Chapter 6 Review Questions

The Health Care Act requires all provinces and territories to provide and fund care that is deemed “medically necessary.” By deeming a service extended rather than necessary, governments can argue for lack of coverage. Over the years, Canadians have seen the de-listing of services such as the completion of medical forms and eye care. Further, with shortened hospital stays and an increased reliance on home care services, many more services are falling outside of the parameters of the Act.

As early as 1867, the federal government charged provinces and territories with the responsibility of creating, delivering, and managing health care. This was done to ensure that local realities and differences would be incorporated into service development. The federal government does influence provincial and territorial decision-making through acts such as the Canada Health Act and funding such as the Canada Health Transfer, but ultimately it is up to provincial and territorial governments to decide how many and what types of health services to support and develop.

The social determinants of health framework highlights how social and economic disparities among populations or groups of individuals impact both individual and community health outcomes. It recognizes that one’s predisposition to poor or good health is as much about one’s social and economic location as it is about one’s genetics and health behaviours. As such, the model holds a holistic view of health.

Integrating a life-course perspective allows for a focus on how exposure to health determinants at different life stages can impact health at other stages, such as through latency effects and pathway effects.

A lack of sufficient, safe, and nutritious food can lead to malnutrition, diabetes, cardiovascular diseases, cancer, degenerative eye diseases, obesity, and poor dental health, and can also impair childhood physical and psychological development.

A community mental health perspective sees mental health promotion and illness treatment as a public health issue, connected to issues of social justice. This approach promotes mental health in multiple ways, including by addressing health from a population perspective; seeing clients in a socio-economic context; generating information on primary prevention; focusing on individual as well as population-based prevention; having a systematic view of service provision; advocating for open access to services; emphasizing the importance of team-based services; seeing mental health from a long-term, longitudinal, life-course perspective; and exploring cost-effectiveness in population terms.

Barriers to access include difficulties in creating trusting relationships with staff due to high staff turnover and burnout rates, long distances to facilities, and limited opportunities for training and support. Community members and health-care professionals often feel underprepared to manage the complex social, psychological, and psychiatric needs of their rural communities.

Latency effects of early childhood experiences predispose children to either good or poor health regardless of their experiences in later life, while pathway effects refer to a situation in which children’s exposure to risk factors at one point do not have immediate health effects but later lead to situations that do have health consequences.