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Canadian Public Health Association

Open Letter to the Quebec Minister of Health

April 29, 2015

The Honourable Gaetan Barrette, MNA
Minister of Health and Social Affairs
Édifice Catherines-de-Longpré
1075, chemin Sainte-Foy, 15e étage
Québec (Québec)
G1S 2M1

The Honourable Lucie Charlebois
Minister for Rehabilitation, Youth Protection and Public Health
Édifice Catherines-de-Longpré
1075, chemin Sainte-Foy, 15e étage
Québec (Québec)
G1S 2M1

Dear Ministers Barrette and Charlebois:

The public health system in the province of Quebec is viewed by public health practitioners throughout Canada as a shining example of how public health practice and social concerns can be integrated with timely and effective health care delivery. While we appreciate the financial and administrative constraints Quebec is currently facing, the question is whether your government’s proposal to cut public health services by 30% is the appropriate method for achieving cost savings while maintaining the quality and timeliness of health services for the citizens of Quebec.

As you are undoubtedly aware, the average lifespan of Canadians has increased by more than 30 years since the early 1900s, and 25 of those years are attributable to advances in public health. There are numerous public health achievements that led to this remarkable achievement that will be jeopardized by your government’s proposed cutbacks.

Here is a short list of some of the things for which public health is responsible in communities across Quebec every day:

  • control of infectious diseases;
  • healthier environments;
  • immunization;
  • motor-vehicle safety;
  • safer and healthier food;
  • family planning and healthier mothers and babies; and
  • safer workplaces.

All of these initiatives are undertaken with relatively small investments and provide every person in Quebec with considerable returns. For example, every $1 invested in:

  • immunizing children with the measles-mumps-rubella vaccine saves $16 in health care costs;
  • car and booster seats saves $40 in avoided medical costs;
  • workplace health and safety programs returns up to $6 in avoided illnesses, injuries and fatalities;
  • introducing cleaner vehicles and fuels to reduce air pollution saves $4 in avoided health problems;
  • fluoridated drinking water results in $38 saved in dental care;
  • tobacco prevention programs saves up to $20 in future health care costs;
  • mental health and addictions saves $7 in health costs and $30 in lost productivity and social costs; and
  • early childhood development and health care saves up to $9 in future spending on health, social and justice services.

Public health activities also reduce pressures on the health care system. We have seen decreased suffering due to illness, reduced costs to the health sector, and the improvement of our society and economy because, relative to many other nations, we have a healthy population.

Your government’s proposed cuts, however, put these accomplishments in jeopardy. They could have the unintended negative consequence of increasing the pressure on your province’s acute health care system as citizens with health conditions that could have been prevented will be presenting themselves in emergency rooms and doctors’ offices throughout the province.

Because of these considerations, the Canadian Public Health Association and the undersigned public health practitioners fully support the concerns expressed by l’Association pour la santé publique du Québec (ASPQ) and their call for your sustained support for public health.

Sincerely yours,

Ardene Robinson Vollman, PhD, RN, CCHN(C)
Chair, Canadian Public Health Association

Cheryl Armistead, MScN
Board Member
Canadian Public Health Association

Marni Brownell, PhD
Associate Professor
University of Manitoba

Cheryl Case, MLT, BSc, MPH
Northwest Territories and Nunavut Public Health Association

Benita Cohen, RN, PhD
Associate Professor, College of Nursing
University of Manitoba
Stephen Corber, MD, DPH, FRCPC

Ian Culbert, BA
Executive Director
Canadian Public Health Association

Ron de Burger, CPH, BA, CPHI(C)
Past President
Canadian Public Health Association

Maureen Dobbins, RN, PhD
Scientific Director
National Collaobrating Centre for Methods and Tools

Catherine Donovan, MD
Associate Professor, Public Health
Memorial University of Newfoundland

Elizabeth Dyke, BA (Honours), MA, PhD (Population Health)
Independent Health Consultant

