-living-wage-assured-basic.html">Jan 19</a><span style="color: #222222; mso-bidi-font-family: Arial;"> <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpLast" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">8.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">Positioning public and
population health: An optimistic view for the future </span><a href="http://drphealth.blogspot.ca/2014/08/positioning-public-and-population.html">Aug 5</a><span style="color: #222222; mso-bidi-font-family: Arial;"> </span> <span style="color: #222222; mso-bidi-font-family: Arial;"><o:p></o:p></span></span></div>
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<span style="color: #222222; mso-bidi-font-family: Arial;"><span style="font-family: Arial, Helvetica, sans-serif;">From
DrPHealth’s perspective, the major Canadian public health stories. <o:p></o:p></span></span></div>
<div class="MsoListParagraphCxSpFirst" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">1.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">Ebola and its implications <a href="http://drphealth.blogspot.ca/2014/07/ebola-threat-analysis-reassurance-and.html">July
30 threat analysis</a> , </span><a href="http://drphealth.blogspot.ca/2014/10/ebolaied-pronounced-e-bowl-eye-d-latest.html">Oct 20 Ebola-ied</a><span style="color: #222222; mso-bidi-font-family: Arial;"> , </span><a href="http://drphealth.blogspot.ca/2014/10/ebolaphobia-when-prudent-caution.html">Oct 20 Ebolaphobia</a><span style="color: #222222; mso-bidi-font-family: Arial;"> </span></span></div>
<div class="MsoListParagraphCxSpFirst" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<span style="color: #222222; font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">2.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><span style="color: #222222; font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">Appointment of the new Chief
Public Health Officer and the immediate stripping of his responsibilities. <a href="http://drphealth.blogspot.ca/2014/09/finally-new-public-health-leader-for.html">Aug
25</a>, </span><a href="http://drphealth.blogspot.ca/2014/11/disempowering-chief-public-health.html" style="font-family: Arial, Helvetica, sans-serif; text-indent: -18pt;">Nov 13</a></div>
<div class="MsoListParagraphCxSpLast" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">3.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">The siege against public
health in Canada <a href="http://drphealth.blogspot.ca/2014/11/public-health-officers-under-duress-how.html">Nov
20</a> , </span><a href="http://drphealth.blogspot.ca/2014/10/quebecs-public-health-system-under-seige.html">Oct 16</a><span style="color: #222222; mso-bidi-font-family: Arial;"> <o:p></o:p></span></span></div>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">4.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">The rise of the Oil and Gas sector –
and while published in 2013, the series speaks to the very issues that played
out in 2014 <a href="http://drphealth.blogspot.ca/2013/12/oil-and-gas-synthesizing-public-health.html">Dec
27, 2013 summary posting</a> <o:p></o:p></span></span></h3>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US" style="color: #222222; font-size: 10pt;">Exploration, specifically fracking
</span><span style="color: #222222; font-size: 10pt;"><a href="http://drphealth.blogspot.ca/2013/12/fracking-and-public-health-risk.html"><span style="color: #888888;">Dec 5, 2013</span></a><span class="apple-converted-space"> </span>and<span class="apple-converted-space"> </span><a href="http://drphealth.blogspot.ca/2012/10/fracking-is-it-obscene-word-in-public.html"><span style="color: #888888;">Oct 18, 2012</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US" style="color: #222222; font-size: 10pt;">Upstream issues (mining, collection and pumping) </span><span style="color: #222222; font-size: 10pt;"><a href="http://drphealth.blogspot.ca/2013/10/oil-and-gas-upstream-public-health.html"><span style="color: #888888;">Oct 29, 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US" style="color: #222222; font-size: 10pt;">Pipeline and transport issues
</span><span style="color: #222222; font-size: 10pt;"><a href="http://drphealth.blogspot.ca/2013/10/oil-and-gas-pipelines-and-other.html"><span style="color: #888888;">Oct 30, 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="color: #222222; font-size: 10pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Downstream
operations (refining) <a href="http://drphealth.blogspot.ca/2013/11/oil-and-gas-downstream-operations.html"><span style="color: #888888;">Nov 4 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="color: #222222; font-size: 10pt;"><span style="font-family: Arial, Helvetica, sans-serif;">End
user contributions
<a href="http://drphealth.blogspot.ca/2013/11/oil-and-gas-downstream-operations.html"><span style="color: #888888;">Nov 6, 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US" style="color: #222222; font-size: 10pt;">Boom- bust economies of rural and remote development </span><span style="color: #222222; font-size: 10pt;"><a href="http://drphealth.blogspot.ca/2013/10/rural-remote-and-northern-development.html"><span style="color: #888888;">Oct 9, 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoNormal" style="background: white; margin: 0cm 0cm 0.0001pt 72pt;">
<span style="color: #222222; font-size: 10pt;"><span style="font-family: Arial, Helvetica, sans-serif;">Boom
economies and the community left behind <a href="http://drphealth.blogspot.ca/2013/12/oil-and-gas-untold-story-of-community.html"><span style="color: #888888;">Dec 10, 2013</span></a><o:p></o:p></span></span></div>
<div class="MsoListParagraph" style="background: white; margin: 9pt 0cm 0.0001pt 36pt; text-indent: -18pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; mso-bidi-font-family: Calibri; mso-bidi-theme-font: minor-latin;">5.<span style="font-size: 7pt; font-stretch: normal;"> </span></span><!--[endif]--><span style="color: #222222; mso-bidi-font-family: Arial;">The rise of Transportation
infrastructure as a contributor to health <o:p></o:p></span></span></div>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Part 1
Transportation and health: </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/04/transportation-and-health-part-1.html"><span style="font-size: 11pt; font-weight: normal;">Apr 22</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="color: #222222; font-size: 11pt; font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">Part 2
Cars: Our love and addiction to the vehicle may be making us sick. <a href="http://drphealth.blogspot.ca/2014/04/cars-our-love-and-addiction-to-vehicle.html">Apr
24</a> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Part 3
