CHS 4

Question 1

Population Health

Answer 1

Definition: Identifying health outcomes of a population group and equitably sharing those outcomes
Population groups: Defined by ethnicity, geography, nation, province, territory, community, or setting
Approach: Broad perspective, considers health as a resource influenced by determinants of health
Goals: Improving health status of a targeted population, addressing health inequities through material and social balance reductions
Benefits: Extends to building a sustainable, integrated health care system
Embraces broader definitions of health and wellness, incorporating holistic concepts
Integrates public health initiatives like health promotion and disease prevention
Public health transforms recommendations into action, funded and implemented by governments, involving collaboration with health care providers, industry, and community agencies
Social media’s role: Platform for campaigns, distribution of health information, and improving health outcomes
Population health vs. public health: Differences explained in Box 6.1

Question 2

The Lalonde Report, 1974

Answer 2

Created by Marc Lalonde, minister of National Health and Welfare in 1974
Introduced the concept of population health to Canada
Document titled “A New Perspective on the Health of Canadians” or Lalonde Report
Acknowledged health determined by more than biology; proposed improvements through changes in environment, lifestyle, and health care organizations

Question 3

Alma-Ata Conference, 1978

WHO convened the conference in Kazakhstan
Focused on global health cooperation and reform
Promoted the slogan “Health for All—2000”
Primary Health Care Definition (from Conference):

Emphasizes care for individuals and communities
Includes essential medical care at primary, secondary, or tertiary levels
Involves cost-effective, comprehensive, and collaborative care

Answer 3

Purpose of Alma-Ata Conference
Key elements of primary health care
Emphasis on community involvement in care
Goal of reducing global health inequities
Focus on a team approach in delivering care

Question 4

Alma-Ata Conference Declaration (10 Points)

Stated health as a fundamental right
Emphasized the highest priority for health
Advocated for community involvement in healthcare planning
Challenged governments to enhance primary health care

Answer 4

Declaration’s focus on health as a fundamental right
Priority placed on achieving optimal health
Emphasis on community participation in healthcare planning
Call for government strategies to improve primary health care

Question 5

Ottawa Charter for Health Promotion, 1986

Expanded on Alma-Ata proposals
Introduction of “health prerequisites”
Emphasized collaborative approach
Outlined five key principles

Answer 5

Broadening of health factors as “prerequisites”
Reinforcement of collaborative approach
Involvement of all government levels in health promotion
Emphasis on individual responsibility for health
Community-level strategies for health enhancement

Question 6

The Epp Report, 1986

Answer 6

Epp Report by Jake Epp, 1986 Ottawa conference: Focused on reducing inequities, managing chronic diseases, preventing diseases, proposed financial support from all government levels

Question 7

Public Health Program Initiative

Answer 7

Public Health Program Initiative: Reviewed determinants of health, analyzed impact on Canadian population’s health, assessed health care system efficiency and effectiveness; completed in 2003
Emphasized link between determinants of health and health outcomes
SES Gradient: Disparity in health outcomes among similar groups; reasons for varied impacts despite common denominators; research continues on health equity in Canada despite universal health care access

Question 8

First Report on the Health of Canadians, 1996

Answer 8

Released by federal health minister David Dingwall and Ontario health minister Jim Wilson in September 1996
Recommendations aligned with proposals from Canadian Institute for Advanced Research (CIFAR) in 1989
Recognized and incorporated determinants of health into findings and recommendations
Acknowledged Canadians among the healthiest populations globally; emphasized need for intensified collaboration among government levels, industry, and private sector to improve Canadian health
Box 6.4: Lists strategies from the report to improve or maintain Canadian health, supporting population health approach principles

Question 9

National Forum on Health, 1994–1997

Initiated by Jean Chrétien
Gathered public input nationwide
Released two final reports in 1997

Answer 9

Emphasized evidence-informed approach
Key recommendation for health improvement initiatives
Contributed to a united population health approach
Followed by subsequent health reports focusing on Canadian health with a population health approach

