Contributors

Rogelio Velez Mendoza Department of History, Faculty of Arts, University of

Kelsey Lucyk Department of Community Health Sciences, Cumming School of Medicine, University of Calgary

Isabel Ciok Bachelor of Health Sciences, Cumming School of Medicine, University of Calgary

Lindsay McLaren Department of Community Health Sciences, Cumming School of Medicine, University of Calgary

Frank Stahnisch Departments of Community Health Sciences and History, Cumming School of Medicine and Faculty of Arts, University of Calgary

Copyright © 2017 by APHA All rights reserved. This publication or any portion thereof may not be reproduced or used in any manner whatsoever without the express written permission of the publisher except for the use of brief quotations in a review.

The opinions in this book belong to the authors and do not represent the official position of the APHA.

Alberta Public Health Association c/o Injury Prevention Centre, University of 4075 RTF, 8308-114 Street , Alberta T6G 2E1

www.apha.ab.ca

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This history of the Alberta Public Health Association (APHA) presents an untold history of public health in the province. The APHA has a long history of efforts aimed at im- proving and protecting the health and well-being of Albertans, since it was founded in 1943. Its current mission is to act as a leading voice for public health in the province and work to strengthen the impact of those who promote and protect its highest standard. The purpose of this project was to conduct an historical analysis of the APHA. This work contributes to the knowledge base of Alberta’s public health history. In addition, Photograph from the APHA Annual Report 1993-94. Image: APHA Archives we aim to use this work to not the first attempt at producing presentations, and this booklet, strengthen the institutional a history of the APHA. For dec- which we present to the APHA in memory of the APHA. Finally, and ades the APHA newsletter has recognition of its upcoming 75th perhaps most importantly, we contained “tidbits” of history. Fur- anniversary in 2018. hope to yield practical, useful, and thermore, for the APHA’s 60th This work was made possible important lessons for contempo- anniversary, novelist and profes- thanks to the financial support of rary public health advocacy. There sor Aritha van Herk compiled a the Alberta Historical Resources is an excellent, and largely un- history of the APHA , entitled Foundation’s Heritage Preservation tapped, opportunity to learn from “Sixty Years of Not-So-Secret Ser- Partnership Program. the experiences of the APHA. vice.” These past efforts have set — The Authors Advocacy is a core public health the foundation for this project. competency and an explicit aim of We historically analyzed APHA Disclaimer: To produce a publication the APHA. The Public Health Agen- archival materials (e.g., meeting that was pleasant to read, we opted cy of Canada defines advocacy as minutes, annual reports, confer- not to include specific citations, but “the ability to advocate for healthy ence programs) in our methods rather to include a list of most-used public policies and services that for this project. These materials sources at the end of each section. promote and protect the health came from the Calgary Archives and well-being of individuals and and the Provincial Archives of Al- Contents communities.” Some organizations berta. We also conducted semi- Preamble…...3 1970s……….18 structured interviews with current are particularly well-positioned for 1930s…….…..4 1980s……….22 public health advocacy; however, and former members of the asso- they are few in number and often ciation who played an important 1940s………...6 1990s……….26 face financial and ideological con- role in its history. The products of 1950s………..10 2000s……….30 this work include peer-reviewed straints. 1960s………..14 2010s……….34 We should note that this work is publications, oral and poster 3

1930s: Conditions for Public Health Advocacy in Alberta

The economic depression and dustbowl conditions that occurred throughout the Alberta during the

1930s profoundly impacted the province. Albertans suffered from deteriorating farming and housing conditions during a period of drought, especially in the south- ern region of the province. Homi- cide and suicide rates were on the rise. The prevention of illness sur- faced as an issue of urgency http://peel.library.ualberta.ca/index.html among those working in public Image courtesy of Peel's Prairie Provinces, a digital initiative of the Libraries. health at the time. The Great De- Photographic collection pression brought heightened enced, such as the differential health during the 1940s. attention to prevention, as public access to health services for ur- Under these conditions, the health workers became more ban and rural residents. These Health Workers Association of Al- attuned to the problems faced by conditions and the advent of the berta (HWAA) formed to bring to- sick individuals — in particular, Second World War brought a gether groups interested in public those who had lost their jobs and renewed commitment for public health, including medical officers were unable to pay for medical “I would feel that I had been remiss in my of health and nurses. The HWAA treatment. duty if I did not call attention to the ine- recognized the need to communi- Before the APHA was created, quality that exists in so far as modern pre- cate public health information ventive health services are concerned be- Dr. Malcolm Bow (1887–1982), tween the citizen who resides in a city [… across the province, which led Deputy Minister of Health for Al- and in] a rural area...“ -Malcom R. Bow, them to publish the Alberta berta, called attention to health 1937 “Public health yesterday, to-day, Health Worker, a science journal. inequalities Albertans experi- and to-morrow.” CJPH 28(7);315 The HWAA evolved into the APHA. Key Events in Alberta History, before 1943 1905 - Alberta becomes a province. 1918 - The University of Alberta begins to Five’) gains official recognition for women 1906 - First Provincial Medical Officer of offer education in public health nursing. as persons from the federal government. Health, Dr. A.E. Clendennan, is appointed. Spanish Flu pandemic kills over 4,000 Alber- 1930 - Mental health clinics are opened 1907 - Alberta Provincial Board of Health tans. Provincial Department of Health is cre- throughout Alberta. is formed. Local Boards of Health now fall ated. 1935 - The Social Credit Party wins the under the Provincial Board and the prov- 1919 - A strike breaks out for union Coal Alberta provincial elections. ince’s Public Health Act passes. Alberta Mine and Railway Workers due to poor 1936 - The provincial government begins Provincial Laboratory is established. working conditions. A.G. MacKay is appoint- providing publicly-funded hospital care. The 1912 - Alberta Provincial Legislature is ed Alberta’s first Minister of Health. Tuberculosis Act, which provides free diag- officially opened. 1924 - After 8 years of prohibition, Alber- nostic and treatment services, is passed. 1916 - Alberta Association of Registered ta’s Liquor Act, which abolished alcohol 1940 - The Cancer Treatment and Protec- Nurses (AARN) begins to regulate nursing sales in the province, is repealed. tion Act is passed; cancer patients now in the province. 1928 - Alberta becomes the first province receive free medical care. 1917 - United Farmers of Alberta and United to provide special facilities to treat those 1941 - Alberta’s population reaches Farm Women of Alberta (UFA/UFWA) lobby with poliomyelitis. 796,169. Life expectancy is 66.3 years for the province for public health services. 1929 - A group of Albertans (‘Famous females and 63 years for males. 4

Health billboard on display in Alberta, ca. 1940. Image: Glenbow Archives NB-55-1217

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1940s: Birth of the Alberta Public Health Association

The APHA was established in Key Events in APHA History, 1940s 1943 during a period of municipal 1943 - First annual meeting of Canadian development and technological Public Health Association (Alberta Divi- change in Alberta. During this sion), which later changes its name to time, the province was shifting the APHA. One topic at the 1943 away from economically de- meeting is ‘Hopes for the Future of Pub- lic Health in Alberta.’ APHA membership pressed conditions to become an costs $1.00, equal to $14.34 in 2016. increasingly urbanized and indus- trialized society. Members from 1944 - Ninety-five members, including 8 various associations came togeth- Board members and 6 guests from the Armed Forces, attend the APHA’s Annu- er for the first time with the spe- al Meeting. Three sections make up the cific goal of coordinating health APHA: Medical Group, Public Health services and providing insight into Nursing Group, and Sanitarian Group. public health. These associations 1945 - The APHA requests a govern- included the Alberta Branch of the ment subsidy to finance its journal, The Canadian Institute of Public Health Alberta Health Worker. Inspectors, the medical officers’ 1946 - The APHA has difficulty obtaining section of the Canadian Public articles for publication in its journal. Health Association, and the public This reflects the reduced public health health nurses’ section of the Al- activities that occurred across Canada berta Association of Registered during and after the Second World War. Nurses. In its first year, the APHA 1947 - Discussions are held regarding Key Events in Alberta History, 1940s included 186 registered mem- the APHA’s affiliation with its national 1943 - First full-time dental health pro- bers who worked in various association, the CPHA. gram offered by a rural Health Unit in health-related settings, including Lamont. The Edmonton Board of Health 1948 - The spread of polio is discussed bans livestock within its inner city. The provincial and municipal depart- as a topic at the APHA convention. last case of smallpox recorded in Alber- ments and divisions, boards of ta. , of the Social Credit health, health institutions, and W.H. Hill was appoint- Party, becomes . schools, in addition to public ed the first president of the APHA in 1943. Prior 1944 - Calgary prepares for typhoid health and industrial nurses. fever outbreak. Across Alberta, hospital to this role, he had pub- services related to childbirth are pro- An early issue that APHA lished on how to afford- vided at no cost. members were vocal about was ably maintain a nutri- 1947 - Calgary physicians claim that the securing fair working conditions tious diet. He produced a table menu for postwar shortage of trained nurses for the public health workforce. a family of 5 living in Calgary for the weekly cost of $6.87. This was reflective makes it difficult to manage the polio For instance, the APHA raised outbreak. Mental health clinics that of the depressed economic conditions closed during the war years begin to concern on behalf of the public that Albertans experienced at the time. reopen. Alberta’s oil boom begins with health nurses who were required Hill also published “Recording Child Hy- the discovery of oil in Leduc, Alberta. to travel great distances to rural giene Activities in Calgary” from his work 1948 - The Banff Chapter of the Alberta locales and even to purchase as a Medical Officer of Health in 1945. In 1957, Dr. Hill became a Medical Officer Association of Registered Nurses is their own uniforms. Resolutions formed. Banff residents at the time lack of Health in Calgary, a position he used public health services, as the national passed on these examples sug- to actively campaign against fluoridation. park was not considered provincial or gest that APHA was vocal about Image: Glenbow Archives NA-2900-32 federal territory. addressing the immediate needs 6

This article (left) of the , published September 6, 1945, pictures the newly elected ex- ecutive of the APHA.

