The population health approach addresses questions such as what are the most important factors affecting the health of Canadians, why some Canadians are healthier than others, and what can be done to improve the health of all Canadians (www.cihi.ca/cihiweb/dispPage:jsp?cw_page=cphi_pop_health_e).
This approach targets the entire population as well as distinct population groups. Efforts to improve health involve examining, and acting upon, the broad range of factors and conditions that have a strong influence on health. These factors and conditions are often referred to as “determinants of health.” The Public Health Agency of Canada recognizes 12 determinants of health (www.phac-aspc.gc.ca/ph-sp/approach-approche/appr-eng.php).
Canadians are not all equally healthy. Some live longer and enjoy better health than others. This is partly because - as individuals - we are all different in terms of our genetic makeup and the sort of lives we lead (e.g. personal health practices, coping skills and lifestyle choices, including smoking, alcohol consumption, fitness and nutrition). Health services (and their availability and accessibility) also play a role. In this context, health promotion and disease prevention are important, but not sufficient, health goals.
In looking at root causes of health problems, we need to keep in mind that some groups of Canadians have fewer opportunities than others in terms of education and employment, the quality of their housing and where they can afford to live, social exclusion, and how well they can feed and provide for their children. Research on the social and economic determinants of health suggests that differences in such opportunities may be linked to differences in health status between groups within Canada (www.cihi.ca/cihiweb/dispPage.jsp?cw_page=cphi_pop_health_e).
Researchers have also noted that income distribution and the growing gap between rich and poor have societal as well as individual effects, not only because of higher health care costs but also because poor children are at a higher risk for learning problems, and as adults are less likely to achieve their full potential as contributors to society ((http://heapro.oxfordjournals.org/cgi/content/full/19/2/269).
Addressing population health requires a sound evidence base, including (but not limited to) surveillance, monitoring information and data, basic methodology development and multiple interventions research (www.cihr-irsc.gc.ca/e/12199.html). Gaps in research and practice knowledge need to be identified. Capacity building in the area of determinants of health, and synthesis, translation and exchange of knowledge to practitioners are also important goals (http://www.nccdh.ca/).
A variety of action strategies are needed, in order to address inequities and improve population health. They include directing efforts and investments at root causes of (poor) health, multiple interventions, collaboration across levels and sectors, citizen engagement and increased accountability for health outcomes (www.phac-aspc.gc.ca/ph-sp/approach-approche/appr-eng.php).
The Toronto Charter for a Healthy Canada (action.web.ca/.../Toronto%20Charter%20-%202003%20(%20english%20)%5B1%5D.pdf), which was endorsed by the City of Ottawa in 2003 (www.ottawa.ca/calendar/ottawa/citycouncil/occ/2003/10-22/hrss/ACS2003-CCV-HSS-0002.htm), calls for actions to be taken by all levels of government, public health and health care associations and agencies, and the media.
Proponents of the population health approach recognize that its full application by governments and other key stakeholders will not only lead to improved health for all, but also to social justice, a sustainable and integrated health system, increased national growth and productivity, and strengthened social cohesion and citizen engagement (http://www.phac-aspc.gc.ca/ph-sp/approach-approche/appr-eng.php#key_elements).