The healthcare sector has come to represent an environmental concern, due to its facilities’ massive consumption of energy and production of biomedical waste. As such, we observe a troubling paradox: while the healthcare sector seeks to ensure population health and prevent illnesses, it contributes directly to greenhouse gas emissions, which in turn greatly hinders population health and well-being.
Social determinants of health are the social, economic, and environmental factors that influence health and well-being. Social determinants influence health as they define the extent of resources and opportunities that can be made available to individuals, given their social location (Marmot & Wilkinson, 2005; Raphael, 2009). They explain the health disparities observed among individuals and represent an important and continuing public health concern within the health promotion and health services spheres of research.
In 2016, Cuba made headlines for the status of its economic embargo with the US, its increasing foreign investments through tourism, and the death of Fidel Castro. Besides these recent events, in a sense foreshadowing Cuba’s future political and economic paths, throughout the 20th century, Cuba’s healthcare system has been acclaimed as one of the best healthcare systems in the world with very good health outcomes for the Cuban people. For example, infant mortality is lower than in the US and the life expectancy is 77.5 years of age (WHO, 2016). What are the Cuban healthcare system’s defining features? Will recent events alter some of its key aspects?
Publicly insured healthcare in Canada, also known as Medicare, is currently being reviewed in a judicial case in the Supreme Court of British Columbia. The lawsuit filed by Cambie Surgery Centre is calling for allowing “medically necessary services” – those covered by public insurance – to be privately insured in order to improve access to care. Health services researchers, policy makers and citizens alike, are worried of the outcome of this 8-month provincial trial, as it is suggested that an outcome in favour of Cambie’s position would lead to a complete overhaul of Canada’s public healthcare system. In the midst of heated debates, we tend to forget that just over a decade ago, a similar legal battle challenging the extent of public insurance in Canada occurred in the province of Quebec. How are these two cases similar or different? What are the implications of each? What are lessons that can be learnt?