From left to right, the picture shows: D. B. Menzies (Edmonton), President of the APHA and provincial sanitary engineer; Dr. Geraldine Oakley (Calgary), medical representative; Miss Madeline McCulla (Edmonton), nurses’ representative and director of the school of nursing at the Universi- ty of Alberta; Dr. M. G. McCallum (Stettler), vice-president; Miss Helen McArthur (Edmonton), immediate past president and superintendent of the public health nursing branch of the provincial government; C.C. Evey (Edmonton), secretary and supervisor of health for the provincial health department. Absent was W. Pillage (Calgary), sanitary inspectors’ repre- sentative. (Image: Courtesy of APHA) of the public health workforce at families where a member had the time. plement preventive health pro- scarlet fever. The APHA suggested As for improving the health of grams. One notable resolution is that healthy breadwinners be ex- Albertans, the APHA passed reso- the association’s call for the empt of this restriction, to ensure lutions during the 1940s to make province to relax the strict quar- their families remained financially the living and working environ- antine measures enforced on supported. ments of Albertans healthier and ALBERTA HEALTH WORKER safer. Some examples include li- The Alberta Health Worker (later known as the Alberta Public Health Work- censing of restaurants and ensur- er and Alberta Public Health Bulletin) was a publication founded by the prov- ing the safe consumption of milk. ince’s Medical Officers of Health in 1941 “in the interests of Alberta Health Others included implementing Departments” to “bring before the Health Workers of Alberta problems that medical examinations for school are particularly ours.” In the foreword of the first issue, the editors write that while national publications of great value to public health already exist- children by nurses, the provision ed (e.g., the Canadian Journal of Public Health and Canadian Medical Associ- of dental services to rural areas, ation Journal), there remained the need for a forum where public health and forming recreational youth matters specific to Alberta could be discussed. Early issues of the Alberta centres. As evidenced by APHA Health Worker included papers on the organization and legislation of public meeting minutes and conference health in Alberta, dealing with undulant fever in the province’s cattle indus- proceedings, there were also dis- try, provincial dairy regulations, methods of dealing with bedbugs in rural cussions within the organization areas, water softening supply in Edmonton (e.g., “The housewife gets her about tuberculosis, fumigation, washing still whiter from one-third to one-half the previous amount of soap poliomyelitis and immunization, used”), Alberta’s field workers and vermin, and improvements in dental as well as how to successfully im- health in the Foothills District . 7

Notable APHA Resolutions, 1940s

 That pensions be established in Health Units. (1944)  That dental service be provided routinely in Rural Health Districts. (1944)  That the Department of Trade and Industry be asked to provide suspen- sions or cancellations of restaurant licenses, on the recommendation of local health authorities.(1944) Helen McArthur (1911–1974)  That public health nurses be compensated through salary adjustments was a public health nurse and and added leave for serving in rural communities.(1944) became the second president of  That the Provincial Board of Health consider relaxing strict quarantine the APHA in 1944. She later became measures for bread-winners in families where another member is suffer- President of the Canadian Nurses Associ- ing of scarlet fever. (1945) ation in 1950, a position which she held  That all milk sold in restaurants be consumed on premises. (1945) until 1954. Other roles she served to the  That no public eating place can open without the written permission of benefit of public health in Canada includ- the local Board of Health. (1946) ed the National Director of Nursing Ser-  That the Medical Officer of Health be empowered to close public eating vices for the Canadian Red Cross Society and the Coordinator of relief services places where considered a menace to public health. (1946) during the Korean War. She was award- ed the Florence Nightingale Medal by the Red Cross in recognition of her 25 As shown from these early con- were in place for public health to years as national director of nursing, a Coronation Medal from the Korean Red cerns, during the 1940s the APHA support the delivery of services Cross for her service during the war, and seemed to have had a dual focus. by public health workers. an honorary law degree from the Univer- First, the association aimed to im- sity of Alberta. prove living and working condi- “At the close of another war- year, many health departments tions for Albertans through sani- are struggling to maintain essen- tary improvements to their envi- tial services with depleted staff. ronments. Second, the APHA To the extent these major pre- attempted to more effectively or- ventive services are maintained, ganize the administration of public we contribute a most valuable impetus to the war effort in our health services in the province. community. […] The health work- Some efforts from the latter focus ers of our province must not fail included advocating for legislation within the extent of their power for public health workers, for ade- and ability.” quate staffing in health units, and -G.M. Little and A. Somerville, 1943 “Foreword,” Alberta Health ensuring that sufficient resources Worker 1943;3

Douglas Hall McCallum (1902– 1979) served as president of the Right: Minutes from the APHA from 1945 to 1946. He later 1944 Annual Meeting of the became the Provincial Dairy Commissioner APHA held at the Palliser in 1959 and the Chair of the Alberta Agri- Hotel in Calgary. cultural Products Marketing Council from 1965 to 1970.

References: 1. Lampard, R. (2008). Alberta’s medical history: Young and lusty and full of life. Red Deer: [self-published]. 2. Schartner, A. (1982). Health Units of Alberta. Edmonton: Health Unit Association of Alberta, 1982. 3. Somerville, A. (1941). “Foreword.” Alberta Health Worker. 4. Watherwell,D. (2005) Making new identities: Alberta small towns confront the city, 1900–1950. Journal of Canadian Studies

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An nurse, Mona MacKinnon, giving an inoculation at a temporary public health clinic in northern Alberta, ca. 1950. Image: Glenbow Archives IP 14a-9566 9 1950s: Finding a Voice and Fighting for Public Health

The archives of the APHA re- Key Events in APHA History, 1950s veal that around the 1950s, APHA 1950 - The publication The Alberta Pub- members began to voice concern lic Health Worker changes its name to that the association now had less The Alberta Public Health Bulletin in impact at the provincial level than 1950. during its first decade. In a 1950 1952 - The Deputy Minister of Health is resolution, for instance, the APHA appointed an ex-officio member of the resolved to write the Provincial APHA Executive Board. Government and Deputy Health 1953 - The membership declines an invitation to have the APHA become an Minister of Health to express their affiliate of American Public Health As- disappointment at being left out sociation’s Western Branch. The issue of discussions concerning the of offering conjoint membership with changes that were occurring for the CPHA first arises in the association. public health in the province (e.g., 1954 - A motion to change the APHA’s Federal Health Grants, changes to constitution, which would allow the the size of Rural Health Units). association to register under the Alber- ta’s Societies Act, is passed. In its earliest decades, the APHA divided its efforts between 1955 - APHA changed its name to “CPHA (Alberta Division).” The APHA co advocating for general public -hosts the CPHA convention at the health measures and protecting Macdonald Hotel in Edmonton. and improving the professional conditions of public health work- and to support the workforce in Key Events in Alberta, 1950s ers. Throughout these early delivering them. Examples of this 1950 - The Government of Alberta im- years, the APHA sought to estab- focus are evident through many of plements a rat-free program. Calgary lish and standardize the delivery the resolutions passed during the loans a health inspector to to of public health services in the 1950s. These included the APHA’s help protect public health after a flood. 1951 - The Health Unit Act is passed, province, disseminate best prac- support for establishing dental which facilitated the opening of new tices in public health suited to services in rural health districts; Health Units (e.g. Camrose). the unique challenges of Alberta, improving isolation accommoda- 1952 - A dental program, with classes and voice the issues and con- tion for communicable diseases in in dental hygiene, begins at the Univer- cerns of the public health work- rural Alberta; and including gam- sity of Alberta. Fluoridation becomes a major issue for the APHA. force in the province. ma globulin in immunization pro- 1954 - 37,000 Alberta children partici- Throughout the 1950s, a main grams for children 4 years and pate in one of the largest medical ex- focus of the APHA was to estab- younger to prevent against Hepa- periments in human history: field trials lish preventive health services titis. Other resolutions sought to of the Salk polio vaccine. 1955 - Dr. Jonas Salk’s polio vaccine is Margaret O’Meara (1917-2010) was born in Edmonton, where she pursued determined to be safe and effective medical training at the University of Alberta. Upon completing her M.D. in against polio. Alberta public health offi- 1943, she enlisted in the Canadian Army, as the first female physician ever to cials begin immunizing 40,000 children join the Canadian Forces. She served as a Major in the medical corps during World with the Salk vaccine. War II. She then returned to Lethbridge to establish a private practice and be- 1956 - Community Health Services, also came the city’s first female Medical Officer of Health. She also practiced medicine known as the Division of Local Health in rural areas and neighboring towns. After retiring from medical practice in 1984, she Services, is created in the Alber- continued to maintain her license until she reached her mid-80s. She was president ta Department of Public Health. of the APHA from 1950 to 1951. 10

