Primer on Population Health

Dr. Rao is a family doctor in Goosefoot, a small industrial town in Canada. The town has a population of 15,000 and is 2 hours by road from the nearest city, Weenigo. Goosefoot was built around the iron ore mining and forestry industries, but these are experiencing difficult times. One forestry operation closed 5 years ago and the mine is laying workers off. A proportion of its workers commute to the oil sands project and some have left permanently. Times are tough.

Over the past half-century, the Canadian population has seen unprecedented gains in longevity, health, and well-being. Improvements in the environment and in health policies, changing lifestyles and therapeutic advances have all contributed to enhancing the length and quality of life (…) Perhaps surprisingly, the improvements in health have not reduced the demands on doctors. Instead, doctors are called on to broaden the scope of what they treat (…) Dramatic medical advances are exciting, but they bring challenges and have raised concerns (…) Discussions over setting appropriate boundaries for medicine led to the surprising insight that there is no agreed criterion for defining what constitutes a disease…

People have claimed to be able to cure ills for as long as history has been recorded. Some cures are based on science, in that their mode of action and the principles underlying them are known. Some are known empirically to improve health, but we do not fully understand how they work. Other treatments have not been shown to be of benefit. Many have never been rigorously tested (…) Every year, approximately 2,000,000 articles summarize the results of scientific research. Many of the conclusions disagree with one another (…) No study is perfect, and yet the ideal of practising evidence-based medicine demands that clinicians base their decisions on scientific evidence...

The theory and methods of population and public health are translated into the essential functions of public health which include health assessment, health promotion, disease and injury prevention and protection from environmental and infectious disease. All health professionals are responsible for certain aspects of these public health functions. A public health professional intervenes at a population level. A clinician is a resource for improving the health of the whole community; a clinical practice can be organised to improve the health of individual patients and clinicians provide preventive interventions for their patients...

Self-tests are provided at the end of each chapter. Here are a few samples:

1. How do the effects of colonization continue to impact on the health of Indigenous Peoples in Canada?
2. In your capacity as advisor to the Minister of Health, how would you design and implement a series of studies to determine the relationship between personal stereo use and noise-induced hearing loss?
3. A 42-year-old female patient living a kilometre away from overhead, high tension power lines is very worried of the lines’ effect on her health. How do you approach this case?

References are provided at the end of each chapter.

A detailed and searchable Glossary is provided. Just click on the “Glossary” tab on the right-hand side of the inner Primer pages.  Here is a sample: