LaLonde report
Encyclopedia
The Lalonde Report is a 1974 report produced in Canada
formally titled A new perspective on the health of Canadians. It proposed the concept of the "health field", identifying two main health-related objectives: the health care system
; and prevention of health
problems and promotion of good health
. The report is considered the "first modern government document in the Western world to acknowledge that our emphasis upon a biomedical health care system is wrong, and that we need to look beyond the traditional health care (sick care) system if we wish to improve the health of the public."
, who was the Canadian Minister of National Health and Welfare
, proposed a new "health field" concept, as distinct from medical care. Lalonde noted that the "traditional or generally-accepted view of the health field is that the art or science of medicine
has been the fount from which all improvements in health have flowed, and popular belief equates the level of health with the quality of medicine." The new concept "envisage[d] that the health field can be broken up into four broad elements: Human biology
, Environment
, Lifestyle, and Health care organization
;" that is, determinants of health
existed outside of the health care systems.
The report is considered to have led to the development and evolution of health promotion
, recognizing both the need for people to take more responsibility in changing their behaviors to improve their own health, and also the contribution of healthy communities and environments to health.
Another innovation of the report was that it proposed that public health
interventions should focus attention on that segment of the population with the highest level of risk exposure
. It this sense, the report was fundamental in identifying health risk behaviours as a determinant of health inequalities.
The proposals advocated by the report seem to have had mixed outcomes; while its nutritional and exercise recommendations are believed to have been widely accepted, there remains disagreement about its overall impact on population health. It has been argued such debates highlight the need for a fuller exploration of the health policies in place.
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
formally titled A new perspective on the health of Canadians. It proposed the concept of the "health field", identifying two main health-related objectives: the health care system
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
; and prevention of health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
problems and promotion of good health
Health promotion
Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...
. The report is considered the "first modern government document in the Western world to acknowledge that our emphasis upon a biomedical health care system is wrong, and that we need to look beyond the traditional health care (sick care) system if we wish to improve the health of the public."
Background
Marc LalondeMarc Lalonde
Marc Lalonde, PC, OC, QC is a retired Canadian politician and Cabinet minister.Lalonde was born in Île Perrot, Quebec and obtained a Master of Laws degree from the Université de Montréal, a Master's degree from Oxford University, and a Diplôme d'études supérieures en droit from the University of...
, who was the Canadian Minister of National Health and Welfare
Minister of Health (Canada)
The Minister of Health is the Minister of the Crown in the Canadian Cabinet who is responsible for overseeing the federal government's health department and the enforcing the Public Health Agency of Canada, Canada Health Act, the law governing Medicare...
, proposed a new "health field" concept, as distinct from medical care. Lalonde noted that the "traditional or generally-accepted view of the health field is that the art or science of medicine
Medicine
Medicine is the science and art of healing. It encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
has been the fount from which all improvements in health have flowed, and popular belief equates the level of health with the quality of medicine." The new concept "envisage[d] that the health field can be broken up into four broad elements: Human biology
Human biology
Human Biology is an interdisciplinary area of study that examines humans through the influences and interplay of many diverse fields such as genetics, evolution, physiology, epidemiology, ecology, nutrition, population genetics and sociocultural influences. It is closely related to...
, Environment
Environmental quality
Environmental quality is a set of properties and characteristics of the environment, either generalized or local, as they impinge on human beings and other organisms...
, Lifestyle, and Health care organization
Health care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
;" that is, determinants of health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
existed outside of the health care systems.
The report is considered to have led to the development and evolution of health promotion
Health promotion
Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...
, recognizing both the need for people to take more responsibility in changing their behaviors to improve their own health, and also the contribution of healthy communities and environments to health.
Another innovation of the report was that it proposed that public health
Public health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
interventions should focus attention on that segment of the population with the highest level of risk exposure
Risk factor
In epidemiology, a risk factor is a variable associated with an increased risk of disease or infection. Sometimes, determinant is also used, being a variable associated with either increased or decreased risk.-Correlation vs causation:...
. It this sense, the report was fundamental in identifying health risk behaviours as a determinant of health inequalities.
The proposals advocated by the report seem to have had mixed outcomes; while its nutritional and exercise recommendations are believed to have been widely accepted, there remains disagreement about its overall impact on population health. It has been argued such debates highlight the need for a fuller exploration of the health policies in place.
Health field
The concept of the "health field", as identified in the Lalonde report, is considered to be composed of four interdependent fields determined to influence individual's health. These include:- Biomedical: all aspects of health, physical and mentalMental healthMental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
, developed within the human bodyHuman bodyThe human body is the entire structure of a human organism, and consists of a head, neck, torso, two arms and two legs.By the time the human reaches adulthood, the body consists of close to 100 trillion cells, the basic unit of life...
as influenced by geneticGeneticsGenetics , a discipline of biology, is the science of genes, heredity, and variation in living organisms....
make-up; - Environmental: all matters related to health external to the human body, over which the individual has little or no control, including the physical and social environment;
- Lifestyle: the aggregation of personal decisions (i.e. over which the individual has control) that can be said to contribute to, or cause, illness or death;
- Health care organization: includes medical practice, nursing, hospitalHospitalA hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....
s, nursing homes, medical drugs, public health servicesPublic healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
, ambulances, dental treatment and other health services.
See also
- Alma-Ata declaration
- Health inequalities
- Public healthPublic healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
- Social determinants of healthSocial determinants of healthSocial determinants of health are the economic and social conditions under which people live which determine their health. They are "societal risk conditions", rather than individual risk factors that either increase or decrease the risk for a disease, for example for cardiovascular disease and...