Winter 1999/2000 - Canadian Public Health Association

Digest
CPHA HEALTH
Volume XXIII, Number 4
Official Newsletter of the Canadian Public Health Association
Health for
All in the Year
2000
Winter 1999
1999 World AIDS Day observed
with special display on Parliament Hill
Deadline for Abstracts
9 January 2000
Canadian Public Health Association
91st Annual Conference
Ottawa ■ Ontario
22–25 October 2000
Ontario Public Health Association
51st Annual Conference
From left to right: Peter Czerny, PAHO Liaison Assistant, Canadian Society for International Health,
Carole Nesbeth, Legislative Assistant to MP Jean Augustine, Elizabeth Holmes, Senior Client
Services Officer, Canadian HIV/AIDS Clearinghouse, CPHA, Neil Burke, Interim Director, Canadian
HIV/AIDS Clearinghouse, CPHA, Ian Stein, Programme Coordinator, International Programs, CPHA,
Andrea Fargo, Legislative Assistant to MP Jean Augustine. ■
Health Minister launches new source of timely, trustworthy health information
Health Minister Allan Rock has
launched the Canadian Health
Network (CHN), an internet-based,
health information service for
Canadians developed by Health
Canada and more than 400 respected health organizations. It is the first
national government and nongovernment partnership of its kind
in the world.
“Eighty-five per cent of Internet
users look for health information
with thousands of web sites on
health-related issues,” said Mr. Rock
in a launch event linking Toronto,
Winnipeg and Montreal by satellite.
“The Canadian Health Network is a
single door to a world of information that will help Canadians make
choices about health and well-being.
The Government of Canada has
played a leadership role in bringing
together this innovative service.”
The CHN is a non-profit service
funded by and developed in partner-
ship with Health Canada. In the
February 1999 Budget, the
Government of Canada announced
substantial investments for a range of
health information and communications technology initiatives. The CHN
is one of these key initiatives, receiving $32 million over three years.
The Canadian Health Network
opens the door to the collective
knowledge and experience of organizations from every province and
territory ranging from the Canadian
Cancer Society to the Tzu Chi
Institute for Complementary &
Alternative Medicine.
From AIDS/HIV to mental health,
substance use and addiction, the CHN
site includes information on a wide
array of health issues. Not only does
it look at specific health topics, the
site also provides insight into regional
and societal health concerns, such as
rural health, Aboriginal health and
homelessness, among others. The
focus of the information is on health
promotion and disease prevention.
Quality information found easily
As people rely on the Web for health
information, they are looking for
resources that provide relevant, current and trustworthy information,
which they can access quickly.
Consultations with Canadians show
some are frustrated by the current
amount of information without a
guide to what they can trust. Bringing
together existing expertise and proven
information sources from publicly
funded health resource organizations
is an efficient way to bring Canadians
health information they can trust.
“If a Canadian woman looking for
information about stress searches on
one of the thousands of health Web
sites available today, she may be
faced with thousands of results on a
single health site alone; wading
through vast amounts of information
simply becomes too onerous a task,”
said Bryan Hayday, chief executive
officer of the Canadian Health
Network. “If she were to type in the
same search terms on the Canadian
Health Network, today, she would
get about 26 results — a much more
manageable number. Furthermore,
the results would be from Canadian
resources that are proven trustworthy, and she could quickly narrow
her search to find resources and
support in her region.”
One of the unique qualities of the
Canadian Health Network is how
the information it offers will be
managed. CHN will share management and decision making through
its distributed network of partners so
that they, and their information and
subject matter expertise, become
CHN’s primary assets. This management structure will enable CHN to
provide the best possible information to Canadians. ■
Inside…
CPHA in action...................................2
Profiles in health................................3
Coming events ...................................4
Partners around the world
Tobacco, smoking & youth ...........5
2000 CPHA Awards............................8
2
CPHA Health Digest
Volume XXIII, Number 4 Winter 1999
CEO’s
Column
CPHA in action
CPHA and the global
effort to strengthen
responses to HIV/AIDS
I was privileged to participate in a
news conference on 1 December
1999, World AIDS Day, where
Canada’s International Cooperation
Minister, Maria Minna, announced
$50 million in new funding to support projects that are successfully
fighting HIV/AIDS in Africa. CPHA’s
Southern African AIDS Training
(SAT) Programme is one of three
projects that will have access to this
new funding to negotiate new and
expanded work in prevention, education and training.
The SAT Programme, funded by
the Canadian International
Development Agency (CIDA) since
1990, provides technical and financial
support to local NGOs and communitybased organizations in their efforts to
put into place effective communitybased prevention and support
responses to the HIV/AIDS pandemic
in eleven southern African countries.
Based in Harare, Zimbabwe, SAT
concentrates on the poorest 20% of
the population, reaching communities
in southern Africa with the least
access to services and support. This
region of 165 million people currently has some 4-6 million HIV-infected
cases recorded, and anticipates more
than 8 million cases by the year 2010.
SAT established a regional training
initiative entitled School Without
Walls (SWW) in partnership with a
number of local experienced community organizations and NGOs willing
to share their institutional and AIDS
expertise with others. SWW aims to
accelerate learning and programme
development in communities which
are struggling within the context of
the ever-changing AIDS epidemic,
and emphasizes a non-formal, learning by seeing and doing approach in
structured field situations.
The SAT Programme is strengthening its gender training and human
rights analysis activities to provide
partners with better support. By giving careful and culturally sensitive
consideration to gender relations,
human rights and development
issues, SAT aims to open new and
improved avenues for HIV/AIDS
prevention, research and practice.
For more information on the SAT
Programme, contact Brenda Millar,
Programme Officer, Tel: 613-725-3769,
ext 174, e-mail: bmillar@cpha.ca
National
immunization
awareness week
a success
Chief Executive Officer
Gerald H. Dafoe
Chief Executive Officer
The second annual National
Immunization Awareness Week, held
24-30 October 1999, was successful in
renewing a national commitment to
infant and child immunization. The
message of “on-time, every time” was
heard across the country as health
providers, health institutions, workplaces, schools and day cares asked
parents to check that their kids’ vacci- Sharon, Lois & Bram launch National Immunization Awareness Week, 24-30 October 1999, at a
nations are up-to-date. Displays, meet- family event held at Mitel Corporation, a high tech company in Ottawa. From left to right: Dr.
