Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献

{"title":"Increase in alcohol outlets by neighbourhood socioeconomic status following the expansion of alcohol sales into convenience stores in Ontario, Canada.","authors":"Naomi Schwartz, Sze Hang Fu, Erin Hobin, Daniel T Myran, Brendan T Smith","doi":"10.17269/s41997-025-01094-6","DOIUrl":"https://doi.org/10.17269/s41997-025-01094-6","url":null,"abstract":"<p><strong>Introduction: </strong>In September 2024, the province of Ontario expanded alcohol sales into convenience stores. It is important to examine differences in alcohol sales expansion by socioeconomic status (SES) as lower SES groups experience a disproportionately higher burden of alcohol-attributable harms.</p><p><strong>Methods: </strong>This repeated cross-sectional study examined whether neighbourhood SES was associated with increases in alcohol outlets immediately following the expansion of alcohol sales. A spatial BYM2 Poisson regression model was used to estimate the association between neighbourhood SES and the number of alcohol outlets.</p><p><strong>Results: </strong>Immediately following expansion, 4200 alcohol outlets were licensed in Ontario. The median increase in alcohol outlets within 1500 m of a neighbourhood was greater in the lowest SES neighbourhoods (400% increase) compared to the highest (183%). In adjusted models, the lowest SES quintile was associated with a greater increase in outlets (relative risk = 2.26, 95% credible interval:1.98-2.58) compared to the highest quintile, with a dose-response relationship by SES quintile.</p><p><strong>Discussion: </strong>A large increase in alcohol outlets was seen across Ontario neighbourhoods. Lower SES neighbourhoods experienced a greater increase in outlets, which may disproportionately increase harms related to the expansion of alcohol sales. These findings highlight the need for strategies to mitigate potential harm in low SES groups and the widening of existing inequities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A national atlas to improve the study of Canadians living with long COVID (post-COVID-19 condition).","authors":"Aisha Ahmad, Naveed Z Janjua, Lisa M Lix, Nahrain Warda, Daryl L X Fung, Anne Bhéreur, Pavlos Bobos, Sara Carazo, Simon Décary, Suzie Goulding, Lorraine Graves, Gary Groot, Douglas P Gross, Kiran Pohar Manhas, Candace D McNaughton, Elham Rahme, Beate Sander, Hind Sbihi, Amol A Verma, Kieran L Quinn","doi":"10.17269/s41997-025-01083-9","DOIUrl":"10.17269/s41997-025-01083-9","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a national atlas of (1) Canadian cohorts studying or with the potential to study adults living with long COVID (LC) and (2) harmonize provincial and territorial administrative datasets to facilitate the creation of validated case-ascertainment algorithms and foster national collaboration on LC research.</p><p><strong>Methods: </strong>We conducted a multifaceted environmental scan that included a comprehensive literature search and a survey of members of Canada's national LC research network between August 21, 2023, and November 10, 2023. We identified provincial and territorial cohorts, including those that were linkable to administrative data and common data elements among administrative datasets.</p><p><strong>Results: </strong>We included 19 Canadian cohorts from five provinces (Alberta, British Columbia, Manitoba, Ontario, and Québec) containing data on over 580,000 adults. The majority of the cohorts measured sociodemographic data (e.g., age, sex) and measures of healthcare use, whereas equity-related measures such as gender, ethnicity, and race were limited. There was wide variability in the definitions of LC used across all cohorts. Comparable population-level administrative data are currently available in Alberta, British Columbia, Manitoba, Ontario, Québec, New Brunswick, Newfoundland and Labrador, Nova Scotia, and Saskatchewan.</p><p><strong>Conclusion: </strong>Canada has a rich repository of LC datasets that are limited by variable definitions of LC and inadequate equity-related measures such as gender, ethnicity, and race. Standardization and diversification of these measures will facilitate efforts to study healthcare use and develop health policy to improve the care of Canadian adults living with LC at a population level.