Not To Be Trusted With Knives

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Public Health Achievement #7: Decline in deaths from coronary heart disease and stroke

July great public health achievement badgeThis month’s public health achievement – the decline in deaths from coronary heart disease (CHD) and stroke (a.k.a., cardiovascular disease [CVD]) – is one that hits close to home for me.  My maternal grandfather died of a heart attack and both my paternal grandparents have had heart attacks as well. My mom is on meds for high cholesterol, hypertension and diabetes (all risk factors for heart attack).  My dad hasn’t been tested, but I’d be willing to bet that he has all of that too.  With all this heart disease on both sides of my family, I’m at high risk for getting it, so anything I can do to mitigate that risk, I’m all for it!

Some random interesting things about the decline of CHD and stroke:

  • Deaths from CVD have been dropping since the mid-1960s. Between 1994 and 2004, it fell by 30%.  This decrease is likely due to a number of things, including:
    • prevention efforts (e.g., decreased rates of smoking)
    • better diagnosis and treatment of hypertension and high blood lipids
  • Even with this decline, we still have a lot of CVD – ~1.6 million people have heart disease or have had a stroke.  And with increasing rates of obesity and diabetes, we may very well see CVD rates start to increase again.
  • 1942 – Canada introduces its first food guide (called the Official Food Rules), which had to take into account wartime rationing while also trying to promote the health of Canadians.  The food guide has been updated several times since then, most recently into its current iteration in 2007.
  • 1971 – ParticipACTION was introduced (remember ParticipACTION?) to get people active.
  • 1986 – “Achieving Health for All: A Framework for Health Promotion,” a federal report, make “health promotion […] the guiding principle behind the further development of public health in Canada.”  Also in that year, the Ottawa Charter for Health Promotion was released at the first International Conference on Health Promotion.
  • 2007 – Nutrition Fact labels become mandatory.

Things You Can Do:

  • Be physically active for 30-60 minutes per day.  Physical activity can take many forms, whether it’s going for a walk and talking the stairs instead of riding elevators, or playing sports. And you don’t have to do 3o minutes at once – 10 minutes here and 10 minutes there will have positive health affects.
  • Eat well.  There’s lots and lots of “rules” for eating well, but it mainly comes down to: eat a variety of real foods – the less processed the  better!
  • Maintain a healthy weight (which eating well and being active will help with).
  • Don’t smoke.
  • Know what your blood pressure, blood lipid and blood glucose levels are.  You can’t feel it when you have high blood pressure or high levels of lipids or glucose in your blood, but they can all be really damaging, so it’s important to catch these things early!

In addition to things you can do individually, we should also be concerned about policy issues – like regulations on things like trans fats and sodium and tobacco, access to healthy foods for all people, and making our environments more conducive to physical activity.

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Public Health Achievement #6: Motor-vehicle safety

March great public health achievement badgeWow, I totally thought I’d done an entry on the public health achievement in June, but when I just went to start my July entry – what with it being mid-July and all – I discovered that I did not, in fact, do one in June.  So here I am back-dating again!

The public health achievement being highlighted by the Canadian Public Health Association’s 100 year anniversary project for the month of June is: motor vehicle safety.

Some random interesting facts about motor vehicle safety:

  • 7 people die every day in Canada from car crashes. This is down from ~16 people per day in the mid-1970s, which has been attributed to things like safer vehicles (e.g., seat belts, airbags, anti-lock brakes), improved roadways (e.g., divided highways, rumble strips), increased traffic law enforcement, more awareness by the public, and better trauma medical treatment.
  • 1921 – “Driving while intoxicated” included in the Criminal Code of Canada.
  • In 1971, a law was introduced that required all new cars to have seat belts.
  • ~93% of Canadians wear their seat belts – though it boggles my mind why the other 7% don’t!
  • 1969 – law passed to make driving with a blood alcohol level of 0.08 mg/dL or more illegal.
  • Car seats reduce the risk of dying by 71% for kids younger than 1 year old.
  • Kids have to be in booster seats until they are 80 lbs or 9 years old now. When I was a kid, we were out of car seats from a pretty young age, and I don’t remember ever being in booster seats at all.
  • 2003 – Newfoundland and Labrador banned the use of handheld cell phones while driving, the first province to do so.  BC introduced a similar law this year.

