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The state of public health in Canada.

The Public Health Agency of Canada recently released the “Report on the State of Public Health in Canada 2008”, the first in a series of annual reports from the Chief Public Health Officer which will address the country’s pressing public health challenges. This report is a must read for everyone who has an interest in the health and well-being of Canadians. Although it does not break new ground and most public health professionals should not learn much that they did not already know, the report does a superb job as an introduction to public health in Canada today (http://www.phac-aspc.gc.ca/publicat/ 2008/cpho-aspc/pdf/cpho-report-eng.pdf). It was obviously written with a much wider audience and a broader and longterm perspective in mind. At less than 100 pages, it is concise enough and written in a very accessible style to be of interest to a general readership not familiar with public health. In particular, health professionals, decisionand policy-makers, NGOs, the media, the general public and elected officials should benefit from a careful study of the report. It defines public health in Canada, provides a brief history of its role in our country and describes major health indicators in comparison with other countries. Chapters 4 and 5 are probably the most important and describe with numerous examples and data the importance of social and economic factors and the challenges of health inequalities. The final chapter is a call to arms for all Canadians to work towards a healthier society through population-level efforts to reduce inequalities and create social, economic and environmental conditions which will support communities and individuals to make healthy choices and reduce hazards. With over 400 references, clear logic and a good underlying conceptual framework, the report provides a rigorous approach to the documentation of health and social problems and it is authoritative in its discussion of potential solutions. It identifies several areas of needed research, illustrates succinctly key successes in policy and intervention and suggests general directions for policy, including: investments in families and children living in poverty; early child development programs; community capacity development; inter-sectoral actions; building the knowledge infrastructure – particularly to increase our understanding of subpopulations; and overall public health leadership. This report is a stepping stone. Not only does it provide a reference for future CPHO reports, it also defines a coherent vision and illustrates the core public health values which will be the basis for PHAC’s leadership in public health in Canada for the years to come. All of us now need to disseminate this report to the widest possible audience. For one, it will now become required reading in my public health course for medical students at McGill.