John Spika (Health Canada), Dr. Carol McConnery (CIAP), Sharon, Lois & Bram, Mr. Kirk Mandy
ings, lunch & learns, advertisements,
(President, Mitel), Dr. Roy West (CIAP Chair), Mr. Gerry Dafoe (CEO CPHA).
and news articles all helped to deliver
the message that children deserve the
head start on good health that immunization provides.
Program in 1996 to help parents and health providers in
Vaccination is one of the great public health achieveCanada work together to make sure children get all the
ments of the 20th century, but complacency about the
shots they need at the right times.
devastation caused by vaccine-preventable diseases, and
This year we welcomed the active involvement of
misinformation about vaccine safety, threaten our envievery province and territory, a partnership which promisable record of immunization. The need for a concerted
es to grow and benefit the health of all Canadians. It will
national effort to keep vaccination rates high is the very
take all of us to maintain the urgency of vaccination and
reason that a Coalition of ten organizations, and multiple
strive to put more diseases into the same category as
funders, formed the Canadian Immunization Awareness
polio – eliminated! ■
CPHA ListServ Notice
Many CPHA members received a notice in lateNovember announcing the inauguration of CPHA’s electronic discussion groups (ListServs). Please note that we
are formulating a process to introduce members to this
new service and will be launching the ListServs in the
new year. All members who indicated on the membership renewal forms that they are interested in participating in an electronic discussion group will be automatically enrolled. All other members will be invited to join
a ListServ of their choice and we will be communicating
the ListServ signup process in the new year. These elecOn behalf of the Board of Directors, David Butler-Jones, CPHA
President, presented Margaret Hilson with a gift in recognition of her
being the recipient of the International Council of Nurses’ (ICN) first
International Achievement Award.
CPHA Health Digest
Canadian Public Health Association
Volume XXIII, Number 4, Winter 1999
The CPHA Health Digest
is an official publication of the
Canadian Public Health Association
and is published four times a year.
It is supplied as a CPHA membership
benefit to members in good standing.
ISSN 0703-5624
tronic discussion groups will provide CPHA members
and the Board of Directors with a new mechanism to discuss critical public health issues of the day. ■
National Office:
400-1565 Carling Avenue, Ottawa,
Ontario, K1Z 8R1 Canada
613-725-3769 Fax: 613-725-9826
E-mail: info@cpha.ca
Executive Managing Editor:
Gerald H. Dafoe
Coordination & Production:
Ian Culbert
Assistant Editor:
Karen Craven
Printed on recycled/recyclable paper
Circulation:
Ellen McWeeny
Canadian Publications Mail Product
Sales Agreement No. 547743.
Translation:
Sylvie Lee
Mission Statement
The Canadian Public Health Association
is a national, independent, not-for-profit,
voluntary association representing public
health in Canada with links to the international public health community.
CPHA’s members believe in universal
and equitable access to the basic conditions which are necessary to achieve
health for all Canadians.
CPHA’s mission is to constitute a special
national resource in Canada that advocates for the improvement and maintenance of personal and community health
according to the public health principles
of disease prevention, health promotion
and protection and healthy public policy.
CPHA Health Digest
Volume XXIII, Number 4
Winter 1999
3
Profiles in health
Mr. Bojangles…Can you read?
“I knew a man, Bojangles, and he
danced a lot, in worn out shoes”
The popular song, Mr. Bojangles,
about a man who loves to dance, got
me thinking the other day. I asked
myself, “Can Mr. Bojangles read?” He
certainly has talent, a whole lot of
heart and dignity. “But can he read?”,
I kept asking myself. This question
probably never occurred to the songwriter, but it occurs to those of us
who are health professionals, educators and/or health consumers with
low literacy skills.
Have you ever encountered a client
or patient who hesitates and looks
very uncomfortable when you ask
her to fill out a medical consent form?
What about an older patient who
does not take his medication correctly? Perhaps you have met someone
who forgets to take the health information you so painstakingly put
together for her to read? After all, all
of this print information can only
help your patient or client. Right?
Unfortunately not, if your patient
or client has low literacy skills.
In 1997, the International Adult
Literacy Survey (IALS) identified
three aspects of literacy: prose, document and quantitative literacy or
numeracy. Skill levels for each of
these measures were allotted to one
of five levels (five being the highest). In 1994-95, about 17% of
Canadians aged 16 to 65 fit in the
lowest level of prose literacy (Level
1). Another 26% achieved the sec-
ond lowest level. Canadians with
low literacy skills can read only simple material that does not use complex instructions (reference IALS).
In the federal government’s 1999
report, Toward a Healthy Future:
The Second Report on the Health of
Canadians, literacy levels are identified as important predictors of
employment, active participation in
the community and health status
(p. 65). They are, interestingly
enough, also important predictors of
the success of a nation.
Canada’s first-place ranking on the
UN Human Development Index
drops to 10th when factors such as
literacy are factored in. In 1995,
compared with Sweden, Canada had
more than twice the proportion of
citizens who lacked adequate literacy skills. (The IALS ranked Sweden
at the highest levels in all three
measures of literacy). The report
goes on to say that Canadians with
low literacy skills are more likely to
be unemployed and poor, to suffer
poorer health and to die earlier than
Canadians with high levels of literacy (Executive Summary, p. X).
Literacy and numeracy skills are
critical for full participation in society. We reward people who are proficient and penalize those who are
not, in employment opportunities,
job success, citizenship and active
participation in the community
(p. 52). People with low literacy
skills often feel alienated and have
difficulty finding and accessing
First Canadian Conference
on Literacy & Health
Charting the
Course for
Literacy and Health
in the New Millennium
28-30 May 2000
Ottawa, Ontario
health information and services. As a
result they suffer poorer health than
those who have higher literacy skills
(p. 52).
