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HSS 2121 Class notes.doc

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Health Sciences
Louise Edmonds

HSS 2121 Class NotesClass 2 History of HC in CanadaCIHR 5 year plan on ageingsilver tsunamibaby boomers will be higher population return from WWII first baby boomers just turned 65 last year 1 in 3 Canadians is a baby boomer born in 50s and 60s this is an area of health care that will be a boom area this will be the future of HC because thegovernment needs to put more funding into this arealower income individuals live less and have a lower QOL than individuals with higher incomeHistory of Health Care in CanadaBritish North America Act of 1867outlined responsibilities for the two levels of governmentFederal government marine hospitals quarantine management care of aboriginalsProvincial government hospitalsasylums charitiescharitable institutions and public health by default because no one else was doing itsocial welfare public health was not identified in this act but it fell to the provinces today it is an ongoing battle between the various levels of government as to who does what Ex this past summerNative Housing problems mold illness no water etcfingers were pointed to Fed Gov bc they are responsible for aboriginal affairs prov gov responsible for housingbut not housing on reserves Aboriginal Medicinewas a great benefit to the settlersthe medicine men had a connection to the spirit world and earth focus on balance and harmonymodern medicine is now turning to aboriginal health care and incorporation of balance into their health carepeople are living longer but with diseases looking for balance in life Origins of aboriginal input into our health care systemMedical care in early Canadacivilian and military doctorsphysician care in the homemany early Canadians born without much medical assistancesome midwivesththIn 18 and 19 Century only the wealthy could afford carebefore public fundingnurses at this time were nunsneeded money in order to afford medical carehospitals not yet builtNursing Carefirst training of nurses in NA at Hotel Dieu hospital in 1600s before physician trainingnurses promoted sanitation mental health vaccinations and well baby William Oslermicroscopes and dissection introduced in labs got medical students out of the classroom and to the bedside Organizations to manage HCBoard of health first set up in Ontario and Quebecresponsible mostly for public healthpasteurizing milk testing cows for TB managing the TB sanatorium people found to have TB were put there controlling venereal disease etcvolunteer organizations helped provide health care as well also helped to raise fundsno hospital system set up yetOutbreaksread on Typhoid Mary worked as a cook for rich people in NYC she was healthy and unaware that she was carrying and spreading typhoid fever quarantine was a way to choose to handle it at this timeput them all in an area togethercommon cholera diphtheria typhoid fever TB influenzapeople didnt know how disease spread at this time they pointed the finger at the Jewish people chapter 7Early 1900spopulation growing industrialization disease and povertymany STIspeople came from rural areas as factories were builtovercrowding occurredgreat depression people didnt have foodpeople started to understand need for government to help in the provision of health careHospital Developmentfirst hospital in Canada built by nuns from France in 1639charitable governments did not pay for them at this timehospitals funded by wealthy individuals and organizations raising moneygovernments got involved in small waysCottage Hospital systemearly hospital development in the maritimescommunity fundraising to pay doctors and nurses some philanthropic contributionsestablished 1934 to serve rural communities in Nfld2030 bedsseen as an innovative and progressive systemstill exists in some rural areas meet needs of very small communityHenry Sigerstbig role in American politicstime of the great depression in the USfarms failed people struggling and unemployedage 34 he was director of University history of medicine in Germanyasked to come to Johns Hopkins in the USHistory of Medicine Department started at that university what to do when people cant afford health carehe argues that individualized medical practice is outdated and should become a state rungovernment and financed system national health insurance is one step along this pathlooked at US capitalist system which wasnt working at that time believed in socialism and that we have an obligation to take care of fellow men and womenhe put support behind soviet unionagainst US political ideology became out of favoursaid students are trained to think about disease not healthwanted to focus on disease preventionspeaks to social determinants of health doesnt just look at sick model of healthtalk of prevention in early 1900sforward thinkinglooking at health care from historical social political economic and cultural perspectives US sees state control as a negativefear in the US of too much government Sigerist came from a different point of viewWhy do we care about him the global context of health is very importanthe brought all of his background and knowledge to the US and appreciated medical knowledge from a broad base He saw what was happening world wide and this informed himwe live in a world with broad and international impacts on health carehe helped us understand why we study the history of medicinewe study it to understand our own health care system and the social and political and economic factors that influence our health care system Its not just looking backward but its also looking forward at what could be eg Gov funding HC for people and what should be he also showed us that medical people can be social activistshe was engaged in affecting change He reminds us of the political and economic contexts of health careso much of health care is about the money Rare to find an aspect of HC that is not influenced by politics and economicsHe showed us that ideology and political culture are important in terms of the HC system that a country develops It highlights the class strugglerich vs poor People who were wealthy during depression still had money to pay the doctor for home visits people in the lower class got charitable help But it showed that there is a class struggle and that has an impact on HC and policyIt highlights for us an aspect of social change being a result of the clash of ideas power struggles world events eg great depressionrise of communismand how all of these things impact social change Norman Bethunea hero in China not well known in Canadaspent 20 months in China seen as national heroproduct of Canada original doctors without bordersa rebel in some senses ladies man drinkergrew up in small towns around Canadian shield born in Gravenhurstlate 30s struggled with TB stayed at Trudeau sanatorium in NY agreed to a risky new therapyartificial collapse of diseased lungdecided he wanted to be thoracic surgeon to help others with TBmany were dying from TB because they couldnt afford treatment
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