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Public Health in Canada 2.0

Author(s): Wally J Bartfay, Emma Bartfay

Edition: 3

Copyright: 2021

Details: KHPContent | 180 days |

We invite you to partake on an exciting learning journey related to public health theory, practice, policy making and research in Canada and abroad that ranges from Alzheimer’s disease trends to the Zika virus pandemic (A-Z).  You will discover on your learning adventure that public health care professionals and workers provide essential health care services for the prevention, promotion and restoration of health for diverse populations across the lifespan; which include public health nurses, physicians, epidemiologists, health promoters and infection control specialists to name but a few. This comprehensive text has been written for upper level undergraduate and/or graduate students enrolled in public or community health science programs and professional programs (e.g., nursing, medicine, physiotherapy, kinesiology). This textbook consists of 14 chapters that were developed and designed based on the 36 core competencies deemed essential for all public health professionals and workers as outlined by the Public Health Agency of Canada (PHAC).  We provide readers with the essential knowledge base and theoretical foundations to engage in safe and cost-effective evidence-informed public health services and policy development across the lifespan.

KEY FEATURES FOR EACH CHAPTER INCLUDE:

  • Learning objectives and a list of specific PHAC core competencies addressed.
  • Web-based resources boxes integrated throughout the chapter.
  • Group activity-based learning boxes.
  • Research focus boxes to reinforce the importance of evidence-informed practice & decision making.
  • Challenges and future directions for each chapter are highlighted.
  • Group review exercise boxes.
  • Chapter summaries presented in bullet form to highlight key concepts.
  • Critical thinking questions to encourage discussions, debates and mastery of concepts.
  • Glossary of key terms.

PEDAGOGICAL FEATURES INCLUDE:

  • Illustrations and flowcharts.
  • Tables and graphs.
  • Coloured photographs and illustrations.
  • References for each chapter.
  • Instructors manual with course outline, chapter highlights and test bank for each chapter.
  • Lecture slides highlighting key concepts and terms for each chapter.

Preface
Special Features and Learning Resources
About the Authors

Chapter 1 Foundations and Essential Concepts for Public Health
Learning Objectives
Core Competencies Addressed in Chapter 1
Introduction
What is public health?
Th e Five Essential Pillars of Public Health
Essential Pillar (i): Evidence-informed public health 
Essential Pillar (ii): Health Promotion and Prevention 
Essential Pillar (iii): Primary Health care
Essential Pillar (iv): Th e 15 Social Determinants of Health
Essential Pillar (v): Holistic Care Paradigm
Th e “Ripple Eff ect” in Public Health
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 2 Understanding the Concept of “Health”: Its Evolution and Definitions
Learning Objectives
Core Competencies Addressed in Chapter 2
Introduction
A Brief History of Health 
Prehistory Times
Ancient Egypt
Persians
Traditional Chinese Medicine
Ancient India
Ancient Greece
Ancient Rome
The Middle Ages 
The Renaissance Period
Industrial Revolution Era
Public Health Activities in Canada: 1900–1950
The Emergence of Holistic Definitions of Health
1950s to Present 
The Lalonde Report, 1974
Alma-Ata Conference, 1978 
The Epp Report, 1986 
Ottawa Charter for Health Promotion, 1986 
The Jakarta Declaration (1997) 
Bangkok Charter for Health Promotion in a Globalized World (2005) 
Current developments in public health in Canada: 2000 and onwards 
Future Directions and Challenges
Summary
Critical Thinking Questions
References 

Chapter 3 “Medicare” in Canada: History and Current Challenges
Learning Objectives 
Core Competencies Addressed in Chapter 3
Introduction
Medicare
The Evolution of Health Services in Canada: A Brief History
Pioneer Nurses
The Grey Nuns 
Pioneer Surgeons and Physicians
Early Outbreaks and Epidemics
British North American Act (1867) 
The Emergence of the Medical Model of Health
The Flexner Report (1910) 
Medical Breakthroughs by Canadians 
Shift from Home and Community to Hospital-based Health Services
Redefining the Federal Governments Role in Health
Employment and Social Insurance Act (1935)
Marsh and Heagerty Report (1943) 
Saskatchewan’s Pioneering Health Care Reforms
National Health Grants Act (1948) 
Hospital Insurance and Diagnostic Services Act (1957)
Medical Care Act (1966)
Federal Health Care Funding Arrangements
The Canada Health Act (1982)
Federal and Provincial/territorial Responsibilities Under the CHA
Chaoulli et al. Versus the Attorney General of Québec
Divergent Interpretations of the CHA
What is “medically necessary”? 
Jake Epp’s Letter 
Diane Marleau’s Letter 
Penalties and Deductions 
Rising Health Care Costs
Future Directions and Challenges 
Summary
Critical Thinking Questions 
References