This article (left) of the Calgary Herald, pub- lished on September 13, 1952, pictures the 1952–53 Executive of the APHA that was elected at the conclusion of the associa- tion’s annual meeting at the Palliser hotel.

From left to right, the picture shows: new APHA president Hugh Bownes (Red Deer), vice-president Evelyn Wilson (Calgary), secretary Mary MacDonald (Edmonton), and past-president Dr. G.H. Ball (Edmonton) (left to right) are Mr. Bownes. Not pictured is treasurer L.V. Overton (Edmonton). (Image: Courtesy of APHA)

ministrators, such as public health inspectors and Medical Officers of Health. The APHA also went fur- ther in its efforts to improve food safety, by advocating for copies of food establishment regulations to be issued to restaurant operators to ensure they had a reference for proper food handling, prepara- tion, and safety. provide Jamieson Kits to all health become more sanitary. They The members of the APHA also units in the province so their pub- placed responsibility for food saw the need to speak up for the lic health staff could test for germ safety in the hands of public ad- proper veterinary inspection of growth in restaurants and butcher SUPPORT FROM THE MINISTRY OF HEALTH shops. Resolutions were also The presence in the APHA of two long-serving and forward-thinking mem- passed that advocated to change bers of the Ministry of Health seems to have facilitated the APHA’s influence the regulations for scarlet fever on provincial health affairs during its earliest years. Dr. Wallace Warren and streptococcal sore throat Cross (1887–1973), Minister of Health from 1935–1957, and Dr. Malcolm from quarantine to isolation, and Ross Bow, Deputy Minister of Health from 1927–1952, both attended to establish Poison Control Cen- meetings of the APHA fairly regularly during their appointments. Bow tres in Alberta. Finally, some reso- attended the APHA’s earliest annual meeting in 1943, at which he presented lutions focused on ensuring that a paper on “Hopes for the Future of Public Health in Alberta.” Cross present- ed at the APHA’s second annual convention. Bow continued to play an ac- public health staff were adequate- tive role in the APHA during his time as Deputy Minister of Health, through ly trained to provide standardized regular participation in the association’s meetings and conventions. For ex- public health services. ample, in 1948, Bow spoke to the association about the new Dominion Another major focus of the Health Grants, and shared charts illustrating the province’s incidence rates APHA during this time was the im- of polio since 1927. At the same meeting he also moved that the APHA in- provement of food safety regula- vite its national affiliate organization, the Canadian Public Health Associa- tions. The APHA advocated for tion, to hold its 1951 meeting in Edmonton. A 1945 directory of APHA mem- restaurants, lunch shops, and milk bers shows that apart from Bow, many other provincial employees and bars to change their practices to heads of institutions were involved as members. 11

Notable APHA Resolutions, 1950s  That the Provincial Department of Health send monthly bulletins to local Boards of Health. (1950)  That the Canadian Medical Association include a refresher course in public health. (1952)  That accommodation for polio cases be provided in certain strategic hos- pitals in Alberta. (1953)  That animals slaughtered in the province be subject to veterinary inspec- George Meldrum Little tion. (1953) (1895-1967) was born in  That copies of food-establishment regulations be issued to operators. Pilot Mound, Manitoba. (1955) He interrupted his medi- cal education to serve in  That educational films on bakery sanitation be made available. (1955) the Royal Army Medical  That professional training grants for post graduate courses include occu- Corps. After practicing pational health nurses. (1957) general medicine, he was appointed the  That poison control centres be established in Alberta. (1958) first Medical Officer of Health of the Red  That food establishments must have hot and cold water. (1958) Deer Health Unit in Alberta in 1932. He  That the dental hygiene assistants institute a course in the application of had previously obtained his diploma in topical fluoride. (1958) public health from the University of To- animals that were slaughtered for public health grants. The other ronto. Little served as Medical Officer of Health for the City of Edmonton from consumption, and to control li- forty percent was provided by 1937 until his retirement in 1960. He was censing among the slaughterhous- local municipalities. president of the APHA from 1948 to es that were operating in the 1949 and later from 1954 to 1955. province. An important change in public The Calgary Herald article health during this decade was the (pictured right), published September 18, 1952, not- Health Unit Act, which divided re- ed that: sponsibilities for health into region- alized units, each with its own “In an effort to block poor health board and system of admin- handling of food in small istration. Sixty percent of the budg- restaurants and lunch counters, the Alberta Pub- ets of health units came from the lic Health Association is province, which included federal seeking reclassification of the licenses for such prem- John Crichton (1922-1999) stud- ied at the University of Edinburgh ises. This recommenda- in Scotland. He was a former staff tion, along with one urging member of the Children’s Hospital and more space in the eating Vancouver General Hospital in Vancou- houses is being forwarded ver. As well, he was a Professor Emeritus to the provincial depart- in the Department of Pediatrics at the ment of health.” University of . He was president of the APHA from 1949 to (Image: Courtesy of APHA) 1950.

References: 1. Lampard, R. (2008). Alberta’s medical history: Young and lusty and full of life. Red Deer. [self-published] 2. Moss, G. “CPHA 1964-65 Annual Report.” Canadian Journal of Public Health. Vol. 56, No. 6, June 1965. 3. APHA. 50 Years in the Alberta Public Health Association. APHA Annual Report 1993–94 4. van Herk A. (2003) “Sixty Years of not so Secret Service: APHA.” [Unpublished] 5. Predy, G. (1984). “A Brief History of Public Health in Alberta.” Canadian Journal of Public Health 75 (Sept./Oct.) .

12 One last chance for questions for Keynote David Suzuki at the 1976 APHA Convention in Lethbridge

Anti-pollution activists, downtown Calgary, 1970. 13 Image: Glenbow Archives NA-2864-5922

The social changes that oc- Key Events in APHA History, 1960s curred globally during this decade 1960 - The APHA includes dental offic- came to have great impact on ers in its membership . public health in Alberta. After the 1963 - The APHA moves that an invita- Second World War, Canadian soci- tion be extended to professionals in ety became more socially con- Bacteriology, Dental Hygiene, and Vet- erinary Medicine to become members scious through its growing aware- of the association. ness of and participation in move- ments such as second wave femi- 1964 - Dental hygienists are included as APHA members. The APHA also opened nism, civil rights, and environmen- membership to Stenographer- talism. Consequently, a demand Technicians and Secretary Treasurers. grew among Canadians for better 1965 - The Sanitarian Section of the health and social services. APHA becomes the Public Health In- The 1960s was a landmark dec- spection Section. The APHA hosts the ade for public health in Alberta. CPHA convention, titled “The Applica- The province became the third in tion of Scientific Knowledge to Public Canada to provide health insur- Health.” ance to its population, with the 1966 - Occupational health workers are included as APHA members. Alberta Health Care Insurance Act. This act ensured Albertans were 1967 - The annual convention theme is provided with comprehensive “A Centennial Look at Public Health,” commemorating Canada’s Confedera- health services. Another mile- tion. Key Events in Alberta History, 1960s stone for Alberta public health 1968 - The APHA Executive produces 1960 - The University of Alberta opens was Edmonton’s commencement and sends out a newsletter to all mem- a new campus on the outskirts of Cal- of adding fluoride to its drinking bers to keep them informed of the as- gary, which later becomes the Universi- sociation’s activities. ty of Calgary. water in 1967. 1969 - The Occupational Health Workers 1961 - Alberta’s population passes the Throughout this period, the Section becomes the Occupational and one million mark at 1,331,944. Life ex- APHA developed new sections to Environmental Health Section. The pectancy is 74.2 years for females and accommodate member interests Health Care Section was also created. 68.4 years for males. pertaining to topics such as occu- 1967 - Alberta introduces screening of trol, health care practices, and newborns for phenylketonuria. The pational health, the region of Provincial Cancer Hospitals Board is Northern Alberta, dental public health services administration. formed to operate cancer treatment health, health promotion, family In the 1960s, mental health and research programs. The University health, environmental health, appears to have captured the in- of Calgary’s Faculty of Medicine is es- epidemiology and disease con- terest of some APHA members. tablished. Edmonton begins adding fluoride to its drinking water Edward Stuart Oxford Smith (d. 2015) attended Cambridge University, the 1969 - The Alberta Health Care Insur- University of London, and the School of Hygiene at the University of Toronto. ance Act passes, providing comprehen- He served as a Medical Officer of Health for the Sturgeon Health Unit in 1983. sive health services to Albertans. The He was also Director of Local Health Services in 1956–1966 and Director of Epidemi- measles vaccine is made available. ology for Alberta Social Services and Community Health. He served as APHA presi- The Social Credit Party Premier Harry dent from 1956-1966. He was a member of the association for more than 25 years Strom opens the Alberta Resources and part of the executive for 16 years. He later became president of the CPHA from Railway. 1974-1975, and served on a number of committees in the association. 14

