Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献_第3页

"Insidious habits": The moral vision of the Lalonde Report in historical perspective. “阴险的习惯”：历史视角下《拉隆德报告》的道德视野。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01063-z

Catherine Carstairs

{"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":"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.","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}

引用次数: 0

Fiscal federalism, Medicare, and the Lalonde report. 财政联邦制、医疗保险和拉隆德报告。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01067-9

Gregory P Marchildon

{"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":"Objectives: 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.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

"We are failing to act on the information we already have": Family planning, abortion, and the Lalonde Report, 1969-1977. “我们没有根据已经掌握的信息采取行动”：计划生育、堕胎和拉隆德报告，1969-1977。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01099-1

Christabelle Sethna

引用次数: 0

Defining the public in public health after Lalonde: the view from the United Kingdom, 1970s‒1990s. 拉隆德之后公共卫生中的公众定义：来自英国的观点，1970 - 1990年代。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01071-z

Alex Mold

{"title":"Defining the public in public health after Lalonde: the view from the United Kingdom, 1970s‒1990s.","authors":"Alex Mold","doi":"10.17269/s41997-025-01071-z","DOIUrl":"10.17269/s41997-025-01071-z","url":null,"abstract":"This article considers the impact of the Lalonde report on ideas about the public and public health in the United Kingdom from the 1970s to the 1990s. It begins by assessing how \"the public\" within the context of public health has been thought of. Three key modes are identified: the public as the whole population, as groups, and as individuals. An examination of the Lalonde report, and its British equivalent, Prevention and Health, Everybody's Business, points to the presence of these three ways of thinking about the public. Nonetheless, the role of the individual in disease prevention appeared to dominate both the Lalonde report and Prevention and Health. The influence of this approach is traced through an analysis of British health education campaigns around alcohol from the 1970s to the early 1990s. The target of such efforts changed over time, away from alcoholics and heavy drinkers and towards creating \"sensible drinkers\". Although alcohol health education campaigns were directed at getting individuals to change their drinking behaviour, they also took into account a population-level view of alcohol consumption. The current article concludes by suggesting that a reappraisal of Lalonde and Prevention and Health points to the existence of collective, as well as individual-based, ways of thinking about publics and doing public health.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 Suppl 1","pages":"39-49"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114858","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}

引用次数: 0

Chronic disease, social medicine, and the Lalonde Report. 慢性病、社会医学和拉隆德报告。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01036-2

George Weisz

{"title":"Chronic disease, social medicine, and the Lalonde Report.","authors":"George Weisz","doi":"10.17269/s41997-025-01036-2","DOIUrl":"10.17269/s41997-025-01036-2","url":null,"abstract":"This paper examines the Lalonde Report from the perspective of a half-century of concern with chronic diseases. By the 1970s, the growing role of long-lasting conditions had, together with new provincial health insurance systems, created new pressures and problems for healthcare in Canada. In responding to these problems, the authors of the report had two models to choose from. In the United States, where chronic disease had been seen as a crisis since the 1930s, the response was a mixture of high-tech preventive and therapeutic strategies and insurance programs for specific groups like the elderly and very poor. Biomedical technology remained at the centre of US healthcare strategy. The authors of the Lalonde Report were more attracted to the British social medicine tradition which, in the form developed by Thomas McKeown, downplayed the effects of biomedical technology and emphasized the role of improved social conditions. McKeown's theories, it is suggested, were shaped by his understanding of the failure of modern medicine to provide effective and appropriate long-term care for those who could not be fully cured. This required significant reallocation of resources. While the Lalonde Report was deeply influenced by the critique of clinical medicine, it recognized but made only brief mention of McKeown's insistence on the need for better long-term care. This lack of emphasis was reflected in subsequent Canadian healthcare policy.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 Suppl 1","pages":"8-14"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114853","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}

引用次数: 0

The Lalonde Report in historical perspective. 历史视角下的拉隆德报告。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-08-01 Epub Date: 2025-09-17 DOI: 10.17269/s41997-025-01032-6

