Status report – Public Health 2016: time for a cultural shift in the field of public health

摘要

Public Health 2016 , the Canadian Public Health Association's annual conference, was held from June 13 to 16, 2016, in Toronto, Canada, and showcased a wide variety of public health issues that fostered considerable discussion at the conference and on social media. ^{Footnote 1 , Footnote 2} The four plenary sessions, while on seemingly disparate topics including technology, violence prevention, racism and harm reduction, all revealed the need for a cultural shift in the field of public health that acknowledges and addresses the broader inequities that influence the health and well-being of populations. They also highlighted some of the key challenges that society faces in achieving the UN Sustainable Development Goals released in 2015. ^{Footnote 3} The impact of the social determinants of health is widely acknowledged in the field of public health, yet much work remains to effectively address these social, economic and environmental factors through policy change and program intervention. Further, while the dominant public health discourse acknowledges the role of income, employment and education, it often skirts around broader social inequities such as racism and structural violence, thereby perpetuating the very same health disparities the field is trying to lessen.The opening ceremony at Public Health 2016 featured introductory remarks by Dr. Camara Jones, the president of the American Public Health Association, who spoke persuasively on the impact of racial disparities, privilege and power as they relate to health inequities. Dr. Jones used the powerful allegory of a two-sided sign displayed in a restaurant window shortly following closing: those within the restaurant enjoying their meal see the “Open” side, while hungry individuals passing by the restaurant see the “Closed” side. This allegory very effectively illustrates how social inequities such as racism create a dual reality whereby individuals on opposite sides of the “Open-Closed” sign receive differential access to opportunities, ultimately maintaining population health inequities.