Question 10

Determinants of Health

Answer 10

Linear perspective on health: Genetics, biology, disease; awareness of health promotion, disease prevention, behavioral risks
Profound effect of socioeconomic factors and other health determinants:
Education
Employment, income level
Built environment (work, living, recreation)
Climate change
Early child development (nutrition, exercise, family dynamics)
Social support networks
Health reliant on combination of these factors
Effect beyond genetics, biology, disease; interconnectivity among determinants
Public Health Agency of Canada (PHAC) identifies 12 determinants of health

Question 11

Income and Social Status

Answer 11

Significance: Major determinants of health
Research link: Strong correlation between income, social status, and health (PHAC, 2013)
Lower socioeconomic status linked to poorer health, earlier death
Higher socioeconomic status associated with better health; health proportional to socioeconomic position

Question 12

Social Support Networks

Stress relief and enhanced well-being
Sources: Family, friends, community
Diverse affiliations contribute
Influenced by age, sex, gender, culture

Answer 12

Men’s evolving engagement
Cultural impact on sharing
Effects on marginalized individuals
Loss of control and mental trauma for marginalized/bullied individuals

Question 13

Education and Literacy

Answer 13

Literacy and education’s impact:
Higher education leads to better jobs, social status, stable income
Financial security offers various opportunities for individuals/families, such as organized sports, recreational activities for children
Benefits of higher education: Widens knowledge, enhances logical thinking, problem-solving skills; motivates community engagement, satisfaction
Success despite lower education levels: Individuals thrive, children succeed, overcome challenges, graduate from colleges/trades
Influence of success: Higher education doesn’t solely mean university degree; community skills, trade graduates find diverse employment opportunities
Disparity in wage earners despite high school graduation rates (90% in 2015), post-secondary education (66% continued) - 2016 Health Status Survey (HSS)

Question 14

Employment & Health

Impact of underemployment/unemployment
Higher mortality & morbidity rates
Stressors on families
Lack of health care benefits

Answer 14

Unemployment rates among Indigenous Peoples
Gender wage gap statistics
Economic inequality faced by women
Effects of contract employment on health

Question 15

Social Environment

Answer 15

Components:
Individual behavior, relationships, community ties
Attachment, social comfort, sense of belonging
Gender, culture, ethnic group
Education, workforce roles
Living conditions, community context, self-perception
Influence on health and life expectancy, overlapping with other determinants
Similar social environments lead to similar values, outlooks, thinking patterns
Impact of community cohesion: Stronger, more involved communities tend to have better health
Variation in community impact: Diverse community structures, involvement in different activities
Challenges in various community setups: Social isolation, especially for new Canadians adapting to a new culture
Volunteerism: Enhances well-being, promotes compassion, harmony, and cohesiveness; volunteers tend to live longer, experience less depression, heart disease
Support resources in communities: Government-sponsored child care, resources for older Canadians; reduces stress, financial burden
Positive impact of social stability: Fosters positive relationships, cultural diversity acceptance, unified communities fostering confidence, value, support, and reduced health risks

Question 16

Physical Environment

Answer 16

Natural environment: Includes food, water, air quality, living spaces
Manufactured/built environment: Homes, schools, workplaces, roads, recreational areas
Impact on health: Built environment structure affects health status; e.g., sick building syndrome, Legionnaire disease
Current environmental concerns: Drinking water infrastructure, air pollution, environmental/global warming, agricultural land pollution, natural resource depletion
Challenges in Indigenous communities: Issues with drinking water, faulty purification systems, multiple advisories (130) in 85 Indigenous communities as of November 2017 (Health Canada)
Responsibility: Building, maintaining structures falls under Indigenous and Northern Affairs Canada

Question 17

Personal Health Practices and Coping Skills

Answer 17

Personal health practices: Linked to self-imposed risk behaviors, health beliefs, behaviors; influenced by self-esteem, sense of control, confidence, life experiences
Influence of life experiences: Example - rejecting the link between smoking and health problems due to family experiences, adverse reactions to immunization affecting future decisions
Coping skills: Help individuals manage situations, influenced by genetics, socioeconomic factors
Varied ability to cope: Some handle stress, challenges better despite socioeconomic difficulties like family disharmony, financial insecurity, marginalization
Challenges for new Canadians: Cultural differences affecting health beliefs, practices, expectations; socioeconomic influences in new environment impact adjustment and coping
Impact of support during transition: More support leads to positive outcomes in confidence and coping abilities for families transitioning to life in Canada