Moving to active transportation: A Public Health winner: </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/04/moving-to-active-transportation-public.html"><span style="font-size: 11pt; font-weight: normal;">Apr 28</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Park 4
Public Transit - moving the masses in a sustainable fashion. </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/04/public-transit-moving-masses-in.html"><span style="font-size: 11pt; font-weight: normal;">Apr 30</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Part 5
Mass transit. Which method is healthiest? </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/05/mass-transit-which-method-is-healthiest.html"><span style="font-size: 11pt; font-weight: normal;">May 5</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Part 6
A Rural Reply. </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/05/transportation-and-health-rural-reply.html"><span style="font-size: 11pt; font-weight: normal;">May 12</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 72.0pt; margin-right: 0cm; margin-top: 0cm;">
<span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">Part 7
Your role in contributing to the public's health. </span><span style="font-size: 14.0pt; mso-bidi-font-size: 13.5pt;"><a href="http://drphealth.blogspot.ca/2014/05/transportation-and-health-your-role-in.html"><span style="font-size: 11pt; font-weight: normal;">May 15</span></a></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">6.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">Coming of age of public health
economics </span><a href="http://drphealth.blogspot.ca/2014/12/inequity-economists-view-of-public.html"><span style="font-size: 11pt; font-weight: normal;">Dec 3</span></a><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">7.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">The rise of Generation Squeeze </span><a href="http://drphealth.blogspot.ca/2014/04/the-squeezed-generation-gensqueeze.html"><span style="font-size: 11pt; font-weight: normal;">Apr 9</span></a><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">8.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">The death of the Canada Health Council
and the Canada Health Accord </span><a href="http://drphealth.blogspot.ca/2014/03/obituary-for-canada-health-accord-death.html"><span style="font-size: 11pt; font-weight: normal;">Mar 26</span></a><span class="MsoHyperlink"><span style="font-size: 11pt; font-weight: normal;">, </span></span><span style="color: #222222; font-size: 11pt; font-weight: normal;"> </span><a href="http://drphealth.blogspot.ca/2014/03/obituary-for-health-council-of-canada.html"><span style="font-size: 11pt; font-weight: normal;">Mar 24</span></a><span style="color: #222222; font-size: 11pt; font-weight: normal;"> <o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">9.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">Chikungunya disease that in one year
has infected over 1 Million people and has crossed into the USA<span class="apple-converted-space"> <a href="http://drphealth.blogspot.ca/2014/02/chikungunya-disease-emerging-threat.html">Feb
18</a> </span><o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 9.0pt; mso-list: l1 level1 lfo2; text-indent: -18.0pt;">
<!--[if !supportLists]--><span style="font-family: Arial, Helvetica, sans-serif;"><span style="color: #222222; font-size: 11pt; font-weight: normal;">10.<span style="font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span style="color: #222222; font-size: 11pt; font-weight: normal;">The untold story
that may belong at the top of the list is the resurgence of discrimination as
manifest by racial protests in the US following police shootings, sexual
discrimination at University and by own Minister of Health’s (Twitter profile
showing her standing among a group of handsome males), persistent policy
neglect of Canadian Aboriginal peoples, mistreatment of residents of African countries
hit by Ebola, immigration debates in the US, Religious tensions that fuel the
tensions between Islamic and Western nations</span><span style="color: #222222; font-size: 11pt; font-weight: normal;"><o:p></o:p></span></span></h3>
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 0cm; margin-right: 0cm; margin-top: 9.0pt;">
<span style="color: #222222; font-size: 11pt; font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">Please comment on which stories you believe should
have made this list, or perhaps those that don’t belong here. <o:p></o:p></span></span></h3>
<span style="font-family: Arial, Helvetica, sans-serif;"><u1:p></u1:p>
<u1:p></u1:p>
<u1:p></u1:p>
<u1:p></u1:p>
<u1:p></u1:p>
<u1:p></u1:p>
</span><br />
<h3 style="background: white; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 0cm; margin-right: 0cm; margin-top: 9.0pt;">
<span style="color: #222222; font-size: 11pt; font-weight: normal;"><span style="font-family: Arial, Helvetica, sans-serif;">May
the year 2014 close with happy holidays for those who enjoy a break and our
heartfelt thanks to those dedicated to serving others who selflessly work
during the season so colleagues may spend time with their families and friends,
or serve to protect us from others and ourselves during festive times. </span><span style="font-family: Calibri, sans-serif;"><o:p></o:p></span></span></h3>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com1tag:blogger.com,1999:blog-5877660600965925295.post-74204439171373390532014-12-20T11:41:00.002-08:002014-12-20T11:44:49.245-08:00Happy Holiday tidings - a time for Public Healthers to reflect on our personal vocationsThe holiday season is upon us and DrPHealth wishes everyone the best for the season, however you celebrate. Be sure to connect with those that have fewer friends than you, live by themselves or in whatever fashion are isolated. Set an extra place at dinner and take the time to find someone to sit with you, your family and friends so they can share in your generosity.<br />
<br />
Canadians are know for their generosity, a giving trend that has slowly slid over the past decade, perhaps in part from tighter finances and tighter pocketbooks. Throughout global religions a common theme of caring for those that are less fortunate than yourself is pervasive. Most of use have entered the caring professions with a true desire to be charitable. At this time of the year take a moment to look into your heart and ask how true you have been personally to this lifetime commitment?<br />
<br />
It is a time to relish in the eyes of children, whose view of this vast world is full of optimism, wonder and joy. Our world will fall to them in the near future, and we will be dependent on their wisdom, leadership and sense of globalism for our personal wellbeing. Keep those children within your reach filled with hope, charity and happiness - and reach out to those children who if touched by just one silent angel may blossom.<br />
<br />