For the past six years, the
Canadian Public Health Association’s
(CPHA) National Literacy and Health
Program has worked with 26 national health associations to raise awareness among health professionals in
Canada about the links between literacy and health. By promoting
plain language health information
and clear verbal communication
techniques, the program has helped
thousands of health professionals
better serve their patients and
clients. CPHA’s Plain Language
Service continues to offer professional plain language revisions and
has produced a Directory of Plain
Language Health Information for
North America.
In May 2000 in Ottawa, CPHA’s
National Literacy and Health
Program is hosting a conference –
the first of its kind in North America
– Charting the Course for Literacy
and Health in the New Millennium.
The purpose of the conference is to
boost the profile of literacy as a key
issue in health. CPHA hopes to
bring literacy and health into focus
as a valid field of research and help
forge links and partnerships among
literacy and health stakeholders.
Highlights from the conference
will include an exhibition of low literacy health consumers’ health stories from across Canada, along with
plain language and clear verbal
communication training for health
professionals. A critical workshop on
the links between the law, literacy
and informed consent will assist
health professionals in better understanding their professional liability.
Health professionals, government
representatives, researchers and academics, literacy providers, health
administrators, policy makers, adult
learners and representatives of pharmaceutical companies will all be on
hand to chart a course for literacy
and health into the 21st century.
It is the hope of the National
Literacy and Health Program along
with its partners that one day, we
won’t have to wonder: Can Mr.
Bojangles read? We’ll know that he
can; and much more than that, we’ll
know that he’s probably healthy too!
For more information, contact
Nancy Foreman, National Literacy
and Health Program, Tel: 613-7253769, ext. 166, e-mail:
nlhp@cpha.ca ■
U of T’s department of public health sciences reaches out
by Megan Easton
There is a story that in the early years of this century, a doctor visited a family with two young children suffering from diphtheria. The doctor had with
him the diphtheria antitoxin developed by Dr. J.G. Fitzgerald, founder of the
Antitoxin Laboratory at U of T, but the family could only afford to buy it for
one child. The other died.
This incident and others like it reinforced Fitzgerald’s mission – to make his
life-saving product, in his words, “within reach of everyone, even the poorest.” Fitzgerald and his lab were precursors to today’s department of public
health sciences at the University of Toronto and while the health threats have
changed over the years, the university’s public health objectives have not.
Today the department’s motto is: make health within reach of everyone,
especially the disadvantaged.
“Our vision now,” says Professor Harvey Skinner, chair of the department,
“is to become a world-class school of public health, with community impact
at the local, national and international level.” The department works with
many health partners at all of these levels and while the current outreach
work rarely involves researchers going to homes with vaccines, the faculty
and students are active in diverse communities both close to home and
across the world.
One unique initiative in the department is the Visiting Lectureship on Native
Health, started by Professor Chandrakant Shah. Celebrating its 10th anniversary
this year, the annual public lecture series brings in Aboriginal speakers to educate students and faculty about issues affecting the health of Aboriginal Peoples.
The driving force behind this successful program is Shah’s determination to
challenge misconceptions about the native community among those who are
or will be health care providers. “I want to give future professionals the
knowledge they need to be able to provide sensitive care,” he says. “I also
believe that when people are educated they stand up to injustices.”
At this year’s inaugural lecture October 19, the elder-in-residence at First
Nations House, Lillian McGregor, honoured Shah for his own 25-year battle
against injustice in Aboriginal health care. With Ontario Health Minister
Elizabeth Witmer and former national chief of the Assembly of First Nations
Ovide Mercredi in attendance, McGregor presented Shah with an eagle feather, one of the highest tributes in native culture.
The distinguishing factor in all of the department’s research, Skinner says, is
the guiding value that goes back to its founding – social justice. “Public health,
within the health sector, is the one group that speaks to the power structure for
those who are not in power so that we can create a reasonable balance in
access to resources for good health and well-being for all Canadians.” ■
Reprinted with permission from The Bulletin, University of Toronto, 1999;53(6):5.
4
CPHA Health Digest
Volume XXIII, Number 4 Winter 1999
It’s never too late to get your flu shot!
The flu (short for influenza) is a
highly contagious repiratory disease
caused by a virus. You may experience symptoms much like having a
common cold, but flu symptoms are
far more serious. They include fever,
head/body aches and pains, weakness, sneezing, sore throat, cough
and sniffles. People with the flu are
often bedridden for up to a week or
more.
The real dangers of the flu are the
complications that can arise from it.
True influenza leaves you weak and
at risk of other infections (e.g.,
pneumonia), heart/kidney failure, or
nervous system disorders.
Anyone can get influenza, but for
some people it can become a serious
or even life-threatening illness. Flu is
easily spread: if you have family
members living with you who are
high risk, you protect them by protecting yourself with a flu shot.
High-risk groups
It is important for people who are
in a high-risk group to get their flu
shot, in order to reduce the impact
of the flu. You are part of a highrisk group if you:
• are an adult or child with chronic
heart, lung, or kidney disorders,
or cystic fibrosis.
• have asthma, diabetes, severe
chronic anemia, cancer or another
Mary Appleton (left) was one of 22 CPHA
staff who were immunized against the flu
during a clinic held October 5, 1999 at
CPHA by VON nurse Carol Miller (right).
Workplace flu immunization clinics are
growing in popularity as a convenient means
of promoting employee health.
Coming events
Health and the Quality of Life:
Our Municipalities in an Era of
Globalization
3rd Conference of Local Health
Authorities of the Americas
13-16 March 2000, Québec City, QC
Contact: Secrétariat du 3e Congrès des
responsables locaux de santé des
Amériques, 938, rue Saint-Maurice,
Montréal (Québec) H3C 1L7,Tel: 514395-1808,Téléc. : 514-395-1801,
Courriel : info@opus3.com,
www.msss.gouv.qc.ca/congres_quebec
long-term illness or have received
an organ transplant.
• are 65 and over or live in a longterm-care facility.
• are a child or adolescent (6
months to 18 years) with a condition treated for long periods with
acetylsalicylic acid.