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging use of oral nicotine pouches among Canadian adolescents: Findings from the COMPASS-Quebec study.","authors":"Katelyn Battista, Mikael Piché-Ayotte, Slim Haddad, Anne-Marie Turcotte-Tremblay, Scott T Leatherdale, Richard E Bélanger","doi":"10.17269/s41997-025-01100-x","DOIUrl":"https://doi.org/10.17269/s41997-025-01100-x","url":null,"abstract":"<p><strong>Objectives: </strong>Oral nicotine pouches are gaining global popularity as a novel alternative nicotine product. Our objective was to examine nicotine pouch use among a large sample of Québec adolescents, including sociodemographic and health-related risk factors, co-use with cigarettes and e-cigarettes, and risk perceptions.</p><p><strong>Methods: </strong>We surveyed 13,914 Quebec secondary school students as part of the 2024 COMPASS study. Participants answered questions on past-month use of oral nicotine pouches, e-cigarettes, and cigarettes, as well as perceived addictiveness and health risks. Poisson regression was used to examine relative risks for current nicotine pouch use by sociodemographic and health factors, current smoking and vaping status, and risk perceptions. Risk perceptions were compared across nicotine products.</p><p><strong>Results: </strong>Nicotine pouches were the most used alternative nicotine product following e-cigarettes, with prevalence of current use (2.6%) comparable to cigarette smoking (3.0%). Older adolescents, cisgender boys, gender diverse adolescents, academically at-risk youth, and current cigarette and e-cigarette users had higher relative risks for nicotine pouch use. Nearly one-quarter of adolescents were unsure of the health risks of nicotine pouches and 16% did not know whether they were addictive. Lower risk perceptions were associated with increased likelihood of current use.</p><p><strong>Conclusion: </strong>Nicotine pouches are an emerging nicotine product that appear to be gaining popularity among Canadian youth. Given their design features which allow for use in most situations and environments, nicotine pouches have considerable potential to follow the same popularity trajectory as e-cigarettes if not regulated appropriately.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of Indigenous community-based research practices, guidelines, and ethical standards.","authors":"Elaine Toombs, Brittany Skov, Megan Campbell, Jessie Lund, Christopher J Mushquash","doi":"10.17269/s41997-025-01090-w","DOIUrl":"https://doi.org/10.17269/s41997-025-01090-w","url":null,"abstract":"<p><strong>Objectives: </strong>There has been increased efforts to identify wise practices among research efforts completed in partnership with Indigenous communities. Community-based participatory research (CBPR) has been a leading guideline for this work in recent years, as such frameworks emphasize collaboration, partnership, and community-guided efforts; however, no work to date has examined how various CBPR standards, ethical guidelines, and practices may vary by community or regional context.</p><p><strong>Method: </strong>The purpose of this scoping review was to summarize Indigenous-specific research practices among relevant frameworks, to identify more common collective values and practices, and other, potentially more unique or distinctive aspects of frameworks within Canadian, Australian, New Zealand, and United States (CANZUS) nation-based Indigenous communities. A scoping review of six databases to retrieve relevant literature describing community-based research principles, guidelines, and ethical standards specifically related to an Indigenous population or community.</p><p><strong>Synthesis: </strong>We retrieved 46 sources proposing an Indigenous-based principle, guideline, and/or ethical standard. When these studies were descriptively analyzed, we derived eight common themes across these frameworks: Benefit to Community, Respect, Reciprocal Relationships, Recognize Diversity, Embed Indigenous Culture, Autonomous and Active Participation, Consultation, and Authenticity. Specific research practices that align within framework values across a research process were also identified across ten themes, and 38 sub-themes. Practices included Learn About Culture, Region, Community, or Nation, Establish and Maintain Meaningful Relationships, Community Engagement or Consultation, Project Design, Develop a Research Agreement, Data Agreement, and/or Protocols, Project Management, Methods, Data Analysis and Interpretation, Knowledge Translation and Exchange, and Post-Research Relationships.