What do we do with the SARS reports?

The magnitude of the SARS disaster led to the establishment of several commissions and inquiries, whose reports are now available. While the reports were triggered by SARS, and focus on many issues arising from SARS, they all clearly acknowledge that concerns regarding public health in this country are long-standing. Virtually every report on the future of our health system has identified the need for investment in public health, disease prevention and health promotion as a key to sustaining our healthcare system. Yet, these earlier recommendations have been largely ignored. We can only hope that with the magnitude of the SARS disaster still relatively fresh in our minds, we will not ignore these new reports.     

Urban health in developing countries: What do we know and where do we go?

The world became mainly urban in 2007. It is thus timely to review the state of knowledge about urban health and the current priorities for research and action. This article considers both health determinants and outcomes in low-income urban areas of developing countries. The need to study urban health in a multi-level and multi-sectoral way is highlighted and priorities for research are identified. Interventions such as the Healthy Cities project are considered and obstacles to the effective implementation of urban health programmes are discussed. Concepts such as the double burden of ill health and the urban penalty are re-visited. Finally, a call for a shift from 'vulnerability' to 'resilience' is presented.     

What do we mean when we say "palatable food"?

The word palatability and related words have not been used in a consistent way. Palatability may be a property of a food, of the organism eating the food, or both. Investigators have failed to distinguish different possible meanings of the statement: "palatable foods increase intake". This may indicate: (1) a simple observation that some foods stimulate more intake than others, (2) an innate response to the taste of foods that alters appetite, (3) a correlate of food intake that does not itself affect intake, and (4) a link in a causal chain involving prior associations between foods and their postingestive consequences.     

Statins and cancer risk: what do we know and where do we go from here?

The relationship between statin use and cancer risk has been evaluated in numerous observational studies and as a secondary outcome in randomized controlled trials evaluating the effects of statins on cardiovascular outcomes. Although there are plausible biologic mechanisms to suggest that statins could inhibit cellular proliferation, the epidemiologic data do not show a consistent reduction in cancer risk among statin users. Despite the current lack of evidence for a chemopreventive effect, there are several methodologic considerations in the studies reported to date that prevent a definitive conclusion that statins do not reduce cancer risk. Given the widespread use of statins, continued monitoring of their risks and benefits is warranted.     

Measuring inequalities in health: What do we know? What do we need to know?

We argue that policy analysis aiming at curving inequalities in health calls for a better understanding of what we know about its measurement pathways. Assuming that health is a good that individuals trade off against other goods, unavoidable health inequalities result when after controlling for unavoidable factors (e.g., age and gender), differences in socioeconomic status of an individual systemically engender differences in health outcomes. However, the measurement of such inequality and underpinning reasons behind are not suggestive of a clear picture. In reviewing the literature, we conclude that it is unclear what the evidence suggests about the reasons for health inequalities as well as the best possible instruments to measure both inequality and socioeconomic health gradients. We provide an evaluation of the different sources of health inequity and we draw upon measurement issues and their policy significance.     

Where do we go from here?

In the past two and a half years since the Senate Committee began its study of the Canadian healthcare system, an abundance of reports on healthcare, at both the provincial and federal levels, have been issued that have provided the public and policy-makers with a comprehensive overview of the key issues and the main options for change. We have clearly reached a point where action of some sort can no longer be deferred on the grounds that further study is necessary. It is now a question of finding the political will to move forward with reform.