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The analysis of the issue definition of autism and different aspects of disability policy are presented. It is observed that although autism became a prominent public issue there was a failure to identify it as a major public problem.

Food guides to help consumers make healthy choices have recently been released in three countries: Japan, Canada, and the United States. The visual symbol that introduces key concepts is a spinning top in Japan, a rainbow in Canada, and a pyramid in the United States. The main features of the new guides are given in printed consumer resources, and more detailed information is available at related websites. Although the process of developing the guides varied among the countries, the resulting recommended food patterns are remarkably consistent. Key words: dietary guidance, food guides, food patterns

The transfusion transmission of hepatitis C and HIV to thousands of Canadian blood recipients was one of this country's largest public health catastrophes. In response to this crisis, and in an effort to prevent such a tragedy from occurring again, the Canadian blood system has undergone substantial reform. Variant Creutzfeldt-Jakob (vCJD) disease was the first infectious threat faced by the blood system since undergoing reform. The response at the time to this risk provides insights into the Canadian blood system's new approach to infectious threats. Our analysis of the decision-making concerning vCJD identifies two dominant themes characterizing the new blood system's approach to safety: (1) the adoption of a precautionary approach to new risks which involves taking action in advance of definitive evidence, and (2) risk aversion amongst policy makers, which has contributed to the adoption of safety measures with comparatively high cost-effectiveness ratios. Overall the principles governing the new blood system have contributed to the system both providing protection against emerging infectious risks and regaining the confidence of the public and recipients. However, the current set of policy factors will likely contribute to increasingly risk-averse policy making that will contribute to continued increases in the cost of the blood system. The challenge the blood system now faces is to find the appropriate balance between maximizing safety and ensuring the system remains affordable. Keywords: Creutzfeldt-Jakob disease; Blood safety; Policy analysis: Risk decision-making; Precautionary principle: Cost-effectiveness; Canada

Canada's health system is an important reflection of its values, principles, and its overall national character. It. is said to be a 'key distinguishing characteristic' of the country according to [...]

The way in which the processes of globalization have affected the spread of infectious disease like severe acute respiratory syndrome (SARS) is being investigated within the context of the global cities network. It is found that the relationship of global city formation and spread of infectious disease is central to understanding the structure of globalized network and this relationship poses new issues for public health and epidemiological efforts at disease containment and tracking.

The term 'blood activism' describes the range of collective challenges that arose among victims of Canada's tainted-blood scandal in the 1990s. This article examines the emergence of blood activism in Canada from the perspective of social movement theory, paying particular attention to the tensions between victims who contracted HIV through tainted blood and those who contracted Hepatitis C, the so-called 'forgotten victims of the tragedy. This study discusses how changes in the political opportunity structure'--loosely defined in the literature as aspects of the movement's external environment--influenced the nature of political action pursued by victims of tainted blood, the negotiation of the movement's collective identity and policy outcomes. L'expression \s?\ activisme du sang \s?\ designe les combats collectifs menes par les victimes du scandale du sang contamine au Canada durant les annees 1990. En s'appuyant sur la theorie des mouvements sociaux, cet article examine l'emergence de l'activisme du sang au Canada en accordant une attention particuliere aux tensions entre les personnes qui ont ete contaminees par le virus du SIDA et les \s?\ victimes oubliees \s?\ de cette tragedie qui ont contracte le virus de l'hepatite C lors de transfusions sanguines. Le texte analyse l'influence qu'ont eu les changements de la \s?\ structure des opportunites politiques \s?\, que la litterature associe de maniere imprecise aux aspects de l'environnement externe des mouvements sociaux, sur l'action politique des victimes du sang contamine, l'identite collective de leur mouvement et les decisions des dirigeants politiques.

This paper presents results from a study of the community health impacts of a petroleum refinery in Oakville, Ontario in Canada. The research is informed by the environmental stress and coping literatures and the focus is on community reappraisal of the refinery's impacts before and after the implementation of a substantive odour reduction initiative on the part of the refinery operators. Community health surveys were conducted in 1992 (n = 391) and 1997 (n = 427) to examine changes in odour perception and annoyance and self-reported health status attributable to the odour reduction plan. The findings reported here suggest an on-going process of cognitive reappraisal, whereby negative perceptions and concerns decreased between 1992 and 1997. Irrespective of this positive reappraisal of the refinery efforts, those living close to the refinery continue to report negative health impacts. A strong mediating effect of odours on the refinery exposure-symptom reporting relationship was confirmed by our results. While the relationship between odour perception and symptom reporting indicates the importance of odour perception and annoyance as the principal mechanism mediating ill-health reporting, the plausibility of other causal pathways is recognized. Residents' sensitivity to the negative effects of the refinery on their health and the health of their children suggests a psychosocial reaction to the environmental stress associated with perceived and actual refinery emissions. Keywords: Reappraisal; Health and well-being; Refinery emissions; Odour perception; Environmental stress; Ontario

The Burkholderia cepacia complex is an important group of pathogens in patients with cystic fibrosis (CF). Although evidence for patient-to-patient spread is clear, microbial factors facilitating transmission are poorly understood. [...]

Varied mobility patterns in Canada significantly influence epidemic peaks of influenza among communities but have little impact on the cases within communities. The central location in a region's political and social hierarchy may be more important in epidemic spread than a central location for travel patterns.

L'auteure examine le genre chez les porteurs du virus SIDA a travers la violence faite aux femmes et les inegalites sociales. Elle attire notre attention en particulier sur le fait [...]

The rate of diabetes among the indigenous Metis of western Canada is slightly less than among North American Indians and twice the general rate for Canada. Diabetes is also associated with education level, obesity, age and sex for this population.

