CANADA — the state in a northern part of North America.
Enters the Commonwealth headed by Great Britain. The area is 9976 thousand km 2 . Population of 23 140 thousand people (1976). The capital — Ottawa (with suburbs of 669 thousand zhit., 1976). The largest cities: Montreal (with suburbs of 2,8 million zhit.), Toronto (with suburbs of 2,8 million zhit.), Vancouver (with suburbs of 1,2 million zhit.). To. — the confederation, is divided into 10 provinces and 2 territories. Provinces are divided into counties and districts. Ofits. language — English and French. The head of state — the queen of Great Britain presented by the governor general who together with parliament carries out legislature. The parliament consists of the senate and the House of Commons. Executive power is carried out by the government, to-rogo the prime minister having large powers is at the head. Each province is headed the lieutenant-governor and has unicameral parliament and the government of the province. The local government is carried out by councils of counties and districts.
To. it is located in the Arctic, subarctic and moderate belts. Smaller, zap. a part is under the softening influence of the Pacific Ocean, big, vost. — preferential flat with sharply expressed midland climate of midlatitudes — it is subject to strong influence of the Arctic basin.
To. — the industrial and agrarian country with a high level of development of capitalist production, a cut dominates in the industry and agriculture. To. also the 2nd place by the amount of the mining industry takes the 7th place in industrial production of the capitalist world. The power industry processing and food industries is developed. Agriculture differs in high marketability, mechanization and specialization. The national structure of the population is heterogeneous: apprx. 45% — English Canadians, apprx. 30% — French Canadians, the others — representatives of ethnic minorities and indigenous people (Eskimos and Indians). Ofits. the data published in editions of WHO on the natural movement of the population are provided in table. To. does not differ on the level of birth rate from the majority of the European countries, but on rates of an increase in population is on one of the first places among economically developed countries that is explained by big inflow of immigrants. In 1973 in To. 184 200 people, generally from Europe and the USA immigrated. Relative rejuvenation of the population (in 1974 St. 46% it were made by people more young than 25 years), and also higher share of men in it also is connected with immigration.
Table. The NATURAL MOVEMENT of the POPULATION of CANADA for 1960-1975 (on 1000 people)
The indicator of the general mortality from 1960 for 1974 decreased. A little child mortality decreased, however in some territories it is rather high and reached in 1974, napr, in the North-West Territories, 42,2 on 1000 live-born. Maternal mortality also decreases. In 1970 — 1972 average life expectancy of men equaled 69,3 years, women — 76,4.
In structure of causes of death in 1972 of 32,7% was necessary on hron, a rheumatic heart trouble, an idiopathic hypertensia and coronary heart disease; 19,9% for malignant new growths; 10,1% for accidents, poisonings and injuries; 10,2% for vascular damages of a brain; 3,2% for pneumonia etc.
In structure of hospital incidence, by data for 1973 (on 100 thousand population), diseases of a respiratory organs made 2183,8; complications of pregnancy, childbirth and a puerperal period — 2135,9; diseases of cardiovascular system — 1625,5; diseases of urinogenital system — 1567,7; injuries, accidents, poisonings — 1567,4; new growths — 932,9; diseases of a nervous system and sense bodys — 706,6; mental diseases — 663,0 etc.
Growth of incidence and cancer mortality is observed. In 1972 cancer cases made 138,7 on 100 thousand population; the most cases of death from cancer was observed on average and advanced age. The number of the patients with diabetes increases though diabetes mortality decreased thanks to rational therapy. Mental diseases and emotional frustration, and also allergic diseases remain important problems of health care.
From infectious diseases in 1975 in the country more than 21,5 thousand cases of scarlet fever and streptococcal infections, apprx. 13 thousand — measles, St. 4 thousand — infectious hepatitis, more than 3 thousand — tuberculosis, St. 2,2 thousand — bacillar dysentery, more than 3,3 thousand — whooping cough were registered. Trachoma and poliomyelitis are almost liquidated; incidence of an active form of tuberculosis decreased with 49 by 100 thousand zhit. in 1965 to 14,9 in 1974. Growth of incidence of veins is observed. diseases. Apprx. 57% of all veins. diseases it is the share of persons of young age — from 15 to 24 years. According to WHO data, in Canada annually there are about 200 thousand cases of gonorrhea and apprx. the 7500th syphilis, including St. 10 thousand fresh cases of gonorrhea and syphilis at teenagers. From all infectious diseases of veins. diseases represent one of the most serious problems. To actions for fight from veins. diseases obligatory premarital examinations which are conducted in 4 of 10 provinces, surveys of pregnant women, a campaign on a dignity belong. to education of the population, the notification about cases of diseases and contacts according to the legislation of provinces, compulsory treatment etc. For increase to lay down. - professional, actions mobile clinics, out-patient clinics, advanced methods of the notification, and also observance of a secret at treatment are entered.
