Printed in Great Britain,99 Lalonde and beyond: Looking back at "A New Perspective on the Health of Canadians'
Bibliographic record
Abstract
the first significant government report to suggest that health care services were not the most important deter-minant of health. After reviewing the evidence, the report suggested that there were four "health fields"— lifestyle, environment, health care organization, human biology—and that major improvements in health would result primarily from improvements in lifestyle, environment and our knowledge of human biology. Lalonde also indicated a broad understanding of the determinants of health in subsequent speeches. While the report was greeted sympathetically at the time, it did not have all that significant an impact in Canada. It was criticised on a number of grounds, in particular that it paid too much attention to lifestyle and too little attention to environment. Further-more, because health is a provincial responsibility in Canada, while the report was a federal report, there was no mechanism readily available to implement the recommendations of the report. The report was nonetheless widely hailed outside Canada, and similar (and often better) reports were published in Britain, the USA, Sweden and elsewhere. The report remains a highly regarded contribution to the transformation in thinking about health that has occurred in the past decade. Since the report was published, our models, con-cepts and thinking have advanced considerably. More sophisticated and comprehensive models of the deter-minants of health are available; national health goals and strategies have been developed in a number of countries; our concepts of health promotion have moved well beyond essentially "victim-blaming " life-style approaches to multi-faceted, community based approaches; there is increasing interest in the health implications of public policy in non-health policy sec-tors, and we have begun to articulate a more positive vision of health.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.006 | 0.003 |
| Scholarly communication | 0.008 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.165 | 0.037 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".