Chapter 4 Indigenous Health in Canada
Learning Objectives
Core Competencies Addressed in Chapter 4
Introduction
Historical Perspectives
Indigenous Status
First Nations/Indian
Inuit
Métis 
Aboriginal Languages
Jesuit Missionaries and Residential Schools
Treaties and Reserves
Indian Act and Bill C-31 
Social and Health Consequences of Colonization
Indigenous Perspectives of Health 
Delivery of Health Services
Cultural Safety and Public Health
Major Current Health Issues
Mental Health Issues, Injuries, and Drownings
Gasoline Sniffing
Health of Indigenous Families
Sexually Transmitted Infections
Cardiovascular Disease and Diabetes 
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 5 Essential Research Methods for the Practice of Public Health
Learning Objectives
Core Competencies Addressed in Chapter 5
Introduction
Basic and Applied Research
Evidence-informed Public Health and Research 
Systematic Reviews 
Meta-analysis
Meta-summaries and Meta-syntheses 
The Research Process in Public Health
Step I: Identification of a problem (Conceptualization phase) 
Step II: Review of the literature 
Step III: Formulate research questions or hypotheses 
Step IV: Design a study
Step V: Ethical approval 
Step VI: Collect data (Empirical phase) 
Step VII: Data analysis (Analytical phase) 
Step VIII: Determine strengths and limitations of the findings
Step IX: Dissemination and application of research findings 
Knowledge Utilization in Public Health
Future Directions and Challenges
Summary
Critical Thinking Question
References

Chapter 6 Epidemiology: Essential Concepts for Public Health
Learning Objectives
Core Competencies Addressed in Chapter 6
Introduction
Historical Developments in Epidemiology: A Brief Overview
Hippocrates of Cos (460–377 BC) 
John Graunt (1620–1674) 
Thomas Sydenham (1624–1689) 
James Lind (1716–1794) 
Edward Jenner (1749–1823) 
William Farr (1807–1883)
John Snow (1813–1858)
Ignaz Philipp Semmelweis (1818–1865) 
Twentieth-Century Developments in Epidemiology and Public Health
Doll and Hill’s Landmark Studies on Smoking and Lung Cancer 
Framingham Heart Study 
Current Developments in Epidemiology and Public Health
Health Surveillance
Basic Concepts in the Epidemiological Triangle
The Epidemiological Triangle of Communicable Disease 
Agent
Natural History of Disease 
Revised and Updated Epidemiological Triangle
Common Epidemiological Measures
Disease Frequency 
Measures of Association
Future Directions and Challenges
Summary
Critical Thinking Question
References

Chapter 7 Human Responses to Disease, Illness, and Sickness
Learning Objectives
Core Competencies Addressed in Chapter 7
Introduction
Nomenclature and Common Classifications of Disease
ICD-10
DSM-V 
What is Disease?
What is Illness and Stages of the Illness Experience?
Stage I 
Stage II 
Stage III 
Stage IV 
Stage V 
What is Sickness and the Sick Role?
The Five Disease Categories
What are Acute and Chronic Diseases?
What are Communicable and Noncommunicable Diseases?
Types of Immunity
Antigenicity
Acquired (Passive) Immunity 
Natural Immunity
Active Immunity
Herd Immunity 
Common Modes of Disease Transmission
Vertical and Horizontal Modes 
Airborne or Respiratory Mode of Transmission 
Fecal/Oral Mode of Transmission 
Waterborne Mode of Transmission
Community- and Hospital-Acquired Nosocomial Infections
Parasitic Mode
Vector-borne Mode
Zoonotic Mode
Health Surveillance
Active Surveillance 
Passive Surveillance
Reportable/Notifiable Disease Lists
Non-reportable/Notifiable Disease
Poisonings
Poisonous Plants 
Pesticide Poisoning
Food Safety and Poisonings
Injuries and Disabilities
Bioterrorism
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 8 Environmental and Occupation Health and Safety
Learning Objectives
Core Competencies Addressed in Chapter 8 
Introduction
What Is Global Warming and Climate Change
Greenhouse Effect 
International Framework and Protocols for Climate Change 
How Does Global Warming and Climate Change Affect Human Health?
Public Safety and Emergency Preparedness Legislation in Canada 
Emergency Management and Incident Management Systems 
Infectious Diseases
Ozone Depletion and UV Radiation
Air Quality and Pollution 
Sick-building Syndrome
Water Quality and Pollution 
What Is Toxicology?
Examples of Commonly Known Toxic Heavy Metals and Chemicals
Mercury 
Lead
Dichlorodiphenyltrichloroethane
Bisphenol A
Canadian Legislation to Preserve and Protect the Environment
Work Environments and Occupational Health and Safety
Bernardino Ramazzini (1633–1714)
Percival Pott (1714–1788) 
Alice Hamilton (1869-1970) 
Occupational Health and Safety in Canada
Work-related Stress 
Environmental and Occupational Risk Assessments for Public Health
Future Directions and Challenges
Summary
Critical Review Questions
References