Delegates of the combined 43rd Annual meeting of the Canadian Public Health Association and the 9th Annual Meeting of the Alberta Public Health Associa- tion gather at the MacDonald Hotel in Edmonton, September 4-5, 1955 (pictured left). (Image: Courtesy of APHA)

Annual conventions on mental cation for Grade 10 students . tion was passed to investigate the health included presentations on An interest in environmental facilities available for education topics such as overviews of men- conditions seems to have devel- and research in environmental tal health (1964), the epidemiolo- oped within the APHA during this and occupational health in the gy of mental disorders (1965), and decade. In 1960 the APHA held a province, to ensure readiness the integration of “adult retard- convention panel on sanitary within the public health workforce ates” into the community (1966). practices used at landfills, fol- regarding these issues. More specific topics also emerged lowed by another on air and wa- The interrelation of social wel- throughout this decade, such as a ter pollution in 1965. In 1965, fare and health insurance was 1968 convention presentation on the association identified the central to the APHA’s discussion the use and abuse of drugs. “rapid expansion of industry in of public health insurance during In 1964, a resolution from the Alberta” as a major contributor this period, as many of the associ- APHA stated that: “Health educa- to pollution. Later, a 1967 resolu- ation’s members worked directly tion is the most powerful weapon THE APHA PRESIDENTS (1960S–1970S) we have in the field of health and The diverse backgrounds of APHA presidents during the 1960s-1970s reflect […] no lasting progress in health the evolving nature of the association during this period. For the first time work can be achieved without in APHA’s history, the tenure of president was held by persons working in simultaneously undertaking to roles other than physicians, sanitary inspectors or engineers, and public educate the population in health health nurses. During the period of 1960-1979, 7 of the 18 APHA presidents matters.” The association fol- were public health nurses. Other APHA presidents from this period included lowed up on this resolution by re- a psychologist (E.J. Kibblewhite, 1960–61), three dentists (Walter Zacherl, questing that the Alberta Depart- 1962–63; T.M. Curry in 1966–67; P. Finnigan in 1970–71, who was also a speech therapist), a nutritionist (Bretta Maloff, 1977–78), and a health edu- ment of Education establish a cator (Jack Matheson, 1974–75). mandatory course in health edu- 15 Notable APHA Resolutions, 1960s  That APHA investigate grievances of public health workers. (1962)  That a consultant in Maternal and Child Health be appointed full time. (1962)  That the position Provincial Director of Dental Services be made full time. (1962)  That the pasteurization of milk be made compulsory. (1962)  That regulations be implemented regarding roped-off swimming areas at beaches. (1964) Walter Zacherl was a dental  That schools establish health education courses. (1964) officer of the Jasper Place Health  That a simple majority be legislated as sufficient in any plebiscite on the Unit around 1959. He obtained fluoridation of public water. (1965) his diploma in Dental Public Health from  That health and welfare programs be integrated into preventive health the University of Toronto’s School of services. (1966) Hygiene in 1959. He was also Associate Professor of Dental Research at the Uni-  That APHA encourage and actively promote the establishment of research versity of Alberta. He went on to work at facilities and courses of study in the environmental health sciences and in Ohio State University, where he found occupational health. (1967) that toothpaste with sodium fluoride  That beverage rooms implement glass washing. (1968) was as effective as stannous fluoride in  That APHA requests the study of facilities for the handicapped and that reducing tooth decay. they be made available. (1969) with the community through pub- lic health programs, and thus un- derstood the implications of social factors (e.g., income, housing) on health. For instance, in 1964, the APHA passed a resolution to relo- cate the offices of Health Units into the same building as welfare services, to facilitate greater col- laboration. Later, in 1967, another resolution was passed suggesting that the responsibilities of welfare services be investigated to deter- mine which of their duties should instead be the responsibilities of the Health Units. Another important issue from this decade was fluoridation. The Calgary Herald, September 4, 1959: “Delegates to the convention of the Alberta question of public water fluorida- Division of the CPHA at the Stampeder Hotel. Standing, left to right, Jim Wocks, tion was first raised in 1965, and Red Deer health inspector; W. A. Milligan, association president, of the sanitary was revisited many times over the engineers division, Edmonton. Seated, left to right, Mollie Policha, vice-president of the Leduc Strathcona Health unit; Dr. Hugh Brown, director of the Lethbridge next forty years. Health Unit, Marion Storey of the Stony Plain health unit; and Dr. E. M Rowlan, treasurer, Foothill health unit.” (Image: Courtesy of APHA) References: 1. APHA. 50 Years in the Alberta Public Health Association. APHA Annual Report 1993–94 2. van Herk A. (2003) “Sixty Years of not so Secret Service: APHA.” [Unpublished] 3. CPHA Health Digest, Vol. 2, No. 3, June 1978 4. “News Notes.” Canadian Journal of Public Health. vol. 50, No. 12 (December 1959) 5. Alberta Timeline. Canadian Encyclopedia. (www.thecanadianencyclopedia.ca/)

16 One last chance for questions for Keynote speaker David Suzuki at the 1976 APHA Convention in Lethbridge. Image: APHA Archives

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This decade was a watershed in Key Events in APHA History, 1970s Alberta´s history. A major change 1970 - APHA voices support for the in politics came as the 36-year Federal and Provincial Breathalyzer Law. rule of the Social Credit party con- cluded, after it lost the 1971 elec- 1971 - The association changes its name from “CPHA, Alberta Division” to tion to the Progressive Conserva- the “Alberta Public Health Association.” tives. In economics, as oil prices 1972 - APHA passes a resolution em- soared globally, the federal and phasizing the need for a Home Care provincial governments invested Program in Alberta. heavily in Alberta’s oil industry. 1973 - APHA requests strong represen- This influx of capital led to an eco- tation of public health nurses on any nomic boom and a population in- provincial planning committees. crease, as people flooded in to be 1974 - APHA sections align more closely part of the prosperity. with CPHA Divisions: Health Services By the 1970s, the APHA seems Administration, Occupation and Envi- ronmental Health, Epidemiology and to have expanded from a profes- Disease Control, Health Promotion and sional association focused primari- Family Health. ly on serving the needs of the 1975 - APHA hosts the CPHA conven- public health workforce to an ad- tion. APHA also passes a resolution to vocacy association which voiced amend association bylaws to attract concerns in the interest of popula- members of various disciplines to apply tion health. One implicit example for Board nomination. of this shift is found in the 1976 - APHA seeks to increase seat belt meeting minutes of APHA’s 1971 Annual General Business use. Meeting. The association re- 1979 - The Jean C. Nelson Memorial Key Events in Alberta History, 1970s solved to petition the Minister of award is established. The first award is given in 1980. 1971 - The province creates the first Health to establish an Alberta Environment Department in Canada. Council of Health and develop a was present in APHA during previ- The Clean Air Act and Clean Water Act master plan for public health ous decades. come into force. Peter Lougheed, a Progressive Conservative, wins the pro- goals for delivery of services for The publication of the report A vincial election, displacing the 36-year the province. This is indicative of New Perspective on the Health of rule of the Social Credit Party. the association’s stronger advo- Canadians by federal Health Minis- 1973 - Dental and nutritional programs cacy voice that developed during ter (see box on next are added to Health Unit services. the 1970s, targeted at a higher page) sparked the health promo- 1974 - is appointed Lieutenant-Governor of Alberta, as the level of decision makers than tion era in public health and the first indigenous person to hold vice- regal office in Canada. Bretta Maloff worked with Alberta Health Services in a variety of 1975 - Public Health services expand to roles, such as Vice-President of the Diabetes, Obesity & Nutrition Stra- include speech language pathology, tegic Clinical Network, as well as the Senior Provincial Director of the early intervention, reproductive health Maternal Newborn Child & Youth Strategic Clinical Network. She has an and health promotion. The Alberta, undergraduate degree in nutrition, with graduate degrees in public Ontario and federal governments agree health nutrition and education. While her background is in nutrition, Maloff later to invest in and develop the Athabasca moved into health promotion and population and public health. She has held various oil sands near Fort McMurray. teaching positions in the Faculty of Medicine at the University of Calgary since 1977. 18

