Canadian Journal of Public Health

Breast milk is the only milk that meets both the nutritional and immunitary needs of infants. Since breastfeeding is widely promoted, public health measures to preserve the nutritional qualities of expressed breast milk (EBM) should be applied in hospital care settings. The Health Technology Assessment Unit (HTAU) of the Centre hospitalier universitaire de Québec was requested by the Neonatal Care Unit to assess the acceptability of a plastic specimen container, designed to harvest tissues and body fluids, for storing collected EBM. An evidence-based public health perspective approach was taken to evaluate the safety of the specimen container. The HTAU recommended that plastic specimen containers no longer be used for storing EBM and that other options should be evaluated for neonatal care units. These recommendations are in accordance with the public health precaution principle and with legal considerations.

Tiêm chủng là một lĩnh vực y tế công cộng trong đó những thách thức liên chính phủ về việc xây dựng chính sách quốc gia trở nên rõ ràng. Đây cũng là lĩnh vực mà việc hài hòa chính sách trên toàn Canada đặc biệt quan trọng. Chiến lược Tiêm chủng Quốc gia là một sáng kiến giữa Liên bang và các tỉnh/thành phố (F/P/T) nhằm đạt được mục tiêu chính sách này. Sự kết hợp giữa hướng dẫn quốc gia và nguồn tài trợ linh hoạt từ liên bang thông qua quỹ tín thác cho đến nay đã hiệu quả trong việc cải thiện tính công bằng trong việc tiếp cận các loại vaccine trong các chương trình của các tỉnh/thành phố với sự bất đồng liên chính phủ hạn chế. Tuy nhiên, sự thành công lâu dài của sáng kiến này sẽ phụ thuộc phần lớn vào sự hỗ trợ tài chính liên bang liên tục và quan điểm của các tỉnh/thành phố về các hướng dẫn quốc gia. Cách tiếp cận này về tiêm chủng là một mô hình có thể áp dụng tốt cho các lĩnh vực y tế công cộng khác, nơi có sự khác biệt lớn về các chương trình giữa các tỉnh/thành phố, nơi mà sự đồng nhất của các chương trình là rất quan trọng và nơi mà chính phủ liên bang không có khả năng hoặc không muốn pháp lý hóa việc hài hòa các chương trình.

The goal of this research project was to identify and suggest means of filling the gaps/needs in Canadian research activity and public policy action on the income and health relationship. The research consisted of an environmental scan and analysis of 321 empirical research pieces from Canada (n=241), the United Kingdom (n=40) and Finland (n=40) followed by a systematic gaps/needs analysis of these studies by members of three advisory committees, consisting of researchers and policy advocates. These data were complemented by key informant interviews with researchers from Canada, the UK and Finland. The gaps/needs were then reviewed and assigned priority rankings by members of the three advisory committees. Numerous gaps/needs in Canadian research on income and health were apparent. They fell into five main areas: (a) training and capacity building in addressing income as a health determinant; (b) developing adequate data and measures; (c) researching specific substantive health issues; (d) researching specific public policy areas; and (e) developing an understanding of the pathways and mechanisms mediating the income and health relationship. Members of the advisory committees achieved a high level of agreement concerning these gaps/needs and means of reducing them. The Canadian Institutes of Health Research (CIHR) and the Institute of Population Health should target specific research initiatives to help fill the identified gaps in knowledge. They should also work together with public policy institutes to synthesize findings concerning income, its distribution, and health, and help distribute these findings to the public in general and policy-makers in particular.

Vancouver’s DTES represents a high-risk neighbourhood, in which there exist a number of community clinics and outreach programs. The purpose of this study was twofold: 1) to describe the population of women attending a weekly women’s program with respect to demographics, risk behaviours and prevalence of STI, and 2) to assess the uptake of STI screening in this setting. A cross-sectional survey was undertaken during a weekly community clinic-based women’s program from October to December, 2004. Women were recruited at the start of the program each week and were invited to provide urine samples for chlamydia and gonorrhea screening. Among 126 respondents, the median age was 42 (36–49), more than half (52%) self-identified as White and 40% as Aboriginal ethnicity. Forty percent were currently involved in the sex trade. Two thirds reported a Pap smear in the past year, while 14% had not accessed sexual health care (Pap smear, STI or HIV testing). Among the 92/126 (74%) women providing a urine sample, the prevalence of chlamydia and gonorrhea was 2.2% and 0.0%, respectively. The majority of women accessing this program were over 35 years of age, and while nearly half were currently involved in the sex trade, cross-sectional screening did not reveal a substantial prevalence of STIs. Women who were not regular program attendees reported less sexual health care, and represented the only two cases of chlamydia found. Innovative programs that better serve the needs of populations that remain unable or unwilling to seek sexual health care in its current formats are needed.

To examine the cost of fruits and vegetables (FV) with respect to different food store types, urbanization level and material deprivation for various urban areas of greater Quebec City. A sample of 85 food stores was selected. They represented five store types (small, conventional, and large grocery stores; greengrocers; convenience stores) in four geographic areas reflecting three different socio-economic levels. We identified three FV baskets (grocery, fresh FV, food supply in the five store types. Four investigators were trained to conduct a survey of prices for the week of September 17–23, 2007. Analysis of variance and t tests were conducted to examine variations in food baskets with regard to the variables defined in this study. A chi-square test was used to measure the frequency distribution of stores throughout the greater Quebec City. Only food store type had a significant influence on FV cost: cost was much lower in large grocery stores and greengrocers. Convenience stores, where prices are higher, outnumbered all others in deprived urban areas, supporting the contention that there are inequities in economic access. Economic access to FV may differ by area in the greater Quebec City, putting rural inhabitants and less privileged urban dwellers at the greatest disadvantage; this may, in turn, contribute to health disparities. The results point to the need to improve our understanding of the way components of the food environment at the regional level affect social inequality.