</p><p><strong>Conclusion: </strong>Several common values and practices underscore many Indigenous community-based research guidelines, principles, and ethical standards. This review may be used to increase knowledge on Indigenous approaches to research across disciplines, facilitate the evaluation of research conducted with Indigenous communities, and assist communities in developing independent practices, principles, and ethical guidelines.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural and contextual relevance of the Indigenous data in the Canadian longitudinal study on aging.","authors":"Grace M Spiro, Megan E O'Connell, Chaneesa Ryan, Laura Warren, Jennifer D Walker","doi":"10.17269/s41997-025-01087-5","DOIUrl":"10.17269/s41997-025-01087-5","url":null,"abstract":"<p><strong>Objectives: </strong>The CLSA is a national data platform for aging research that used epidemiology-based sampling methods and explicitly excluded people living on First Nations Reserves and other provincial First Nations settlements as possible CLSA participants. As such, the CLSA research approach did not use Indigenous community engagement. Nevertheless, the CLSA sample includes a sizeable subsample of participants who self-identified as First Nations, Métis, or Inuit. This project seeks to describe the self-identified Indigenous subsample of the CLSA from the baseline data collection and interpret that description with the aid of an Elder Advisory Circle.</p><p><strong>Methods: </strong>We conducted a descriptive analysis of the self-identified Indigenous subsample of the CLSA from the baseline data collection. The analysis was presented to an Elder Advisory Circle for consultation.</p><p><strong>Results: </strong>The lack of community-engaged approaches to Indigenous research and sampling approaches appears to have resulted in a sociodemographic profile of older Indigenous Peoples that does not match the lived experience of the Elder Advisory Circle and contrasts with other data available on Indigenous Peoples in Canada. We feel the existing CLSA data does not reflect the sociodemographic profile of older Indigenous Peoples.</p><p><strong>Conclusion: </strong>We use this community consultation process to provide recommendations for the appropriate use of the Indigenous-identified data in the CLSA, and we conclude by recommending great caution when using the data from the Indigenous subsample in the CLSA data.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in the dispensing of opioids for pain and concurrent benzodiazepine use among First Nations People in Ontario, Canada, from 2013 to 2021.","authors":"Alice Holton, Tianru Wang, Bisola Hamzat, Sacha Bragg, Bernadette deGonzague, Graham Mecredy, Tonya Campbell, Tony Antoniou, Lorrilee McGregor, Jonathan Bertram, Tara Gomes","doi":"10.17269/s41997-025-01097-3","DOIUrl":"https://doi.org/10.17269/s41997-025-01097-3","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate dispensing trends and the characteristics of First Nations People in Ontario dispensed an opioid for pain and concurrent benzodiazepine treatment.</p><p><strong>Methods: </strong>We conducted a population-based serial cross-sectional study by quarter of registered (Status) First Nations People in Ontario who were dispensed an opioid for pain between April 1, 2013, and December 31, 2021. We reported quarterly trends in prevalent and incident opioid dispensing (rates per 1000 people), and the prevalence of concurrent benzodiazepine use among individuals receiving opioids for pain. For the final year (2021), we stratified rates by age, place of residence (within or outside First Nations communities), and sex.</p><p><strong>Results: </strong>Between 2013 and 2021, the quarterly rate of opioid dispensing for pain decreased by 25.0% among First Nations People in Ontario, from 74.7 to 56.0 per 1000 people. In stratified analyses for the year 2021, opioid use for pain was more frequent among First Nations People living outside versus within First Nations communities (118.2 vs. 91.2 per 1000, respectively) and among females relative to males (124.6 and 93.9 per 1000, respectively). Concurrent prescription benzodiazepine use among First Nations People receiving a prescription opioid for pain decreased from 20.9% in Q2 2013 to 16.7% in Q4 2021. In stratified analyses, concurrent use was more prevalent among females, adults aged ≥ 65 years, and First Nations People living outside First Nations communities.