Building Bridges: Creating an
Integrated Approach to Women’s
Health
Organized by the Health Association of
BC; the Women’s Health Bureau, BC
Ministry of Health; and a number of
other partners, including Health Canada.
29 April - 1 May 2000,Victoria, BC
Contact: Anne Speer,Women’s Health
Bureau, BC Ministry of Health,Tel: 250952-2237, Fax: 250-952-2799, E-mail:
anne.speer@moh.hnet.bc.ca
Can I protect myself from the flu?
The easiest way to protect yourself
and those around you from getting
the flu is to get your flu vaccination
each fall. Yearly vaccination prevents
the flu in most people; in others, vaccination usually reduces the severity
of the illness. By the way, you cannot
get the flu from a flu shot. ■
The First International
Conference on Women, Heart
Disease and Stroke: Science and
Policy in Action
Heart and Stroke Foundation of
Canada
7-10 May 2000,Victoria, BC
Contact: April Taylor,Taylor &
Associates,Tel: 613-747-0262, Fax: 613745-1846, E-mail: gtaylor@netrover.com
Buckle Up Bears pilot program
Buckle Up Bears is a corporate and community partnership aimed at raising
awareness of correct installation and use of car seats for children. In 1998,
The Co-operators and the Canada Safety Council agreed to partner in the
development and piloting of a child seat clinic program. Their efforts have
been supported by the counsel and expertise of the Infant and Toddler
Safety Association.
Buckle Up Bears involves the development of a “how to”
manual on creating community partnerships to hold car seat
inspection clinics, training of inspectors, and development
of informative materials for caregivers and children.
Pilot locations in 1999 were Metro Toronto, Burlington,
Oakville and Ottawa. Subject to a favourable pilot evaluation, the program will be expanded nationally in 2000.
• Four out of every five kids are not correctly buckled up
while riding in motor vehicles.
• Motor vehicle collisions are the number one cause of death for children
ages 1 to 9.
• 75% of crash-related deaths and serious injuries can be prevented by the
correct use of a child restraint on every trip.
In Ontario, Transport Canada’s Roadside Observational Child Restraint Use
Survey found many child passengers travelling without the most basic protection. Common errors included:
• 25% of infant car seats were not installed rear-facing;
• 27.5% of forward-facing car seats were not tethered; and
• Restraint use was lowest for children from 5 to 9 years of age.
Clearly, education on the correct installation and use of vehicle child
restraints can help make families and communities safer.
For more information, please contact: Dominique O’Rourke, The Co-operators,
1-800-265-2612 ext. 2274; Raynald Marchand, Canada Safety Council, 613-7391535 ext. 226; or Valerie Lee, Infant & Toddler Safety Association, 519-5700181. ■
Values in Health Policy
Centre for Health Economics & Policy
Analysis (CHEPA) Conference 2000
17-19 May 2000, Hamilton, ON
Contact: Conference Coordinator,
CHEPA,Tel: 905-525-9140 ext. 23198,
E-mail: monrosek@fhs.mcmaster.ca,
www.chepa.mcmaster.ca
Removing the Barriers II
Keeping Canadian Values in Health
Care: Inclusion, Diversity and
Social Justice in Health
25-27 May 2000,Vancouver, BC
Contact: Dr. Ralph Masi,Tel: 416-3684196, Fax: 416-638-6076, E-mail:
ralph.masi@utoronto.ca
First Canadian Conference
on Literacy and Health
Charting the Course for Literacy and
Health in the New Millennium
Organized by the Canadian Public
Health Association’s National Literacy
and Health Program
28-30 May 2000, Ottawa, ON
Contact: CPHA Conference Services,
Tel: 613-725-3769, Fax: 613-725-9826,
E-mail: conferences@cpha.ca
10th International Nursing
Conference
Ending Violence Against Women:
Setting the Agenda for the Next
Millennium
1-3 June 2000,Vancouver, BC
Contact: Elaine Liau, Conference
Services, UBC Interprofessional
Continuing Education,Tel: 604-8224965, Fax: 604-822-4835, E-mail:
elaine@cehs.ubc.ca
Beyond 2000: Healthy Tomorrows
for Children and Youth
Hosted by the Canadian Paediatric
Society, Canadian Institute of Child
Health and the Canadian Academy of
Child Psychiatry
14-18 June 2000, Ottawa, Ontario
Contact: Conference Secretariat,Tel:
613-526-9397, ext. 229, Fax: 613-5263332.
22nd Annual Guelph Conference
and Training Institute on Sexuality
What’s Hot? Complexity and Change
in Sexuality and Sexual Health
19-21 June 2000, Guelph, ON
Includes pre-conference workshops/
institutes from June 12-18
Contact: Office of Open Learning,
University of Guelph,Tel: 519-7675000, Fax: 519-767-1114, E-mail:
info@opening.uoguelph.ca,
www.open.uoguleph.ca/sexconf
ITCH 2000
An international conference
addressing information technology in
community health
23-27 August 2000,Victoria, BC
Contact: ITCH 2000,Tel: 250-7218576, Fax: 250-472-4751, E-mail:
itch@hsd.uvic.ca, http://itch.uvic.ca
CALL FOR PAPERS
Adolescent Medicine –
Perspectives and Challenges
An international conference at the
threshold of the 21st century
11-14 Sept. 2000, Jerusalem, Israel
Contact: ISAS International Seminars,
Tel: 972-2-6520574, Fax: 972-26520558, E-mail: isas@netvision.net.il
Deadline: 29 February 2000
CALL FOR ABSTRACTS
Health for All in the Year 2000
CPHA 91st Annual Conference
OPHA 51st Annual Conference
22-25 October 2000, Ottawa, ON
Contact: CPHA Conference Services,
Tel: 613-725-3769, Fax: 613-725-9826,
E-mail: conferences@cpha.ca
Deadline: 9 January 2000 ■
www.cpha.ca
CPHA Health Digest
Volume XXIII, Number 4
Winter 1999
5
Partners around the world
Tobacco, smoking and youth
Gathering the evidence and implementing “best practices” to protect
children and young people from becoming addicted
by Leanne Riley, Scientist, Tobacco Free Initiative, WHO; Wick Warren,
Demographer, Office on Smoking and Health, National Center for Chronic
Disease Prevention and Health Promotion, Centers for Disease Control and
Prevention (CDC); Jim Chauvin, Assistant Director, International Programs,
CPHA; and Brian Bell, CPHA member and consultant
The World Health Organization
(WHO) estimates tobacco-related
mortality to be over 3.5 million deaths
per year. This number is expected to
rise to almost 10 million by the year
2030. Yet, tobacco use is considered
to be one of the chief preventable
causes of death in the world.
