As I mark my second anniversary as the Chief Public Health Officer of Canada, I am struck by the complex public health challenges we face. These deeply rooted issues involve interconnected social drivers that demand collaborative and comprehensive approaches. Harnessing our multiple perspectives and levers for change continues to be a critical requirement for lasting change.
The ongoing opioid crisis is one of these complex challenges. It continues to have devastating impacts on the lives of thousands of Canadians. Statistics Canada data confirm that overall life expectancy at birth did not increase from 2016 to 2017; this is a first for Canada in more than four decades and is largely attributable to the opioid crisis. Our response must balance a full range of harm reduction measures, treatment and care with broad prevention initiatives that target the underlying social causes of problematic substance use.
I chose Preventing Problematic Substance Use in Youth as the focus of my 2018 annual report with the aim of bringing prevention to the forefront. Implementing effective measures as early as possible to address risks such as childhood trauma, stress, poverty and inadequate housing, along with promoting positive, supportive environments that build resilience can collectively prevent problematic substance use. This is true for the prevention of opioid-related harms as well as for the prevention of problematic use of other substances, including alcohol and cannabis. The widespread social acceptance of alcohol in Canada has helped to hide the significant harms related to its problematic consumption, pointing to a need for new and comprehensive public health measures.
Since the release of my annual report, I have been working with my chief medical officer of health colleagues across the country to catalyze action to reduce the harms of youth vaping in Canada. While vaping is a less harmful alternative to smoking for adult smokers, we are seeing an alarming number of youth vaping highly addictive nicotine. As health professionals, we are in a unique position to educate young patients and their parents about the health risks associated with vaping.
This year, we have also witnessed a concerning resurgence of vaccine-preventable diseases such as measles. Vaccines are safe and highly effective and have saved millions of lives worldwide. Yet, in part because of that overwhelming success, some now fear the prevention more than the disease. These sentiments have been further fueled by disturbing trends in the spread of vaccine-related misinformation and disinformation online and through social media.
As a society, we must work to protect and sustain the health benefits of widespread immunization. Earlier this year, I released a Statement on the Current Measles Outbreak and Vaccine Hesitancy urging parents and guardians to seek out reliable and trusted sources of information on vaccines, and for health professionals to take the time to answer the questions of concerned parents and patients. I have also engaged directly with experts across multiple sectors to collaborate on reducing the spread of misinformation and disinformation. This included a roundtable discussion with participation from journalists, social media, and experts in parenting, vaccines, public policy and digital literacy. A number of the strategies we discussed focused on the importance of improving the digital and science literacy of Canadians to help them evaluate the reliability and credibility of vaccine information online.
Like vaccinations, antibiotics are a key public health innovation that has long protected and improved the health of Canadians.
Earlier this month, I released my second Spotlight Report, Handle With Care: Preserving Antibiotics Now and Into the Future. The report examines the factors that drive us to prescribe and use antibiotics unnecessarily, contributing to the problem of antibiotic resistance in the community setting. Given that 92% of antibiotics are prescribed in the community, we have an opportunity to implement a range of actions at the individual, organizational and societal levels to reduce unnecessary use of antibiotics and to help maintain the effectiveness of these life-saving drugs. If we don’t act now, we may face a future where infections such as gonorrhea and C. difficile become untreatable, and common procedures such as chemotherapy, hip replacements and caesarean sections are too risky to perform because of the risk of acquiring a life-threatening, untreatable infection.
For the third year of my term as Chief Public Health Officer of Canada, addressing stigma across health systems will be a key focus for my work. I have been listening to people with lived and living experience of stigma as well as system leaders. Hearing these diverse perspectives is important to enable us to better understand how we can improve our health systems to be more inclusive, safe and trauma-free. I also had the opportunity to welcome the United States Surgeon General to Canada. Together we spoke at the Canadian Public Health Association’s conference, drawing attention to the impacts of multiple and crosscutting stigmas such as racism, homophobia, transphobia, weight bias and mental illness stigma. Stigma is, in fact, a driver of morbidity and mortality at the population level.
In the face of these complex and serious public health challenges, I strongly believe that by working together we can better support all Canadians in achieving optimal health. In fact, it is only through this systems approach that we can create long-lasting positive change.
Dr. Theresa Tam
Chief Public Health Officer