Chapter 9 Global Health: A Primer
Learning Objectives
Core Competencies Addressed in Chapter 9
Introduction
What are the Millennium Development Goals?
What are the Sustainable Development Goals?
What is Globalization?
Common Global Burden of Disease Measures 
Disability-adjusted life year
Healthy life years (HeaLY) lost measure
Health-adjusted life expectancy measure 
Quality-adjusted life year 
Implications for Public Health 
What are Neglected Tropical Diseases (NTDs)?
Global Spread of Infections 
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 10 Program Planning and Evaluation in Public Health 
Learning Objectives
Core Competencies Addressed in Chapter 10
Introduction
Accessing and Developing Web-based Health Programs and Sites
What is Program Planning?
Strategic or Allocative Planning
Operational or Activity Planning
What is Program Evaluation?
What are the Types of Program Evaluations Conducted? 
What is the Program Planning and Evaluation Process? 
Step I 
Step II
Step III
Step IV
Step V 
Step VI
Step VII
Step VIII
What are Program Logic Models? 
What is Health Services Research?
What is Outcomes Research?
Ethical Considerations for Public Health Professionals and Workers
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 11  Current and Emerging Mental Health Issues in Canada
Learning Objectives
Core Competencies Addressed in Chapter
Introduction
What is mental health?
Mental Health Commission of Canada
School-based Mental Health Promotion
Mental Health First Aid Training in Canada
Major Theories Related to the Origins of Mental Illness and Disorders

  1. Supernatural theory
  2. Psychogenic theories
  3. Somatogenic theories

What is Stress?
      General Adapation Syndrome Model
      Physiological Responses to Stressors

  1. Nervous system
  2. Endocrine system
  3. Immune system

Personality-types and Stress
Coping and Managing Stressors
            Positive coping and stress management techniques
            Negative coping and stress management techniques
                        Public Health Caution Related to Natural Health Products and Stress          
Major Mental Illnesses
Anxiety Disorders
Generalized Anxiety Disorder (GAD)
Obsessive Compulsive Disorder (OCD)
Post-Traumatic Stress Disorder (PTSD)
Panic Disorders
Phobias
Mood Disorders, Depression and Suicide
            Depression
            Bipolar disorder
            Seasonal affective disorder
            Suicide: A Canadian contex
Schizophenia
Major Eating Disorders
            Anorexia nervosa
            Bulimia nervosa
            Bing-Eating Disorder (BED)
Public Health Challenges Related to Eating Disorders
Future Directions and Challenges
Summary
Criticial Thinking Questions
References

Chapter 12
Learning Objectives
Core Competencies Addressed in Chapter
Introduction
A Brief Overview of the Human Brain and Nervous System
Traumatic Brain Injuries and Concussions
                  Glasgow Coma Scale
                  TBI’s: A growing public health concern
                  Helmets for the prevention of TBIs and concussions example
Parkinson’s Disease
                  Prevalence of Parkinson’s Disease
                  Impact of Parkinson’s Disease and Implications for Public Health
Multiple Sclerosis
Amyotrophic Lateral Sclerosis
Myasthemia Gravis
Huntington’s Disease
Dementia and Alzheimer’s Disease
Direct and Indirect Health Care Costs Associated with Dementia
Future Directions and Challenges
Summary
Criticial Thinking Questions
References

