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It is commonly understood that our health care system is struggling when it comes to the integration of health innovations. It is often claimed that we should seek to increase its so-called “receptor capacity.” Framing the issue in these terms is not only misleading, but it’s also illogical: How can one ask a tiny river like the one I used to swim in as a kid —la rivière à Simon— to redirect properly the whole Niagara Falls?
A report recently released by the Health Council of Canada declares that unless governments change their approach to addressing the needs of poorer and socially disadvantaged Canadians, we are destined to continue to paying handsomely for the consequent demands on our health care system.
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Jusqu’au 19e siècle, les chercheurs étaient souvent confinés dans les profondeurs de leur laboratoire. L’émergence des sociétés scientifiques et des revues savantes, puis l’augmentation du nombre d’étudiants universitaires et de l’intérêt des citoyens pour la Science, ainsi que la médiatisation des effets environnementaux des biotechnologies ont radicalement changé l’impact social du travail des chercheurs.
Are you living in a healthy city? If it is easy to transit from a point to another one without taking your car and if you have access to infrastructures where you can practice physical activities, you might live in such a city. What is a healthy city? Why this issue is so important? What can we do to make our environment favourable to good living habits?
In the mid 1980s, the World Health Organization (WHO) initiated the Healthy Cities Project. The main objective of this project is to engage local governments and communities in developing and planning urban policies where health is considered. According to Evelyne de Leeuw, from Deakin University in Australia, it is important to address the social determinants of health to make people healthier. In this interview she explains why this issue is important and what do we mean by healthy city.
À l’échelle de la planète, les villes continuent à se développer rapidement ; aujourd’hui, c’est plus de la moitié de la population mondiale qui y habite. Toutefois, si cet essor est souvent commenté, on insiste moins sur un autre aspect tout aussi important : les enfants comptent désormais pour le tiers des habitants des villes (Satterthwaite et Bartlett 2002). Ils représentent en effet une partie importante de la population urbaine. Or, que ce soit dans les pays prospères ou ailleurs, l’aménagement urbain s’adresse généralement aux adultes et, plus particulièrement, aux adultes motorisés.
Entre l’aménagement de voies réservées au transport en commun et la création de quartiers multifonctionnels, plusieurs mesures peuvent être prises pour améliorer la santé des citadins. La conseillère en urbanisme, Sophie Paquin, nous explique ce qu’est un environnement favorable à la santé et pourquoi il est intéressant d’agir selon une approche basée sur l’environnement plutôt que sur les comportements. Elle nous donne aussi quelques exemples de ce qui peut être fait pour encourager la pratique d’activité physique.
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This time, Hinnovic turns its attention to a “social” technology that is increasingly being used to address medical innovations and, more generally, issues surrounding scientific and technological developments: public participation.
Involving the public within the governance of the healthcare system is not a new phenomenon, but it seems to be a “trendy” issue at this moment. Official instances, governmental bodies or nongovernmental organisations almost unanimously call for public participation. What are the goals pursued through the multiple projects of public participation? Is this participation always necessary or adequate, whatever the issues debated? What is its impact? Are the policies or decisions better when the public contributes? Julia Abelson, from McMaster University, brings light on these questions and others.
There is a widespread view in Canada and in most other developed countries that there need to be greater citizen involvement and accountability in health care decisions. The question, however, is how and to what extent they should be involved. Published literature has shown that while citizens are prepared to be engaged in policy development and priority-setting, they are less enthusiastic about being involved in making specific decisions on health services (e.g., making choices between technologies).
Le Commissaire à la santé et au bien-être du Québec (CSBE) a pour mission de contribuer à l’amélioration de la santé et du bien-être de la population québécoise en évaluant le système de santé, en consultant les groupes et individus concernés, et en faisant des recommandations au Ministère de la Santé et des Services sociaux. Ghislaine Cleret de Langavant, sous-commissaire à l’éthique au CSBE, s’entretient avec Pauline Boinot de la place importante que cet organisme gouvernemental veut donner au public dans sa structure et des divers rôles que ce dernier peut y jouer.
Are emotions legitimate contributions to public participation in health decision-making?
The growing acceptance that both ‘the public’ and ‘patients’ should play a part in decision making about health policy and services has led to an expansion in the types of spaces in which public officials come face to face with those who use their services. Questions about the way in which those spaces should be designed in order to facilitate effective dialogue have exercised both practitioners of participation and researchers who study them.
