As the Lalonde Report was produced in 1974, it is 38- years old. It can be suggested that this report provided the initial means to view health in terms other than the traditional biomedical model. The Lalonde report introduced the idea of health being determined by environment and lifestyle, opposed to strictly human biology. The social determinants of health were discussed and health was characterized as more then just absence of disease. The need for prevention and health promotion were stressed and the biomedical model was challenged. This report was the primary point for a transitioned thinking away from the biomedical model and towards lifestyle models of health with emphasis on prevention and health promotion.
Although Canada failed to fully grasp the suggestions or implement any ground-breaking policy at the time of publication, the Lalonde report laid ground work for different health perspectives that shaped later reports. The issue with these commissioned reports is that they are just that-reports. Educated researchers, then and now, take years to develop innovative research-supported ideas that can be presented to both the government and public. After the report is released they can only hope that policy makers use this valuable information in their decision-making process. All too often the research based reports are ignored. The Lalonde report was a prime example of this disconnect within policy development. The report was released as a federal report in 1974, however health care in Canada remains a provincial responsibility leading to failure to execute the findings as suggested in the report. (Lalonde and beyond, 1986). This research and policy making disconnect is all too common in Canada’s political landscape. More recently there has been an increase in knowledge translation tactics to attempt to bridge this gap between the academic world and politics. I feel this is extremely important as health promotion and population health initiatives require policy implementation which is evidence based. Policy makers appear to be gaining an interest in the research world and some funding streams demand support byan influential policy maker. Hopefully this will push academics to focus on politically relevant subjects and help the policy makers embrace and apply the valuable information.
This development is critical in the world of health promotion as it has become increasingly evident public policy is a strong influencer on the health of the population. I really appreciated Rachael’s statement that the public policy must “strengthen the ability of the citizenry to influence the determinants of health” and this strengthening must be created through public policy focused on improving living conditions and “empowering communities” (Rapheal, 2008). These broad public policies referred to must be supported by strong research indicating specific suggestions to play to the environmental impact on population health. These suggestions have to be appropriately timed and politically relevant therefore knowledge translation is necessary to move these initiatives into action.
As we refocus on the Lalonde report; one wonders if knowledge translation between researchers and policy makers could have made a significant impact on our health care system decisions. Perhaps an increase of health promotion programs would have been implemented at the time. Instead, according to the Raphael article, very few programs were initiated and those that were initiated seemed to have very narrow focus on specific health behaviours. Retrospectively, had Canadians embraced and implemented Lalonde’s suggestions (as the United Kingdom seemed to), today we would be more advanced in our views of health and its relationship to environmental and lifestyle factors. In 1974 Lalonde connected environment and lifestyle as key contributors to health, however our government failed to apply this knowledge effectively and make large policy changes. I am hopeful that with the new focus on evidence based policymaking and knowledge translation we will witness academics and policymakers streamlining our approach to meaningful evidence-based health policy. Although whether this will occur in a timely fashion still remains unclear.
Lalonde and beyond: Looking back at “A New Perspective on the Health of Canadians”. (1986). Health Promotion International, 1(1), 93-100. doi:10.1093/heapro/1.1.93
Raphael, D. (2008). Grasping at straws: a recent history of health promotion in Canada. Critical Public Health, 18(4):483-495.