Four Preventive Care Programs
Four issues have been chosen to show the scattered approaches to prevention outside the structures of the traditional health care system. In Chapter 17 the problems of horizontal and vertical coordination within the health service organizations will be considered. This material is presented to raise the issues of lack of coordination between different departments of the provincial governments and with non-governmental organizations in the preventive sector of health care.
Statistics Canada collects data about accident mortality rates which include suicides and homicides (Canada Statistics Catalogue, annual). These rates vary enormously between the provinces and, furthermore, considerable variation can be found from one year to the next. Fluctuations are particularly evident in provinces with small populations. These data may be used to justify the introduction of preventive programs (Canada 1990f). Accidents (including suicides and homicides) are the primary cause of death among young people above the perinatal age in Canada and the reason that many are impaired, disabled and handicapped. Consequently provincial governments are anxious to prevent accidents as much as they can.
A New Perspective on the Health of Canadians (Canada 1974a) identified health status risks as being related to lifestyle, environment and biological risk, but the health departments themselves can do little in these areas except to provide educational programs. Most of the preventive work is done by others who have a special interest in a particular area. Quite often this interest is related to the question "who pays for the results of accidents?" Insurance companies providing income support to the injured would prefer to reduce demands upon their funds.