The organization of health care
According to the constitution of the country responsibility for the organization of health services is conferred directly on operating controls of provinces and local authorities (municipalities). The federal government bears responsibility for rendering army to medical aid, indigenous people (Eskimos and Indians), and also in districts which have national value (ports, the airports, etc.).
Federal body of health care is min. - in national health care and social security. Directly the deputy minister knows questions of health care, the public health department presented by three managements is subordinated to Krom: public health cares, programs of health care, medical services. Management of health protection has seven functional divisions: control of quality of foodstuff, pharmaceuticals, hygiene of the environment, use of medicines with not the medical purpose, the laboratory center for fight against diseases, field actions and administrative services. Management of programs of health care consists of divisions: development and estimates of programs of health care, i.e. planning of health care, hospital insurance and diagnostic services, medical service, research programs, economies of health care and statistics, human resources and planning of medical institutions, health systems, gigabyte. norms, target service of settlements, programs of financing and management. This management performs management of programs of insurance due to illness. Control of medical services is exercised by medical service of Eskimos, Indians and all residents of Yukon and the North-West Territories, and also directs quarantine and immigration medical services, service of professional hygiene for federal employees, national service of prosthetics and medical service in civil aviation.
Besides, deal with issues of health care: Federal bureau of statistics, in charge of collecting demographic data and other data dignity. statistics; mines - in for veterans, leading work with BC and security services of health of veterans of war; mines - in agriculture, in charge of production of food products - according to a gigabyte. norms. The large role in health care of Canada is played by the public and charitable organizations (the Canadian Red Cross, an award Jerusalem-tsy St. Jonah, the Victorian award of sisters, etc.).
In provinces there are departments of health care (with department or without department of social security) as which improvement of the environment, fight against infectious diseases, protection of motherhood and the childhood, acquisition on a dignity enter. and demographic statistics, etc. In some provinces the special public institutions subordinated directly to the minister of national health care and social security direct hospital and medical insurance, fight against tuberculosis and cancer, and also fight against alcoholism and drug addiction.
Local health services know questions of improvement of the environment, prevention and fight against infectious diseases, protection of motherhood and the childhood, planning of a family, stomatol, the help, demographic statistics, a dignity. educations. In the large cities public health departments are engaged in the organization of work of specialized services, such as psychiatric, rehabilitation (for hron, sick and crippled), and also assistance at home.
Local health services together with the authorities of provinces participate in work on accident prevention, in actions for pollution control of air, water and the soil.
V K. there is a hospital insurance and insurance in connection with the extra hospital help. Both types of insurance are entered by all provinces. Almost all population is captured by them. Along with the systems of insurance controlled by the government in To. there is a voluntary insurance. E.g., in the Province of Ontario in 1941 the private non-profit organization entering into hospital association of the state so-called is created. Blue Cross. He offers insurance with partial payment of the expenses by some types of medical aid which are not included or partially covered by national programs of insurance. All anticarcinogenic actions — diagnosis and treatment both out-patient, and inpatients — are carried out free of charge due to hospital insurance and subsidies of the governments of provinces and confederation.
Hospital help to the population is given in the general and specialized-tsakh. B-tsy the general type, as a rule, state, however many institutions intended for recovering, treatments hron, patients and sisterly leaving — private. In 1973 in To. there were 1411 BCs on 212 650 beds (9,7 hospital beds for 1000 zhit.). The vast majority of BC (913 on 125 253 beds) — the general type in which there were 80 972 beds of a therapeutic and surgical profile, 11 747 — obstetric, 14 892 — pediatric, 4933 — for mentally sick, 7473 — for hron, patients and 5236 beds of other profiles. Besides, there are 498 specialized BCs: 20 tubercular BCs on 2327 beds, 1 infectious-tsa on 336 beds, 5 maternity homes on 518 beds, 7 children's BCs on 2774 beds, 125 psychiatric BCs on 56 466 beds, 196 BCs for hron, sick on 20 481 beds and 144-tsy other categories on 4495 beds.
Extra hospital help to the population is given generally by doctors of a private practice, the fees the Crimea are paid by either patients, or local bodies of health care from means of medical insurance. V K. group medical practice begins to extend. St. 1000 doctors participate in it. Most of groups incorporate doctors of various specialties.