APHA Convention Program (pictured left) with the keynote address by David Suzuki (pictured below). The Convention was held in Lethbridge, from April 28–30, 1976)

APHA took an active role in its de- rights. Examples of these presen- within the APHA in 1976, when velopment in Alberta. In this dec- tations include “Priorities for Pre- the association hosted environ- ade, a new type of resolutions be- vention in Indian Health” and mental scientist David Suzuki as its gan to emerge. These resolutions “Involvement of the Native Con- keynote speaker at an APHA con- promoted healthy eating and liv- sumer.” ference in Lethbridge. His presen- ing, and encouraged individuals to Interest in environmentalism tation was titled “Science and its take control of their health. seems to have reached a peak Impact on the Health of Man.” Some of the topics presented THE LALONDE REPORT AND HEALTH PROMOTION at APHA conventions during this In 1974, the Minister of National Health and Welfare, Marc Lalonde, tabled period focused on urban environ- the report A New Perspective on the Health of Canadians in the House of ments. Examples include “Public Commons. The report proposed a “health field” concept distinct from the health problems of the urban en- health care system. The health field consisted of human biology, environ- vironment” presented in 1971 by ment, lifestyle, and health care organization. Importantly, the report sug- architect Douglas Joseph Cardinal, gested that efforts focus more on preventing health problems (in lifestyle and “Rapid population growth – and environment fields), versus treating them within the health care system perspectives. Sociological view” after illnesses had developed. This document was highly influential as a ma- presented by Professor Allen jor contribution to the development of health promotion in Canada. Health Olmsted in 1978. Some presenta- promotion gained a strong following in the APHA, which is partly represent- tions delivered at the 1975 joint ed by the presentations on this topic delivered at annual conventions. For instance, concurrent sessions were held on lifestyle, physical measures, and APHA/CPHA conference also sug- approaches to lifestyle during the 1977 convention in Calgary. This conven- gest that interest was growing in tion was titled, “Lifestyle– by Chance or Choice?” Aboriginal health and Aboriginal 19

Notable APHA Resolutions, 1970s  Petition the Minister of Health to establish the Alberta Council of Health to develop a master plan for the delivery of health services. (1971)  That more lecture hours on health care needs of elderly and seniors be provid- ed in medical and nursing schools. (1972)  That APHA ask the government to amend the Municipal Government Act, to permit Municipal Councils to pass compulsory pasteurization bylaws without first needing a plebiscite. (1973)  That APHA inform the public of concern about the standard of public health Kenneth Blom entered the field service delivery. (1976) of Public Health Inspection in  That APHA inform the Minister of Social Services and Community Health about 1956 as a trainee in the Rural the foreseeable decline in the standard of public health service delivery in the Health Region in 1958. He worked at the province. (1976) Yorkton Melville Health Unit from 1958-  That APHA support school health education from grades K-12. (1978) 1967. He then moved to the Mount View  That APHA discourage smoking and encourage its elimination in schools. (1978) Health Unit. In 1973, he was a Senior  That APHA urge the province to sponsor tobacco cessation programs and per- Public Health Inspector. After that, he mit municipalities to restrict smoking in public places. (1978) was Program Manager in Coaldale until  Propose the formation of an Alberta Council on Smoking and Health. (1978) his retirement in 1992. Blom was award-  That APHA ask the province to ensure that all milk served and distributed to ed a lifetime membership by the Canadi- public be pasteurized. (1979) an Institute of Public Health Inspectors in 2016 for his numerous accomplishments In 1971, the name of the asso- solved to support the province in in public health. He was president of the ciation was changed from “The implementing the Breathalyzer APHA in 1976. Canadian Public Health Associa- Law. A few years later, it also en- tion, Alberta Division” to “the Al- dorsed provincial seat belt legis- berta Public Health Association.” lation. By the end of the decade, This latter name remains, today. the APHA had also passed a reso- The APHA was also attentive to lution pointing to the hazards of topics related to environmental smoking. safety. In 1970 the association re- Other recommendations which the APHA supported Betty Patricia (Pat) Yates (1922-2015) was born in throughout the decade advocat- Calgary, where she trained ed creating a province-wide at the Holy Cross Hospital home care program, emphasizing to obtain her Registered a community orientation of med- Nurse designation in 1944. ical students to health care, and She later returned to the University of Alberta to earn her Bachelor of Science in giving medical and nursing stu- Nursing. She applied her nursing skills in dents more instruction on caring the Armed Forces during the Second for seniors and elderly persons. World War and also in hospitals, schools, and in public health until her retirement In 1979, the APHA upgraded its in 1987. She was active in the Alberta newsletter. This is one of the first Association of Registered Nurses editions produced in the new for- throughout her career and served as mat (pictured right). president of the APHA from 1975-1976.

References: 1. Lalonde, M. (1974) “A New Perspective on the Health of Canadians.” 2. van Herk A. (2003) “Sixty Years of not so Secret Service: APHA.” [Unpublished] 3. APHA meeting minutes and conference program. 4. Canadian Cancer Society. http://www.cancer.ca. 5. APHA. 50 Years in the Alberta Public Health Association. APHA Annual Report 1993–94

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Karen Mills, President of the APHA from 1980 -1981, speaks at the 1984 APHA-CPHA joint convention in Calgary after her installation as CPHA President for 1985 and 1986.

Image: APHA Archives

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1980s: Towards a Focus on Health Equity

The oil boom of the 1970s did Key Events in APHA History, 1980s not last. By the early 1980s, eco- 1981 - APHA members struggle with the nomic recession and a lower de- underfunding of community health ser- vices in the province. The association mand for oil negatively impacted grapples with increasing its membership. Alberta and its industry. People The APHA is granted tax-exempt status as began to leave the province due a registered charity. to its climbing unemployment 1982 - The issue of mandatory seat belt rate. The economic downturn was use resurfaces from the 1970s. met by the Conservative Govern- 1983 - The APHA provides funds to support ment with cutbacks in public ser- a film project by CPHA: “Canada’s Amazing vices, layoffs, and austerity re- Health History.” The APHA raises its voice forms which lasted for two dec- on the practice of charging user fees to ades. medical patients, as well as on alternatives The 1980s was perhaps the to institutional care. busiest decade for the APHA. It 1984 - The APHA responds to the pro- was during this period that the posed regulations for Alberta’s New association put forth the highest Child Welfare Act. number of resolutions in its histo- 1985 - The APHA successfully applies for ry. The APHA also seems to have a grant from the MSI Foundation to en- been influenced by foundational hance the Edmonton sample included in work in health promotion, such as a Health Promotion Survey. 1986 - The APHA continues to experi- Key Events in Alberta History, 1980s the Lalonde Report (1974) and ence difficulty in building its member- 1980 - The World Health Organization the Ottawa Charter for Health ship base among the public. APHA meets declares smallpox eradicated. The last Promotion (1986). Members with the province’s Health and Social case reported in Canada was in 1962. have indicated that these works Services. The Alberta Heritage Foundation for Medical Research is established. mobilized the APHA to take a 1987 - The APHA hosts the “APHA Sum- 1981 - Alberta Premier Peter Lougheed more active role in advocating mer School on Health Promotion.” and Prime Minister sign for health beyond improvements an energy-pricing agreement. to public health services. tive. Of special attention is the 1983 - AIDS becomes a reportable con- The association began work- creation of an inequities group dition in Alberta. The Nursing Profes- sion Act is passed, legislating mandato- ing towards health equity within the APHA to address these ry registration of nurses. through intersectoral action, and issues related to inequity. The 1984 - The Canada Health Act is passed. maintained an interest in health 1980s were a period of activism in 1985 - The $30-million Tyrrell Museum from an environmental perspec- the APHA, as the association of Paleontology is opened in Drumhel- ler. is elected Premier of Karen Mills received her Registered Nursing degree from the University Alberta. of Alberta’s School of Nursing. She worked as a staff nurse for the Ed- 1986 - Conservative majority was re- monton Board of Education in 1965, and later returned as its Associate duced in provincial parliament. Twenty- Director of Nursing from 1973–1980. She was appointed to the Canadian three people die in a head-on collision Delegation of the World Health Organization’s World Health Assembly in between a CN freight train and a Via Geneva. In 1989, Mills was awarded the R.D. Defries Award by the Cana- Rail passenger train . dian Public Health Association (CPHA) and also received an Honorary Life Membership 1987 - Alberta enacts seat belt legislation. award. She served on the Canadian Journal of Public Health’s editorial Board. She also 1988 - Calgary hosts the Winter Olympics. served as APHA president from 1980 -1981, and as CPHA President. 22

Clippings from Edmonton Journal men- tioning APHA circa 1982.

