The first annual report of the Chief Medical Officer of Health to the Legislative Assembly has just been released. Dr. Sheela Basrur provides a concise diagnosis of the state of the public health system in Ontario and its capacity to respond to outbreaks of infectious diseases and other public health threats. She identifies staffing, lab, communications, information technology and other areas of continuing concern and the investments and organizational changes needed to enhance public health preparedness.
What is striking ” but unfortunately not surprising ” is that fundamental social determinants of health are not analyzed at all. Beyond mentioning that health promotion and underlying determinants is part of the mandate of public health units, she does not indicate how these determinants are, or should be addressed. The report highlights the new Ministry of Health Promotion and its role in coordinating inter-ministerial cooperation, but does not discuss how its total emphasis on health living leaves poverty, inequality, inadequate housing, social exclusion and so many other factors untouched.