Question 18

Healthy Child Development

Answer 18

Commencement: Healthy development starts pre-birth, influenced by maternal health practices (e.g., nutrition), risks (e.g., drinking, smoking, drug use)
Adverse effects of maternal behaviors: Fetal alcohol syndrome, drug use, smoking, and concerns about cannabis use during pregnancy; warnings by Health Canada due to potential adverse effects on fetus and child
Determinants affecting child development: Range from employment insecurity to family stressors, disharmony, breakdown
Health Canada’s focus: Emphasis on healthy child development, ongoing research; Canadian council on Social Determinants of Health formed Healthy Child Development Task Group (2014–2017)
Task Group’s objectives: Innovate research methodologies, collaborate with stakeholders, formulate evidence-based plans
Research outcomes: Insufficient awareness of social determinants’ impact on brain development in children aged 0–3; more research needed on poverty, food insecurity, neglect, lack of stimulation, and their impact on child development
Potential interventions: Improved understanding for implementing screenings, assessments, and interventions based on cause-effect relationships between determinants and child development

Question 19

Biology and Genetic Endowment

Answer 19

Definition: Attributes inherited from parents influencing vulnerability to specific diseases, health issues
Genetic studies: Aid in understanding disease risks (e.g., Huntington disease, cystic fibrosis, certain cancers, Alzheimer’s); helps assess risks of passing conditions to offspring; individuals’ varied preferences in accessing this information
Influence of socioeconomic factors and environment: Impact on biology; ideal conditions promote better physical, mental health; healthy, active lifestyle in older adults with robust social networks and accessible medical care may prevent chronic diseases, musculoskeletal decline

Question 20

Health Services

Answer 20

Components: Diagnosis, treatment (maintain/restore health), disease prevention, health promotion; integral to population health approach
Impact on population health: Type, delivery of health services affect overall population health; availability of primary care, health promotion, disease prevention programs crucial for healthier population
Key services: Immunizations, preventive care (e.g., breast screening, prenatal care, well-baby initiatives), community and long-term care services
Challenges in Canadian health services: Financial, logistical, and human resource constraints; cost restraints affecting prompt access to diagnostics, physicians, procedures; inadequate staffing in hospitals (e.g., nursing shortages)
Inequities in isolated communities: Issues with access, treatment; shortage of human health resources, especially primary care providers in rural/isolated areas

Question 21

Gender Identities

Answer 21

Definition: Personal expression beyond biology or sexual orientation; includes a range of self-identified social/cultural differences, lifestyle, and sense of self
LGBTQ2: Acronym encompassing various identities—Lesbian, Gay, Bisexual, Transgender, Transsexual, Queer, Questioning, Two-Spirit
Definitions of identities within LGBTQ2 umbrella (e.g., lesbian, gay, bisexual, transgender, transsexual, queer, questioning, two-spirit)
Challenges as determinant of health: Acceptance/rejection impact well-being; employment obstacles due to societal stigma; lack of gender-sensitive care in the medical community
Transitioning challenges: Long waits, assessments, uncertainty about procedures covered under public health plans; criteria based on World Professional Association for Transgender Health standards
Genital surgery facilities in Canada: Only two facilities conducting genital surgery—private clinic in Montreal and Women’s College Hospital in Toronto; conditions include good mental/physical health, hormonal treatment, living in desired identity for at least a year

Question 22

Culture and Ethnicity in Health

Answer 22

Definitions: Culture as a way of life; ethnicity linked to race, origin, language, religion
Influence on Health: Impact on health beliefs, behaviours, and lifestyle choices
Challenges for Different Groups: Minorities facing inequities, isolation, and socioeconomic issues; influence of larger group’s cultural environments on minorities
Barriers in Health Care: Fear, language difficulties, family non-involvement; support from family, friends, or community crucial in navigating the health care system
Refugee Challenges: Newly arrived refugees face health challenges requiring specialized care; support from government, individuals, or private groups varies; financial insecurity due to unemployment affects daily living
Language Barrier: Access to language learning programs provided but attendance challenging; decisions on attending classes may affect family dynamics
Other Barriers: Religion, dress, climate, regulations, community acceptance, health care practices pose additional challenges
Overlooked Refugees: Illegally arrived refugees await immigration hearings, lack support networks, rely on limited assistance, and face mental, emotional, and physical risks.