Look in the mirror and ask those insightful introspective questions - what more can I do to be a better person and what can I do to make the world a better place now and in the future.<br />
<br />
Happy holidays to all our friends. <br />
<br />
DrPDrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-15481732489267022272014-12-03T01:52:00.000-08:002014-12-03T01:52:00.232-08:00Inequity – an economists view of the public health issue (and very supportive)<div class="MsoNormal">
<span lang="EN-US">When
economists speak to the need to address a central public health issue, we need
to pay attention. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">A special
report from TD Bank Economics discusses the implications of income inequality
on economic growth and long-term prosperity. <a href="http://www.td.com/document/PDF/economics/special/income_inequality.pdf">TD
economics special report November 24, 2014</a> <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">The headline
message to take home is the TD report references an <a href="http://www.oecd.org/forum/oecdyearbook/growth-and-inequality-close-relationship.htm">OECD
2014 report </a> that shows a 1% increase
in inequality results in a 0.6-1.1% reduction in GDP growth. The TD study details further how Canada has
performed internationally (and there are some positive indicators). Both these resources will aid in future
conversations. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Notable in
the discussion is the debunking of the myth that global productivity growth
benefits everyone and detailed analysis of who is benefiting the most and
least. It further demonstrates that the </span>Canadian misalignment of growth has
actually been carried mostly by the middle-income earners. The change in relative average income is
reproduced below.</div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUgPNMqzAi6uJ5ryKTmXSDhhv4uuCknZ53kmyuf5ds62DAoAFk35oBtVhu1tGeUfP6YBVRrNypkGEnpRaRwRxwRgOuKFx6j8O1SbbVA7WbRh_Ot5SyI2YKeo0UXfodsseya-YzcCFl_Og/s1600/Average+Canadian+Real+Income,+by+Quintile.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUgPNMqzAi6uJ5ryKTmXSDhhv4uuCknZ53kmyuf5ds62DAoAFk35oBtVhu1tGeUfP6YBVRrNypkGEnpRaRwRxwRgOuKFx6j8O1SbbVA7WbRh_Ot5SyI2YKeo0UXfodsseya-YzcCFl_Og/s1600/Average+Canadian+Real+Income,+by+Quintile.jpg" height="536" width="640" /></a></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The growth by
highest-income earners is punctuated graphically with the Canadian income share
earned by the highest 1% having increased from 7 ½% to 12 ½% in the past thirty
years, and one of the larger absolute and relative increases among developed
countries. <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Our
colleagues south of the border may well be interested in the report as well as
it lays out the relatively poor performance of the US (and Mexico) on an
international basis. Comparisons between
the US and Canada are notable as charted below in the disproportion of the distribution
of wealth, however less “fair” work practices has fueled recent productivity
gains in the US and stymied </span>Canadian competitiveness in the international marketplace. </div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigkSrXOc94IaLRoBOAaczN-l1wv4Ztq_cKGSBMjU9-6xcWCmb27w0sNLxlbRH_QbILLZY2s_LONWPKdFCo0b6N6_v-4i0-WMwUvqlqB_JqGNJtv6lxQ_SQn1lCW4BODDQNONqjdvfzwkk/s1600/Share+of+Net+Worth+Held+by+the+Top+20%25.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigkSrXOc94IaLRoBOAaczN-l1wv4Ztq_cKGSBMjU9-6xcWCmb27w0sNLxlbRH_QbILLZY2s_LONWPKdFCo0b6N6_v-4i0-WMwUvqlqB_JqGNJtv6lxQ_SQn1lCW4BODDQNONqjdvfzwkk/s1600/Share+of+Net+Worth+Held+by+the+Top+20%25.jpg" height="532" width="640" /></a></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The paper
explores a variety of options to continue to support equity in Canada and draws
heavily on analysis of changes in Gini coefficients arguing Canada’s relative
success at holding the Gini coefficient relatively constant. (For more on the Gini
coefficient <a href="http://drphealth.blogspot.ca/2011/09/health-equity-headed-south-gini.html">September
2011</a> <a href="http://drphealth.blogspot.ca/2012/06/inequity-communicating-message.html">June
2012</a>) While negating increased
taxation, the document does explore alternative approaches to ensuring income equality
mostly through differential costs of services based on means (a more palatable
form of taxation based on actual use and less open to taxation avoidance). <a href="http://drphealth.blogspot.ca/2014/03/redistribution-through-taxation.html">DrPHealth
March 2014</a> discussed an International Monetary Fund report that supports
redistribution of wealth as an economy improvement activity as well as reducing
inequity. <o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">A great
read and an invaluable resource for those engaging with business and economists
about the value of addressing a central public health issue. The economic case for public health continues
to mount. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-19431898881942512672014-11-30T14:17:00.005-08:002014-12-01T14:24:48.551-08:00Canada steps to the plate and sending personnel to fight Ebola<div class="MsoNormal">
<span lang="EN-US">Let us give
credit where credit is due. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US"><a href="http://drphealth.blogspot.ca/2014/10/ebolaphobia-when-prudent-caution.html">DrPHealth
Octo 29 Ebolaphobia</a> chastised the Canadian government for not only its
token response to the very real issues around Ebola but what also turned out to be limiting the NGO sector response for
Canadians. Curing this time several other countries including Cuba and China
stepped up and sent significant human and support resources to this
international effort. For those wishing
to protect our borders, containment of Ebola in its current location is the
most logical, rationale, and less expensive option.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The cost of
all the planning that has occurred in the past month must run into the
millions, but without a solid accounting of the meetings, the training, the
teleconferences, the documents, the videos and numerous other resources aimed
at protecting Canadians on Canadian soil, the real cost will never be
measured. Instead, the number of West
African deaths has increased by some 2500 and tentative success is being
suggested in Guinea and Liberia (but not Sierra Leone). <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">This week,
the normally silent Minister Ambrose stepped to the plate with an announcement
that Canada will send up to 40 military medical personnel to combat the spread
of the disease. <a href="http://www.theglobeandmail.com/news/national/canada-sending-40-military-personnel-to-fight-ebola-in-sierra-leone/article21811653/">Globe
and Mail coverage</a>. Not only are they
being deployed, but are headed to the hottest of the countries in Sierra Leone.
