Health Care: A Community Concern?

By Anne Crichton; Ann Robertson et al. | Go to book overview

CHAPTER 12

Evolution of Public Health
Departments

With the reduction in the significance of infectious diseases in Canada over the last twenty-five years, public health, like other sectors of the health care system, has been seeking to carve out new territory and a new role for itself within the overall context of the provision of community-based services. Several histories of the development of public health services in various jurisdictions in Canada exist (e.g., Lewis 1984). While a full exposition is beyond the scope of this chapter, a number of points are relevant to the present discussion.

In a very general way public health could be said to comprise those activities which are undertaken with collective responsibility for the protection of the health of the public, primarily through primary prevention measures. 1 Public health activities generally are directed toward particular population groups who are basically "well" but who could be considered to be "at risk" for health problems (well-baby programs and school immuni‐

____________________
1
Primary prevention refers to those activities which are believed to prevent the onset of disease, for example, immunization, prenatal education, well-baby clinics, etc. Secondary prevention refers to those activities which are believed to minimize the effects or slow the course of existing disease, for example, screening and monitoring programs, nutrition counselling for diabetes, etc. Tertiary prevention refers to those activities which are believed to promote recovery from a disease, for example, cardiac exercise programs, back pain programs, etc. Generally, primary prevention is the domain of public health; secondary and tertiary prevention services are sometimes provided by public health agencies, but may also be provided by other jurisdictions in the health care system, such as other primary care settings (doctors' offices and community health clinics), and outpatient clinics of hospitals.

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