What led up to this consultation?

In 2004, the First Ministers of Health committed to a collaborative process with experts to develop a Public Health Strategy for Canada. Part of this exercise includes drafting a set of goals for improving the health status of Canadians.

Much work has already been done across Canada to help set the stage for developing these common public health goals and further strengthening public health. Almost all of the provinces and territories have in some manner identified public health goals for their jurisdictions. Work has also progressed at the federal level for over 30 years including:

• The landmark Lalonde report in 1974, A New Perspective on the Health of Canadians broadened our understanding of the factors that determine good health.
• The Ottawa Charter for Health Promotion and Achieving Health for All: A Framework for Health Promotion, both released in 1986, expanded the emphasis in health promotion from factors controlled by individuals to societal factors and conditions.
• In 1994 the Federal/Provincial/Territorial Advisory Committee on Population Health (ACPH) sponsored a project to propose a framework and process for developing national health goals.
• First Report on the Health of Canadians in 1996 identified health goals, referring to them as “challenges.”
• In 1997 the strategic directions set out in National Health Goals for Canada: Analysis of Feasibility and Options by ACPH were accepted by the Conference of Deputy Ministers of Health.
• Toward a Healthy Future: Second Report on the Health of Canadians was released in 1999, examining the major determinants that influence the health of Canadians.
• Directions Towards Health for All in Canada in 2000, presented to the Conference of Deputy Ministers of Health by ACPH, was an update of the 1997 strategic directions. It includes new directions and a minimum indicator set.

We can also gain some knowledge and inspiration by looking beyond our own borders. Many countries, including Sweden, U.S., U.K., Australia and New Zealand have identified public health goals for their populations and we can learn from their varied experiences. The U.K., for example, targeted five key health conditions in the early 1990s, but over time found its preoccupation with diseases ineffective and shifted its focus to addressing the broader determinants of health. Australia’s experience was the opposite. It began with a program to address broad determinants of health, but later narrowed its focus to a set of health priorities. One of the barriers to the broader vision was its difficulty in addressing issues that fell outside the health sector, such as the environment, housing and income disparity. The overarching aim of the Swedish goals is to create “the conditions for good health on equal terms for the entire population.” The objectives were developed using a collaborative approach and they address the “upstream” key determinants of health.