1. BSPH 221 Lecture 22: The Lalonde Report
Dr J. I. Sitali

2. Background
The Lalonde Report is a 1974 report produced in Canada formally titled A new perspective on the health of Canadians.
It proposed the concept of the "health field", identifying two main health-related objectives:
Health care system.
Prevention of health problems and promotion of good health.

3. Marc Lalonde, who was the Canadian Minister of National Health and Welfare, proposed a new "health field" concept, as distinct from medical care.
Lalonde noted that the "traditional or generally-accepted view of the health field is that the art or science of medicine has been the fount from which all improvements in health have flowed, and popular belief equates the level of health with the quality of medicine.

4. " The new concept" envisage[d] that the health field can be broken up into four broad elements:
Human biology
Environment
Lifestyle
Health care organization
That is, determinants of health existed outside of the health care systems.

5. The report is considered the "first modern government document in the Western world to acknowledge that our emphasis upon a biomedical health care system is wrong, and that we need to look beyond the traditional health care (sick care) system if we wish to improve the health of the public."

6. THE LALONDE REPORT
Many scholars pick 1974 as a year that marked the beginning of Health Promotion as a profession.
This was a result of a policy statement entitled ‘’ A New Perspective on the Health of Canadians’’.
This report was called the Lalonde Report.
Named after the minister of Health and Welfare at the time.

7. The report carried two main health objectives these were:
Strengthening the Health Care System
Prevention of Health Problems and Promotion of Good Health.

8. The first objective addressed the need for conscious effort to increase resources and improve service delivery of health services.
The latter addressed the need for disease prevention and implementation of health promotion services.

9. 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.

10. Another innovation of the report was that it proposed that public health interventions should focus attention on that segment of the population with the highest level of risk exposure.
In this sense, the report was fundamental in identifying health risk behaviours as a determinant of health inequalities.

11. 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.

12. A historical account of government health policy describes the beginnings of the public health movement.
This gave us pure water, improved sewage and public sanitation.
It moves on to the events leading to the establishment of universal health care in Canada, and the growth of health promotion after the Lalonde Report.

13. It emerges that none of these major advances follow a neat and logical course.
They all take a long time and progress towards eventual implementation occurs in fits and starts in a non-linear way.
Unforeseen obstacles like wars and depressions slow things down.
Ideological differences make continuous development difficult.

14. Once adopted, there is dispute about their outcomes, so that the debate about whether it is health-related initiatives or general prosperity that is responsible for the increased longevity of Canadians is far from being resolved.

15. Health field
The concept of the "health field", as identified in the Lalonde report, is considered to be composed of four interdependent fields determined to influence individual's health.
These include:
Biomedical: all aspects of health, physical and mental, developed within the human body as influenced by genetic make-up;

16. Environmental: all matters related to health external to the human body, over which the individual has little or no control, including the physical and social environment;
Lifestyle: the aggregation of personal decisions (i.e. over which the individual has control) that can be said to contribute to, or cause, illness or death; which the individual has

17. Health care organization: includes medical practice, nursing, hospitals, nursing homes, medical drugs, public health services, paramedic services, dental treatment and other health services.

18. [[Look at the Lalonde Report]]

19. The end!