1. How can we make Health Care a more effective determinant of health? Michael M. Rachlis MD York University November 29, 2002

6. Relative risk of CHD death in the British civil service and the explanatory power of risk factors. From Marmot M. J Epi Comm H. 1978;32:244-249.

8. Determinants of Health 1. Income and social status 2. Social support networks 3. Education 4. Employment and working conditions 5. Social Environments 6. Physical Environments 7. Personal health practices 8. Healthy child development 9. Biology and genetic endowment 10. Health services 11. Gender 12. Culture

9. But Health care could be a more important determinant of health if services were re-designed.

15. “ Medicine (Health) is a social science and politics is nothing but medicine writ large!” Dr. Rudolf Virchow 1848

19. The prevention policy paradox The higher the level of preventive action, the more effective it is at promoting health but the more political barriers it faces.

28. Therefore I’m suggesting that when you’re fighting this battle, as I hope you will to maintain Medicare, you’ll not forget that the ultimate goal of Medicare must be the task of keeping people well rather than just patching them up when they’re sick. Tommy Douglas

30. Courage my friends, ‘tis not too late to make a better world! Tommy Douglas