Chapter 13  Major Emerging and Re-emerging Infectious Diseases: A Canadian Perspective
Learning Objectives
Core Competencies Addressed in Chapter
Introduction
What are Infectious Diseases?
What is the Chain of Infection?
A Brief Overview of the Human Immune System
What are Emerging and Re-emerging Infectious Diseases?
Global Surveillance and Risk Assessments of EIDs and REIDs
Examing Major Emerging and Re-emerging Infectious Diseases from a Canadian Context
                  Asian Influenza (Avian Flu or Bird Flu)
                  Blastomycosis (Gilchrists disease)
                  Chikungunya
                  Ebola Virus Disease (EVD)
                  Lyme Disease (Lyme Borreliosis)
                  Sudden Acute Respiratory Syndrome (SARS)
                  West Nile Virus (WNV)
                  Zika Virus Infections
Future Directions and Challenges
Summary
Critical Thinking Questions
References

Chapter 14  Major Noncommunicable Diseases: Current and Future Challenges
Learning Objectives
Core Competencies Addressed in Chapter
Introduction
Prevention of Noncommunicable Diseases in the 21st Century: Four Targeted Behavioural Risk Factors

  1. Tobacco Use and Smoking
  2. Physical Inactivity and Sedentary Lifestyles
  3. Unhealthy Diet
  4. Harmful Use of Alcohol

Premature Mortality and HALE Trends in Canada
Chronic Disease Multi-morbidity in Canadians
Major NCDs: A Canadian Perspective
i. Cancer
Is there a relationship between sugar consumption and cancer?
Palliative, End-of-life Care (EOLC) and Community-based Hospice Services
ii. Cardiovascular Disease
Ischemic Heart Disease
Hypertension
Stroke
iii. Chronic Respiratory Diseases
Asthma
Chronic Objective Pulmonary Diseaes (COPD)    
iv. Diabetes (DM)
Insulin Metabolism
Prevalence of DM
Prediabetes
Impaired glucose tolerance and impaired fasting glycaemia
Type 1 DM
Type 2 DM
Gestational diabetes 
Importance of Influenza Vaccinations for Clients with CRDs and CVD
Future Directions and Challenge
Summary
Critical Thinking Questions
References

 

Appendix A: 36 Core Competencies (Public Health Agency of Canada)

Glossary of Key Terms

Wally J Bartfay

Dr. Wally Bartfay is currently Associate Dean Undergraduate Studies and Director of the Bachelor of Allied Health Sciences and Bachelor of Health Sciences Programs at Ontario Tech University (formerly University of Ontario Institute of Technology) in Oshawa, Ontario, Canada. Dr. Bartfay has held various administrative and research positions in nursing and the health sciences including Director of Cardiac Iron-overload Research Group (CIORG) at Queen’s University in Kingston, Ontario, and Nursing Research Director at the University of Windsor. He was also the first Director of the Graduate Health Sciences Program at Ontario Tech University.

Dr. Wally Bartfay’s career in nursing spans more than 35 years, and he has practiced and taught nursing in four provinces in Canada in a variety of settings including community health, mental health, medical-surgical nursing, and adult critical care and trauma services. Dr. Bartfay has taught nursing and health sciences in several institutions across Canada including Red River Community College in Winnipeg, Manitoba, Western in London, Ontario, Queen’s University in Kingston. Dr. Bartfay began his career in the health sciences by fi rst receiving his Diploma in Nursing Sciences from Dawson College (CEGEP) in Montreal, Quebec. He subsequently obtained his Bachelor of Arts (BA) degree in health sociology from McGill University, and his Bachelor of Science degree in nursing (BScN) from Brandon University. He obtained his Master’s of Nursing (MN) from the University of Manitoba with a specialization in community health nursing, and his Doctorate (PhD) from the Institute of Medical Sciences at the University of Toronto.