<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Before
shining our Canadian egos, a few points need to be made. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-ansi-language: EN-US; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="EN-US">These
military medical personnel are being specifically deployed to a British
hospital which is treating only health care workers who have contracted the
disease. <o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-ansi-language: EN-US; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="EN-US">In
making the announcement, Ambrose blamed the failure of the Canadian medical
system to be prepared to manage individuals with Ebola rather than the goverment's lack of leadership<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-ansi-language: EN-US; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="EN-US">There
has been no lifting of the visa restrictions for persons from areas with intense
persistent transmission of Ebola<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<!--[if !supportLists]--><span lang="EN-US" style="font-family: Symbol; mso-ansi-language: EN-US; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; font-stretch: normal;">
</span></span><!--[endif]--><span lang="EN-US">The
past month has seen a trickle of Canadian volunteers join the fight with a
clear discouragement from allowing Canadians to contribute their skills (save
for a pair of laboratory teams from the Level 4 NML facility)<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="mso-list: l0 level1 lfo1; text-indent: -18.0pt;">
<span lang="EN-US"><br /></span>
The
chastisement done, let us now regroup and look at how much further we in Canada
can muster our humanity, compassion and expertise in the defense globally
against this threat. </div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span>
<span lang="EN-US"><i>The Canadian Red Cross is seeking up to 1200 health care workers to work over the next 6 months in response to the need, and much of this is supported by Canadian government funding. The Canadian government has commited over $100 Million in aid support for fighting Ebola, much of which will help defray costs of Canadian health care workers who join this important effort. </i></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-31220040255902834972014-11-27T02:18:00.000-08:002014-11-27T07:27:05.629-08:00Children: Governments may not be listening. Two previously successful provinces slide away from their roles as leaders. With age/experience/expertise perhaps we begin to better appreciate that people like being part of a winning team and ignore the messages of underachievement. If we want populations to adopt a certain behaviour, reinforce that that is part of the majority as well as being smart.<br />
<br />
While there were constructive messages entrenched in the posting on the suggestions of Campaign 2000 and the Royal College of Physicians and Surgeons of Canada, the dominate theme is that governments are failing in their commitment to children. Despite couching this in the most positive of packages, two Canadian provinces drove spikes into the lives of children over the last week in the name of protecting the taxpayer. <br />
<br />
Quebec, long held up for its very progressive child care program, has begun to back away from a universal program and applying an equity lens to access to subsidy. On the surface perhaps a logical step. Deep down it is the erosion of a policy that had the most hope for addressing the failings of the Canadian early childhood development system Globe and mail reporting on Quebec child care subsidy<br />
<br />
Way across the country in Alberta the Alberta government after typically buying in fully to the EDI (Early Development Index) mapping and improvement program, quietly abandoned the initiative and withdrew its funding. So quietly that we can’t even provide a link to reporting on the event but need to rely on those inevitable “reliable sources”.<br />
<br />
In the face of the calls for action as outlined in the previous posting Canada's children getting needed support, and all within the week of International Children’s week, not only should the two governments be ashamed and taken to task, but those in public health should be sitting up and asking some very very difficult questions on who is directing policy regarding children.<br />
<br />
Let us continue to celebrate by reinforcing the work happening in provinces like Newfoundland and Labrador and Ontario, where children, and in particular children living in poverty are receiving central attention of government. Least we be depressed, it may be worth reminding the governments of Alberta and Quebec that they were in conjunction with Newfoundland and Labrador the only three provinces that demonstrated improvements in the proportion of children living in poverty Campaign 2000 25th anniversary report. <br />
<br />
Why when provincial governments are able to demonstrate best practices are they embarrassed and unwilling to take pride in their actions? Kudos to the three for their successes – they are something that should be sung so loudly from the top of the Rockies, Appalachian and Torngat mountains so that all of Canada can be astounded by their success. <br />
<br />
Because everyone loves a winner!!!!<br />
<div>
<br /></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-62698319307603117032014-11-26T07:36:00.000-08:002014-11-26T07:36:01.976-08:00Canada's children getting needed attention from two very different groups. <div class="MsoNormal">
<span lang="EN-US">Two papers
of utter importance in relation to the state of our children are essential
reading. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Campaign
2000 that continues to remind us of Canada’s failed commitment to eliminate
poverty by the year 2000 issued its annual report on the lack of success of the
last 25 years of effort. Most notable in
the report card is the need to migrate to the Low income measure based on half
of the median level of income in an area since the long form census shifted to the
National Household Survey(NHS). By its
very nature the NHS will undermeasure those in poverty, those in single parent
situations, and those that are less engaged with community. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The good
news is that poverty levels continue to creep down slowly, but still 19.1% of
Canadian children are living in impoverished conditions. Regrettably this is still
an increase over the base year of the parliamentary resolution in 1989 of 15.8%<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Restructuring
the low income level (poverty) level, has significantly shifted relative
rankings of provinces in respect to poverty rates. The Yukon and Alberta at the lowest end,
while Nunavut, Manitoba and Saskatchewan at the highest levels. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Welcomed in
the report is emphasis on the state of indigenous children with estimated rates
of poverty approaching 40%<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The full
report can be accessed from <a href="http://www.campaign2000.ca/">Campaign 2000</a><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">Balancing
activism with academics is becoming a natural linkage when change is
required. The Royal College of Physicians
and Surgeons of Canada , a body that rarely wanders into advocacy issues, has
released one of the best and most comprehensive policy statements on children’s
wellbeing punctanted by a <a href="http://ceomessage.royalcollege.ca/">message
from the CEO</a>. This body steeped in
tradition is taking a bold step by adopting and communicating a position on
early childhood development. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">One needs
to remember that the Royal College
oversees only the specialists of the country, of the 40,000 active fellows only
5% or so are pediatricians. That the
Royal College recognizes the lifetime investment and health benefits in
substantive attention to the early years is an endorsement of the required
attention. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Read the 15
recommendations of the <a href="http://www.royalcollege.ca/portal/page/portal/rc/common/documents/advocacy/EBBDEL_statement_e.pdf">policy
statement on early childhood development</a> from the Royal College, and
compare with the <a href="http://www.campaign2000.ca/anniversaryreport/CanadaRC2014EN.pdf">Campaign
2000</a> recommendations. When such disparate
organizations are saying almost the same thing, is it possible that someone may
listen? <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-83329731157112802672014-11-20T15:23:00.002-08:002014-11-20T15:23:45.432-08:00Public health officers under duress. How well do we stand up for Canadians? <div class="MsoNormal">
Ouch <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
This week saw public health officers nationally licking their
wounds following a scathing commentary <a href="http://www.theglobeandmail.com/globe-debate/public-health-officers-should-focus-on-disease-not-politics/article21610596/">Globe
and mail - November 17th</a> by a
Maclean’s editor. Colleagues within
Canadian Doctors for Medicare among others responded <a href="http://www.theglobeandmail.com/globe-debate/dont-limit-the-role-of-health-officers-to-needles-and-pills/article21648693/#dashboard/follows/">G&M
November 19</a> with a bolstering defense.
