From the Canadian Medical Association

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The good old days

For me, and perhaps for many of you, summer vacation always brings back memories of the good old days of summers past. Most of us have happy recollections of summertime. However, some of Canada’s good old days were not so good! If you were sitting in your doctor’s waiting room a century ago, and there were 10 newborns waiting to be seen by the doctor, odds were that at least three of them would die within the next year.

In the Canada of 1910, childhood scourges such as measles, whooping cough and diarrheal illness were frighteningly common and often fatal. In Montreal, the infant mortality rate, which tells us the number of children who die within a year of birth, was 375 per 1,000 live births. And Canada’s capital, Ottawa, wasn’t doing much better; its infant mortality rate was 250/1,000. Today, the national rate is five deaths per 1,000 births.

If you were waiting to see your doctor in 1950, there’s a good chance you would have been breathing in heavy cigarette smoke. At that time roughly 60% of Canadian adults smoked. That was the year British physicians first made the connection between cigarette smoking and lung cancer. Today the smoking rate is 18%, and smoking has been widely banned in indoor public places across Canada.

Now let’s travel back further to 1920. According to Statistics Canada, a baby girl visiting the doctor’s office could expect to live to age 61, a baby boy to 59. Fast forward to 2010, and those same babies have a life expectancy of 83 and 78 years, respectively — an increase of more than 30% in less than a century.

How did this happen? On the medical front, mass immunization has saved countless lives by almost eliminating infectious threats such as smallpox, measles, mumps and polio. Thanks to medical research, we have seen a huge improvement in the treatment of illnesses such as diabetes and hypertension and a huge drop in early deaths from heart disease. Our quality of life as we age has improved thanks to surgical advances such as hip and knee replacement. Cancer detection, treatment and survival have all improved dramatically.

I have seen the results of many of these changes first-hand in my family practice in Saskatoon. I have also seen another remarkable transformation, for which the credit belongs to you. In 2010, many of my patients are taking responsibility for their own health in ways that were virtually unknown when I entered practice. They are eating healthier food and exercising more. They have become active participants in their own care. People take the initiative in looking for information about their health. They ask questions. They work with their doctors in order to make decisions together that are best for them.

But your work — and your physician’s work — is far from done. Obesity is a serious problem in Canada, and unless it is controlled, the impact on the health-care system will be severe. Meanwhile, mental illness, another widespread problem, often remains hidden from sight because of the tragic stigma attached to it. It represents a growing challenge to our medical system — ask any family physician.

Still, we’ve come a long way in the past century. We’ve made such progress that I can’t help wondering what the next century holds.

Have a safe and happy summer.

Dr. Anne Doig
President
Canadian Medical Association