Implications of health promotion for integrated health systems.

Summarizes key conclusions and recommendations found in the Centre for Health Promotion's position paper on the role of health promotion within integrated health systems. The original position paper was based on advice received from a working group of organizations and practitioners interested in health promotion. This group was established to formulate recommendations for the government of the Province of Ontario, which was in the process of reforming its system of health care delivery.

A prelude to health for all.

A seminal report produced in Canada during 1974 has helped to diminish the dominance of the medical model for health systems.

PIP: In an attempt to explain why some people were healthy and others were not, Canada's Minister of Health and Welfare, Marc Lalonde, in 1974, presented a document to his country's Parliament which came to be known as the Lalonde Report. Created with the goal of presenting a new perspective upon health and charting a path to separate health policy into manageable segments, the report was largely a response to the introduction of a prepaid health insurance scheme in Canada which required the federal government to pay for half of the costs of medical and hospital services. Costs and the corresponding public expenditures quickly increased amid evidence that the population's health status was not improving. It became clear that cancer, cardiovascular disease, respiratory illnesses, and accidents were not being prevented by a health system based upon the medical model. The final chapter of the Lalonde Report offered objectives, strategies, and 74 recommended courses of action for governments, nongovernmental organizations, and the general public. The report contains material which was revolutionary at the time it was published, but which is now widely accepted. Broad objectives proposed included reducing mental and physical health hazards for the segments of the population at high risk, and improving access to good mental and physical health care where necessary. Overall, Canadians were unsupportive of the changes to the health system implicit in the report.

Health communication research and health promotion.

This paper examines the relationship between health communication research and health promotion. In doing so, it identifies a number of research questions, priorities and capacity requirements pertaining to the intersection of the two fields. It concludes by suggesting that there is a great need in Canada to find support for the development of training and research programs in health communication research in general, and with an emphasis on health promotion in particular.

Disadvantaged women and smoking.

High rates of smoking are found among disadvantaged women, and there is a demand for cessation interventions specifically targeted to meet their needs. This project used a number of information sources to examine the factors associated with these women's smoking behaviours and the potential barriers and supports to cessation. Few of the women-centred cessation programs whose representatives were contacted were appropriate for, or available to, disadvantaged women in Canada. Interviews with 386 disadvantaged women revealed that their smoking was intimately linked with their life situation of poverty, isolation and caregiving; smoking was a mechanism for coping with the stress of their lives. Agencies outside traditional tobacco control organizations, such as women's centres, were well positioned to initiate or expand services that support smoking cessation for these women and were trusted by the women who used their services. The findings have implications for programs, research and policy.

Pediatric injuries: parental knowledge, attitudes and needs.

OBJECTIVE: To understand current parental knowledge, attitudes and information needs about childhood injuries. METHOD: Telephone survey of 1,516 parents in Metropolitan Toronto and Barrie. RESULTS: Over half of the parents knew that injuries were the leading cause of death and about 70% believed that injuries were the most preventable of major health disorders. However, most parents were not particularly concerned, and most had limited understanding of the major causes of injury. Traditional modes of receiving safety information by obtaining pamphlets from doctors' offices or drug stores and through media coverage were preferred. CONCLUSIONS: Although parents were aware of the risk of general childhood injury, they need to be educated about specific injury risks and effective countermeasures. A concerted and thoughtful effort is needed to market safety information for parents in Ontario.

Smoking among disadvantaged women: causes and cessation.

This study aimed to identify social-psychological factors associated with smoking and smoking cessation among disadvantaged women. Individual and group interviews were conducted with disadvantaged women in Atlantic Canada. Participants were predominantly poor, unemployed, geographically isolated, and single parents. The factors associated with smoking included coping with stresses, loneliness, powerlessness, low self-efficacy, social pressures, and addiction. Support from peers (i.e., women in similar circumstances) and partners was considered important. Health professionals and traditional cessation programs were not perceived as supportive. Participants viewed women's centres and women's agencies as appropriate deliverers of cessation programs. Methodological issues are discussed.

Development of a national health promotion survey: the Canadian experience.

This paper discusses the development of a national health promotion survey in Canada carried out in June 1985. It does so by describing the events leading up to and surrounding 15 milestones, the last one being the release of the results of the survey in February 1987. A number of lessons are drawn from the experience to date. They include the need to allocate enough time to plan the survey; the need to maintain continuity of staff; the benefits of forming an analysis team; the value of advisory groups; the value of adjusting sampling to political requirements; and the need for researchers and programme people to work together. It is expected that additional lessons will be learned as the process continues and as the survey is repeated in 1988.

A comparison of alcohol, tobacco and drug use as determined from household and school surveys.

Comparisons of results from different types of surveys are necessary to establish the best and cheapest methods of assessing drug use. This paper reports results from a school survey and a household survey conducted in Ontario. Both surveys were done in 1983 and used unbiased samples of the population in the same age groups. There are some methodological differences between the two studies. Younger students were more likely to report the use of tobacco, alcohol and cannabis in the student survey than in the household survey. Similarly, older students (18 and 19) reported more alcohol use in the student survey. In general, the results indicate that respondents are more likely to give socially desirable answers to questions answered at home than at school. Also, alcohol and drug users may be more likely to be missed in household than in school studies as the former have a much higher non-response rate.

Epidemiologic field units on narcotic-related problems.

Much more understanding is needed of the epidemiology of narcotic-related problems. This paper describes a research strategy which is responsive to the heterogeneous nature of such problems. It is suggested that it is feasible and useful to establish, for defined geographic areas, epidemiologic field units which would have continuity, be comprehensive and develop programmatically relevant information on a timely basis. The possible areas of inquiry and the components of such a unit are discussed.