Those wishing entertainment need only scroll down to the commentaries
submitted to either of the pieces to see the divisiveness of the
debate. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
As one commentary suggests - what is worse six health officers
saying don’t limit our activity? or a magazine editor thinking they understand disease
better than doctors? <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Colleagues, time for some solid reflection. Clearly the debate on Canada's CPHO role has
fueled burning embers and ignited a few fires.
There are those on either side of the fence that are using the opportunity
to express opinions. In the absence of a
solid documented evidence base we have excellent individuals expressing
opinions. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The medical profession led by the Canadian Medical
Association have increasingly migrated in the past few years to encouraging
governments to address foundational issues that affect health and support those
in staying healthy. On National Children’s
Day the Royal College issued a policy statement calling on greatly increased
spending on early childhood development <a href="http://www.royalcollege.ca/portal/page/portal/rc/common/documents/advocacy/EBBDEL_statement_e.pdf">Royal
college statement on early childhood development</a> . Such migration is also being seen in other
health disciplines as well. </div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
However, the Globe and Mail editorial is a sobering reminder
that Canada is a nation of diverse opinions, and we are stronger for the
diversity. It is a reminder that as a public health professional
we need to continuously justify our roles and carry our responsibilities with
dignity. It is a call to action to meet
with those groups that perceive investment in social supports as a drain on
their wallets rather than as a contributor to economic vitality
nationally. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
To address the concerns on a moral basis will have limited
benefit. To speak in economic terms
using well established value for money arguments will help influence the Peter
Taylor’s of the world who are not prepared to accept moral arguments on the
betterment of society. <o:p></o:p></div>
<div class="MsoNormal">
Can we use this latest in a series of onslaughts to rise to something
better? Or do we wallow in self-pity and
fuel the skepticism of our critics? <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
It is notable that on numerous public attempts to eliminate
or constrain the voice of public health, the public has risen in support. It has been the behind doors suppression of the
public health voice that has been most hurtful, and even more hurtful when such
suppression is supported by other health colleagues. <o:p></o:p></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com1tag:blogger.com,1999:blog-5877660600965925295.post-78304402405634300502014-11-13T01:46:00.000-08:002014-11-13T01:46:00.209-08:00Disempowering the Chief Public Health Officer - another blow to the Canadian public health infrastructure<div class="MsoNormal">
<span lang="EN-US">The new
Chief Public Health Officer (CPHO) is
facing his second test. Dr. Taylor is
merely a month into his tenure when the federal government announced that they
are restructuring the senior approach to management at the Public Health Agency
of Canada and separately the medical leadership from the mundane administrative
functions. Gone are the seemingly
insignificant functions of acting as a deputy minister, of controlling how and
where resources are directed, and presumably gone are making key hiring
decisions including that of the new president.
<a href="http://www.theglobeandmail.com/news/politics/ottawa-to-limit-power-of-canadas-top-doctor-the-chief-public-health-officer/article21550260/">Globe
and mail November 12</a> Thus the new president of the agency becomes a
political appointment and not selected for their prowess in public health, a
trend that has castrated public health entities across the country outside of
Ontario.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">If you are
looking for details, check out bill C43, Sections 253 through 258. It is buried
in another of Harper’s omnibus pieces of legislation that contain some 400 sections
with key changes that are buried treasure for those looking for reasons to
criticize the current government. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">All this is
not surprising in an agency that has been a thorn to the Conservatives since elected. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US">That Dr.
Taylor was conveniently unavailable for comment on such a critical issue is
notable, as is the carefully prepared statement that he appears supportive. As DrPHealth stated at the time of the
announcement <a href="http://drphealth.blogspot.ca/2014/09/finally-new-public-health-leader-for.html">September
25th posting</a> “W</span><span style="background: white; color: #222222; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%;">ith all respect to the person and the position,
the announcement is one more step in Harper's alienation of health in general
and public health specifically.”</span> <span lang="EN-US"><o:p></o:p></span></div>
<div class="MsoNormal">
<span style="background: white; color: #222222; font-family: "Arial","sans-serif"; font-size: 10.0pt; line-height: 115%;"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">More
surprising are the public health leaders noting that such has been the trend
nationally and something that might be welcomed. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">This right
on the heels of the embarrassing Canadian handling of movement of residents,
workers, visitors and responders in the countries with persistent intense
transmission of Ebola. All good public
health experts have disagreed with Canada’s phobic response, yet the CPHO has
been silent and has not publically spoken on Canada’s misinformed approach to
protection from Ebola. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">To his
credit, we have the <a href="http://drphealth.blogspot.ca/2014/11/its-here-at-last-2014-canadian-public.html">CPHO
report </a> that mitigates some of the
major slips, but right now the score is 2 against and 1 for. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Greg, you
have some major scoring to do to get back in the game. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-92076344265231721272014-11-10T08:21:00.002-08:002014-11-10T08:21:55.723-08:00Peace and war. Remembering the tragic toll of global violence and celebrating those that serve for our protection<div class="MsoNormal">
<span lang="EN-US">In an
annual tradition for DrPHealth, it is time to reflect on our progress (or lack
thereof) in addressing global peace.
