Ottawa signals new interest in population health
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* Barbara Sibbald

The federal government is going to boost population-health initiatives with new funding, Health Minister Allan Rock said during a speech at the CMA's 132nd annual meeting in August. Mean-while, the CMA General Council has approved a series of resolutions designed to strengthen the physician's place at the forefront of health promotion. In general, population health is a concept in which the emphasis is on the health of the entire population, not the health of an individual. The accent, therefore, is on health improvement via health promotion, not by the provision of acute or individual care. Many doctors disagree with the concept, since they treat patients - and their problems - individually. (Figure)

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/161/7/789.1/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/161/7/789.1/F1)

Figure. Allan Rock: new emphasis on population health

Rock told delegates that health promotion and disease prevention would be a priority from "this day forward."

"Sustaining our health care in the long term depends on our ability to improve the health of Canadians," Rock said. He said diabetes alone costs the system $9 billion a year - along with 25 000 deaths - and two-thirds of Canadians lead "dangerously inactive lives."

The minister also promised new money. "I am not talking about taking money from care and cure to spend it on prevention and promotion," he said. "I know only too well how badly those dollars are needed where they are. I do not regard this as an either-or proposition. I think we have to focus on both."

Meanwhile, Dr. Cynthia Forbes, chair of the CMA's Council on Health Care and Promotion, pointed out that physicians have "lagged behind in the population-health debate." The CMA addressed this through resolutions that called for collaboration with others to improve population health, promotion of the positive ways the health care system affects Canadian health, ensuring that public policies consider potential health consequences and promotion of medical and social interventions to ensure an optimal start to life for children.

Forbes said physicians are often antagonistic toward proponents of the population-health model, in part because of their concerns that it will undermine acute care. "[Population] health has become a highly politicized health rhetoric used as a shield to justify spending cuts," said Forbes.

She added that the public fails to appreciate and understand the services offered by physicians, such as smoking-cessation and hypertension-control programs. In addition, physicians are concerned that the evidence-based approach to care isn't being applied to population health.

## Acknowledgments

It took 132 years, but for the first time CMA members could watch goings-on at general council without being there - all they had to do was turn on their office computer. "It was part of an initiative to communicate to members across the country," explains CMA Secretary General Peter Vaughan, a strong proponent of using new technology to improve communications. Only about 250 delegates represent the CMA's 46 000 members at General Council. "We're trying to use technology to be open and transparent to everybody about what the association does," says Vaughan.

The Webcast at [www.cma.ca](http://www.cma.ca) covered the opening ceremonies, speeches by CMA President Hugh Scully and federal Health Minister Allan Rock, the debate over motions and much more. It ran for all 3 days of General Council from Aug. 23-25. The success of the Webcast is now being evaluated. "It was a good first step," says Vaughan.