Fare well to Nova Scotia? Public health investments remain chronically underfunded. 2021

Hilary A T Caldwell, and Sarah Scruton, and Katherine Fierlbeck, and Mohammad Hajizadeh, and Shivani Dave, and S Meaghan Sim, and Sara F L Kirk
Healthy Populations Institute, Dalhousie University, 1318 Robie Street, Halifax, NS, B3H 3E2, Canada.

Inspired by Fiset-Laniel et al.'s (2020) article entitled "Public health investments: neglect or wilful omission? Historical trends in Quebec and implications for Canada", we assessed public health investments since the establishment of the Nova Scotia provincial health authority in 2015. We analyzed Nova Scotia Department of Health and Wellness budgets from 2015-2016 to 2019-2020 and observed that less than 1% of funding was budgeted for public health annually, an amount well below the recommendation that 5-6% of healthcare funding be spent on public health. Healthcare spending has increased annually since 2015-2016, but proportions of funding to different programs and services have remained static. Specifically, we did not observe a change in investment in public health over time, suggesting that while the government does not necessarily spend too much or too little on healthcare, it spends far too little on public health. This chronic under-funding is problematic given the high rates of non-communicable diseases in Nova Scotia and health inequities experienced within the population. The 2020 COVID-19 pandemic has highlighted the importance of public health work, and the need for a pandemic recovery plan that prioritizes investment in all areas of public health in Nova Scotia.

UI MeSH Term Description Entries
D009674 Nova Scotia A province of eastern Canada, one of the Maritime Provinces with NEW BRUNSWICK; PRINCE EDWARD ISLAND; and sometimes NEWFOUNDLAND AND LABRADOR. Its capital is Halifax. The territory was granted in 1621 by James I to the Scotsman Sir William Alexander and was called Nova Scotia, the Latin for New Scotland. The territory had earlier belonged to the French, under the name of Acadia. (From Webster's New Geographical Dictionary, 1988, p871 & Room, Brewer's Dictionary of Names, 1992, p384)
D011634 Public Health Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. Community Health,Environment, Preventive Medicine & Public Health,Environment, Preventive Medicine and Public Health,Health, Community,Health, Public
D002017 Budgets Detailed financial plans for carrying out specific activities for a certain period of time. They include proposed income and expenditures. Budgetary Control,Budget,Budgetary Controls,Control, Budgetary,Controls, Budgetary
D005380 Financing, Government Federal, state, or local government organized methods of financial assistance. Federal Aid,Financing, Public,Grants and Subsidies, Government,Hill-Burton Act,Subsidies, Government,Government Financing,Act, Hill-Burton,Aid, Federal,Aids, Federal,Federal Aids,Government Subsidies,Government Subsidy,Hill Burton Act,Public Financing,Subsidy, Government
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000073296 Noncommunicable Diseases Diseases which are typically non-infectious in origin and do not transmit from an affected individual to others. The four main types of noncommunicable diseases are CARDIOVASCULAR DISEASES (e.g., heart attacks and stroke), CANCER, chronic respiratory diseases (e.g., CHRONIC OBSTRUCTIVE PULMONARY DISEASE and ASTHMA) and DIABETES MELLITUS. Non-communicable Chronic Diseases,Non-communicable Diseases,Non-infectious Diseases,Noninfectious Diseases,Chronic Disease, Non-communicable,Disease, Non-communicable,Non communicable Chronic Diseases,Non communicable Diseases,Non infectious Diseases,Non-communicable Chronic Disease,Non-communicable Disease,Non-infectious Disease,Noncommunicable Disease,Noninfectious Disease
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D054624 Health Status Disparities Variation in rates of disease occurrence and disabilities between population groups defined by various factors including socioeconomic characteristics (see SOCIOECONOMIC DISPARITIES IN HEALTH), age, ethnicity, economic resources, or gender and populations identified geographically or similar measures. Health Status Disparity,Disparity, Health Status

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