Three deaths in the past month of Canadian military personal on Canadian
soil are a sobering reminder of the costs of a path other than peace. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">2013 has
seen two new armed conflicts and one resolved with 33 active conflicts – a number
that has remained fairly constant for the past decade. Seven of these are defined as wars with over
1000 deaths. The formal listing of
conflicts is found though the Uppsala Department of Peace and Conflict datasets
accessible at <a href="http://www.pcr.uu.se/research/ucdp/datasets/ucdp_prio_armed_conflict_dataset/">UCDP/PRIO
data files</a>. <a href="http://en.wikipedia.org/wiki/List_of_ongoing_armed_conflicts">Wikipedia</a>
maintains a good list as well and lists 12 conflicts with over 1000 annual deaths
and 29 additional conflicts. Slight
variance in definitions leads to inclusion of issues like the Mexican drug war
as an armed conflict with Wikipedia and not a conflict under the PRIO
guidelines. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The newest
conflict being in the eastern regions of the Ukraine where so far this year an
estimated 3700 people have died. Four of
these conflicts appear to have taken over 10,000 lives with the Syrian Civil
War accounting for roughly 40% of all global armed conflict deaths in 2013 at
nearly 75,000. The ISIS conflict is now
the second largest global cause of war related deaths while the South Sudanese conflict has abated going into 2014 and the
current year deaths estimated at only 10% of 2013 where deaths exceeding
10,000. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">At nearly 2
Million cumulative deaths the Afghani civil conflicts involving the Taliban and 4.5 Million in the tensions between North
and South Korea these have the largest cumulative toll. The Korean conflict approaching 70 years and
the Taliban insurgency 35 years speaking to the challenges of intergenerational
conflicts in which families are in a constant state of potential crisis. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">While total
numbers of war related deaths are not easily tracked, the listing in Wikipedia
once again suggests deaths in 2013 as about 100,000. The positive news is that cumulative through
early November in 2014 would suggest these numbers have decreased by about a third. In addition to the Ukraine, the surging
conflicts are in Libya, Nigeria and Central African Republic where combined
deaths exceed the cumulative toll from Ebola. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Four
Canadian have lost their lives in military duty, two within training exercise
and Warrant Officer Patrick Vincent and Corporal Nathan Cirillo in targeted killing
on Canadian soil. <a href="http://www.forces.gc.ca/en/honours-history-fallen-canadians/index.page">Fallen
Canadians</a> <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">The
shooting of five RCMP with three deaths in Moncton in June, combined with one
car crash and one on duty sudden cardiac event round out the list of those that
have died in the service of protecting the people of our country from the effects
of conflict. <a href="http://canada.odmp.org/">Officer Down</a> <o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">In a
tribute to those that serve to protect us, homicide in Canada continues to edge
downwards with current rates about half of their peak in the mid 1970’s. In honour of those that do serve, celebrate
the success of their efforts <a href="http://www.statcan.gc.ca/pub/85-002-x/2013001/article/11882-eng.htm?fpv=2693">Homicide
in Canada</a> <o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<br /></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-15717241228045781502014-11-04T07:26:00.001-08:002014-11-04T07:26:22.857-08:00It’s here at last!!!! – the 2014 Canadian Public Health Officers report<div class="MsoNormal">
<span lang="EN-US">At least
this year there were a couple of Tweets as the report was released on October 29. It should be the public health event of the
year and we should be celebrating like a gallery opening for an artist. It is the release of the annual (or so) Canadian
Public Health Officer’s report. This year
brought to you by our new leader-in-arms, Dr. Greg Taylor. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Regrettably
once again, what should be a huge celebration has been relegated to a silent
launch. Media attention is non-existent.
There were no press releases or media briefings, so why should the media be
aware? The Minister of Health (what’s
her name? <a href="http://drphealth.blogspot.ca/2014/08/one-year-of-minister-whats-her-name.html">One
year of Minister Ambrose posting</a> ) has made no notes or acknowledgement. It appears that this annual event is looked
forward to by the government with even less gusto than the Auditor General’s
report. ‘Tis a shame.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The easy to
read, very focused and only slightly government promoting document is well
worth the 15 minute read despite the 110 pages. This year’s focus being on the future of
public health, with a delving into three emerging public health topics in
depth, ageing, climate change, and digital informatics. To its credit the entire report does not once
mention Ebola, which these days is a real accomplishment. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">In a
carefully crafted call to action, the report challenges the public health
community to proactively address the public health issues of ageing. Not through the lens of seniors needing care,
but through the lens of the majority of persons past retirement age who are
relatively healthy and wanting to maintain and sustain their relative well
being in independent settings. The
report only falling off this to address the incoming tide of challenges faced
by those with diagnosis of dementia, one of the few causes of mortality that is
currently increasing. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The second
section acts as a primer for climate change and public health. Nothing extraordinary or controversial other
than a federal leader actually acknowledging that climate change is real and is
happening, that should not be overlooked and credit to the CPHO for being so
forthright in making the obvious a statement of fact. Those who have followed the climate change
and health discussions for the past two decades will note a distinct shift away
from efforts to mitigate to a wholesome discussion on how public health has a
role in adaptation. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The third section
braves a topic that public health’s current innovators are exploring in how better
to use the digital world. In our
opinion the weakest of the sections filled with longer discourse and less
concrete recommendations, particularly where better examples of digital
utilization exist, however DrPHealth acknowledges that after 414 posting and 3 ½
years of blogging and Tweeting, that perhaps we have a slightly skewed view of
the digital world. Potential biases aside, the section could have been so much
more given our current state of experimentation. Granted the section calls for
research, evaluation and most importantly adoption by public health providers –
something with which even we would concur. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">After perusing
the three sections, the reader should be left with a nagging question – is this
the go forward agenda for Dr. Taylor?