Dr. Bartfay is the recipient of several research grants as primary investigator and co-investigator including grants from the Anemia Institute of Research and Education, Canadian Institute of Health Research (CIHR), Canadian Council of Cardiovascular Nurses, American Health Assistance Foundation, J. B. Bickell Foundation, and the Garfi eld Kelly Cardiovascular Research and Development Fund. He has over 150 publications including several peer-reviewed articles, conference proceedings, monographs and chapters in books. He is coauthor of the books Public Health in Canada (2014, Pearson) and Community Health Nursing: Caring in Action (2010, Nelson). Dr. Bartfay’s work has appeared in national newspapers and other media and he serves as a reviewer for several nursing and other scientific journals.

Dr. Bartfay is the recipient of various teaching awards including the University of Windsor Male Teacher of the Year Award (2005); Faculty of Health Sciences Teaching Award, Queen’s University (2003), and the Reddick Award for Excellence in Nursing Education, Queen’s Nursing Society (2002). In addition, he is the recipient of various civil awards including Air Transit Act of Humanitarian Kindness Recognition Accolade for emergency medical assistance (2016); Air Canada’s Honorary Flight Nurse Award for Humanitarian Emergency Services (1989), and the Meritorious Award for Emergency Humanitarian Service (1989). He was also named to the Most Venerable Order of the Hospital of St. John of Jerusalem, Priory of Canada. Dr. Bartfay’s current research includes noncommunicable disease management, population and public health, and e-health platforms and technologies.

Emma Bartfay

Dr. Emma Bartfay is Professor of Epidemiology in the Faculty of Health Sciences at Ontario Tech University. After completing her doctoral degree at Western University in London, Ontario, she began her career as a research scientist at the Queen’s Cancer Research Institute in Kingston, Ontario, before joining academia in 2005 at Ontario Tech University. Since then, she has developed and taught a variety of undergraduate and graduate courses in epidemiology, global health and communicable diseases, where she is passionate about global health issues such as neglected tropical diseases and environmental health. In 2013, Dr. Emma Bartfay was nominated by the Faculty of Health Sciences for the Ontario Tech University Award for Excellence in Teaching, and was named the “most influential professor” by student alumni. In 2019, Dr. Bartfay was nominated for a second time and has subsequently won the Ontario Tech University Award for Excellence in Teaching.

Dr. Emma Bartfay also has a productive research career, where she received numerous research grants and awards. Most notably, she received the prestigious Ontario Ministry of Health and Long-term Care Career Scientist Award in health services research through the Health Research Personnel Development Program Open Competition. Additionally, Dr. Bartfay has obtained many Tri-Council and major national peer-reviewed research grants from agencies such as CIHR, NSERC, SSHRC, the National Cancer Institute of Canada (NCIC), the Canadian Heath Services Research Foundation (CHSRF), the J. P. Bickell Foundation, the Clare Nelson Bequest Fund and various internal grants to support her research.

To-date, Dr. Emma Bartfay has accumulated over 100 scholarly products, which includes high-impact international peer-reviewed journal publications, conference proceedings, book chapters, books and monographs. She is the co-author of the textbook Public Health in Canada (2014, Pearson). Dr. Bartfay’s work has appeared in national newspapers and other media, including featured interviews by the Elderbranch (US) and by Saint Elizabeth Health Care (Canada) in relation to her work in dementia care. A series of her work in dementia diagnosis was published in such international journals as the International Journal of Geriatric Psychiatry, Geriatric and Gerontology International and Public Health. Her work has also been selected as the Editor’s choice and was cited in the World Alzheimer’s Report.

Dr. Emma Bartfay is an active contributor both in academia and in the wider community. She has been invited and served as a guest editor for an international journal in public health, a session chair and member of the technical program committee for a global health conference, as well as to sit on journal editorial boards and grant review panel of funding agencies. Dr. Bartfay also made significant contributions in the community. In the past, she has served on the Protocol Review Committee at the Windsor Regional Cancer Centre, the Scientific Advisory Committee at the Centre for Environmental Health of Ontario, the Kingston, Frontenac, Lennox and Addington Palliative Care Integration Project Evaluation Committee. Most recently, she served on the Steering Committee for the Age-Friendly Durham, a regional initiative funded by the Ontario Seniors’ Secretariat. Based on the WHO framework of age-friendly community, the committee developed an action plan to meet the needs of the residents and to address the challenges of the aging population, which was later unanimously endorsed by the regional council. Upon its conclusion, the Age-Friendly Durham steering committee has evolved into the Durham Council on Aging where Dr. Bartfay continues to serve in the same capacity.

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