David Wright

{"title":"The Lalonde Report in historical perspective.","authors":"David Wright","doi":"10.17269/s41997-025-01032-6","DOIUrl":"10.17269/s41997-025-01032-6","url":null,"abstract":"It has been fifty years since the publication of A New Perspective on the Health of Canadians, a Green Paper circulated under the name of then Canadian federal Minister of Health and Welfare, the Honourable Marc Lalonde. Since its publication in 1974, the Lalonde Report, as it is commonly known, has been credited with launching a new era of health promotion, with a sustained focus on the social determinants of illness, disease, and disability. It was also surprisingly influential, breaking new ground for other international accords. At the same time, it has garnered a certain amount of criticism for its emphasis on individual responsibility for health outcomes, with some researchers sensing a neo-liberal agenda that occluded structural and environmental contributions to health inequities. At a time when Canadians are again debating the future of a health care system, this Introduction and the historical articles that follow aim to place the Lalonde Report in its political, social, and epidemiological context. It will provide a much-needed reflection on one of the most important public policy documents in contemporary Canadian history.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":"116 Suppl 1","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114848","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}

引用次数: 0

Exploring the local impacts of heat on mortality: A small-area spatial analysis of Montreal, Toronto, and Vancouver, Canada. 探讨高温对死亡率的局部影响：加拿大蒙特利尔、多伦多和温哥华的小区域空间分析。

IF 2.6 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-07-31 DOI: 10.17269/s41997-025-01086-6

Matthew Quick, Monica Duong

{"title":"Exploring the local impacts of heat on mortality: A small-area spatial analysis of Montreal, Toronto, and Vancouver, Canada.","authors":"Matthew Quick, Monica Duong","doi":"10.17269/s41997-025-01086-6","DOIUrl":"https://doi.org/10.17269/s41997-025-01086-6","url":null,"abstract":"Objectives: The objectives of this study were to quantify the small-area associations between heat and mortality and to characterize the spatial patterns of mortality risks at hot temperatures.Methods: Daily mortality and temperature data were retrieved for the cities of Montreal, Toronto, and Vancouver during the summer months between 2018 and 2022. Spatial distributed lag non-linear models quantified the associations between temperature and mortality at the small-area scale. Heat-mortality hotspots were identified based on the relative risks of mortality at hot temperatures. The spatial patterns of mortality at hot temperatures were described using small-area sociodemographic and environmental characteristics.Results: Hot temperatures were associated with elevated relative risks of mortality in Montreal and Vancouver compared to median summer temperatures. At 95th percentile temperatures, 38% and 18% of areas in Montreal and Vancouver were classified as heat-mortality hotspots, respectively. In Toronto, 95th and 99th percentile temperatures were not associated with elevated relative risks of mortality and no heat-mortality hotspots were identified. In all cities, the relative risks of mortality at hot temperatures were positively correlated with population density and residential instability. Areas with high levels of greenness had lower relative risks in Montreal and Toronto.Conclusion: Understanding the small-area associations between heat and mortality is important for public health programs that aim to reduce the health impacts of extreme heat. The impacts of heat on mortality exhibited considerable spatial variability, and small-area vulnerability was found to be characterized by high population density and high residential instability.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762265","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}

引用次数: 0

The geographic distribution and community correlates of electronic cigarette use in Canada. 加拿大电子烟使用的地理分布和社区相关性

IF 2.9 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-07-25 DOI: 10.17269/s41997-025-01084-8

Adam M Lippert, Daniel J Corsi

{"title":"The geographic distribution and community correlates of electronic cigarette use in Canada.","authors":"Adam M Lippert, Daniel J Corsi","doi":"10.17269/s41997-025-01084-8","DOIUrl":"https://doi.org/10.17269/s41997-025-01084-8","url":null,"abstract":"Objectives: Electronic cigarettes and other novel electronic nicotine delivery systems (ENDS) have grown rapidly in popularity and accessibility. In this study, we compiled a large sub-provincial dataset on smoking and vaping behaviour in Canada to inform targeted surveillance and prevention.Methods: Twelve national-level survey datasets were concatenated. Multilevel models were used to derive precision-weighted estimates of census division-level smoking and ENDS use prevalence, adjusted for age, sex/gender, and data source. We developed visualizations of the geography of smoking and ENDS use across Canada and used Census Divisions for spatially explicit correlational analyses of community characteristics associated with vaping.Results: The age- and sex-adjusted prevalence of past-month (i.e., current) ENDS use in Canada was 4%, with higher estimates observed in several Atlantic provinces: New Brunswick (5.6%), Prince Edward Island (4.8%), Nova Scotia (4.7%), and Newfoundland and Labrador (4.5%) followed by Manitoba (4.1%). Estimates for the remaining provinces were below 4%. The prevalence of ENDS use varied considerably across CDs, even in provinces where vaping was generally uncommon. Suburban and exurban communities in Ontario and Quebec demonstrated especially high ENDS use. Spatial analyses revealed select correlations with community factors such as economic composition.Conclusion: Sub-provincial data revealed geographical variability in ENDS use across Canada. Localized surveillance and prevention efforts may be improved by considering the community features associated with high rates of use, and benchmarking regional regulations on the advertising and sales of ENDS products to communities with lower estimated rates of use.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719065","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}