Recent trends indicate that smoking
prevalence among adolescents, and
especially among adolescent females,
is rising. Information available from
developed countries suggests that
most people begin using tobacco
products before the age of 18, and
the age of initiation is decreasing.
Should this trend continue, WHO
estimates that tobacco use will result
in the deaths of 250 million children
and young people alive today, many
of them in developing countries.
Adolescents and school-aged children
should, therefore, become the focus
for intervention strategies designed to
reduce and eliminate addiction to
tobacco products. Carefully designed
surveys will provide a clear picture
of the risk behaviours of this population group, which can then be used
to design and implement effective
and comprehensive tobacco control
policies and activities.
The Tobacco Free Initiative at
WHO (TFI/WHO), with financial
assistance from the United Nations
Foundation for International
Partnerships, has initiated a joint
project with UNICEF titled “Building
alliances and taking action to create
a generation of tobacco free children and youth.” The aim of the
project is to assemble evidence,
technical support and strategic
alliances to address the negative
impact of tobacco and to encourage
and support initiatives that will
encourage children and adolescents
to lead healthy lives free of tobacco.
The project is conceived as an iterative process, consisting of three phases. The first phase will focus on harnessing the evidence for action. The
second phase will select and develop
the components of a comprehensive
country-specific approach to address
tobacco use. The final phase will
involve taking the project to scale.
As a first step, WHO, in collaboration with the Centers for Disease
Control and Prevention (CDC) is
implementing the Global Youth
Tobacco Survey (GYTS), a schoolbased survey of students in grades
associated with ages 13-15 (countryspecific grades, levels, or forms are
identified that correspond with these
ages). It assesses students’ attitudes,
knowledge and behaviours related
to tobacco use and environmental
tobacco smoke (ETS) exposure, as
well as youth exposure to prevention curriculum in school, through
community programs, and media
messages. The GYTS provides information on where tobacco products
are obtained and used, and the
effectiveness of local enforcement
measures.
The TFI/WHO and CDC provided
training to indigenous researchers in
Barbados, Costa Rica, China, Fiji,
Jordan, South Africa, Sri Lanka,
Ukraine, Venezuela, and Zimbabwe
on the GYTS methodology and support for its implementation. CPHA,
through its Tobacco-Free Children
and Youth project, an initiative supported by Research for International
Tobacco Control (RITC), a secretariat
housed at the International
Development Research Centre
(IDRC), provided support to the
Russian Public Health Association,
for the implementation of the GYTS
in secondary schools in the Russian
Federation (Moscow).
The GYTS country research coordinators came together, along with
representatives from other countries
interested in implementing the survey (Poland, the Philippines, India
and Singapore), at a meeting organized by TFI/WHO in Singapore,
September 23-27, 1999, for the purpose of sharing experiences on the
survey methodology and training in
data analysis techniques and report
writing. CPHA was also represented
at the meeting, to learn more about
the GYTS and to hold discussions
with TFI/WHO about the potential
of involving partner public health
associations in the GYTS and related
activities. The participation of sever-
Three participants at the GYTS Researchers’ Meeting, Singapore, September 23-27, 1999.
From left to right: Dr. Konstantin Vyshinsky, Russian Federation; Dr. Mohammed Shreim, Jordan;
and, Dr. Ricardo Granero,Venezuela
al researchers was made possible
through the contribution provided to
CPHA by RITC/IDRC for the
Tobacco-Free Children and Youth
project.
Seven countries (Barbados, China,
Jordan, Russian Federation, Sri
Lanka, Ukraine, and Venezuela)
have completed the GYTS at this
time. Each country is currently
preparing their own detailed report
and these should be available from
WHO in 2000. The following results
are general statements which do not
identify the specifics for any country:
• current cigarette use (the percent
having smoked one or more days
during the 30 days preceding the
survey) ranges from a prevalence
greater than 30 percent (two
countries) to three countries with
prevalence below 10 percent;
• in six of the seven countries, over
20 percent of the students who
had ever smoked cigarettes, initiated smoking before age 10;
• in six of the seven countries, between
1/3 and 2/3 of students who were
current cigarette smokers purchase
their cigarettes in a store; and,
• in all seven countries, over 1/2 of
current smokers stated a desire to
“stop smoking now.”
The GYTS researchers’ meeting
took place immediately prior to an
international consultation on tobacco
and youth, organized by TFI/WHO
(in cooperation with the WHO
Regional Office for the Western
Pacific) and co-sponsored by the
Singapore Ministry of Health and the
Singapore Cancer Society (Singapore:
September 28-30, 1999).
The meeting, entitled “Tobacco and
Youth: What in the World Works?”,
brought together people from over 30
countries, all of whom share concerns
about the high rates of initiation, consumption and prevalence of tobacco
use among youth and who wish to
work together to develop viable solutions. Participants represented a broad
range of people and organizations
from developing and developed countries. They addressed the questions of
what policies, programmes and interventions are known to work and are
successful and those that experience
and evidence suggest may work and
are worth further efforts and or
research.
Delegates identified several important points for consideration for
future initiatives, which include the
following key points:
• Several new international instruments, such as the Framework
Convention on Tobacco Control
and the Convention on the Rights
of the Child, afford important,
legally binding platforms from
which to launch sustained and targeted public health and human
rights strategies and interventions
for tobacco control;
• The implementation of effective
tobacco control measures calls for
governments, non-government organizations, professional associations
and others to examine and learn
from the strategies and tactics of the
tobacco industry and to apply these
to future efforts;
• The centrepiece of tobacco prevention and control efforts must be the
process of positive youth development and the successful transition
of young people to adulthood; and,
• Evidence suggests that the challenge for the future is not so much
to develop new programmes as it
is to come up with creative and
innovative ways of packaging and
delivering current ones.
