Canadian journal of public health = Revue canadienne de santé publique
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Five cycles of data from the Canadian National Longitudinal Survey of Children and Youth (1994/5-2002/3) were used to examine patterns of child care use in Quebec and the rest of Canada to explore the impact of Quebec's implementation of universal child care. ⋯ Findings suggest that since the introduction of Quebec's universal child care program, there was an increase in the use of regulated child care for families of preschool-aged children in the province, although by 2002 Quebec had not achieved the coverage of universal child care programs attained by many European countries.
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Can J Public Health · Jul 2008
Civil society? What deliberative democrats can tell advocates about how to build public commitment to the health promotion agenda.
Closing the health inequity gap can be seen as an issue of justice, however what concretely best serves the interest of justice is in dispute. It is argued that standard policy-making mechanisms are inadequate to address this issue, and therefore more and better public dialogue is required. Drawing on deliberative democratic theory and practice, three public organizing considerations are offered: organizing within the state sphere, organizing within the public sphere, and using cross strategies. It is recommended that public resources be provided to involve the public in deliberations about population health promotion issues related to the wicked problem of health inequities.
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Food insecurity, which has been recognized as an important determinant of health, is estimated to have affected almost one in ten Canadian households in 2004. Analyses of indicators of household food insecurity on several recent population health surveys have shed light on markers of vulnerability and the public health implications of this problem. ⋯ This requires the consistent administration of a well-validated measure of food security on a population survey that routinely collects detailed information on the economic circumstances of households. Health professionals can contribute to the amelioration of problems of food insecurity in Canada by advocating for improved monitoring of the problem at a population level.
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Can J Public Health · May 2008
Non-medical use of prescription opioids and public health in Canada: an urgent call for research and interventions development.
While the public health problem of psychoactive drug use is well recognized, the emerging phenomenon of non-medical use of prescription opioids has been largely ignored in Canada. Most evidence on this issue and related harms in North America to date come from the United States (US), where the prevalence of non-medical opioid use in key populations, as well as related morbidity and mortality, recently have risen substantially. ⋯ However, a comprehensive assessment of the problem of non-medical prescription opioid use is hindered by the spotty--or absent--nature of crucial indicators and data. We urge that the necessary efforts and resources for systematic assessment of the evolving phenomenon of non-medical opioid use and its key facets be established in Canada, and that policy-makers implement sensible intervention strategies targeting this problem within a public health framework, specifically avoiding unintended negative consequences (e.g., undermining access to pain treatment).
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Can J Public Health · May 2008
What's public? What's private? Policy trade-offs and the debate over mandatory annual influenza vaccination for health care workers.
Policy decisions about public health services differ from those for personal health services. Both require trade-offs between such policy goals as liberty, security, efficiency, and equity. In public health, however, decisions about who will approve, pay for, and deliver services are often accompanied by decisions on when and how to compel individual behaviour. ⋯ Proponents assert less worker absenteeism (efficiency) while opponents stress coercion and alternate personal infection control measures (liberty and individual rights/responsibilities). Consequently, stakeholders talk past each other. Determining the place of mandatory influenza vaccination for health care workers thus demands reconciling policy trade-offs and clarifying the underlying disputes hidden in the language of the policy debate.