引用次数: 0

From policy to plate: strengthening implementation of Canada's national school food policy. 从政策到餐盘：加强加拿大国家学校食品政策的实施。

IF 2.9 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-07-18 DOI: 10.17269/s41997-025-01089-3

Annette Blais, Benjamin Organ, Nicole Weber, Mavra Ahmed, Mary L'Abbé, Daniel Sellen, Vasanti Malik

{"title":"From policy to plate: strengthening implementation of Canada's national school food policy.","authors":"Annette Blais, Benjamin Organ, Nicole Weber, Mavra Ahmed, Mary L'Abbé, Daniel Sellen, Vasanti Malik","doi":"10.17269/s41997-025-01089-3","DOIUrl":"https://doi.org/10.17269/s41997-025-01089-3","url":null,"abstract":"Canada's newly released National School Food Policy (NSFP) and its associated federal funding commitments mark significant progress toward a more coordinated school food system in Canada. However, significant gaps remain that could undermine the policy's effectiveness and longevity. Current bilateral agreements between federal and provincial/territorial governments highlight disparities in per-student funding, raising concerns about whether the allocated resources are adequate to achieve universally accessible, high-quality meal provision. Additionally, while the NSFP encourages school food programs to adhere to Canada's Food Guide and provincial nutrition guidelines, ambiguous language and the absence of enforceable standards leave room for inconsistent nutritional quality across programs. Furthermore, without a structured framework for monitoring and evaluation, there is no mechanism to assess program effectiveness, track nutritional outcomes, or ensure program accountability. To maximize the NSFP's impact, we urge policymakers to establish transparent funding rationales, develop clear and evidence-based national guidelines, and implement robust monitoring systems. Strengthening these policy components is essential to ensuring an equitable, effective, and sustainable approach to NSFP implementation in Canada.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661052","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}

引用次数: 0

Raising awareness of occupational carcinogens among apprentices in an approach to promoting health in the workplace. 提高学徒对职业致癌物质的认识，以促进工作场所的健康。

IF 2.9 4区医学

Canadian Journal of Public Health-Revue Canadienne De Sante Publique Pub Date : 2025-07-16 DOI: 10.17269/s41997-025-01079-5

Zoé Rollin, Andrea Tadeo Granda

{"title":"Raising awareness of occupational carcinogens among apprentices in an approach to promoting health in the workplace.","authors":"Zoé Rollin, Andrea Tadeo Granda","doi":"10.17269/s41997-025-01079-5","DOIUrl":"https://doi.org/10.17269/s41997-025-01079-5","url":null,"abstract":"Goals: The aim of this article is to report on an interventional research project - based in the human and social sciences, particularly sociology and educational sciences - designed to better understand how auto body technician, hairdresser, and beautician apprentices perceive the prevention of occupational carcinogenic risks, and to experiment with educational interventions aimed at raising their awareness of this issue.Methods: The associated methodology combines interviews with apprentices and training professionals (n = 72), and over a hundred hours of observations in practice workshops and in classrooms. Interventions were carried out in four classrooms, the effects of which were measured by interviews and administered questionnaires.Results: Although apprentices are concerned about their health, their position within the division of labour offers them very limited scope for preventive action. Professional norms tend to reinforce certain barriers to prevention. Carcinogenic risk, due to its delayed effects, remains difficult to apprehend and calls for specific intervention strategies. The interventions help to inform and initiate changes in their practices, but they struggle to make learners' awareness of the structural obstacles to prevention. All of these findings have been used to create tools that make up an educational kit available to trainers.Conclusion: Preventing occupational carcinogenic risk among apprentices is a complex issue, and interventions in schools are one way of addressing it. However, a global change in practices requires these projects to be transferred to a larger scale, along with structural changes in working environments to promote the health of apprentices.","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651173","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}

引用次数: 0