“Towards a New Perspective on Health Policy” provides a rare comprehensive
overview of health and health policy. It is a response to a logjam in Canadian health
policy, manifested by government inability to allay public concerns about the health
care system, recurring crises in public health, uncertainty about the future of health
promotion and little progress on implementing the consequences of recent findings
about health inequalities. Fifteen separate short historical and conceptual studies and
discussion papers were commissioned to flesh out the context of current health
policy. Ideas and an intellectual framework were developed in an iterative way by
presenting intermediate results to more than 3,500 people at over 90 different
events. This final report is addressed to everyone involved in the health field, including
government officials, health professionals, researchers and citizens with an
interest in health and health policy.
The report takes a variety of approaches to the issues. It begins by examining the
writing and publication of the Lalonde Report in 1974, perhaps the most prominent
health policy document in recent Canadian history. It explores developments both
prior to and following that Report, locating the current situation in a broad intellectual
context. Historical and conceptual analyses find fresh perspectives on health
policy, and lead to a number of ideas designed to unblock the current logjam and indicate
possible directions for Canadian health policy in the 21st century.
The Lalonde Report introduced an important new idea about going beyond medical
care to improve the health of Canadians. It led to the development and evolution
of health promotion, at first encouraging people to take more responsibility for their
own health, and later recognizing the contribution of healthy communities and environments
to health. The policies advocated by the Lalonde Report seem to have had
mixed outcomes. For example the Report’s nutritional and exercise recommendations
have largely been adopted, but there remains widespread disagreement about
its overall impact on the health of Canadians. These debates suggested the need for
a fuller exploration of other major stages of health policy.