(An item from the ISHN Member information service) In 2004, Canada's federal government and all provinces & territories agreed to an accord that would reform the health system in Canada. Billions of dollars for health funding, primarily for health care, were committed by the federal government as a strategy to buy long lasting change and reform the system. A small part of that accord included some promises on health promotion, primarily with regard to immunization, coordinated responses to outbreaks of infectious diseases and the creation of a Public Health Agency of Canada. As well, first Ministers agreed that "  In addition, governments commit to accelerate work on a pan-Canadian Public Health Strategy. 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." (The Accord was signed as Canadian governments also agreed to establish and intergovernmental consortium on school health promotion.)
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.    

(An item from ISHN Member information service) An article in Issue #4, 2012 of Critical Public Health opens the door to a discussion of how public health systems need to divest themselves of terms, practices, structures and underlying assumptions imported from the health care system. The authiors note that "Public Health specialists have increasingly deployed the concept of ‘dose–response’ in areas such as diet (‘five-a-day’), alcohol (‘21 weekly units’) and physical activity (‘150 minutes of weekly activity’). Using these examples and a case study that sought to establish an optimal dose of physical activity for mental health gain, this article offers a critical assessment of the nature, robustness and function of ‘dose’ in public health. Drawing on a ‘sociology of knowledge’, the article argues that dose–response can best be considered an analogy that does not necessarily translate favourably from its original expression in toxicology to some public health domains – an over-extended analogy. Rather than having technical robustness, its attractiveness and utility is seen to lie in it possessing ‘cultural capital’ (ie sounding medical). Here, the ability to link behavioural concerns to clinical practice, to simplify complex ideas and to act as a regulatory form of behavioural governance. The article is skeptical of further empirical pursuits in identifying optimal doses and offers an alternative course for public health framing. Read more..