December 13, 2021 | Ottawa, ON | Public Health Agency of Canada
Today, my annual report on the state of public health in Canada, entitled 'A Vision to Transform Canada's Public Health System', was tabled in Parliament by the Honourable Jean-Yves Duclos, Minister of Health. The report is an appeal to strengthen our public health system in Canada, in order to ensure we are better equipped against present and future health threats.
COVID-19 has greatly tested public health systems in Canada and around the world. From the onset of the pandemic, Canada's public health system was thrust into the spotlight, as the first line of defense against the SARS-CoV-2 virus. As the pandemic has continued to unfold, we have witnessed our public health system rapidly adapt to meet the challenge of protecting the health of Canadians. It has risen to the occasion - but at a serious cost: our public health system is stretched dangerously thin and it is in need of critical reinforcements.
The pandemic has served as an important wake-up call on the need for public health renewal in Canada. And while fighting the pandemic remains Canada's top priority, other complex public health challenges require urgent attention. These include the health impacts of climate change, the opioid overdose crisis, antimicrobial resistance, and worsening mental health amongst Canadians.
Throughout the consultation sessions I held to inform the development of this report, I often heard that the broad role of public health was not fully understood by those outside of the public health sector. In public health, the population is the patient. Public health's mission is to prevent injury and illness, promote healthy behaviours, and to ensure that ALL people have an equal opportunity to stay healthy and well. Public health is the outbreak that did not happen, the traumatic injury that did not occur, and the opioid overdose that was avoided.
An effective health system is about more than treating illness through medicines and hospital procedures - it means preventing these illnesses from happening in the first place. The public health and healthcare systems complement each other: by keeping people healthy, our public health system reduces the burden on our healthcare system and contributes to its sustainability. We must change the way we think about and value health in our country, so that we come to value prevention and wellness the way we value medical treatments and care.
In my 2020 annual report From Risk to Resilience: An Equity Approach to COVID-19, I described how people in Canada were not on an equal footing when the pandemic took hold. Broader inequities in our society have resulted in disproportional impacts of COVID-19 on the health of some populations in Canada. The same people who were affected most severely by COVID-19 will also be those harder hit by other health crises.
We must take action to ensure that everyone in Canada is equally protected and able to achieve their optimal health moving forward.
In my report, I describe four priority areas of action, intended to stimulate public health system transformation:
- Strengthening our public health workforce: The pandemic has taken a toll on public health workers, who have been working day and night for nearly two years, with frequent reports of burnout. At the same time, it has also sparked increased interest in the field of public health. We must further this progress and work to recruit, retain and build the next generation of public health professionals, with a highly skilled, diverse and inclusive workforce that best reflects the communities it serves. Surge capacity is also required to rapidly expand the workforce in times of emergency.
- Improving our public health tools: Our pandemic response was hindered in part, by significant gaps in our public health surveillance and data systems - including a lack of data on race and ethnicity, a lack of comparable data between provinces and territories and information gaps at the local level.
- Working across federal, provincial and territorial governments, the Pan-Canadian Health Data Strategy aims to address these gaps in a secure and ethical manner. Its timelines must be accelerated to ensure that public health has the right data at the right time for effective decision-making. We must also strengthen a "made-in-Canada" research agenda, in order to identify which public health interventions and models are most effective to improve the health of populations and reduce health inequalities.
- Modernizing our models of governance and collaboration structures: The pandemic has demonstrated unequivocally that we cannot work in siloes, and that complex public health challenges require a "whole of society" approach, working together across jurisdictions, sectors, industries, communities and borders. We must ensure that these efforts are better supported, with collective action based on clear and measurable indicators, to understand if we are meeting our goals of achieving better health for all.
- First Nations, Inuit and Métis communities must also be supported in developing their own public health priorities, plans, and solutions.
- Ensuring stable and consistent funding to match the mandate of public health: As we have seen in the past, public health resources are often scaled back after public health emergencies as governments move to address other priorities. This is referred to as the "boom and bust" cycle of public health spending. This places the public health system at a disadvantage at the onset of each crisis by not having the capacity or the networks required for a rapid response.
- Moving forward, public health needs sustained investments at all levels of government. Pan-Canadian objectives and priorities should be established across federal, provincial and territorial governments, and federal funding could be used to support these priorities with an annual report card back to Canadians on our progress.
While the COVID-19 pandemic is not yet over, this is a time for forward thinking. My hope is that the recommendations outlined in my report spark a much-needed national dialogue and catalyze collective action on public health renewal.
We have witnessed remarkable achievements throughout the pandemic, including the largest mass vaccination campaign in Canadian history, which mobilized many sectors and individuals across the country, examples of Indigenous community ownership of the pandemic response, and innovative local efforts to help community members in need. This is just a glimpse of what is possible when we all work together.
The public's health is a responsibility that we all share. To fully realize a world-class public health system, we must all be invested.
By joining forces across communities, governments, sectors, and internationally, we can build a public health system that best serves us all, and supports a healthy and thriving society.
It is in working together, that we can make sure we get it right.