This paper assesses the extent to which Canada's universal health care system has eliminated socio-economic barriers in the use of physician services by examining the role of socio-economic status in the differential use of specific, publicly-insured, primary and specialist care services. Data from the 1994 National Population Health Survey, a nationally representative survey, were analysed using multiple logistic regression. In order to control for the association between primary and specialist utilisation, a two-staged least squares method was used for models explaining specialist utilisation. Health need, as measured by perceived health status and number of health problems, was found to be consistently associated with increased physician utilisation, for both primary and specialist visits. Whereas the likelihood of an individual making at least one visit to a primary care physician was found to be independent of income, those with lower incomes were more likely to be frequent users of primary care, that is, make at least six visits to a primary care physician. Even after adjusting for the greater utilisation of primary care services by those in lower socio-economic groups, and, therefore, their higher exposure to the risk of referral, the utilisation of specialist visits was greater for those in higher socio-economic groups. Canadians lacking a regular medical doctor were less likely to receive primary and specialist care, even after adjustments for socioeconomic variables such as income and education. Although financial barriers may not directly impede access to health care services in Canada, differential use of physician services with respect to socio-economic status persists. After adjusting for differences in health need, Canadians with lower incomes and fewer years of schooling visit specialists at a lower rate than those with moderate or high incomes and higher levels of education attained despite the existence of universal health care. Keywords: Socio-economic status; Utilisation; Primary and specialist services; Canada

This study uses data from the 1994 National Population Health Survey and applies the methods developed by Wagstaff and van Doorslaer (1994, measuring inequalities in health in the presence of multiple-category morbidity indicators. Health Economics 3, 281-291) to measure the degree of income-related inequality in self-reported health in Canada by means of concentration indices. It finds that significant inequalities in self-reported ill-health exist and favour the higher income groups - the higher the level of income, the better the level of self-assessed health. The analysis also indicates that lower income individuals are somewhat more likely to report their self-assessed health as poor or less-than-good than higher income groups, at the same level of a more 'objective' health indictor such as the McMaster Health Utility Index. The degree of inequality in 'subjective' health is slightly higher than in 'objective' health, but not significantly different. The degree of inequality in self-assessed health in Canada was found to be significantly higher than that reported by van Doorslaer et al. (1997, income related inequalities in health: some international comparisons, Journal of Health Economics 16, 93-112) for seven European countries, but not significantly different from the health inequality measured for the UK or the US. It also appears as if Canada's health inequality is higher than what would be expected on the basis of its income inequality.

Resistance to the fluoroquinolone antibiotics is increasing in Canada. Researchers tested the susceptibility of strains of Streptococcus pneumoniae to these antibiotics between 1993 and 1998. The percentage of strains that were becoming resistant to the drugs increased from zero in 1993 to 1.7% in 1998. Resistance was more common in elderly patients and those living in Ontario. The use of fluoroquinolones was also greatest in the elderly and Ontario residents. The number of prescriptions for flouroquinolones increased 7-fold between 1988 and 1997.

Although gender differences in schizophrenic symptom expression have been widely established, no systematic studies have documented if these differences extend to the perception of quality of life. This survey gathered international data on the perception of quality of life among 102 outpatient men and women with schizophrenia from Canada, Cuba, and the United States. Using portions of Lehman's Quality of Life Interview, quality of life was assessed on the domains of social relationships, health, living situation, leisure, finances and general quality of life. Gender differences were tested with ANOVA where site was treated as a nested variable and separate t-tests comparing men and women within each country. Although no differences were found for the combined sample, differences were observed between men and women in Canada and Cuba on the social relationship domain. In Canada, women with schizophrenia reported a higher quality of life for social relationships. In contrast, Cuban men with schizophrenia reported higher quality of life for social relationships than Cuban women. Findings from the three sites show no differences for the other domains. With the possible exception of social relationships, these findings suggest no discernable differences in the perception of quality of life for men and women with schizophrenia. Overall, men and women with schizophrenia were only somewhat satisfied with some aspects of life. These findings have implications for developing comprehensive community care that includes quality of life promotion.

The 1995 General Social Survey was conducted to determine Canadians' exposure to environmental tobacco smoke or second-hand smoke. The results indicate that almost half of non-smokers are exposed to second-hand smoke and that adolescent nonsmokers are most likely to be exposed to second-hand smoke. The findings also reveal that more men are exposed to second-hand smoke and that second-hand smoke exposure is most common at home and in manufacturing industries.

Geneticization is a broad term referring to several related processes such as a spreading tendency to use a genetic model of disease explanation, a growing influence of genetics in medical practice, and the slow changing of individual and societal attitudes towards reproduction, prevention and control of disease. These processes can be demonstrated in medical literature on preventive genetic screening and counselling programs for [Beta]-thalassaemia in Cyprus, the United Kingdom and Canada. The preventive possibilities of the new genetic and diagnostic technologies have been quickly understood and advocated by health professionals, and their educational strategies have created a web of social control, in marked contrast to the alleged voluntary decision-making process and free choice. Genetic diagnostic technologies have led to considerable changes in control and management of [Beta]-thalassaemia, and have generated a number of unresolved incongruities. Key words: [Beta]-thalassaemia, genetic screening, geneticization, prenatal diagnosis.

Physicians in Canada may be undertreating other, unrelated conditions in patients with chronic diseases. Researchers evaluated the care of 1,344,145 elderly patients eligible for free medications under the Ontario Drug Benefit program. Patients with diabetes were 60% less likely to receive estrogen-replacement therapy, when medically indicated. Those with emphysema were 31% less likely to be taking cholesterol-lowering medications. Doctors may be neglecting other medical conditions for which treatment could be beneficial, while focusing on management of the primary, chronic disease.