Table of Contents - Workbook

Overview and Context

A. What Is Public Health?

Many Canadians are familiar with the health care system and how it works. However, fewer Canadians have a good understanding of what public health is, how it is organized and where it fits within the overall health system in Canada.

Having the medical services we need when we are sick are vital, but public health focuses on what we need to do as a society to help everyone stay healthy. Public health is part of every aspect of our lives, from our homes to our workplaces, and our schools to our communities. It encompasses everything we do, from the food we eat to the safety of our environment, and from access to safe walking/biking trails to preventing the outbreak of disease. Public health is about the way we live.

While there is no consensus on essential public health functions, the following describes the activities that are normally associated with public health practices across the country.

• Health surveillance – Surveillance includes collecting, interpreting and communicating health data and then acting on this information. It helps in the early recognition of outbreaks, disease trends, cases of illness, and health factors. For example, surveillance can help identify and deal with immediate situations such as contamination of public water supplies, and it can also be used to track data over the longer term, such as smoking and cancer rates.
• Health promotion – Public health practitioners work with individuals, agencies and communities to understand and improve the health of the population. Health promotion includes strengthening the skills of individuals to encourage healthy behaviours and it also includes building the healthy social and physical environments to support these behaviours.
• Disease and injury prevention – We know that many diseases can be prevented or delayed. There are measures to prevent infectious diseases, and much can also be done to prevent or delay chronic diseases, for example, by ensuring access to healthy food and opportunities for physical activity, and supporting smoking cessation. Many injuries can be avoided through measures such as ensuring safe equipment in playgrounds, and seat belt and bicycle helmet use.
• Health protection – A long-standing core function of public health, protection includes ensuring safe food and water supplies, providing advice to national food and drug safety regulators, protecting people from environmental threats, and having a regulatory framework for controlling infectious diseases in place. Ensuring proper food handling in restaurants and establishing smoke-free bylaws are examples of health protection measures.
• Population health assessment – By understanding the factors that influence good health and those that create health risks, we can ensure the appropriate services and policies are in place.
  

B. Determinants of Health

We've learned a lot in the past several decades about what determines health and where we should be concentrating our efforts. At every stage of life health is determined by complex interactions between social and economic factors, the physical environment and individual behaviour.

There are a range of personal, social, economic and environmental factors that influence, or determine our health and well-being. These are related to our living conditions, including whether we are rich or poor, our social networks, how much education we have, where we live, the types of jobs we hold, and if we have opportunities for physical activity and available healthy food. Our access to health services, and our gender and cultural backgrounds also influence our health.

Not everyone in Canada enjoys the same level of health or shares the same risk of ill-health. Certain vulnerable groups, for example, low-income families, some aboriginal communities, and disabled people are more at risk. There is a growing body of evidence that suggests that addressing inequalities in society is key to helping improve the health outcomes of all Canadians. To address those health disparities, we need to ensure that those living on the lowest incomes, for example, have the same access to and can make the same use of the information, programs and services as those in the highest level. Public health should not be a “have” or “have-not” issue, it is a concern of the whole of Canadian society.

We expect that the discussions on public health goals currently taking place will address what factors citizens consider most vital in promoting public health. These determinants may be different for individual communities or even cultural groups. This is why it is so important that we hear from all levels of government, non-governmental organizations, individuals, business, industry, cultural groups and other community organizations regarding health determinants and other concerns.

Key Determinants of Health

• Income and social status
• Social support networks
• Education and literacy
• Employment / working conditions
• Social environments
• Physical environments
• Personal health practices and coping skills
• Healthy child development
• Biology and genetics
• Health services
• Gender
• Culture

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