There are many aspects in the report that reflect his thinking and we
can hope that this is an initial statement of his vision for the future of the
Public Health Agency of Canada, our national guide in public health matters. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Don’t stop
reading at this point. Just when you
think the report is done lies the hidden gem.
Do not skip the Appendix A. In
the twenty pages of the appendix, the report lays out a solid statistical
foundation on the Health of Canadians. Ideal
for future reference, and perhaps mandatory reading for any trainee and
provider in public health to stay current on trends in health and wellbeing in
Canada. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The full
report is available on line at <a href="http://www.phac-aspc.gc.ca/cphorsphc-respcacsp/2014/index-eng.php">2014
CPHO report</a> or downloadable from the
same link as a .pdf for future reference. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">This is the
first real action by the newly appointed Dr. Taylor, and deserving of a “well
done Greg”. We look forward to more of
your leadership and willingness to test the boundaries. Perhaps next year you could add a press release? <o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<br /></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-18154632963537936862014-11-03T01:40:00.000-08:002014-11-03T04:20:40.203-08:00Child care and public health policy. Where is Canada heading?<div class="MsoNormal">
<span lang="EN-US">The Harper
government announcement on child care and family support is a pre-election
activity that is drawing considerable attention with vastly differing opinions
on its value. <o:p></o:p></span><a href="http://www.cbc.ca/news/politics/stephen-harper-announces-family-tax-cut-child-care-benefit-boost-1.2818591" style="font-family: Calibri, sans-serif; font-size: 11pt; line-height: 115%;">Globe
and Mail coverage </a><span style="font-family: Calibri, sans-serif; font-size: 11pt; line-height: 115%;"> </span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">How can
anyone question the value of putting money into the hands of parents so that
they can provide better care? Detractors of the government will find subtle reasons, but where will this policy take Canadians? <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">The
downsides of the issue. How far really does $720 per child take any parent? When child care can cost upwards of $50 per
day. It amounts to not even a month’s care. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">That the
benefit will be applied January 1, but only first paid out in June, just a few
months before the election smells of buying vote. Parents and families will receive a nice
retroactive pay check as the campaigning starts. No doubt more than a few will be confused that the future
cheques and benefits will reflect similar sized payouts unless they support the incumbents. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Digging deeper and most disconcerting, while the
benefit increases the affordability of child care for those in need, it does
nothing to improve availability or quality of care. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">On the
second half of the announcement is a step towards addressing a long standing
inequity in Canadian tax laws that actually encourage families to obtain two
incomes rather than having a single large earner. The value however is predominately to be
gained by higher incomes earners, hence a mitigating effort by the government
by limiting the benefit to a maximum of $2000.
For the far left an unacceptable tax benefit for the rich, for the far
right an unacceptable limitation on an inequity. From a policy perspective, for a government
that made a promise, perhaps keeping no
one happy is the sign of reasonable policy development.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">It has been
a decade since Paul Martin promised a universal child care program for
Canadians, and an issue that Harper first dismantled and now is reconstructing
in his own image. A step forward, but
not necessarily a stride in the right the direction. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Perhaps most disconcerting in all of this policy development, is that there was no public discourse. There was no public input, debate or opportunity for refinement. Once again, our prime minister has taken a dictatorial approach to leadership, albeit the perception being that of a benevolent despot.</span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-32796294502726868872014-10-30T02:37:00.000-07:002014-10-30T02:37:00.687-07:00Distracted driving, road health and a celebration of a public health success<div class="MsoNormal">
<span lang="EN-US">Ontario and
BC took a step upward in addressing the epidemic of carnage on the road caused
by distracted driving. It was merely a
handful of years ago when debates were being held on the safety of cell phone
use while at the wheel, now texting has become the major culprit. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Humans will
continue to invent technologies that modify health risk and in doing so will
keep the public health workforce gainfully employed. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">In typical
fashion when threats are being first addressed, the statistics are
sensationalistic and perhaps inflated, but the numbers promoted by the CAA are
staggering culminating in the conclusion that driver distraction now
contributes to 20-30% of motor vehicle collisions <a href="http://distracteddriving.caa.ca/education/">CAA distraction information
page</a><o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<span lang="EN-US">That impressive
number can be contextualized within the continuously decreasing number and rate of fatalities and collisions on our
roads, a real testament to the efforts of the road health/safety
community. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Where the
disconcerting flaw in logic may arise is the impact imposed by aggressively
increasing penalities where education and options have not been sufficiently explored. Ontario’s new fines of up to $1000 for
driving with a handheld device and BC has added demerit points to tickets
associated with distracted driving.
Whether either will modify behaviours sufficiently remains to be
seen. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">BC is no
doubt celebrating in the wake of successfully addressing impaired driving through
fines, suspensions and insurance costs and such success reinforces that
enforcement can be a primary driver in behavioural change. Despite these
progressive actions, speeds on BC highways have increased with many divided
highways having limits of 120 km/hr – and the impact of such a move will need evaluation.
<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Both
efforts are to be applauded, and other provinces should be encouraged to refine
regulations to address more than cell phone use where such remains uniquely
identified. Distracted driving has been
an offense for much longer, the change being that the definition now
incorporates explicitly items such as handheld devices. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Our roads
are becoming safer through the combined efforts of vehicle engineering, road
design, driver training, enforcement, and public education. Such a success is deserving of a public health
high five. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-52317510269180296842014-10-29T02:04:00.003-07:002014-11-10T19:27:44.888-08:00Ebolaphobia - when prudent caution becomes an irrational fear<div class="MsoNormal">
<span lang="EN-US">Events of
the last week demonstrate the level of irrationality that public fervor can
escalate to amid the fear of the unseen. The irrationality verging on a new phobia aptly called Ebolaphobia and suffered by those yielding unreasonable power. The pinnacle of inappropriate behaviour was achieved in the high level
quarantine of a nurse returning from West Africa. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Canada is
no less implicated in this irrationality.
