HLTB03 Midterm Notes: Health, Illness, and Health Care in Canada
Chapter 3: The Emerging Public Health Systems in Canada
¾ Public health policy and practice are concerned with preventing injury and illness within a population.
¾ It was only during the last two or three decades of the 20th century that substantial efforts were made to reform the
Canadian medical care system and turn it into a health care system.
¾ Recently, health promotion has become a goal health policy.
¾ Health promotion encourages and empowers individuals to make healthy choices and discourages them from making
¾ The health promotion framework draws attention to a wide range of social determinants of health and illness that
differentially affect the health status of the population as a whole, as well as the health status of various sub-groups
¾ The growing emphasis on health promotion, combined with more traditional concerns about illness prevention, is
¾ Our main focus in this chapter is the new public health and the emergence of a new health system in Canada.
¾ We argue that the efforts to develop a new public health system are the result of the confluence of several forces,
including globalization, the emergence of a new balance of socio-political forces, including globalization, the
emergence of a new balance of socio-political forces, climate change, and the inability of both the public health
systems and health care systems to deal with existing and emerging health problems.
¾ Modernization involves a number of major structural and institutional transformations to societies.
¾ The development of modern, science-based public health and health care systems is generally seen as one indicator
of the modernization process.
¾ The historically unprecedented production of wealth associated with societal modernization and the rise of capitalist
industrialization were achieved, in part, at the expense of the health and safety of growing class of waged workers.
¾ Unregulated capitalism was unsustainable. It was in this context that initial public health efforts aimed at regulating
the terms and conditions of work for the capitalist working class were first developed.
¾ The rise of capitalism was accompanied by rapid urbanization, that is, the widespread movement of people from rural
areas to cities to take up jobs in the new factories.
¾ The rapid and uncontrolled growth of cities resulted in extremely unsanitary and unhealthy living conditions.
¾ Unsafe water supplies and inadequate sewerage and waste disposal systems created an environment where
infectious diseases such as typhoid, cholera, smallpox, and tuberculosis thrived.
¾ Thus, in addition to efforts to regulate the terms and conditions of factory work, early public health efforts consisted
of introducing immunization and public education campaigns, effective water treatment and food safety mechanisms,
and new sewerage and waste disposal systems. These are all still elements of all public health systems.
¾ Colonialism was another motor and consequences of capitalist growth and it too contributed to the need to develop
public health systems. On the one hand, colonialism provided a source of cheap raw materials and labour for the
voracious capitalist systems of Europe and North America. On the other hand, it provided a worldwide market for the
vast quantities of commodities that the industrial mode of production made possible.
¾ The incorporation of colonies into the world capitalist system resulted in the establishment of new trade, travel, and
residential patterns for indigenous and migrant workforces as well as for colonial administrators, merchants, and
soldiers. These, in turn, created new disease vectors.
¾ These factors also motivated the development of the Canadian public health system.
¾ Compounding difficul]]Z(Zv[o]ÀoÇuoovP}PZ]ooÇ]}µo]}vul]
difficult for municipal and provincial governments independently to raise the tax revenues necessary to develop
public health systems.
¾ For most of the 20th century, the Canadian public health system functioned reasonably well.