Question 23

Alma-Ata Definition of Primary Health Care

Answer 23

Core Attributes: Essential, practical, scientifically sound, and socially acceptable health care methods and technology
Universality: Available universally to individuals and families within the community
Community Involvement: Emphasizes full participation of the community
Accessibility: Ensures accessibility at every stage of development
Affordability: Provided at a cost that the community and country can sustain
Ideals: Embodies the principles of self-reliance and self-determination

Question 24

Socioeconomic Status (SES) Explained

Answer 24

Definition: Measurement combining education, occupation, income, social status, and sometimes geography
Purpose: Positions individuals/groups on a socioeconomic gradient for health studies
Levels: Categorized as low, medium/average, and high
Health Correlation: Higher SES often correlates with better health outcomes; lower SES linked to poorer health
Exceptions: Individuals from lower SES backgrounds can enjoy good health and productivity
Research Focus: Studies examine multiple population groups to identify health gaps and necessary interventions
Indigenous Communities: Often situated at lower SES levels, facing poverty, unemployment, and poor living conditions

Question 25

Declaration of the Alma Ata

Answer 25

International Conference on Primary Health Care: Alma-Ata, September 12, 1978
Urged immediate action from governments, health workers, and global community for global health enhancement

Question 26

outcomes or declarations of the Alma Ata conference

Answer 26

1. Health as a Fundamental Human Right
   -Health encompasses physical, mental, and social well-being
   Collaboration across sectors for global health
2. Disparity in Health Status
   -Disparities between developed and developing nations are unacceptable
   Shared concern for health inequalities
3. Economic and Social Development
   -New International Economic Order for optimal global health
   Health is vital for sustainable progress and global peace
4. Right and Responsibility of Individuals
   -Individuals have the right and responsibility in healthcare planning and execution
5. Governments’ Responsibility
   -Governments should ensure all individuals lead productive lives
   Prioritize primary healthcare for social justice
6. Importance of Primary Health Care
   -Practical, affordable, and sustainable healthcare
   Foundation for continuous healthcare process
7. Components of Primary Health Care
   -Shaped by economic, sociocultural, and political factors
   Offers comprehensive services and involves diverse sectors
8. Government Policies for Primary Health Care
   -National policies to integrate primary health care
   Political commitment and resource mobilization required
9. Collaboration for Universal Access
   -Collaborate for universal access to primary health care
   Global impact of individual health
10. Optimizing World Resources
    -Redirect resources from conflicts to social and economic development
    Allocate resources to primary health care

Question 27

International Conference on Primary Health Care emphasizes

Answer 27

Urgent need for national and international action to establish and implement primary health care globally
Particularly vital in developing countries and in line with a New International Economic Order
Urges support from governments, international organizations, NGOs, health workers, and the global community
Calls for increased technical and financial assistance, especially in developing nations
Encourages collaboration to introduce, develop, and sustain primary health care in alignment with the Declaration’s principles

Question 28

Population Health Goals

Answer 28

Identifying Health Outcomes: Targets specific population groups for equitable health access.
Determinants Influence: Multiple factors impact health, overseen by Canada’s Public Health Agency.
Framework Components: Encompasses promotion, prevention, diagnosis, treatment, and interventions for Canadians’ health.
Lalonde Report (1974): First to highlight non-biological health determinants.
Alma-Ata Conference (1979): Emphasized global health cooperation and primary to tertiary care.
Key Conferences: Ottawa Charter (1986), Public Health Program Initiative, National Forum on Health (1994-1997).