Current trends in Canadian health care: disease prevention and health promotion.

The Canadian national health insurance plan has not extended to disease prevention in any comprehensive way, and to this extent is incomplete. The Task Force on the Periodic Health Examination has done outstanding work, but no provincial insurance plan has systematically adjusted the benefit schedule to reflect its recommendations. Thus, the place of disease prevention under the Canadian system of universal health insurance is remarkably similar to that in the United States. Health promotion has a somewhat different meaning in Canada from that in the United States, emphasizing intervention at the population level more than health education of individuals. The health promotion movement now enjoys considerable support in Canada, especially in the public health sector, in voluntary agencies, and in the policies of the federal and several provincial departments of health. The movement is almost completely separate from mainstream health services, and is unrelated to the insurance program. To date, there has been mostly talk, but several structures are in place which should lead to action.