April 18, 2005 – “Producing health is possible. Do we want to do it? “
This is the fundamental question posed by the very first National report on the state of health of the population of Quebec1, presented a few days ago by the national director of public health, Dr Alain Poirier.
A positive health check, but …
In the first pages of its document which contains more than a hundred, the National Institute of Public Health of Quebec (INSPQ) recalls that the general health of Quebecers has improved considerably over the past decades. For example, infectious diseases are no longer the main threat to health, as they once were.
However, other “great evils” have appeared in Quebec: accidents (on the road, at home, during sports activities), developmental and social adaptation problems among young people, violence, mental disorders and others. suicide are now part of the equation to be solved.
The extent of chronic diseases, such as cancer, cardiovascular disorders, respiratory disease and diabetes, is also a major public health problem. These four chronic diseases alone are responsible for more than 70% of deaths in Quebec.
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Chronic diseases: an important issue Over the past 50 years in Quebec, the number of deaths attributable to cardiovascular disorders has declined, while that associated with cancer has steadily increased. As for diabetes, it affects 56% more adults today than in 1987. In addition, more than 14% of the Quebec population is now considered to be obese. |
Modifiable lifestyle habits
If certain determinants such as heredity, age and sex are essential in the appearance of chronic diseases, the majority of these result from modifiable lifestyle habits. “We know that inadequate diet, sedentary lifestyle (…), smoking (and) excessive alcohol consumption are involved in deaths linked to chronic diseases in proportions of up to 80%”, underlines the report. of the INSPQ.
However, the means to prevent these major health problems are found outside the health system, insists the INSPQ. One-dimensional solutions to health problems are no longer enough. From now on, they should also be based on the economic, physical and social environments.
Focus on the environment, not just the individual
According to the authors of the report, in prevention, educational interventions “although essential, are not sufficient”. Estimating that 40% to 60% of adults have more than one modifiable factor in chronic disease, their strategy is to “target the environment of individuals” so that it is easier for them to make healthy choices. and maintain them.
Three main areas of prevention are specifically favored: the fight against smoking, the consumption of at least five fruits and vegetables per day, and the integration of physical activity into leisure or daily travel.
The proposed global approach also requires local, regional and provincial actors to work in partnership. Both government departments and agencies as well as municipalities, schools, workplaces, community organizations and the private sector have a role to play in this regard.
How to create this partnership? In his introductory remarks to the INSPQ report, the Minister of Health and Social Services, Dr Philippe Couillard, proposes that from now on health be seen “as a shared responsibility between people, communities and society as a whole”.
Martin LaSalle – PasseportSanté.net
1. National report on the state of health of the population of Quebec: producing health, National Institute of Public Health, Ministry of Health and Social Services, April 2005. To access the report: http: //msssa4.msss .gouv.qc.ca [site consulté le 15 avril 2005].
