A review of progress after ten years was part of the accord and the Health Council of Canada was created and mandated to prepare it, along with other regular reporting. The full report notes that the progress has been dismal and recommends a totally new approach based on a systems approach and with an emphasis on equity. What is even more disappointing, along with the poor results achieved in Canadian's health and the health care system, is the absence of any attention, even in this mandatory decade review, of any real understanding that health care does not produce any improvements in health. If we are to improve the health of Canadians, we will need major new investments in health promotion. And, of course, as noted in the Ministers' promises, we need to do that through inter-sectorial action through settings such as schools.
have declined slightly, the percentage of obese adult Canadians has increased. The lack of notable improvements over the last decade is also reflected in Canada’s ranking internationally. Canada most often ranks in the middle when compared to other
high-income countries on a number of measures of health outcomes and status." This writer has already commented on the research and reports that suggest that Canada's focus on physical activity rather than diet, inequities, stress, advertising and other social factors that underlie obesity. We also know that it is now firmly recognized that health is influenced by where we live, work, learn and play, ie in non-health settings. The recent 2013 WHO health promotion conference has firmed up that recognition with its call for "Health in All Policies", an appeal to all sectors to work on health and equity. But we also know that health promotion is the weak sibling in the health system. We continue to organize our health promotion efforts around diseases instead of truly taking a population health approach and working in a sustained way with the sectors that govern or support settings such as schools, families, workplaces, municipalities and others.
The Health Council report jumps onto a new bandwagon doing the rounds in health care reform. It advocates for a "triple aim" approach where the focus is on "better health, better care and better value". The report suggests a priority be established for equitable access to care. And, logically, suggests that the systems approach consider systemic capacities such as leadership, policies, legislation, spreading innovations and monitoring/reporting. This is all decent stuff about modifications to the health care system but the report fails miserably when it ignores tha fact that our health is not created nor supported by the health care system. That is where diseases are treated. I looked for but did not find any mention in the report of any new in vestments or reforms to Canadian health promotion programs. the report discusses health care issues such as pharma-care, home care, electronic records, wait times and all those other things that hospitals and health care staff need to be worried about.
But if we are to truly consider how Canadian governments need to clean up their act in regards to the health of Canadians, the Health Council of Canada will need to finish writing its report. It will need to look at that paragraph in the 2004 Health Care Accord that was cited above and determine if they have implemented this promise: "For the first time, governments will set goals and targets for improving the health status of Canadians through a collaborative process with experts. The Strategy will include efforts to address common risk factors, such as physical inactivity, and integrated disease strategies. First Ministers commit to working across sectors through initiatives such as Healthy Schools."