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- Page navigation anchor for RE: A forgotten vulnerable group: Canadian children visiting relatives in the developing world.RE: A forgotten vulnerable group: Canadian children visiting relatives in the developing world.
I agree with Dr. Patrick et al. In fact, I would not hesitate to announce that by far the majority of illnesses in Canada are either self-inflicted through ignorance and complacency upon the part of the patient and then the healthcare system does its fair share of inflicting pain and suffering upon the rest. Is it time to take on another task to confuse an already confused public with too much information? Is it not time to simplify our healthcare systems for the ease of patient usage? I cannot understand why such people cannot attend their family doctor, who in turn is able to access all of the information on reputable medical websites, without more interference from others.
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Through the embrace of a culture of ridiculous political correctness; the dumbing down of society, to the extent that AI must be called upon to substitute for our incompetence; our attempts to be all things to all people, we cannot even manage to get the basics right. No wonder we need a nanny state? Is it now vitally important that we show our fallibility, by interfering with a parent's right to decision-making and caring for his children when they travel to third world countries. All the bureaucrats of the medical world have succeeded in doing, with each new attempt to improve health care, is to complicate the process. For example, read all the output from Diabetes Canada with respect to its guidelines and see how easy it is to complicate the treatment of an illness to the detriment of pa...Competing Interests: None declared. - Page navigation anchor for A forgotten vulnerable group: Canadian children visiting relatives in the developing worldA forgotten vulnerable group: Canadian children visiting relatives in the developing world
Editorial staff of CMAJ recently boasted championing the health needs of “vulnerable populations” [1]. It has been more than a decade since the CMAJ championed better access to safe and appropriate pre-travel clinical prevention for vulnerable Canadians travelling overseas [2]. The most vulnerable group of travellers are children and their hard-working immigrant parents visiting friends and relatives (VFR) [3], who still live in economically poor countries across the globe. In Calgary, imported cases of malaria are mapped mostly to municipal wards with the highest proportion of immigrant travellers returning from African and South Asia [4]. Epidemiological studies among Canadians consistently identify VFR travellers as bearing the greatest burden of preventable travel-related diseases such as malaria, hepatitis A and typhoid fever [5]. Yet the federal and provincial governments continue to avoid addressing this ongoing problem, in part due to constitutional confusion over responsibility [6].
Across Canada, provincial governments have deinsured pre-travel clinical prevention while paying foreign physicians for unregulated care, when travellers seek medical attention for fully preventable or self-treatable diseases (for example, Ontario [7,8]). This financing paradox applied to travel medicine’s continuum-of-care perversely promotes cash-strapped high-risk travellers to avoid effective pre-travel clinical prevention for life-threatening conditions, such as malaria an...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Poverty as a medical conditionPoverty as a medical condition
In a welcome CMAJ editorial, Patrick et al. [1] announce that “vulnerable populations” is to be a continuing thematic focus of the journal. We wish to draw attention to one important cause of vulnerability – poverty – and how a focus on poverty and other social determinants could herald a salient shift in our model of disease and research for the journal and for medicine more broadly.
CMAJ’s mission, as stated by Patrick et al., is to “champion knowledge that matters for the health of Canadians”, including “high-quality evidence and analysis”. Traditionally, medical evidence and analysis have been oriented around diseases, from basic research on the biology of disease and clinical epidemiological research on disease screening/intervention to disease-specific clinical guidelines. This orientation is consistent with a medical model that still places biomedical diseases at the centre [2]. While Engel’s rival biopsychosocial model was once touted in the pages of major journals [3], it has been somewhat displaced by newer humanistic movements like narrative medicine and person-centred medicine.
The subtle ambitiousness of Engel’s proposal is often underappreciated. Engel argued not merely for accepting psychological and social factors as distant upstream ‘social determinants’, but for widening the borders of disease to permit these entities. Applying this model to poverty could mean recognizing poverty as a medical condition for which we can screen with validat...
Show MoreCompeting Interests: None declared.
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