</p><p><strong>Conclusion: </strong>Opioid analgesic prescribing patterns for First Nations People living in Ontario indicate a decrease in both overall prescribing rates and concurrent benzodiazepine use.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The socioeconomic patterning of physical activity among middle-aged and older adults in Canada using the Canadian Longitudinal Study on Aging (CLSA) data.","authors":"Jane Yuan, Shehzad Ali, Kathryn Nicholson, Saverio Stranges, Jane Thornton","doi":"10.17269/s41997-025-01088-4","DOIUrl":"https://doi.org/10.17269/s41997-025-01088-4","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between socioeconomic status (SES), using indicators of education and wealth, and meeting physical activity guidelines (PAG) (150 min of moderate-to-vigorous physical activity (PA)) to evaluate whether socioeconomic inequalities exist in the practice of leisure-time physical activity (LTPA).</p><p><strong>Methods: </strong>This is an analysis of cross-sectional data from the Canadian Longitudinal Study on Aging (2012-2015), a nationally representative cohort of middle-aged and older Canadian adults (N = 25,113). Multivariable logistic regressions, stratified by age and sex groups, were performed to estimate how SES affects the likelihood of meeting PAG, adjusting for demographic, lifestyle, and other health-related factors. We explored weight status as an effect modifier.</p><p><strong>Results: </strong>The proportion of middle-aged and older adults meeting PAG was 21.2%. Respondents with wealth > $1 million were 50% more likely to meet PAG compared to those with wealth < $50,000 (males: OR = 1.47 [1.27, 1.72]; females: OR = 1.52 [1.28, 1.80]). Males with higher education were 15% less likely to meet PAG (OR = 0.85 [0.76, 0.94]) compared to those with less than post-secondary, whereas no significant association was observed among females (OR = 1.03 [0.92, 1.16]). When stratified by weight status, the association between wealth and meeting PAG was significantly stronger for normal-weight (OR = 1.50 [1.07, 2.09]) than overweight males (OR = 0.97 [0.81, 1.15]) of the lowest wealth group. Among females, the association was significantly stronger for those overweight (OR = 1.19 [1.02, 1.38]) compared to those normal-weight (OR = 1.17 [0.96, 1.42]) in the $100,000 to less than $1 million wealth group.</p><p><strong>Conclusion: </strong>A need exists to remove wealth-related barriers of LTPA at the public health level for middle-aged and older adults, such as improving affordability and accessibility of recreational facilities. Longitudinal research is needed to establish causality, as is research on the underlying mechanisms of inactivity to influence change through policy action.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on opioid toxicity mortality rates in Nova Scotia: An interrupted time series analysis (2009-2023).","authors":"Cindy Feng, Mark Asbridge, Amy Grant, Lihui Liu, Guanjie Lyu, Fahima Hassan","doi":"10.17269/s41997-025-01092-8","DOIUrl":"https://doi.org/10.17269/s41997-025-01092-8","url":null,"abstract":"<p><strong>Objectives: </strong>To examine trends in opioid toxicity mortality in Nova Scotia and its health zones from 2009 to 2023, focusing on differences between pharmaceutical and non-pharmaceutical opioid-related deaths.</p><p><strong>Methods: </strong>We conducted a population-based study using data on annual opioid toxicity mortality rates from 2009 to 2023, stratified by health zone and opioid type. An interrupted time series (ITS) analysis was applied to assess changes in mortality trends across three pandemic-related periods. Comparisons were made between pharmaceutical and non-pharmaceutical opioid mortality to assess evolving patterns of opioid-related harm.</p><p><strong>Results: </strong>Opioid toxicity mortality in Nova Scotia declined during the peri-pandemic period (2019-2021) but increased significantly post-pandemic, particularly in non-pharmaceutical opioid-related deaths, which steadily rose after 2021. Pharmaceutical opioid-related deaths remained higher than non-pharmaceutical deaths. Health zone analysis revealed geographic variation: the Central Zone experienced stable pharmaceutical mortality with rising non-pharmaceutical deaths post-pandemic; the Eastern Zone saw higher pharmaceutical mortality pre-pandemic, which declined during the peri-pandemic period, while non-pharmaceutical deaths remained low; the Northern Zone had stable pharmaceutical mortality but rising non-pharmaceutical deaths post-pandemic; and the Western Zone exhibited consistently lower mortality rates across both opioid types.