Canada - World Health Organization Regional Office for Europe

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Health systems in transition Canada
In Quebec, the Public Health Act of 2001 empowers the Minister of
Health and Social Services to initiate intersectoral actions that reflect policies
favourable to the health of the provincial population. The Act also requires
that the legislative and regulatory proposals from all other departments and
agencies in the Quebec Government be subjected to a mandatory health impact
assessment. In Ontario, the provincial government is exploring a “health in all
policy” approach that appears to have originated in Finland (Ståhl et al., 2006).
This approach, if implemented, would embed a health equity assessment tool
in the development of all policies in the Ontario Government (HCC, 2010b).
While there have been a number of intersectoral health initiatives in Canada,
few have set targets with clearly defined objectives within specified time
frames. In addition, these initiatives have not generally been accompanied by
a systematic evaluation of processes and outcomes. While these are features
that the Canadian initiatives share with similar intersectoral initiatives in other
countries (PHAC, 2008), there is an opportunity for more specific target setting
and systematic evaluation in future intersectoral initiatives.
2.7 Health information management
To support system-wide planning, provincial governments have invested in
health ICT infrastructures with plans to create EHRs for all provincial residents.
As befits its federal character, Canada has a plurality of information systems in
place for the collection, reporting and analysis of health data.
2.7.1 Data and information systems
At the P/T level, governments have been collecting detailed administrative data
since the introduction of universal hospital and medical insurance plans. At
the federal level, Statistics Canada has been collecting population health data
through both the national census taken every five years and large-sample health
surveys, including the Canadian Community Health Survey (CCHS), a crosssectional
patient self-report survey, and the Canadian Health Measures Survey
(CHMS), a direct measure survey of the Canadian population. Statistics Canada
is governed by a legislative framework – the Statistics Act – that makes the
provision of basic census data compulsory while protecting individual privacy
and confidentiality. However, the Government of Canada decided, as of the 2011
Census, to eliminate the compulsory long-form census that had asked 20% of
respondents additional health questions in favour of a voluntary survey.