(1) The Canadian Public Health Associa- tion voted overwhelmingly to ask the federal government to halt plans to test U.S. Cruise missiles in Canada. The resolution presented by the APHA was one of several aimed at uncontrolled proliferation of nuclear weapons.

(2) The APHA, along with other interest groups and citizens, called for the study into the health effects of the exposure to hydrogen sulphide.

(3) Provincial health testing experts found no virus or bacteria to account for the flu-like symptoms being rec- orded by many city residents... The APHA has joined other organizations which are calling on the province to launch a major health study into the Amoco blowout.

(Image: Courtesy of APHA) adopted a broader scope in ad- joined a provincial council to Health), supported bans for smok- dressing population health prob- combat smoking (Alberta Inter- ing in the workplace and public lems. For instance, the APHA tack- agency Council on Smoking and spaces, and advocated for greater led issues outside of the health A NEW STATEMENT OF PHILOSOPHY sector, such as regulating the In 1983, APHA president Gerry Predy circulated a Statement of Philosophy transportation of dangerous among APHA members for their consideration and comment. He believed goods and standing against cruise that the previously unwritten philosophy of the APHA needed to be explicit missile testing in Alberta. in guiding the association’s future work. One part of this statement read :

During this decade, the APHA In order to have positive impact and continuity of direction on also passed a number of resolu- behalf of health at the provincial level, it is essential to extend tions more specifically tied to the the power to influence social, economic and political develop- environment, such as resolutions ments beyond the local scene to the provincial, national, and regarding acid rain and landfills. international levels wherever possible, and vice versa.

Another key issue for APHA The philosophy statement went on to outline the importance of considering during this decade was tobacco. such broad developments for their potential impacts on population health. Advertising and sponsorship were It also noted that the APHA, as an association affiliated with a national deemed problematic for the con- branch, should seek to engage a diverse membership comprised not only of flict of interest they introduced health professionals, but also of members from the general public. This was into public health. The association intended to encompass a comprehensive view of health within the APHA. 23

Notable APHA Resolutions, 1980s  Transportation of dangerous goods. (1981)  Motor vehicle accidents. (1982)  APHA position on cruise missile testing. (1982)  Policies of flexibility regarding work options. (1982)  Fluoridation of public water supplies. (1983)  Nuclear disarmament. (1983)  Balance billing education campaign. (1983) Gerald “Gerry” Predy ob-  Prenatal education classes. (1984) tained his Bachelor’s Degree  Tobacco advertising and sponsorship.(1985) in Physics, and went on to  Immunization by health units. (1986) complete medical training. He  Tax increase on cigarettes.(1986) graduated with an MD from the University of Alberta in 1976, and has  Public health seniors’ health programs. (1987) been working in public health since 1978.  Create an inequities group within APHA.(1988) He began his work with the Edmonton  Continuing education for day care workers. (1989) Board of Health as the Clinical Medical  Mental health services for the elderly. (1989) Officer. He then became Deputy Medical  Controlling chlorofluorocarbons. (1989) Officer of Health, and later Senior Deputy Medical Officer of Heath. He also took on oversight on advertising of smoke- The 1980s were also a period other roles in the Capital Health region. less tobacco . of increased partnerships and He is currently Senior Medical Officer of Another important topic for the collaborations within the APHA. Health for Alberta Health Services and an APHA was adolescent health. In- During this decade, the associa- adjunct professor at both the University of Alberta and Concordia University. He terest in this topic was spurred by tion worked together with organ- was president of the APHA from 1982 - the Alberta Adolescent Nutrition izations like the Alberta Council 1983. study, which found that 82% of for Smoking and Health, the Al- Grade 8 students did not meet the berta Foundation for Nursing Re- recommendations of Canada’s search, and the Environment Food Guide. Council of Alberta (ECA) on a number of health advocacy pro- Gerald Bonham attended the School of Hygiene at the Universi- jects. ty of Toronto. He later became a Also in this period, the APHA’s Medical Health Officer in several places Jean C. Nelson Memorial Foun- in British Columbia (BC). Subsequently, dation awarded its first scholar- Bonham was the Senior Assistant Depu- ship, recognizing excellence in ty Minister of Health for the BC Govern- ment. In Alberta, he became Chief Med- graduate students training in ical Health Officer for Calgary and a pro- public health. fessor at the University of Calgary’s medical school. His academic work fo- Pictured right: APHA’s first cused on subjects such as child health rural president, Mollie Cun- care, fluoridation, and evidence-based ningham (left) receives the decision-making regarding drug approv- gavel from out-going presi- als and administration. He was presi- dent Marianne Symington dent of the APHA from 1985-1986. (right) in 1988.

References: 1. APHA. 50 Years in the Alberta Public Health Association. APHA Annual Report 1993–94 2. Schartner, A. (1982). Health Units of Alberta. Edmonton: Health Unit Association of Alberta. 3. Predy, G. (1984). “A Brief History of Public Health in Alberta.” Canadian Journal of Public Health 75 (Sept./Oct.) 4. Vancouver Sun and/or The Province from Jan. 25 to Jan. 27, 2013 5. van Herk A. (2003 ) “Sixty Years of not so Secret Service: APHA.” [Unpublished]

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Registration table at the 1989 APHA Convention in Edmonton Image: APHA Archives

Group photo at the 1991 APHA Convention in Grand Prairie. 25 Image: APHA Archives

1990s: Advocacy and Public Health in Times of Austerity

In 1992, succeeded Key Events in APHA History, 1990s Peter Lougheed as Premier of Al- 1990 - The APHA holds its annual conven- berta and the province accelerat- tion in Calgary, themed “Reaching out: a ed its implementation of fiscal decade of challenge.” APHA prepares a cuts and program reductions. The formal response to the Rainbow Report, the Premier’s Commission on Future Conservative Government re- Health Care for Albertans. The main point duced welfare benefits and of APHA’s response is that the report omits healthcare benefits. By the mid- poverty as a determinant of health. 1990s, the province found stabil- 1991 - The APHA holds its annual conven- ity as the oil prices again began to tion “Enviromania ‘91: Partners in Time” in rise. Grande Prairie. Calgary introduced water For the APHA, the 1990s began fluoridation. with a convention in Calgary. At 1993 - The APHA celebrates its 50th Anni- this meeting, a survey was con- versary with a banquet. Attendees receive ducted among APHA members, brochures with a list of highlights of the association’s work over the last 50 years, which reflected the belief that the as well as a list of past presidents. May 12 association’s most important is declared “Calgary Health Day” by city function was public health advo- Mayor Al Duerr in honor of the APHA An- cacy. These findings led the APHA niversary. to review its mission and reorient 1994 - Following regionalization (the pro- the priorities of the association. cess by which health services in Alberta One priority the APHA developed provincial health status indica- shifted from Regional Health Authorities to nine Health Regions), APHA members during this time was to lobby for tors and goals. Another was to report feeling disconnected and having Key Events in Alberta History, 1990s become more involved in envi- fewer opportunities for networking. They ronmental advocacy issues. also express concern about the lack of 1990 - Midwifery is legally recognized understanding of public health among by the province under the Health Disci- Another issue of great con- decision-makers. plines Act. Alberta appoints its first cern to the APHA was the HIV/ Mental Health Patient Advocate. The AIDS epidemic that became a 1998 - Leadership Plan was accepted at Ambulance Services Act is proclaimed. public health priority in North the 1998 Annual General Meeting. The Plan gave the Board direction for its activi- 1991 - Federal legislation is enacted for America by the 1990s. The asso- the mandatory pasteurization of milk. ties, and a committee was struck to ad- 1992 - Ralph Klein is elected Premier. ciation passed resolutions relat- dress revenue generation. 1994 - Government of Alberta passes ed to condom availability, HIV 1999 - The APHA introduces the District the Regional Health Authorities Act to antibody testing by life insurance Representative Program. The program eliminate local hospital and public companies, sexual health educa- consists of identifying a representative for health boards and replace them with tion, and HIV testing for insur- each of the five districts in the province. 17 regional health authorities. 1995 - Floods in Medicine Hat, Alberta, ance and immigration. force 5000 people from their homes. 1997 - The Calgary Declaration is signed Sheilah Sommer has a BSc in Nursing and a MSc in Community Health by most provincial premiers to regulate Sciences. She joined Orion Health, an injury and illness prevention, amendments to the Constitution of assessment, and rehabilitation service, in 2006. Here, she served as Canada. the president and Chief Executive Officer. She has more than 20 years 1999 - The province announces that it of clinical background and experience in hospital management. She was presi- will compensate 242 people who had been involuntarily sterilized. dent of the APHA in from 1997 -1999, and president of the CPHA in 2005. 26

