Table
of Contents - Workbook
Building on a Strong Foundation
“Good health is the bedrock
on which social progress is built. A nation of healthy
people can do those things that make life worthwhile,
and as the level of health increases so does the potential
for happiness.”
Marc Lalonde, Minister of National
Health and Welfare, 1974 |
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 (Appendix
A). 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 (Appendix
B).
Links to all of the resources and studies
cited above can be found on our public health goals Web site,
at www.healthycanadians.ca.
Public health goals allow all levels of government
to focus their public health efforts and identify new opportunities
for collaboration. Only we can decide what the appropriate
public health goals are for Canadians in the 21st century
and the best approaches for arriving at them. But it is
clear that whatever goals we finally adopt, for those goals
to be accepted and endorsed by Canadians, all sectors of
society must be intricately involved in the process and
their adoption. Hence, this exercise.
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