Stuff You Can Do:

  • Wear your seat belt and use appropriate child restraint devices for kids.
  • Use transit, cabs, or designated driver’s if you are drinking.
  • Don’t use a handheld device while driving.

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Public Health Achievement #5: Recognition of tobacco use as a health hazard

The May great public health achievement badge public health achievement being highlighted by the Canadian Public Health Association’s 100 year anniversary project for the month of May is: the recognition of tobacco use as a health hazard.

When I was a teenager, I worked in a donut shop1.  At the time (the early 1990s), smoking was allowed in restaurants and coffee shops in Ontario (where I grew up) and I remember there was a non-smoking “section,” which consisted of about three stools at a bar and a couple of tables, while the rest of the place was the “smoking” section.  There was nothing separating the non-smoking section from the smoking section and it seemed so ridiculous to me that they’d even bother putting the “no smoking” signs on those few tables and the bar – what, like the smoke was going to stop floating through the air at that imaginary boundary? Of course, laws have changed quite a bit since then and not only are you not allowed to smoke in restaurants anymore (at least in Ontario, where I was then, and BC, where I am now), but in Vancouver you also can’t smoke on restaurant patios, within 6 ft of doorways, building air intake and openable windows, and, starting Sept 1, 2010, at any public parks or beaches.

Some random interesting facts about tobacco as a health hazard:

  • 1 Canadian dies every 11 minutes from the effects of tobacco.  That’s more than 47,000 people every year!
  • More than 1000 non-smokers die every year in Canada from the effects of second-hand smoke.
  • Nicotine is as physically addictive as heroin or cocaine.
  • Good news: The overall rate of current smoking (Canadians aged 15+ years) declined from 25% to 18% between 1999 and 2008.
  • Bad news: Every 10 minutes, two Canadian teenagers start smoking.

Want to quit smoking?  Here are some resources2 :

  • Top 10 reasons to quit smoking (English PDF 100 KB) (Inuktitut PDF 100 KB)
  • Planning for My Quit Day Checklist (English PDF 40 KB) (Inuktitut PDF 40 KB)
  • I Quit! Contract and I Support You! Contract (English PDF 60 KB) (Inuktitut PDF 60 KB)
  • 8 Things to Do When You Quit Smoking (English PDF 170 KB)
  1. zomg, I can’t believe there’s a Wikipedia page on that donut shop chain!  Even if it is just a Wikipedia stub with no references!! []
  2. taken directly from the CPHA 100 website []

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Public Health Achievement #4: Vaccination

April great public health achievement badgeIn BC, we are experiencing an outbreak of measles, with 83 confirmed cases in the province as of May 10.  It is believed that measles came into the province from people who were visiting during the Olympics1 and has spread to unvaccinated (or partially vaccinated2) individuals in the province.  Which brings us to the topic of vaccination.

One hundred years ago, infectious diseases were the leading cause of death worldwide. In Canada, they now cause less than 5% of all deaths—thanks to immunization programs. (Source)

The MMR Controversy

There are, however, some anti-vaccination campaigns out there, most notably one against MMR vaccine in particular. In 1998 a study was published in the Lancet by Andrew Wakefield and 12 co-authors linking MMR to autism.  After that, rates of MMR immunizations in the UK decreased dramatically and, as a result, cases of measles and mumps increased.  Since we don’t see these diseases much in developed countries – thanks to vaccination – we tend to forgot how dangerous they can be.  Measles can and does cause serious disability, and even death, in some children.  The Wakefield paper has since been retracted by 10 of his co-authors and was then fully retracted by the journal after a General Medical Council investigation found Wakefield “to have acted “dishonestly and irresponsibly” and to have acted with “callous disregard” for the children involved in his study.  For example, he failed to get ethics approval for the invasive procedures he used in his study and, what I find most interesting, he had filed patents for vaccines that rival the MMR one.  So, by discrediting the MMR vaccine he stood to gain a substantial amount of money by selling an alternative vaccine in its place3.  Despite all of this, however, there still remains a significant amount of fear that MMR can cause autism, and some parents will not vaccinate their children.