In 1992 the APHA developed a funding proposal to produce a video on public health in Alberta. The video, titled “Taking it to the streets,” was created as a tool that would articulate the concept of public health, in the context of dramatic health reform. Also in 1992, the APHA sought to orient its newsletter around health issues. The association felt that this approach would lead to more contact with members through a “short and catchy format that would not be des- tined for the ‘to-be read’ pile.” Eventually, the APHA re- launched the newsletter as ‘The Promoter’ with four issues per calendar year. In January 1997, APHA went ‘on-line’ with its own homepage on the CPHA website, and later its own web address. The Program Committee also developed a Media Release Protocol to facilitate the sharing of infor- mation with the press, which the APHA Board adopted at a 1999 meeting. By the end of the decade, the rising sun logo had also been adopted.

pline. In 1992, the APHA Board The APHA celebrated a victory or studied in universities or gov- sought to increase its member- in 1991 when the fluoridation of ernmental institutions. Nursing ship. Its goal was to reach 500 Calgary’s water was instated, in was the most represented disci- members by 1993, the associa- part as the result of APHA’s advo- APHA INFLUENCE IN HEALTH REFORM cacy efforts. Reform of the health care system received much attention from the APHA The APHA also continued to and its members during the 1990s. In August 1992, the provincial Minister develop partnerships throughout of Health approached the association requesting its help in outlining pre- the decade. The 1994 Partnership sent issues and challenges in public health. The APHA responded by identi- Project on Literacy and Health fying the following three areas: (a) the need for continued action on health brought increased awareness to reform including the completion of provincial health goals, objectives, and the relationship between literacy action; (b) the need to position public health within the health reform pro- cess, along with education of politicians and the public to understand the and health. A booklet on the pro- contributions and key role of public health in the health system; and (c) the ject elicited positive responses need for sustained funding to carry out the work of the organization with a from 15 Members of the Legisla- request for a sustaining grant. In the APHA’s annual report for 1993/4, the tive Assembly. president noted that members could be proud of the association’s input An ongoing challenge for the into the Health Goals document. As worded by then president Pearl Upshall, APHA during the 1990s was its de- “The content of this and other health reform documents are full of public clining membership amid the as- health.” The APHA did lament, however, that the term ‘public’ (health) had sociation’s desire to increase its been changed to ‘population’ (health) in reflect of changing times, but it took comfort in the fact that the notions, principles, and philosophies of impact on public health in Alberta. public health were entrenched in the reform. In 1994, the APHA published a In 1991, the membership totaled document speaking to Alberta’s Health Reform, titled Creating a New Health 344. Half of these members were Reality. In 1998, the APHA participated in the Health Summit, which result- employed by regional Health ed in 30 recommendations for the government on future directions for Units, and the other half worked health care in Alberta. 27

Notable APHA Resolutions, 1990s  Support for preventing of HIV in injection drug users.(1990)  That appropriate staff-to-child ratios be implemented in day cares. (1990)  That warning labels be included on alcoholic beverages. (1991)  Support for comprehensive school health. (1991)  Support for access to abortion. (1991)  HIV testing by life insurance companies should follow specific informative Hildegard Campsall began her and privacy guidelines. (1992) nursing career at the Peace River  That dental health care be provided for children from poor families. (1992) Health Unit after graduating from the University of Alberta. In 1981, she  Support for prevention of injuries among Canadian aboriginal people. (1992) became director of Peace River Health  Support for the prevention of family violence. (1993) Unit No. 21. She was the first person in  Support for the fluoridation of community water supplies. (1993) public health in Alberta to hire a certified  Urge the Premier of Alberta to develop a plan of action to reduce the audiologist for her unit. Later, Campsall level of poverty among families in Alberta. (1993) worked in the communities of Cadotte  Support for proposed gun control legislation. (1995) Lake and Little Buffalo. She was presi-  Advocating against travel in the back of a pickup truck. (1997) dent of the APHA from 1995 -1997.  To pass legislation designating all public places smoke free including res- taurant catering to persons under 18 years. (1997) planning sessions, resulting in the  Lobby officials to raise minimum wage and link it to inflation.(1999)  Support for making helmets necessary on bicycles. (1999) Leadership Plan. The plan set guidelines for the Board and its tion’s 50th Anniversary. The Board of the decade, under President activities, and made suggestions had considered the option of Sheilah Sommer (1997-99), APHA to address revenue generation offering direct membership to began a process of renewal and and to re-build the APHA’s pres- prospective APHA members, sepa- underwent several strategic ence across the province. rate from CPHA membership (APHA’s national affiliate associa- tion), which was mandatory at the time. This idea materialized in 1993 when 30 new members were recruited through direct membership applications. Unfor- tunately, the goal of 500 members was never realized. Interestingly, though, the APHA did gain 91 new members through joint CPHA- APHA memberships in 1994. Membership in the APHA reached its peak in 1985, with approxi- mately 450 members. By the end

References: 1. APHA. 50 Years in the Alberta Public Health Association. APHA Annual Report 1993–94 2. Celebrating 100 Years of Public Health in Alberta...... 100 years of prevention, promotion and protection. 2006 3. Wilkins, B. (2015) “Campsall family contributor to Peace River culture.” Peace River Record Gazette. May 6. 4. APHA meeting minutes and conference program. 5. OrionHealth Rehabilitation & Assessment Centres Website (orionhealth.net)

28 The Millennium Project was a major initiative of the APHA during the 2000s that argued for the renewal and strengthening of public health in Alberta. Image: APHA Archives

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At the turn of the century, high Key Events in APHA History, 2000s oil and natural gas prices further 2001 - The APHA Millennium Project strengthened Alberta’s economy. culminates after 10 years of work with However, at the same time, Alber- its final report, Showcasing our Past, ta was becoming the province with Creating our Future. the most income inequality. In the 2003 - Aritha van Herk addresses the 2001 election, the Conservative membership with a presentation titled “60 Years of Not-so-Secret Service,” an Government regained a strong ma- account of the APHA’s history. jority, and Ralph Klein made fur- 2005 - The APHA hosts the “2005 Reality ther efforts to privatize some gov- Check” conference. ernment functions. One of these 2006 - The APHA participates in the ASH- efforts was Alberta’s Health Care EN Project and subsequent community Protection Act (Bill 11), which ex- consultations. It hosts the “Celebration of panded the role of private health Public Health Partnerships” conference. care and thus spurred discontent in 2007 - The APHA hosts an “APHA Sum- the sector. mer School” on the social determinants The APHA entered into the of health. APHA also loses its operations funding from the province during this 2000s with most of its efforts fo- year. The Collaborative Action for Ca- cused on the Millennium Project. pacity Building with Vulnerable Youth in The goal of this project was to im- Alberta project commences. prove the health of Albertans by 2008 - The report Public Health Renewal enhancing public health capacity and impact (see next page for de- in Alberta: Report of the 2008 Think tails). Tank is finalized. One long-time member recalls this as “the event that changed Key Events in Alberta History, 2000s The new millennium brought challenges for the APHA, such as everything […as] the Alberta Govern- 2000—Alberta’s Health Care Protection ment then realized we were a force in Act (Bill 11) passes. The Bill intends to building a solid membership foun- public health in Alberta.” expand the role of private health care dation, being a strong voice with- facilities, and is widely opposed in government, and securing sus- for members, to help them make through protests organized by Alberta tainable funding for itself. In these an informed decision regarding the Friends of Medicare, who argue it candidates’ positions on health opens the door to privatization. challenges, the association at- 2002 - Canada signs the Kyoto Accord, tempted to advance health- issues. committing the country to lower its friendly public policy by formulat- The association sought to ad- greenhouse gas emissions. ing positions on the principles of vance public policy during this pe- 2003 - Mad-cow disease is discovered public health. At one point the riod by emphasizing the social de- on a northern Alberta farm. terminants of health (SDOH). The 2005 - Same-sex marriage becomes APHA even developed and distrib- legal in Canada. Heavy rainfalls cause uted a provincial election package association also drew attention to flooding and the evacuation of 1,500 Calgarians; 40,000 homes are dam- Ardene Robinson Vollman has been involved with the APHA since 1992. aged. She served as president of the APHA from 1999-2002, and as Chair of the 2006 - Canada’s first stand-alone facul- Canadian Public Health Association’s Board of Directors from 2015–2016. ty with a sole focus on public health She has also served as Scientific Director for the Primary Health Care Strate- opens in Edmonton. gic Clinical Network of Alberta Health Services, and has worked as a consultant for the 2007 - Largest residential fire in Ed- Community Health Nurses of Canada. She is currently working on the fourth edition of monton’s history occurs. her book, Canadian Community as Partner: Theory and Multidisciplinary Practice. 30