Further information about the GYTS
can be obtained through the TFI/WHO
web site (http://www.who.org/toh).
The report on the International
Consultation on Tobacco and Youth:
What in the World Works? will be
available early in the year 2000. ■
6
CPHA Health Digest
Volume XXIII, Number 4 Winter 1999
Partners around the world
Turkish conference highlights role of culture: smoking cessation programs
Janet Nevala, Coordinator, Program
Training and Consultation Centre
(PTCC), Ontario Tobacco Strategy,
Ottawa-Carleton Health Department
In May 1999, on behalf of CPHA
International Programs, I travelled to
Turkey to participate as a volunteer
technical consultant at the Second
Turkish National Congress on
Smoking and Health. I shared with
other health professionals experiences about and provided workshops on Canada’s tobacco control
initiatives undertaken as part of the
Ontario Tobacco Strategy and the
National Strategy to Reduce Tobacco
Use. These events were coordinated
and organized by the Public Health
Association of Turkey (PHA-T), a
CPHA partner public health association since 1992.
Turkey is a fascinating country,
rich in history and culture. Tobacco
is part of that history. As such, it presents unique challenges to public
health intervention. In fact, devices
to smoke tobacco, such as the
nargile (water pipes for tobacco),
have provided centuries of enjoyment for Turkish smokers. Nargile
smokers used to be the earliest and
most coveted customers at Istanbul’s
coffee houses. Like everything else
from the past, the nargile has been
largely forgotten, but the art of
smoking as part of Turkish culture
has not. Ironically, according to the
1997 Smoking Behaviour and
Attitude study (supported through
IDRC), all segments of the smoking
population consistently agree on
when they smoke: after meals (35 to
50%) and when they drink tea or
coffee (30-45%).
According to a 1988 nation-wide
study in Turkey, smoking prevalence
among those 15 years and older is
44% (63% males, 24% females). In
the IDRC-funded survey, smoking
among professionals was found to
be quite high: journalists (63%),
teachers (51%) and physicians (43%)
were found to have the highest
smoking rates.
The statistics reflect a significant
problem and the PHA-T is taking
action. It established a working
group to carry out tobacco control
activities. The PHA-T has advocated
for stricter laws on tobacco products
and smoking, and was instrumental
in organizing the country’s first
(1997) and second (1999) National
Congresses on Smoking and Health.
Congress speakers, both international and local, covered many
issues including environmental
tobacco smoke, the tobacco industry, women and smoking, media
advocacy and cessation. The participants were primarily physicians and
nurses, all keen to learn more about
effective cessation interventions.
First Romania health promotion
summer school focusses on
tobacco and smoking
by Sherryl Smith, Health Promotion Coordinator, Somerset West Community
Health Centre, Ottawa; and, Roxana Budei, MD, Program Officer, Romanian
Public Health & Health Management Association, Bucharest
The Romanian Public Health & Health Management Association (RPHHMA)
organized the country’s first Health Promotion Summer School in July 1999.
Modelled on the annual Health Promotion Summer Schools in Ontario, it
brought together health sector professionals from around the country, for the
purpose of improving knowledge and skills on two topics: Tobacco &
Smoking, and Health Project Design and Management. The Summer School
took place July 5-16, in Baile Felix (Oradea District) in northwest Romania.
The goals of the five-day workshop on tobacco and smoking were to
increase awareness among participants of current theory and practice in the
field of health promotion, to develop strategies for the prevention of tobacco
use among women and youth, and to investigate ways of working with the
media on this issue. Sherryl Smith acted, on behalf of CPHA, as a volunteer
facilitator for the workshop, sharing with Romanian colleagues the Canadian
experience on tobacco and smoking prevention and cessation initiatives.
Workshop participants included nine primary care physicians and one
nurse. Three of the physicians worked in school settings, while others had
Turkish people have an old tradition of expressing themselves with humour. A cartoonist Kamil
Yavuz transfers his thoughts into cartoons which reflect his wit and sense of humour and
understanding about the smoking culture.
Following the conference, the PHAT invited me to make three presentations: one in Istanbul on cessation
interventions; and two in Ankara:
one on smoking cessation and the
stages of change; and the other on
youth and the denormalization of
smoking. Many health professionals
are at the contemplation stage of
quitting smoking, and wish not only
to quit but to assist their clients in
obtaining a smoke-free lifestyle.
As a result of its tobacco and
smoking advocacy, the PHA-T
intends to develop, in collaboration
with CPHA, a project on schoolbased tobacco interventions and dissemination of the best practices to
health professionals working in hos-
pitals and clinics. It also wants to
establish a network of tobacco control advocates and conduct a followup survey to the original 1997
knowledge and attitude study to
identify significant changes in
behaviour since legislation was
introduced in 1997/8.
In Turkey, the challenge faced by
all practitioners working in tobacco
control is that smoking is part of the
Turkish culture and smoking means
a lot to the people who smoke. A
major learning from this experience
is the realization of the significant
role culture plays in the reasons
why people continue to smoke, and
that this is an issue that must be
addressed in Canada. ■
private practices in pediatrics. One was the director of the local public health
authority, and two were medical residents in public health. All but one were
female, which made for an interesting discussion on smoking cessation and
prevention among women.
Although the prevalence of smoking among Romanians is high, the influence of the family appears to be strong such that the age of initiation of
smoking is later than elsewhere (late teens), which could be a protective factor in terms of young teens’ smoking. However, the influence of western culture, and particularly lifestyle advertisements for tobacco products, is having a
negative impact. The smoking incidence among youth is increasing, especially among adolescent females.
