Public Health

Question 1

What is the portrait of diabetes among the Indigenous communities?

Answer 1

Diabetes is the driving force of cardio-vascular disease among indigenous population.

• It is prevalent among younger people too (20 years younger than in the rest of QC)
• A lot of new diagnosis (60%)
• The numbers keep going up

Question 2

What is the problem in our approach with CV diseases in Indigenous communities ?

Answer 2

There is a sudden surge in CV disease over the past decade; it is going to become an ever-bigger problem. Why is that ?

BECAUSE WE BLAME THEM AND TELL THEM WHAT TO DO.

Maybe it is OUR fault and we are not listening to what the patients need. WE HAVE TO CHANGE.

Question 3

What can physicians do about the rising problem of CV diseases among Indigenous communities ?

Answer 3

Right now, what are we doing as physician to perpetuate the trauma that Indigenous people suffered: “you have diabetes and stop doing that”.

What we need to do is UNDERSTAND issues and be non-judgmental, be positive and be there when they are ready. Be aware to avoid power imbalance and have some SELF REFLECTION.

Question 4

Stakholders in the policy environment?

Answer 4

Tobacco industry

Commercial outlets

Media

Governments

Physicians & health care professionnals

Patients

Vulnerable populations

Question 5

What can tobacco cause as diseases?

Answer 5

Lung & other cancers, pulmonary disease, CV disease, heart attack, stroke, infection, infertility, pregnancy, impotence

Question 6

What happened in 1950, 54, 57, 62, 64, 70, 86 (pas sure cest a lexam mais aussi ben l’apprendre yuoohu)?

Answer 6

• 1950: first evidence of effects of smoking on health in 1950 (LC patients)
• 1954: first public warning on the hazards of smoking by CMA
• 1957: US PH service first statement on cigarette smoking as a cause of LC
• 1962: Royal College of Physicians of London UK report
• 1964: US Surgeon General report on smoking & LC in men
• 1970s & 1980s: mounting evidence on other smoking-related diseases
• 1986: US Surgeon General identifies passive smoke/second-hand smoking as a major health hazard

Question 7

According to WHO, what percentage of one billion smokers live in low/middle income countries?

Answer 7

80%

Question 8

What report gave rise to health promotion and prevention in 1974?

Answer 8

Lalonde Report. Introduced the concepts of listyle &environment in health status and outcomes.

Question 9

What was the Toabcco Act designed to do? What were the provisions? The response?

Answer 9

• Designed to
  
  • Protect the health of Canadians
  • Protect youth from using tobacco
  • Enhance public awareness of health hazards
• Provisions
  
  • Ban on tobacco advertising and sponsorship
  • Strict labeling requirements
• Response
  
  • Imperial Tobacco loses Quebec Superior Court, 2002
  • Unanimous Supreme Court upholds Act, 2007

Question 10

According to WHO, what is the single most effective deterrent to tobacco use? Why?

Answer 10

Increasing the price of tobacco through higher taxes.

Because of the price elasticity - meaning no matter how elastic (in this case, big) the price is, people are going to buy it (especially among youth)

Question 11

What were the impact of policies on smoking & health (name 6)?

Answer 11

• Smoking in Canada has decreased from 5 out of 10 to 2 out of 10 Canadians since 1965
• Smoking still higher among males
• Smoking has negative correlation with educational attainment
• Remains a leading risk for early death and disability
• The current federal government has pledged to “set the groundwork” to reduce tobacco use to 5% by 2035
• Important regional variation in smoking rates and the rate of decline: Quebec has both the highest smoking rates and the steepest rate of decline)

Question 12

Name 3 new challenges par rapport au tobaccocabocabo.

Answer 12

• E-CIGARETTES :
  
  • Harm-reduction or gateway to smoking?
  • Nicotine e-cigarette not approved for sale in Canada, but no regulation of products
• CONTRABAND :
  
  • Raising taxes has an impact on increasing incentives for a black market in tobacco
  • Tackling Contraband Tobacco Act passed November 2014
• CANNABIS:
• Canada has taken important steps toward liberalizing its policies with respect to cannabis, mostly delivered through smoking
  
  • 2001: federal government legalized medical use of cannabis, licensed growers of medicinal-grade marijuana, and medical exemption procedures
  • 2017: Cannabis Act legalizes cannabis for individuals over 18, as well as possession of 30 grams or less of cannabis, in effect October 2018.

Question 13

What is the 3-pronged approach pertaining the policies?

Answer 13

Protection of non-smokers

Advertising bands and health warnings

Taxation strategies