In 1972 preventive and urgent stomatol, help was given to school students of 318 dental surgeries.
In the country 40 independent centers of medical rehabilitation, 36 out-patient departments of BC on rehabilitation, 230 psychiatric out-patient clinics, 28 venerol, clinics, 65 tubercular clinics in most of which of patients with active forms of tuberculosis is treated (1971) functioned. The name and content of work of healthcare institutions To. not fully correspond to the concepts accepted in the USSR (see. Treatment and prevention facilities abroad).
Medical care of women and children
In departments of health care of provinces advisory services on health protection of children and mothers are organized. In 1972 (without data on the Province of Quebec) in the country there were 452 points on prenatal service of women, 911 children's consultations, 154 institutions on health protection of school students. To. treats the countries in which relatively actions for planning of a family began to be carried out recently. Long time worked in the country the legislation prohibiting abortions and distribution of contraceptive means. In 1969 the federal government made the decision, to include policy of planning of a family in system of national actions for health care, keeping, however, certain restrictions for abortions. Sale of contraceptive means was allowed.
Since 1972 questions of planning of a family in To. is engaged mines - in national health care and social security, and also the voluntary organization — Federation on planning of a family, combines edges St. 20 associations, and the Royal commission on studying of position of women. In 1972 in the country there were 62 consultations concerning planning of a family.
Sanitarno - anti-epidemic actions take an important place in activity of federal, provincial and local bodies of health care. Work on fight against pollution of the soil, water and the air basin is carried out. Under control there is use of chemical substances in agriculture. In 1971 according to the plan of immunization of the population it is carried out apprx. 6 million inoculations against tetanus, diphtheria, whooping cough, smallpox, a rubella, measles, cholera, belly and a sapropyra.
Resort business. V K. there are St. 30 resorts in which for treatment are used hydrosulphuric, calcic, hloridno-nat-riyevye carbonic and other mineral waters. The largest resorts are: the resort of Banff located in yuzh. parts of the country in Albert's province, in Krom are applied to treatment hydrogen-sulfide, sulfate-calcium and radioactive waters; Caledonia and Kalsbad-Springs located in sowing. - vost. parts of the country in the Province of Ontario where for treatment use hloridno-sodium, carbonic and hloridno-sodium waters rich with bromine.
In 1974 in the country there were 37 277 doctors (1 doctor on 603 zhit.). Security with doctors in various provinces considerably fluctuates. The lowest indicator (1 doctor for 1310 zhit.) — in the North-West Territories, the highest (1 doctor on 575 zhit.) — in British Columbia. In the country a large number of doctors from among immigrants works. Only in 1974 to the country 1200 doctors immigrated. The minister of national health care and social security To. took the measures limiting entry of doctors into the country. Besides, in the country in 1974 8487 dentists, 1362 specialists in hygiene of teeth, 3146 physiotherapists, 13 267 druggists, 12 320 medical laboratory assistants, 6974 people of technicians of radiological services, 2036 employees of medical registry, 123 824 nurses (1973), 36151 not diplomaed nurse, 59 638 assistants to nurses worked. The general security with nurses and their assistants made 72,3 on 10 thousand zhit.
Preparation of medical shots is carried out by 16 medical schools which are a part of high fur boots. In 1974 they were ended by 1561 persons. Increase in release by the Canadian schools up to 1900 doctors annually is planned. Eight high fur boots have pharm, schools, 10 — dental surgery. 190 sisterly schools are engaged in training of nurses. Total quantity of students at these schools in 1971/72 academic year made 28 883 people, graduates of 1972 — 9881 people
the Medical science
the Principal federal organ on scientific research in the field of medicine and health care is the Council for medical researches subordinated directly to the minister of national health care and social security. Financing of scientific research is carried out at the expense of federal and provincial budgets, and also the voluntary and charitable organizations, various firms etc.
The main directions of the scientific research financed by the federal government are: pharmacology, pharmaceutical chemistry, food, microbiology, epidemiology, pesticides, prosthetics, environmental control, clinical laboratory techniques etc. On a mutually advantageous basis scientific exchanges and cooperation with the USSR are carried out. E.g., since 1971 plans of studying of medicobiological problems of the North, joint with the USSR, are developed.
Bibliography The fifth review of a condition of health care in the world (1969 — 1972), page 101, Geneva, WHO, 1977; World Health Statistics Annual 1972, at. 1, p. 54, Geneva, 1975; World Health Statistics Annual 1978, v. 1, p. 23 a. o., Geneva, 1978.
V. B. Tsybulsky.