Legislation was passed recently banning tobacco advertising and the sale of
tobacco products to minors, but its application is variable. The group commented on the need to convince both public health professionals and the public about the morbidity and mortality facts related to tobacco use. Many people
appear demoralized and cynical of the effect in Romania that public policy
strategies could have. Considerable attitude shifting was required during the
course of the workshop in order to develop any realistic strategies for action.
By the end of the workshop, the participants had a better appreciation of
what could be accomplished. Human resources appears to be a key element
in any youth-oriented smoking and tobacco control and prevention. Teachers
do not have the knowledge, skills or time to implement smoking and tobacco
interventions; the key person may be the school doctor for school-based programs. However, they need accurate data and effective strategies, and, more
importantly, they have to set an example and be a role model for the students.
…see Romania, page 7
CPHA Health Digest
Volume XXIII, Number 4
Winter 1999
7
Partners around the world
Russia has one of the highest rates
of tobacco consumption among the
industrialized countries with almost
60% of Russian men identifying
themselves as smokers. As one of
the world’s top three tobacco markets, various sources report that
Russians smoke between 205 and
300 billion cigarettes annually.
According to WHO estimates, each
year 280,000 Russians die of tobaccorelated illnesses, and yet the problem shows no signs of abating;
instead the number of smokers continues to grow. The new smokers
include increasing numbers of
women and children. Clearly this is
a problem with enormous health,
social and economic implications.
The Russian Public Health
Association (RPHA) has identified the
issue of smoking and youth as an
area of acute public health concern.
With funding from the Research for
International Tobacco Control (RITC,
a secretariat housed at the
International Development Research
Centre) and technical assistance from
CPHA, the RPHA conducted a survey
on tobacco use among youth in
Moscow. This survey was part of the
WHO Global Youth Tobacco Survey
(GYTS) and preliminary data from it
confirm the magnitude of the smok-
ing problem in Moscow. The survey
reports that 67% of Muscovites
smoke or have smoked at some time
in their lives and many (22%) began
smoking before 11 years of age.
While 75% indicate that they now
want to stop smoking, only 2% have
ever received assistance to do so
from a program or a professional.
Clearly there might be a high
demand for such assistance if it existed.
Ironically, while advertising of
tobacco reaches a high proportion
of school students through television
and billboards (40% and 58%
respectively), anti-smoking messages
are seen by fewer students in Russia
than in any other country. Only 34%
of students remember being taught
about the dangers of smoking and
the survey revealed a high number
of students who claimed to have
been offered free cigarettes by cigarette company representatives. A
high proportion of Moscow school
students (63%) are buying their cigarettes in stores or from street vendors. It is not surprising that by the
time they graduate from school, 53%
of males and 28% of females are
smoking.
Trans-national tobacco companies
in Russia have approached the
Romania, from page 6
This mission was carried out through the Romanian Public Health and
Health Management Association Project, and is made possible through a
financial contribution from the Canadian International Development Agency
share with Russia. The RPHA has
just been granted funding from
CIDA to translate into Russian the
book, Smoke and Mirrors: The
Canadian Tobacco Wars, by Rob
Cunningham (published by IDRC).
This book tells the history of tobacco control in Canada, offers insights
on strategies employed by tobacco
companies in promoting their product, and offers suggestions on how
these strategies may be countered
effectively.
Public health experts consider
tobacco smoking as the leading
cause of avoidable death in Russia.
If Russia is to successfully address
this threat to its people, particularly
its youth, a collaborative effort is
required by governmental and nongovernmental organizations, the
media, and the general public. As
Russia’s national public health association, the RPHA believes that it has
a crucial role to play in this effort to
give young people an opportunity
for longer, healthier lives. ■
This article is based on information
contained in several papers by Dr.
Andrei Demine, President of the
RPHA. For more information on the
RPHA Phase 2 Project, contact either
Andrei Demine at hefrus@glas.apc.org
or Pat Trites, CPHA Project
Coordinator at 613-725-3769, ext.
173, e-mail: ptrites@cpha.ca
CANADIAN INTERNATIONAL IMMUNIZATION INITIATIVE
Opportunities for Short-Term Assignments
Currently, CPHA is developing a database of persons who may be available
for short-term assignments to assist the WHO and UNICEF in strengthening
national childhood immunization systems to work towards polio eradication, the elimination of measles and the combatting of childhood diseases
in developing countries. The Initiative is scheduled to run through to 2003.
If you are interested in registering, please contact: The Canadian
International Immunization Initiative, Fax: 613-725-9826, E-mail:
ciii@cpha.ca, Internet: www.cpha.ca ■
ld
or
F
rati
e
d
e
on o f P u b l ic H e a l t h A s
so c
iat
io
9 t h I n t e r n a t i o n a l C o n g re s s
ns
One of the lessons learned from the workshop is the need to emphasize
the concepts of health promotion and disease prevention, especially in a system that remains grounded in a tertiary specialized medical system. The role
of nurses and primary health care physicians needs to be enhanced and
resources made available to facilitate their role as health educators. Television
appears to be the medium of choice to reach young people, and could be
used to provide an impetus for policy development by building bottom-up
support for legislative controls.
The participants identified three follow-up activities to advance the tobacco
and smoking/public health agenda:
1. establish a working group on tobacco and smoking within Oradea
District to develop a workplan for moving ahead on tobacco and smoking activities;
2. the RPHHMA is to organize a national conference on tobacco and smoking in the fall of 2000; and,
3. develop a communications strategy for a mass media campaign.
From the RPHHMA’s point of view, this workshop represented the first step
in the national campaign against tobacco products and smoking. The
Association intends to liaise with the Ministry of Health to obtain up-to-date
data on tobacco and smoking consumption and behaviour, especially among
youth. It will also prepare a project proposal for a national tobacco and
smoking cessation and prevention program for youth and young adults, with
the assistance of CPHA. ■
President of the RPHA expressing a
desire to know more about the public health aspects of tobacco smoking. Like tobacco companies in
many other countries, including
Canada, some trans-nationals in
Russia have approached NGOs with
proposals to collaborate on tobacco
education programs for children.
