Public health has been defined as the art and science of promoting and protecting good health, preventing disease, disability and premature death, restoring good health when impaired by disease or injury, and maximizing quality of life. In literature, public health is portrayed mostly as a product of western civilization, while other world regions are considered recent adopters. To the extent that the west spawned the scientific and industrial revolution, on which basis many of today’s public health technologies have benefited, there is some justification for this view. This is reflected in formal histories of public health, which depict it as mostly deriving from Greco-Roman traditions. Such works are the product of enormous scholarship, but there is a need to broaden this perspective to recognize the contributions of other centers of early science and technology development. This editorial intends to recognize these multicultural foundations, so as to promote broader ownership of public health.
This comprehensive review article reflects the contemporary debate on the role of schools of public health in developing countries. Sixteen authors bring together multiregional perspectives on this issue from several countries, synthesizing a unified position on the need for SPHs as an imperative investment for low and middle income countries, so as to more effectively address the health of their populations.
Citation: Rabbani F, Shipton L, White F, Nuwayhid I, London L, Ghaffar A, Ha BT, Tomson G, Rimal R, Islam A, Takian A, Wong S, Zaidi S, Khan K, Karmaliani R, Abbasi IN, Abbas F. Schools of public health in low and middle income countries: an imperative investment for improving the health of populations? BMC Public Health (2016) 16:941 DOI 10.1186/s12889-016-3616-6.
Almost half a million British Columbians experienced some level of household food insecurity in 2011-2012, according to a new report from PROOF, a research group based at the University of Toronto.
Drawing on data from Statistic Canada’s Canadian Community Health Survey, the report finds over one in ten B.C. households struggling to put food on the table in 2011-12. Families with children under the age of 18 were at an even greater risk of food insecurity, with one in six B.C. children living in a food insecure household.
At its mildest level, food insecurity means worrying about feeding yourself and your family before your next pay cheque. As the problem gets worse, people can’t afford to have balanced meals. Then they begin to skip meals, cut portion sizes and eventually go days without eating, all because they can’t afford the food they need. Those impacted often face physical and emotional hardships which compromise their health. British Columbians living in food insecure households reported poorer health and were more than twice as likely to experience depression and anxiety disorders, compared to those in food secure households.
Those most at risk are low-income renters. People on social assistance in B.C. are particularly vulnerable, with 76 per cent reporting food insecurity. Yet, almost two-thirds of food insecure households are in the workforce – working but just not able to make ends meet. Dr. Valerie Tarasuk, a professor in Nutritional Sciences at the University of Toronto and the lead investigator of PROOF says “these findings point to the need for provincial government actions to ensure that all British Columbians are able to afford to the food they need.” While the introduction of the Canada Child Benefit will help families, Dr. Tarasuk says BC needs to evaluate the effects of this benefit and other provincial income assistance programs on food insecurity rates to make certain no one is left behind.
One of the most striking findings in this report is the difference in food insecurity rates across the province. Worst off is northern British Columbia, where almost one in six households were food insecure in 2011-12. The situation is especially dire for families with children in this region — one in four was food insecure. Also concerning is the high prevalence of food insecurity among families with children in the Island and Interior Health Authorities. In these regions, food insecurity affected one in five families.
Brent Mansfield, Director of the B.C. Food Systems Network, described the report as “an important first step for the province because it lays bare the extent of food insecurity in B.C. and pinpoints areas of particular vulnerability. We hope the next step will be policy action to lower these numbers.”
The report examined results for B.C. from Statistic Canada’s Canadian Community Health Surveys conducted between 2005 and 2012. B.C. was one of 3 provinces that chose not to measure food insecurity on this survey in 2013 and 2014, so more recent data on food insecurity will not be available for B.C. until the 2015 results come out later this year.
PROOF is a Canadian Institutes of Health Research (CIHR) funded research program initiated to identify effective policy interventions to address household food insecurity. The full report on food insecurity in British Columbia is available to download from PROOF’s website: www.proof.utoronto.ca.
The Health and Literacy Institute organized by the Centre for Literacy and Bow Valley College in Calgary in October 2008 brought together people from across Canada and the United States who were interested in examining how to design health literacy curricula for health care providers. BC participants who attended the sessions realized then that the province was ideally positioned to lead the way in Canada by bringing together people from different sectors to collaboratively develop a provincial health literacy strategy (Health Literacy Strategy).
Over the next few months, the group met to plan and convene the first BC Health Literacy Roundtable at Douglas College. On March 27, 2009, 34 individuals from a variety of organizations met to initiate discussion on the need for a Health Literacy Strategy for BC, identify existing strengths and actions and build on these as a foundation for the future, identify concrete steps to move the health literacy agenda forward, and seek consensus on next steps to maintain momentum and commitment.
The Roundtable participants agreed that a strategic process was an important stage that would precede the development of a strategic plan. There was also strong support for the concept of a ‘network of networks’ approach to map and connect the various activities taking place and the organizations involved in the area of health literacy, as part of a longer range coordinated knowledge exchange and integrated process.
It became clear that there was enough interest and energy to collaboratively design a Health Literacy Strategy for the province. Fourteen Roundtable participants volunteered to continue in a coordinating capacity to maintain the momentum achieved during the day’s discussion by articulating the strategy and bringing it back to the larger group for further discussion.
Since that time, the coordinating committee has continued to meet and work on developing a Health Literacy Strategy for BC, resulting in this draft strategic plan for improving health literacy in BC. Reviewing this draft will be the next step in the conversation that is planned for the 2nd BC Health Literacy Roundtable, to take place on June 11 2010 at Douglas College.
This document starts with a definition and articulation of the rationale for focusing on health literacy. The next section presents a vision, goals and structures for the strategy. The third section looks at the principles and values of the collaborative work of designing and implementing a Health Literacy Strategy. The fourth section explores issues related to monitoring and reporting.
Representatives from several organizations were involved in planning and coordinating the roundtable, including: Public Health Agency of Canada, Douglas College, Public Health Association of BC, Health and Learning Knowledge Centre of the Canadian Council on Learning, BC Academic Health Council, BC Ministry of Health Services, BC Mental Health and Addictions Services, and Providence Health Care