Current policies essentially preclude health care workers from
participating in care efforts as Canada has rescinded permission for
participation pending a review of its policies.
The number of Canadian workers in West Africa has eroded to merely
sixteen workers with plans only to send a small number of relief deployments
once the processes with the Canadian policies are met. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">These health
care worker heroes are returning from months using high level protective
equipment when the highest risk time for infection is early in their sojourn and
disease development overseas most likely. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Currently
upon their return, they are stripped of their autonomy, essentially placed
under house arrest, and deprived of the professionalism for which they have
demonstrated a level of valour that many of us admire and should be aspiring
to. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">It does not
make sense. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">For some
who are employed, provinces and employers may provide salary support to remain
off work. For physicians, having giving
up to two months income to volunteer, they are further deprived of an
additional three weeks income while segregated from society. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Canada has
actually been relatively logical in some of its approaches, with screening occurring
at the points of entry, and travelers with any risk reported to their local Medical
Officers of Health who can provide support and monitor wellbeing while balancing
the needs of the individual and risk to the population. It is this balance of protecting the public
and respecting the person that these professionals have been trained. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">That has
not precluded organizations issuing the paychecks of the MOHs from expecting
disclosure of names, imposing unreasonable additional limitations, and
certainly such organizations have diverted limited public funds to alley the
phobias demonstrated by health care workers who would never possibly be exposed
to anyone remotely linked to West Africa countries. It behooves those in the public health community to apply a level of professionalism and skill that is exemplary. Collectively we need the ongoing avenues to reflect on our ethics in meeting this challenge.<o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Political led responses have historically led to tragic consequences for individuals. Leper colonies, Canada’s quarantine islands,
tuberculosis sanatoriums, are further examples of where the political reaction
has exceeded the bounds of rationality and undermined any ethical sense of
autonomy. </span><br />
<span lang="EN-US"><i><br /></i></span>
<span lang="EN-US"><i>On November 1st Canada announced a preclusion on visas for any person from countries with widespread and persistent intense transmission. A move that violates an international convention that Canada was instrumental in negotiating in the wake of the impact travel restrictions during SARS had on the Canadian economy without adding to disease control. Such actions verge on idiocy. </i></span><i>http://news.nationalpost.com/2014/11/01/canada-wont-issue-visas-to-residents-of-countries-with-widespread-ebola/ </i><br />
<i><br /></i>
<i>November 10, is the absence of any rational reason, Canada has announced that all travellers from countries with persistent intense transmission would be placed in a 21 day quarantine, unless they were health care workers returning who had used appropriate protective gear. The number to be affected is likely very low, but such action is unwarranted. Who is making these perverse decisions? </i></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Were we
welcoming back military heroes from risking their lives to protect our country,
we would do so with open arms and with social and economic supports. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US">Let us
consider treating our health care warrior heroes similarly. They are protecting our country by fighting
an unseen enemy on foreign soil so that our borders may be safe. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US"><br /></span></div>
<br />
<div class="MsoNormal">
<span lang="EN-US">Thanks to
those who have made the effort, and a voice of encouragement for those with
skills to consider using them to protect not just our country, but our global
community while truly saving lives. <o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0tag:blogger.com,1999:blog-5877660600965925295.post-38042830478515732632014-10-23T08:11:00.001-07:002014-10-23T08:11:34.056-07:00When fear becomes a phobia itself<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Canada collective is grieving the tragic events of
October 22 and the loss of one of our country defenders Cpl Nathan
Cirillo. Terrorism has struck close to
the heart of the country and unmasked our fears. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">For some the events and actions will be remembered for
the heroics and a system that contained the damage when the horror could have
been much worse. For others, the
sensationalist reporting and stirring into a frenzy will feed percolating fears. Terrorism survives because it incites
fear. It restricts individual freedoms
not through edict, but by activating phobias. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Decision makers are not immune to becoming
phobic. We can expect calls for enhanced
security in parliament, in government buildings, in public places, in critical
infrastructure. Perhaps we can learn from the misguided response south of the border where dollars from social programs into homeland security. The thousands that die annually from preventable
deaths because services are not available in order to reduce the risk for an unseen
threat. <o:p></o:p></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">Terrorism has struck home. The threat of terrorism will test our collectivity, rationality and our confederation. The stresses and phobic
reactions will fertilize our fragile mental wellbeing. </span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;"><br /></span></div>
<div class="MsoNormal">
<span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;">The best words to recite and remember at this time were written by </span><span style="background: white; font-family: Arial, sans-serif;">Calixa
Lavallée</span> in 1880. <span lang="EN-US" style="font-family: "Arial","sans-serif"; mso-ansi-language: EN-US;"><o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 14.4pt; margin: 7.5pt;">
<span style="font-family: Arial, sans-serif;">O Canada!<br />
Our home and native land!<br />
True patriot love in all thy sons command.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 14.4pt; margin: 7.5pt;">
<span style="font-family: Arial, sans-serif;">With glowing hearts we see thee rise,<br />
The True North strong and free!<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 14.4pt; margin: 7.5pt;">
<span style="font-family: Arial, sans-serif;">From far and wide,<br />
O Canada, we stand on guard for thee.<o:p></o:p></span></div>
<div class="MsoNormal" style="background: white; line-height: 14.4pt; margin: 7.5pt;">
<span style="font-family: Arial, sans-serif;">God keep our land glorious and free!<br />
O Canada, we stand on guard for thee.<o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<span style="background: white; font-family: Arial, sans-serif;"> O Canada, we stand on guard for thee.<o:p></o:p></span></div>
DrPHealthhttp://www.blogger.com/profile/14205539218855076544noreply@blogger.com0