</p><p><strong>Conclusion: </strong>This study reveals significant shifts in opioid-related mortality trends in Nova Scotia, with a rise in non-pharmaceutical opioid deaths post-pandemic, while pharmaceutical opioids remain a major contributor. Geographic variations across health zones highlight the need for region-specific public health strategies. Ongoing efforts to reduce both pharmaceutical and illicit opioid misuse through harm reduction and improved prescribing practices are crucial.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Insidious habits\": The moral vision of the Lalonde Report in historical perspective.","authors":"Catherine Carstairs","doi":"10.17269/s41997-025-01063-z","DOIUrl":"10.17269/s41997-025-01063-z","url":null,"abstract":"<p><p>The Lalonde Report, A New Perspective on the Health of Canadians, is rightly celebrated as an important Canadian contribution to the development of health promotion. It introduced the \"Health Field Concept\"-the idea that health was the result of human biology, health care systems, the environment, and lifestyle. Although the health field concept was new, the report drew on a long tradition within public health of blaming individuals for their own health problems. With less evidence, some scholars have also made the case for the Lalonde Report contributing to the social determinants of health. But A New Perspective paid little attention to the systemic barriers that prevented people from eating well, exercising, drinking less, or quitting smoking. While it occasionally acknowledged the constraints of poverty, the focus was much more on people's individual responsibility to improve their health. This paper contextualizes the Lalonde Report in the longer history of public health campaigns in Canada and shows the extent to which the Lalonde Report was a product of its time, age, and authors. At the end, the paper will address the intellectual origins of the social determinants of health and argue that the Lalonde Report made only a marginal contribution to the social determinants of health.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 Suppl 1","pages":"15-21"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fiscal federalism, Medicare, and the Lalonde report.","authors":"Gregory P Marchildon","doi":"10.17269/s41997-025-01067-9","DOIUrl":"10.17269/s41997-025-01067-9","url":null,"abstract":"<p><strong>Objectives: </strong>The development and afterlife of the Lalonde Report in Canada is re-examined along with the majority and minority narratives of its policy context and ultimate impact. The main purpose of this inquiry is to produce a deeper understanding of the Lalonde Report.</p><p><strong>Methods: </strong>This historical analysis relies on primary sources, many of which have never been accessed before. These sources include summaries of cabinet discussions at the time prepared by the Privy Council Office, memorandums and reports generated by officials within the Department of Health and Welfare during the development of the Lalonde Report, and federal-provincial discussions of the Lalonde Report in the months following its release.</p><p><strong>Results: </strong>Three factors came together to produce the Lalonde Report, only one of which directly addressed the policy of public health in Canada; the other two have largely been ignored in the secondary literature. This lacuna has resulted in a misleading understanding of the policy context of the day, which was heavily focused on meeting Quebec's demands for greater autonomy in social policy, including health, as well as reducing federal fiscal exposure by replacing shared-cost Medicare transfer regime with a permanent tax transfer to the provinces.</p><p><strong>Conclusion: </strong>This history explains why the Lalonde Report had such limited impact in Canada. The extensive time and energy absorbed by this shift in Medicare financing meant that both federal and provincial governments paid little attention to developing pan-Canadian strategies, interventions, and programs, based on the insights provided in the Lalonde Report.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 Suppl 1","pages":"22-29"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}