Academic learning about public health in a Canadian university: contributions for Brazilian education

Patuzzi, Gregório Corrêa; Lira, Adrielle Priscilla Souza; Santos, José Diego Marques; Reinisch, Andrieli Oliveira Barros; Veleda, Aline Alves

doi:10.1590/1983-1447.2017.03.2016-0012

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Sumário

Experience Report • Rev. Gaúcha Enferm. (Online) 38 (3) • 2017 • https://doi.org/10.1590/1983-1447.2017.03.2016-0012 copy

Academic learning about public health in a Canadian university: contributions for Brazilian education

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

This paper aims to discuss Brazilian undergraduate students'learning in the public health.

Methods

This is a descriptive, reflexive study, characterized as an experience report. Theoretical references of the Canadian and Brazilian health systems were used in order to analyze the public health and the impact of international educational exchange in professional qualification.

Results

There are theoretical and conceptual similarities in health systems, in the understanding of social determinants. However, the application of the social determinants of health yielded more results in the Canadian system.

Conclusion

Public health learning in a Canadian university highlighted a great focus on determinants, allowing the students to think about Brazilian health care models. With this experience, discussions can be held in educational spaces, reflecting the social implication of Science without Borders Program in professional education.

Keywords
International educational exchange; Public health; Health systems; Canada; Brazil

	Brazilian Health Model	Canadian Health Model
Principles and Guidelines	Universal, decentralized, unified, regionalized and capable of providing resolution⁽⁴4. Presidência da República (BR). Lei n° 8080, de 19 de setembro de 1990. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Diário Oficial [da] República Federativa do Brasil. 1990 set 20;128(182 Seção 1):18055-9.⁾.	Universal, decentralized, regionalized, community based, and capable of providing resolution⁽⁵5. The Association of Faculties of Medicine of Canada. Primer on population health: a virtual textbook on Public Health concepts for clinicians. Ottawa: AFMC; 2013.⁾.
Scope	National territory	National territory
Health Policies	It uses epidemiology to plan public policies. It conducts integrated actions of promotion, protection and recovery, assists and prevents.	Policies that aim to establish healthy communities with sustainable development®. It uses social determinants of health as bases.
Health Promotion	National Policy. It promotes the quality of life and minimizes the vulnerability and the health risks related to their determinants and conditions.	It is based in social epidemiology and health surveillance concepts.
Social Participation	Guaranteed by a specific law⁽⁶6. Presidência da República (BR). Lei n° 8.142, de 28 de dezembro de 1990. Dispõe sobre a participação da comunidade na gestão do Sistema Único de Saúde (SUS) e sobre as transferências intergovernamentais de recursos financeiros na área da saúde e dá outras providências. Diário Oficial [da] República Federativa do Brasil. 1990 dez 31;128(249 Seção 1):25694-5.⁾.	There is no law that forces or promotes social participation in the creation of public policies. However, there is a government agreement recognizing the need to dialogue with civil society to create better programs⁽⁷⁾.
Private Enterprises	Supplementary to the system⁽⁴4. Presidência da República (BR). Lei n° 8080, de 19 de setembro de 1990. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Diário Oficial [da] República Federativa do Brasil. 1990 set 20;128(182 Seção 1):18055-9.⁾.	Complementary to the public system, which only offers basic services (ex.: assistance to urgencies, prevention and control of chronic and infectious diseases). Rehabilitation services are only offered by private health insurances⁽²2. Mossialos E, Wenzl M, Osborn R, Sarnak D, editors. 2015 International profiles of health care systems: Australia, Canada, China, Denmark, England, France, Germany, India, Israel, Italy, Japan, the Netherlands, New Zealand, Norway, Singapore, Sweden, Switzerland, United States. New York (NY): The Commonwealth Fund; 2016.⁾.
Understanding of Health	Health is a right for everyone and a duty to the State, according to the Federal Constitution⁽⁴⁾.	Health insurances are not defined as right to all, but the state recognizes as its duty to facilitate the access to health services without financial obstacles⁽⁸⁾.

	SDOH IN BRAZIL	SDOH IN CANADA
Understanding and comprehension	Social, economic, cultural, ethnic/racial, psychological and behavioral factors which influence in the occurrence of health problems and their risk factors for the population⁽¹¹11. Buss PM, Filho AP. A saúde e seus determinantes sociais. Physis: Rev Saúde Coletiva. 2007;17(1):77-93.⁾	They are described as the situation in which the population are born, grow up, work, live, and age⁽¹²12. World Health Organization [Internet]. Geneva: World Health Organization; 2016- [updated 2016 Jan 1, cited 2016 Dec 9]. What are social determinants of health? Available from: http://www.who.int/social_determinants/sdh_definition/en/. http://www.who.int/social_determinants/s... ⁾.
Are social health determinants	Environment, work, education, production of food, water and sewer systems, health services, housing, social and community networks, lifestyles, gender, age, and hereditary factors.	Income and social status, social support networks, literacy and education, unemployment and job security, social context, physical environments, personal health practices and coping strategies, healthy child development, biology and genetic factors, health services, gender, and culture⁽¹³13. Public Health Agency of Canada [Internet]. Ottawa: Public Health Agency of Canada; 2013- [updated 2013 Jan 15, cited 2016 Dec 9]. What makes Canadians healthy or unhealthy? Available from: http://www.phac-aspc.gc.ca/ph-sp/determinants/determinants-eng.php#unhealthy. http://www.phac-aspc.gc.ca/ph-sp/determi... ⁾.

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[1] Corresponding author: Gregório Corrêa Patuzzi, E-mail: gregorio.patuzzi@hotmail.com