Trevor Hancock: How we keep Canada healthy is a great story

CBC-TV is airing Keeping Canada Alive, a series full of the usual dramatic life-and-death stories of health care, as well as some segments about family practice and home care. But nothing about keeping people healthy in the first place, no stories about the great work public health and its allies do every day to keep Canadians out of the health-care system.

So here are my suggestions for Keeping Canada Healthy, a followup TV series that CBC should do. Public health might not be as gripping, but it is at least as important in reducing disease, injury, disability and premature death as anything the health-care system does.

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Episode 1: Yes, you can drink the water.

Most Canadians are fortunate in being able to turn on the tap and get safe drinking water. In this episode, we look at the workings of a municipal water-treatment plant and follow a public-health inspector as she tests the water quality in a small water-supply system.

We also visit a First Nations community under a boil-water advisory — one of 118 in Canada, 25 of which are in B.C. We learn about the problems faced by these communities, and what is being done to ensure they, too, have clean, safe water.

Episode 2: You can breathe the air, too.

Outdoor air pollution still kills and sickens thousands of people in Canada every year. We begin in Hamilton, Ont., where Clean Air Hamilton has been working since 1998, with considerable success. There we attend some of the events that are part of their annual Smart Commute Week.

But we spend 90 per cent of our time indoors, so mostly we breathe indoor air. One of public health’s great accomplishments has been making smoking socially unacceptable. So not only do we have marked reductions in tobacco-caused death and disease, we also have non-smoking areas everywhere.

We accompany one of B.C.’s tobacco-enforcement officers as they enforce the Tobacco Control Act in their communities, ensuring public spaces are smoke-free and tobacco is not sold to minors.

Episode 3: Smallpox, diphtheria, tetanus, polio — what are they?

Our great-grandparents knew and feared these diseases, but they are largely unknown today. In fact, smallpox was eradicated globally in 1980. The chief public health officer of Canada noted in his 2008 report that “in Ontario alone, 36,000 children died from diphtheria between 1880 and 1929,” while “at its peak in 1953, polio caused nearly 500 deaths in Canada” and left many others disabled.

The low levels of these and other infectious diseases today is due to a combination of public health actions — notably immunization — and broader social changes, such as improved living conditions and nutrition. But our lack of familiarity with these diseases means that today — mistakenly — some fear the vaccine more than the disease.

In this episode we follow a team of public-health nurses organizing an immunization campaign, accompany a hospital infection-control nurse in her work, and visit research labs where vaccines against such modern-day scourges as malaria and HIV are under development.

Episode 4: Safe food — mostly.

Historically, our food was often the source of infectious diseases, and while food safety is still a challenge, it is greatly improved. We accompany a public-health inspector as he inspects restaurants and other food establishments, visit a slaughterhouse to see how our meat is kept safe and accompany a team from the Canadian Food Inspection Agency and provincial and local staff as they work to identify and control an outbreak of salmonella.

Episode 5: Healthy food — not so much.

The chief public health officer also noted that “Canada’s first food guide was introduced in 1942 to reduce nutritional deficiencies resulting from wartime food rationing.” The nutritional quality of our diet remains a challenge, although these days poor nutrition is more likely due to over-eating, too much salt, fat and sugar, and too little fruit and vegetables.

In this episode we spend time with community nutritionists and other public health staff as they work to improve food security locally, visit a school that is removing junk food and pop and creating healthy meals, and drop by a community garden, where they are not only growing food but building community.

If not CBC, maybe B.C.’s Knowledge Network could take this on — it needs doing.

Dr. Trevor Hancock is a professor and senior scholar at the University of Victoria’s school of public health and social policy.

thancock@uvic.ca

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