Not surprisingly, they state that they
are not targeting children in their
advertising and that smoking should
be a free, informed and responsible
adult decision. The RPHA maintains
a policy of non-collaboration with
the tobacco industry and has developed a written policy outlining the
rationale for its position.
The RPHA intends to supplement
evidence obtained in the Global
Youth Tobacco Survey with a qualitative study aimed at understanding
the meaning of tobacco use among
young people. Along with technical
assistance from CPHA, the study will
be conducted with financial support
from RITC and the Russian Public
Health Association Project, funded
by the Canadian International
Development Agency (CIDA). The
information gained will enable the
RPHA to assist in developing more
efficient and effective smoking prevention and cessation programs.
Tobacco control is a multi-faceted
area in which Canada has much
useful experience and information to
W
Where there’s smoke… there’s trouble
Sept. 2–6, 2000, Beijing
“Challenges for Public Health
at the Dawn of the 21st Century”
For information, write to the WFPHA secretariat,
c/o APHA, 800 I St. NW, Washington, DC 20001-3710
or fax 202-777-2534 or e-mail <allen.jones@apha.org>.
8
CPHA Health Digest
Volume XXIII, Number 4 Winter 1999
2000 CPHA awards
The CPHA Honorary Awards and Recognition Committee shall study the proposed
slate of nominees and make recommendations to the Executive Board of the CPHA.
Nominations should be documented following the guidelines provided below and forwarded to the CPHA Honorary Awards and Recognition Committee no later than
May 31, 2000. Nominations received after this date cannot be given consideration
for the 2000 CPHA awards.
Defries Award
Robert Davies Defries, CBE, MD, DPH, LLD
(Sask), DrPH (Montreal), for whom the award is
named, was a pioneer in Canadian public health
education, research and policy. Dr. Defries devoted a lifetime to the development of public health
in Canada and particularly to the Canadian Public
Health Association of which he was an Honorary
Life Member. Dr. Defries was also the first editor
of the Canadian Journal of Public Health.
Presented in the form of a medal and citation,
the Defries Award is CPHA’s highest honour. It is
presented to CPHA members who have made outstanding contributions in the broad field of public
health. Preference is given to Canadian contributions and individuals who have substantially supported the objectives of CPHA. The Defries Award
carries with it an Honorary Life Membership.
The Ron Draper Health Promotion Award will
be presented to an individual, group or organization engaged in community work. The Awards
Committee will consider nominations on the basis
of those who have made a significant contribution
to health promotion by working in the community
to: build healthy public policy, create environments that support health, enable community
action, enhance personal skills, and/or re-orient
health services.
Honorary Life Membership
This membership is awarded for exceptional
excellence as an educator, researcher or practitioner in the field of public health, as demonstrated by achievements, valuable and outstanding
research or distinguished service in the advancement of public health knowledge and practice.
Certificate of Merit
The Certificate of Merit provides CPHA with an
opportunity to give official recognition to individuals/groups/associations/corporations who have
given especially noteworthy services to public
health and whose contribution furthers CPHA in
achieving its objectives. These
individuals/groups/associations/corporations do
not necessarily need to be directly associated with
CPHA.
The 2000 Certificate of Merit will be awarded to
an individual/group/association/corporation
who/which has made a noteworthy contribution in
the area of advancing the agenda of public health as
it relates to “Health for All in the Year 2000.”
Ron Draper Health
Promotion Award
Ron Draper was at the forefront of progressive
social policy development for years. His vision,
dedication and commitment to the first, second
and third health promotion conferences were
major contributions to moving health promotion
forward nationally and globally. In 1988, CPHA
recognized Mr. Draper’s contributions by awarding
him the R.D. Defries Award and an Honorary Life
Membership.
Nomination for
Janssen-Ortho Inc. Award
Since 1973, with the support of Janssen-Ortho
Inc., this award has been presented to an individual who has significantly advanced the cause,
legitimized and stressed the responsibility and
state of the art of public health. Candidates for
this award do not have to be CPHA members.
(check one)
❏ Defries Award
❏ Honorary Life Membership
❏ Ron Draper Health Promotion Award
❏ Janssen-Ortho Inc. Award
❏ Certificate of Merit
Nominee
Name of Nominee: ___________________________________________
Title: ______________________________________________
Address: ______________________________________________
______________________________________________
Telephone: ______________________________________________
Who Can Nominate/
Be Nominated
1. All CPHA members and CPHA Provincial/
Territorial Branches/Associations (hereinafter
referred to as “nominators”), are encouraged to
nominate persons/groups who they feel are eligible
to receive an award.
2. Individuals/groups may be nominated for more
than one award in any given year. However,
separate nomination forms must be completed
for each award for which the person/group is
nominated.
Nominee Documentation
Because the CPHA Honorary Awards and
Recognition Committee must review all nominations
it receives on the basis of the written description of
the nominee, it is extremely important that nominators carefully submit all of the documentation
requested below:
1.Overview
A 300-word (maximum) description of the candidate’s achievements, the nature and impact of
the activities involved and the audiences
reached.
2.Biography/Profile
A 250-word (maximum) biography of the person or
a profile of the organization/group.
3.Letters of Recommendation
Three sponsors (exclusive of the nominator)
should submit letters of recommendation in support of the nominee.
4.Resume (for R.D. Defries Award and
Honorary Life Membership)
A current, detailed resume, including a list of
publications, should be submitted.
Nominator
(must be a member of CPHA)
Nominator: ______________________________________________
Address: ______________________________________________
______________________________________________
Telephone: ______________________________________________
NOMINATIONS RECEIVED AFTER MAY 31, 2000
CANNOT BE GIVEN CONSIDERATION FOR THE 2000 CPHA AWARDS
RETURN TO: CPHA Honorary Secretary
CPHA Honorary Awards and Recognition Committee
Canadian Public Health Association
400-1565 Carling Avenue, Ottawa, Ontario K1Z 8R1
Telephone: (613) 725-3769 Fax: (613) 725-9942
Please Note: A separate form must be submitted for each nomination. An updated
resume, where appropriate, must accompany this completed nomination form but will not be accepted in lieu of this completed form.