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CPHA 2012 conference

2012 June 15

The Canadian Public Health Association’s 2012 conference just wrapped up in Edmonton. I attended this conference last year for the first time (in Montreal), and both times now, I’ve come away inspired, fired up, chock full of ideas and motivation and useful new knowledge. One long-returning attendee said of the conference that “it feels like coming home”, and I can’t agree more. Here are the highlights, mostly for my own records.

Sex work

On the plane to Edmonton, I wrote a draft op-ed arguing for decriminalization of sex work, thinking that perhaps I would try to publish in CMAJ and get the medical community at large on board with this issue.

At the conference, I attended an excellent all-day workshop on advocacy skills, led by Shari Graydon of informedopinions.org (formerly the Vancouver Sun’s “token feminist”), which turned out to be focused especially on writing op-eds. I further developed my draft op-ed there, and met a former classmate who turned out to be writing the exact same op-ed as me.

I also attended CPHA’s Policy Forum and heard how they develop their policy, and how proud they were of having intervened in the InSite case, so I figured sex work would be a natural next step. Their lawyer agreed with me, including the probable Supreme Court appeal of the Bedford case (see latest ruling) at the top of a list of issues for which a public health argument might gain traction in a court case. So I told them I’d be preparing a policy proposal for CPHA to support the decriminalization of sex work, including possibly intervening in this case, and I asked around for support in my effort. I got some words of encouragement and some good contacts.

Substance use

CPHA, to my great pleasure, went on and on about how proud it was of having successfully intervened in the Supreme Court of Canada case around InSite: a national public health organization successfully challenging its own government in court is apparently almost unprecedented in history. (Read the extremely interesting ruling here.) They came away thinking that they should use the law more often to achieve public health goals.

They also explained in detail how they achieved intervener status in the case and how they prepared the factum (statement) they submitted as an intervener, and the detailed legal, scientific, and rhetorical considerations that went into it. Very, very instructive.

I also learned about BCCDC’s harm reduction program, which I contributed to in a small way once, but never knew about the big picture. Very inspiring, particularly for its empowerment of drug users to contribute to policy development. Their newest project is to make naloxone (an anti-opiate medication that can save people from overdose death) directly available in the community to people who need it, instead of keeping access restricted.

Aboriginal health

Evan Adams and Charlotte Reading were fiery and proud and unapologetic plenary speakers (though less so than the formidable Jess Yee was last year). I loved it.

Dr. Adams called out Canada’s abject failure to meet the commitments it made in signing the 2005 Kelowna Accord or the UN Declaration on the Rights of Indigenous Peoples. Dr. Reading talked even more provocatively about ongoing structural racism in Canada as a negative social determinant of Aboriginal health, but I wondered whether even this audience was aware of the long and ongoing history of racist Canadian policy towards Aboriginals. I think ignorance of history is the next layer up in the determinants of ill health; these structures won’t change until non-indigenous people understand what’s happening. But they don’t teach this stuff in our Eurocentric public schools: I didn’t even know about residential schools until medical school (and residential schools are just the most salient in a long list of abuses). This needs to change.

I also learned the phrase “Nothing about us without us“, a slogan that has been adopted by a number of oppressed groups, including indigenous people, people with disabilities, drug users, and ethnic minorities around the world.

I also saw a brief talk on tuberculosis among Inuit and First Nations people, and was pointed toward an apparently very comprehensive 2010 Senate report on the matter called The Way Forward.

I missed Leslie Varley and Cheryl Ward’s cultural competency workshop, but apparently their online course is very, very good, and I’ll aim to work through it in the next month or two.

Environmental health

The built environment is a major determinant of whether we walk, bike, or drive; what kind of food we eat and water we drink; the quality of air we breathe; and so on—and thus our rates of heart disease, obesity, diabetes, stroke, lung disease, cancers, etc. Infrastructure, urban planning, architecture, and marketing are all crucial in public health. In particular, Richard Jackson, with his PBS series on the topic, and Karen Lee, who leads New York City’s visionary design team, were very entertaining and inspiring on this topic.

Michael Brauer, discussing the potential public health benefits of infrastructure projects that are not intended to have public health benefits, pointed out a very striking study showing a drop in premature birth and low-birth-weight infants in the vicinity of new checkpoints on the New Jersey Turnpike, presumably due to a reduction in traffic congestion and therefore air pollution in the area. Wow!

David Suzuki, the keynote, took a biologist’s perspective to embed humanity within the natural world, a species that spent most of its history as exclusive hunter-gatherers, only very recently  developing agriculture and then moving to big cities, disconnecting us (non-indigenous people especially) materially and spiritually from our still-fundamental dependence on and stewardship of nature, falsely elevating the man-made economy above the natural environment, and producing a growing public health disaster. He provided a lot of ideas that people kept referring back to throughout the conference, and he was hilarious.

And more

  • Engagement: One presenter showed this helpful diagram illustrating how “participation” in decision-making is not as simple as yes-or-no, but can be conceptualized as a series of increasingly participatory steps. Another discussed a very interesting case of a remote island taking control of its social determinants of health, one of a series of “citizen engagement” cases cited in a recent CIHR publication. It is very nice to see participatory research held in such high esteem these days!
  • Homelessness: Don’t miss “Here at Home”, an NFB web documentary on homelessness.
  • Economics and public health: We heard from the APHA’s Georges Benjamin about the economic benefits of public health investment, and from Mark Anielski, author of The Economics of Happiness, about the growing movement to implement an economy based on well-being rather than money. Most interesting tidbit: a graph of Canadian cities ranked from most to least life satisfaction, with showed low variation, but Sherbrooke at the top and Vancouver second from last (see page 21 of this report).

All in all

Last year, I found many pearls of inspiration which were so potent that they triggered a social justice revolution in my brain, but they seemed to be the exceptions, buried in the small sessions; the plenaries too often seemed to flirt with the self-congratulatory, utilitarian, paternalistic tone more typical of classical public health. This year, though, I found enough critical perspectives in prominent places, and enough celebration of “speaking truth to power”, to convince me that Canada’s “independent voice of public health” really is my kind of organization. So I plan to get more involved.

Next year in Ottawa!

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