Some random interesting facts about vaccination:

  • immunization saves 3 million lives and prevents 750,000 disabilities per year worldwide each year (according to the WHO4)
  • still, 9 million kids age of 5 and younger die every year of diseases that could be preventable by vaccines. 9 million!!
  • Canada achieved one of the highest rates of H1N1 immunization (45% of the population was vaccinated, compared to 25% in Australia, 20% in the US and 7% in the UK).

Stuff you can do:

  • If you were born after 1956 and haven’t received two doses of the MMR vaccine – go get vaccinated!
  • Get informed about what vaccines are available and what ones need booster shots (e.g., you need a tetanus booster every 10 years)
  • Keep your immunization record up-to-date.
  • Traveling to another country? Visit your local travel clinic to find out what diseases are endemic to the area you’ll be visiting and if there are any vaccines you can get for those diseases.

For the record, I totally wrote something up for this back in April, but then WordPress eated it and I was too disheartened to write it all over again that day and then I forgot about it and now I’m posting it two weeks after April ended. (Though I’m backdating it so it will appear in my archives for April.  Because I’m awesome like that). Given that I have a problem with blogging about things things on time (see: BC Premiers series, abandonment thereof), I probably should stop creating “series” on my blog. I won’t, but I probably should.

  1. although another case appears to have come from someone returning home to the Interior after visiting India []
  2. to receive full protection from the measles, mumps & rubella (MMR) vaccine, you need two doses.  Receiving only one dose leaves you only partially protected []
  3. you can read the whole story over on Wikipedia []
  4. that is to say, the World Health Organization.   Not The Who. I have no idea what their stats on immunizations say []

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Public Health Achievement #3: Healthier environments

March great public health achievement badgeSomehow it’s almost the end of March and I’ve just realized that I completely missed posting about the public health achievement for February1.  Yikes! Anyway, here’s March’s:

Healthier Environments

Usually when we think of “health” we think of medicine, nutrition & physical activity.  But things like water and air quality are tremendously important to health as well.  Just think of the seven who died, and thousands who were sickened, by the E. coli-contaminated water in Walkerton, ON in 2000.

Some random interesting facts about healthier environments

  • the regulation of sewage and the water supply was first started in Quebec in 1894. This type of work reduced diseases such as cholera, diphtheria and typhoid fever which used to be common because drinking water would get contaminated by sewage. Shockingly, some cities still do not process their sewage today (!) including Victoria, BC, Halifax, NS and St. John’s, NL.
  • community water fluoridation – which helps prevent tooth decay – was first started in Canada with a pilot project in Brantford, ON in 1945. Today about 45% of Canadians have access to fluoridated water, though the rates vary from none to very little of the populations in Yukon, Nunavut, BC & NL to the majority of the population (~75%) in Ontario & Alberta.
  • the Environmental Protection Act was passed (reducing the contribution of vehicles to air pollution in 1988).
  • 20%-30% of the bacteria in water samples from urban watersheds (i.e., where we get our water from) can be traced to dog poop!

Stuff you can do:

We all know about the things we can do to be kinder to the environment (like walking, biking or taking transit instead of driving; or using reusable mugs and shopping bags rather than disposable ones). But here are a few other, less commonly thought about things you can do to make your environment healthier:

  • Pick up your dog’s poop! Not only is dog poop left in yards or on sidewalks just plain gross, it can be a health hazard too!
  • Use Health Canada’s Hazardcheck website to check your environment for (and learn more about how to deal with) hazards!
  • Install a carbon monoxide detector in your home.
  • Use a dehumidifier if your house is damp to prevent the growth of mould2
  • Pay attention to consumer safety warnings/recalls to make sure you don’t have any hazardous products in your home.
  • If your community doesn’t already have them, advocate for fluoridation of water and for sewage treatment3.
  1. I’m going to write it after this and back date it. Because clearly I’m not above such things []
  2. being a basement dweller, I know all about the nastiness of mould! []
  3. I’m looking at you, Victoria, BC []

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Public Health Achievement #2: Control of infectious diseases

Note: I’m not sure how, but I completely managed to miss writing about the February public health achievement during February. So I’m writing this in late March (because I suck) and back dating the post so it will show up in February in my blog archives. Because I’m not above back dating, apparently.

