Remarks from the Chief Public Health Officer on December 13, 2021

Speech

December 13, 2021 | Ottawa, ON | Public Health Agency of Canada

The COVID-19 pandemic continues to create stress and anxiety for many Canadians, particularly those who do not have ready access to their regular support networks. Through the Wellness Together Canada online portal, people of all ages across the country can access immediate, free and confidential mental health and substance use supports, 24 hours a day, seven days a week.

Thank you all for joining me today for the launch of my 2021 annual report - 'A Vision to Transform Canada's Public Health System'.

COVID-19 represents the biggest public health crisis that our country has confronted in a century. From the onset of the pandemic, Canada's public health system was thrust into the spotlight, as the first line of defense against the SARS-CoV-2 virus. Public health has always worked behind the scenes to protect and improve the health of people across this country, but our work has become much more visible during the past two years.

Every year, I deliver an annual report on the state of public health in Canada as part of my mandate. This year, as we find ourselves at a critical juncture- still responding to the pandemic, but also looking towards pandemic recovery, I reflect on Canada's pandemic experience and propose key actions to strengthen our public health system and ensure we are better equipped for the future.

I often say that as Canada's Chief Public Health Officer, the population is my patient. That is what it means to work in public health. Public health is concerned about the population's health as a whole. Its mission is to prevent injury and illness, promote healthy behaviours, and to ensure that ALL people have an equal opportunity to stay healthy and well. Public health is the outbreak that did not happen, the traumatic injury that did not occur, and the opioid overdose that was avoided.

COVID-19 has been a stress test for Canada's public health system. Over the course of the past two years, we have witnessed our public health system switch into overdrive, as it rapidly adapted to meet the challenge of protecting our health during a global pandemic. And incredibly, it rose to the occasion, but at a serious cost. Our public health system has been stretched dangerously thin and it is in need of critical reinforcements.

And as the emergence of the Omicron variant of concern has reminded us, public health must be ready and able to respond at a moment's notice when new threats to our health emerge.

The call for public health renewal in Canada is not new. It has been echoed by many others in the field over the years, including past Chief Public Health Officers in annual reports dating back to 2008. However, the COVID-19 pandemic has served as an important wake-up call.

Simply put, we were not prepared to face a public health emergency of the magnitude of COVID-19. We can no longer dismiss the voices or delay necessary actions - there are increasingly urgent signs that we need to act now.

As I discussed in last year's annual report From Risk to Resilience: An Equity Approach to COVID-19, people in Canada were not on an equal footing when the pandemic took hold. Broader inequities in our society, including colonialism, racism and other forms of stigma, have resulted in disproportional impacts of COVID-19 on the health of some populations in Canada.

This year, fighting the pandemic remains Canada's top priority, but other complex public health challenges also require urgent attention. These include the health effects of climate change, the opioid overdose crisis, antimicrobial resistance, and worsening mental health. We know that the same people who felt the impacts of COVID-19 more severely, will also be those harder hit by other health crises.

We must take action to ensure that everyone in Canada is equally protected and able to achieve their optimal health moving forward. Canada's best defense against future public health threats is a strong public health system and a healthier population.

In my report, I describe four priority areas of action, intended to stimulate public health system transformation:

  • First, we must renew and reinvigorate our public health workforce. The pandemic has seriously impacted public health workers across the country, with frequent reports of burnout.
  • The pandemic has sparked increased interest in the field of public health. We must work to recruit, retain and build the next generation of public health professionals, with a highly skilled, diverse and inclusive workforce that best reflects the communities they serve. Surge capacity is also required to rapidly expand the workforce in times of emergency.
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  • Second, our public health toolbox needs some serious upgrades!
  • There is no doubt that our pandemic response was impacted, in part, by significant gaps in our public health surveillance and data systems - including a lack of data on race and ethnicity, a lack of comparable data between provinces and territories and information gaps at the local level.
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  • Working across federal, provincial and territorial governments, the Pan-Canadian Health Data Strategy must be accelerated to address these gaps in a secure and ethical manner - and ensure that public health has the right data at the right time for effective decision-making.
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  • We also need to strengthen a "made-in-Canada" research agenda, in order to identify which public health interventions are most effective to improve the health of populations and reduce health inequalities.
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  • Third, we will need to modernize our governance models and collaboration structures.
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  • The pandemic has demonstrated, once and for all, that we cannot work in siloes, and that complex public health challenges require a "whole of society" approach, working together across jurisdictions, sectors, industries, communities and borders. We must ensure that these efforts are better supported, with collective action based on clear and measurable indicators, to understand if we are meeting our goals of achieving better health for all.
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  • First Nations, Inuit and Métis communities must also be supported in developing their own public health priorities, plans, and solutions.
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  • Finally, appropriate investments are key to enabling these advances in our workforce, tools and governance.
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  • As we have seen in the past, public health resources are often scaled back after public health emergencies as governments move to address other priorities. This is referred to as the "boom and bust" cycle of public health spending. This places the public health system at a disadvantage at the onset of each crisis by not having the capacity or the networks required for a rapid response. It also impacts public health's capacity more generally, as its objectives - disease prevention and health promotion - are much longer term.
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My hope is that the recommendations outlined in my report spark a much-needed national dialogue and catalyze collective action on public health renewal.

However, key to this, will be a fundamental shift in the way we think about and value health in our country. An effective health system is about more than treating illness through medicines and hospital procedures - it means preventing these illnesses from happening in the first place.

In fact, these systems are complementary- by keeping people healthy, our public health system reduces the burden on our healthcare system and contributes to its sustainability.

As people of Canada, we value our healthcare system. It is built into the social fabric of our country. We must come to value prevention and wellness to the same extent that we do medical treatments and care.

I would like to conclude on a positive but pragmatic note: Canada's public health system is not perfect, and significant work lies ahead in terms of our transformation process, we must get ready to roll our sleeves up. But I have always had great hope and confidence in our system's vast potential. And I know that many of my counterparts at the provincial and municipal levels are equally optimistic.

However, to fully realize our vision of a world-class system, we must all be invested. The public's health is a collective responsibility that we all share. We have seen examples of greatness throughout the pandemic; including the largest mass vaccination campaign in Canadian history, which mobilized many sectors and individuals to great success, Indigenous ownership within the pandemic response, and innovative local efforts to help community members in need. This is just a glimpse into what is possible when we work together.

Public health is for everyone, by everyone. Joining forces across communities, governments, sectors, and internationally, we can build a public health system that best serves us all, and supports a healthy and thriving society. It is in working together, that we can make sure we get it right.

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Contacts

Media Relations
Public Health Agency of Canada
613-957-2983
media@hc-sc.gc.ca

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