Academic journal article Public Health Reviews; Rennes

New Era for Schools and Programs of Public Health in Canada

Academic journal article Public Health Reviews; Rennes

New Era for Schools and Programs of Public Health in Canada

Article excerpt

INTRODUCTION

From about five programs in the 1990's, there will be in September 2011, 15 Canadian universities offering MPH or MPH-type degrees in public health and as many as 500 new graduates who receive their master's degree annually. Ten years ago, there were no schools of public health, and now there are seven developed or rapidly emerging, although thus far only one is in the process of being accredited by an independent, internationally recognized body. Most universities are exclusively targeting graduate level training, including e-learning and continuous professional development, as an integral part of their curriculum, but there are at least three that offer undergraduate programs.

The involvement of more than 20 different academic institutions has resulted in a strong interest to create a network of programs and schools of public health in Canada. Initial priorities of this new network will be to improve the quality of the programs including development and refinement of core competencies, facilitate communication and collaboration between the members and, finally, promote public health training, research and capacity building activities. Greater collaboration may also lead to higher standards, reduced duplication and greater efficiency of efforts. To date, no clear quantitative ascertainment of our public health workforce's needs has been done.

CHANGING CONTEXT FOR PUBLIC HEALTH TRAINING IN CANADA

Up until the early 1970's, only two schools of public health (SPHs), or hygiene as they were called then, existed in Canada: one at the University of Toronto (1927-1975) and the other at the University of Montréal (1945- 1975).1-3 They were both closed thereafter for different reasons and integrated within their respective faculty of medicine. There were also limited options for graduate training in public health. In the mid 1970s, the specialty of Community Medicine was recognized by the Royal College of Physicians but some of the new trainees had to pursue their academic training in the basic public health sciences in other centres such as in the United States or overseas.

The 1974 Lalonde Report (New Perspective on the Health of Canadians), and the 1986 Ottawa Charter for Health Promotion were landmark documents emphasizing the importance of the broad determinants of health, including medical services, and the necessity to go beyond the previously dominant biomedical focus.4,5 The vision of a 'new public health', more socially and politically oriented, was coming forward.6 This later orientation was recently reinforced in 2008 by the WHO Report on the Social Determinants of Health led by Sir Michael Marmot and a team of commissioners from around the globe, including Canada.7

Early in the 21st century, Canada experienced some significant public health emergencies, first with the E. coli epidemic in Walkerton, Ontario, in May 2000, and then the Cryptosporidium contamination in North Battleford, Saskatchewan, during the spring of 2001, showing deficiencies in the safety of drinking water and the lack of protective measures in place for the population.8,9 Following the 9/11 tragedy in 2001 and the anthrax crisis that followed in the US, Canadian public health authorities had to reconsider our own capacity to address similar events, recognizing the scarcity of emergency preparedness capacity in place. But more was to come. In 2003, an international outbreak of Severe Acute Respiratory Syndrome (SARS) arrived in Toronto, the largest city in the country, demonstrating directly to the population, public health authorities and political leaders the vulnerability of our health system.10 The social and economic costs were tremendous, but the impact was even greater on the confidence people had in Canada's public health systems, which were unprepared and incapable of facing such an event.11

After the SARS episode, different inquiries took place identifying in particular the lack of capacity in the public health system, the need for better communication and coordination of services, and the need for training on a large scale (graduate training and continuing education of professionals) to fill the identified gaps. …

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