Joan Eakin, PhD
Professor Emerita
University of Toronto

Josephine Etowa, PhD, MN, BScN, RN
Associate Professor & Loyer-DaSilva Research Chair in Public Health Nursing
University of Ottawa

Karen Fish, MA
Knowledge Translation Specialist
National Collaborating Centre for Determinants of Health

Daniel Fuller, PhD Public Health
Assistant Professor
School of Public Health, University of Saskatchewan

Eleni Galanis, MD, MPH, FRCPC
Physician Epidemiologist
BC Centre for Disease Control

John Garcia, PhD
Professor of Practice
School of Public Health and Health Systems, University of Waterloo

Norman Giesbrecht, PhD
Dalla Lana School of Public Health, University of Toronto

Trevor Hancock, MB,BS, MHSc
Professor and Senior Scholar
School of Public Health and Social Policy, University of Victoria

Suzanne Jackson, PhD, MSc, BSc
Associate Professor
Dalla Lana School of Public Health, University of Toronto

Joel Kettner, MD, MSc, FRCSC, FRCPC
Public Health Physicans of Canada

Ronald Labonte, PhD, FCAHS
Professor and Canada Research Chair Globalization and Health Equity
Faculty of Medicine, University of Ottawa

Yvette Laforêt-Fliesser, RN, BScN, MScN
Edellys Training Corporation

John Last, OC, MD, DPH, FRCPC
Professor Emeritus
University of Ottawa

Rosamund Lewis, BSc, MDCM, FCFP, MSc, FRCPC, MMgmt
Associate Medical Officer of Health
Ottawa Public Health

Marie des Anges Loyer, BScN, MA, MPH, Med, PhD
Director, School of Nursing (Retired)
University of Ottawa

Shannon MacDonald, PhD
Adjunct Assistant Professor
University of Alberta

Marjorie MacDonald, PhD
Public Health Association of British Columbia

Lynn McIntyre, MD, MHSc, FRCPC
Professor, Department of Community Health Sciences
University of Calgary

Donna Meagher-Stewart, BScN, MHSc, PhD
Director and Secretary
Public Health Association of Nova Scotia

John Millar, MD
Vice President
Public Health Association of British Columbia

Christina Mills, MD, FRCPC
Past President
Canadian Public Health Association

James H. Mintz, BA
Managing Partner
Centre of Excellence for Public Sector Marketing

Pemma Muzumdar, MPH
Communications Coordinator
National Collaborating Centres for Public Health

Ann Pederson, MSc
BC Women’s Hospital + Health Centre

Rosana Pellizzari, MD, MSc, CCFP, FRCPC
Medical Officer of Health
Council of Ontario Medical Officers of Health

Monique Potvin Kent, PhD
Replacement Professor
University of Ottawa

Elaine Power, PhD, Public Health Sciences
Associate Professor
Queen’s University

Michael Rachlis, MD, MSc, FRCPC, LLD (Hon)
Adjunct Professor
University of Toronto

Daniel Rainham, PhD in Population Health
Associate Professor
Dalhousie University

Robert Schwartz, PhD
Dalla Lana School of Public Health, University of Toronto
Isaac Sobol, BA, MD, MHSc
Public Health Physician
First Nations Health Authority

Colin Soskolne, PhD
Professor emeritus
University of Alberta

Jerry Spiegel, MA, MSc, PhD
University of British Columbia

Malcolm Steinberg, MBBCH, DoH, MSc Epid
Clinical Assistant Professor
Faculty of Health Sciences, Simonr Fraser University

Linda Strobl, BScN, RN
Pulbic Health Nurse
City of Hamilton Public Health Services

James Talbot, BSc, MD, PhD
Associate Professor
School of Public Health, University of Alberta

Shannon Turner, BA, BSc, MSc
National Co-Chair
Prevention of Violence Canada

Lynn Vivian-Book
Newfoundland and Labrador Public Health Association

Sharon Yanicki, RN, BSN, MSc, PhD candidate
Coordinator Public Health & Lecturer
University of Lethbridge