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58 CHAPTER 3 ■ Saskatchewan in Motion

the provincial and territorial governments and are provided free of charge with as-
sistance from the federal government. The Canadian healthcare system has come
under stress in recent years due to a number of factors, including changes in the way
services are delivered, fiscal constraints, the aging of the baby-boom generation, and
the high cost of new technology. Reforms are under way in most provinces and ter-
ritories. Most reforms consider placing greater emphasis on promoting health, pre-
venting illness and injury, and managing chronic diseases. The federal Public Health
Agency of Canada acts as a focal point for disease prevention and control and for
emergency response to infectious diseases; however, public health services are gen-
erally delivered at the provincial/territorial and local levels (Health Canada, 2005b).

Public Health Issues

Although Canadians are among the healthiest people in the world (Public
Health Agency of Canada, 2007), they still face significant public health
challenges:

• Infectious disease factors: In Canada, HIV rates have increased over the past
five years, and sexually transmitted infections continue to spread. In
addition, risks of a number of communicable diseases are increasing (e.g.,
West Nile virus), as well as possible emergencies and disasters associated
with climate change and international terrorism.
• Chronic disease burden: More and more Canadians are directly associated with
one or more risk factors, such as smoking, unhealthy eating, and physical
inactivity, that often lead to the major chronic diseases, which account for two-
thirds of all deaths in Canada: cardiovascular disease, cancer, diabetes, and
respiratory disease. A number of initiatives have been implemented to address
these issues. For example, the federal, provincial, and territorial health
ministers have set a target to reduce obesity rates by 20% and an objective of
increasing physical activity through public health policies and effective action.
Recently, a Strategy for Cancer Control was developed and initiated.
• Determinants of health and disparities: Although Canadians are among the
healthiest people in the world, some groups are not as healthy as others. Key
health disparities in Canada are related to socioeconomic status, Aboriginal
heritage, gender, and geographic location. Demonstrated changes to key
indicators involve infant mortality, childhood obesity, poverty and child
poverty, and road accidents, as well as the health and standard of living of
Aboriginal people and visible minority immigrants. Recognizing that health
is determined by complex interactions among social and economic factors,
the physical environment, and individual behaviors, work to address health
disparities and action on the determinants of health, in collaboration with