February great public health achievement badge

One of my favourite courses in all of my undergraduate degree program was virology. I remember being in first year and reading through the courses I would be taking over the next four years and seeing it listed as a Biochem course I could elect to time in my final year and being super excited. And when it finally came to be fourth year, the course did not disappoint. To this day I still have a love for viruses – especially ebola and dengue!  But while I love to learn about viruses, I certainly don’t want to be infected with anyone of them!  Which is why I’m glad that Public Health has made great strides in the Control of Infectious Diseases, which just so happens to be the February theme for the 12 great public health achievements in honour of the 100th anniversary of the Canadian Public Health Association.

Some random interesting facts about infectious diseases:

  • 28% of Canadian troops returning from WWI were infected with syphilis and/or gonorrhoea

  • In 1997, a new surge of sexually transmitted infections (STIs)1) started, notably of chlamydia, gonorrhoea and syphilis. These diseases are preventable and treatable, but we need to ensure that we promote “disease prevention and effective, non-judgemental public education” to keep these diseases under control.
  • The first known outbreak of polio in Canada occurred in 1910
  • ~11,000 people in Canada were  paralyzed by polio between 1949 and 1954. Thanks to the creation and widespread use of polio vaccines, Canada was declared polio-free in 1994.
  • Despite a significant drop in rates of tuberculosis in Canada as a result of the use of antibiotics to treat TB, rates still remain high among Aboriginal people.  In 2008, the TB rate among Aboriginal people was ~6X more than  the overall Canadian rate. In Nunavut, the rate of TB was more than 38 times (!) the national rate. Immediate improvements in health and social conditions are needed to reduce this inequity.

Stuff you can do:

  • Education yourself about, and protect yourself against, STIs.
  • Advocate for measures to eliminate the health inequities (of which TB is just one) between Aboriginal people and the rest of the Canadian population.
  1. formerly known as sexually transmitted diseases (STDs) and before that as venereal disease (VD []

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Public Health Achievement #1: Safer and Healthier Foods

January great public health achievement badgeYesterday I got an email from the Canadian Public Health Association1, which is celebrating its centenary in 2010, telling me about the website they’ve launched to celebrate the successes of the field of public health over the last 100 years.  Would you believe “that 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?”  Thirty years!  That’s almost my entire lifespan so far in *extra* years of life!

As part of their celebration, they have listed twelve great achievements of public health in last 100 years – one to highlight each month:

January Safer and healthier foods
February Control of infectious diseases
March Healthier environments
April Vaccination
May Recognition of tobacco use as a health hazard
June Motor-vehicle safety
July Decline in deaths from coronary heart disease and stroke
August Healthier mothers and babies
September Acting on the social determinants of health
October Universal policies
November Safer workplaces
December Family planning

And they even have snazzy badges to put on your blog (as seen above).  And far be it from me to be able to resist a snazzy blog badge!

This month’s theme – Safer and Healthier Foods – is one that is near and dear to my heart, what with being a nutritional scientist and all.  And the fact that it’s the theme of my birth month is just the icing on the cake2!

Some random interesting facts about food and nutrition:

  • the idea that vitamin deficiencies could cause disease was first published in 1912
  • Canada’s first food guide – The Official Food Rules – were first published in 1942 with the aim of preventing nutrient deficiencies during wartime rationing
  • goiter was eliminated in Canada by the mandatory fortification of salt with iodine (1949)
  • sometimes symptoms of food poisoning don’t appear for a month after you eat contaminated food!
  • the Canadian Community Health Survey (Cycle 2.2) in 2004 was the first time in 35 years (!) that we had national nutrition data
  • Canada was the first country to mandate labeling of trans fats
  • more than 10% of Canadians (that’s about 3 million people) experience food insecurity

Fight Bac!

Stuff you can do:

Check out the cpha100 website to read about all the cool things that public health has done to make our food safer and healthier, from fighting foodborne illnesses to the creation and updating of Canada’s Food Guide to work on food insecurity.

  1. being that I now work in Public Health, I joined the CPHA []
  2. ha ha! icing and cake in a nutrition posting []
  3. the whole avoiding processed foods will help with that []
  4. I know that there is always lots of debate around the Food Guide, but the basics – eat real, whole foods; eat more plant-based foods; use reasonable portion sizes; get variety in your diet – and the fact that studies show that if you follow the Food Guide, you meet the nutrient recommendations, are pretty solid []