Pictured left is the cover of the Millennium Project report. Pictured below are the credits for those who wrote it.

ronments.” At the start of the decade, the Board made efforts to include members of the Alberta Communi- ty Health Nurses Society, Canadian Institute of Public Health Inspec- tors, Alberta Medical Association, and others in their activities. Build- the health effects of macro-level this decade, APHA conferences ing partnerships seems to have economic trends, such as globaliza- were declared “smoke-free envi- been one of the association’s pri- tion. The commitment of the APHA THE MILLENNIUM PROJECT to addressing the SDOH is evident The purpose of this project was to showcase public health in Alberta. The in the many resolutions passed project was divided in two phases. The first phase was to plan activities that during this decade related to in- showcase public health across the province. In the second phase, these ac- come, poverty, homelessness, tivities were meant to be implemented in local districts. The outcomes of globalization, child hunger, and these activities were shared at the provincial level. The objectives also in- food security. cluded strengthening linkages and networks between public health, health Additional health issues that the promotion, and population health programs and providers in Alberta. Over APHA was involved in during these 66 projects were submitted for possible selection during Phase One. Fifty- three people attended the workshop and audience evaluations of the pro- years included advocating for the ject presentations and the response was very positive. Phase Two ofthe public funding of midwifery ser- Millennium Project took place between May 1, 2000 and September 22, vices, preventing hot water scalds 2001. The goal was to create a future for public health in Alberta. This was among the elderly, implementing done by gathering information on the values and visions of public health physical activity programs in sen- professionals, developing recommendations from the data collected, and iors housing facilities, and support- writing a proposal for action to guide future public health practice. Funding ing the home care needs of adults for Phase Two was received from Alberta Health & Wellness, Health Canada, with long-term disabilities. ten Regional Health Authorities, and the Alberta Community Health Nurses Even in the 2000s, APHA mem- Society’s International Conferences in Community Health Nursing Research bers maintained their involvement fund. The project was supported by the Alberta Consultative Health Re- in anti-smoking initiatives. During search Network. 31

Notable APHA Resolutions, 2000s  Raise the awareness on the increased risk of collision from use of cellular phones while driving. (2000)  Meeting the health needs of urban aboriginal people. (2000)  Suicide: A major public health issue in Alberta. (2001)  That shelter allowances be increased. (2001)  Support for the public funding of midwifery services in Alberta. (2002)  Call on the Government to consider health impact of climate change and Douglas R. Wilson is a reduction of greenhouse gases to meet the Kyoto accord (2002) Professor Emeritus at the  Support to implement a newborn hearing screening program (2003) University of Alberta’s  A call for standard mandated public health information for non-English School of Public Health speakers. (2003) and Faculty of Medicine  Elimination of soft drink promotion in schools. (2003) and Dentistry. He has been involved in  That the APHA commits to collaborate with Alberta Healthy Living Net- public health for over 21 years. He be- came interested in public health through work on healthy living. (2005) learning about the social and environ-  Support for comprehensive poverty reduction among persons with disa- mental determinants of health. He bilities. (2005) played an essential role in establishing  For low-income Albertans to acquire sufficient and nutritious food in a the Centre for Health Promotion Studies dignified manner. (2006) at the University of Alberta. He contin- ues to volunteer his time in various ca- orities during this period. For ex- of the health of infants and chil- pacities to public health in Alberta. He ample, the APHA participated in dren; immunization and control / served as Acting Past-President of the the Alberta Healthy Living Network elimination of communicable dis- APHA in 2004 and 2005. along with 60 other organizations. eases through memorial lectures, It also participated in the Alberta awards and scholarships. ing the Public Health Agency of Social Health & Equity Network. Another landmark event dur- Canada, Alberta Health & Well- Also during this decade, the Dr. ing this period was the 2007 ness, SEARCH (Swift Efficient Appli- John Waters Memorial Fund was APHA Summer School on the so- cation of Research in Community established to acknowledge and cial determinants of health, which Health) Canada, Public Health promote the development of na- was co-hosted by the University Works, Capital Health, Chinook tional, provincial and/or regional of Alberta’s School of Public Health, Community Health Nurses public health policy; the protection Health. The objective was to sup- Association, Alberta Healthy Living port the development of selected Network, and the Alberta Social core competencies in public Health & Equity Network. health and build skills to take ac- tion on the social determinants of health. Later, other partners joined the summer school, includ-

Pictured left: APHA Summer School Participants in 2007. Pictured right: Former presidents Bob Campbell and Maya Charlebois at the 2008 APHA Annual Meeting.

References: 1. van Herk A. (2003) “Sixty Years of not so Secret Service: APHA.” [Unpublished] 2. “Celebrating 100 Years of Public Health in Alberta...100 years of prevention, promotion and protection”. 2006 3. Alberta Timeline. Canadian Encyclopedia. (www.thecanadianencyclopedia.ca/) 4. APHA. The Promoter. Fall 2007 and Spring /Summer 2008 5. APHA meeting minutes and conference program.

32 Participants of APHA’s Strategic Planning session, 2015. Image: APHA Archives Placeholder

From left to right: Lisa McLaughlin, Cynthia Watson, Angeline Webb, Benjamin Kung, Kenda Swanson, Lindsay McLaren, Amy Beck

Student Board members present a poster at the APHA’s Annual Provincial Forum, 2016. Image: APHA Archives

Kenda Swanson (left) and Maria McInerney (right). 33

This most recent decade has brought significant changes, includ- Key Events in APHA History, 2010s 2012 - The City of Red Deer considers ing the economic changes brought cancelling its water fluoridation pro- on by a drop in oil prices. In terms of gram. The APHA presents evidence in political changes, in 2015, the favour of fluoridation. The City Council longstanding Conservative Party subsequently votes to maintain com- leadership gave way to a historic munity water fluoridation. election win by the New Democratic 2015 - APHA helps to repeal the excep- Party. Natural disasters, including tion of Menthol cigarettes from the Al- berta Tobacco & Smoking Reduction Act. the 2013 flood in Calgary and the 2015 - APHA supports the Canadian As- 2016 wild fires in Fort McMurray, sociation for Physicians for the Environ- refocused attention on the environ- ment’s campaign regarding the phase ment. out of coal-fired electricity generation. What does the future hold for the APHA? As always, it is up to its mem- brings together thousands of individu- bers. The association has invested als including business, health and rec- much time and energy to continue reational leaders and non- influencing public health in the ab- governmental organizations who sup- sence of government funding. This port a meaningful investment in the includes participating in formal stra- prevention of disease and injuries. tegic planning to explore how, in the Pictured above are some of the organiza- Concurrently, the APHA has been in- face of limited financial resources, it tions the APHA has partnered with in the vited to participate in Government can serve its members and find ways 2000s. committees such as the Provincial to thrive. The APHA has found inno- Advisory Committee on Tobacco and vative ways to help build capacity, and works with other organizations the Provincial Gambling Advisory such as by hosting interns funded that have common goals, including Committee. through the Alberta Government’s the Alberta Policy Coalition for A priority for the APHA in this dec- Serving Communities Internship Pro- Chronic Disease Prevention ade has been renewed efforts to gram, and engaging research practi- (APCCP), the Public Health strengthen its involvement and activi- cum students, including students Knowledge Translation Network, ties around the social determinants of from the Bachelor of Health Sciences the Indoor Tanning is Out Coalition, health. In a way, this represents a re- program at the University of Calgary. and the Alberta Recreation and turn to some of the association’s earli- Moreover, the APHA has devel- Parks Association. These partner- er priorities in the 70s and 80s, during oped a strong partnership network, ships are critical to the APHA’s ad- which the APHA refocused its efforts vocacy capacity. A good example of to tackle social problems which have a Key Events in Alberta History, 2010s the partnerships was seen in 2013. 2010 - Chinese Oil Producer, Sinopec direct consequence on the health of Corp, buys shares in . That year, the APCCP formed Well- the population. Relatedly, in 2014, the 2011 - After city council vote, Calgary ness Alberta, a campaign which membership approved a resolution in stops fluoridation of drinking water. 2013 - Torrential rains in northern and Kim Raine is a Professor in the Centre for Health Promotion Studies, School of southern Alberta cause flooding Public Health, University of Alberta. A nutritionist by profession, she is a career throughout the province. researcher supported by the Canadian Institutes of Health Research, Heart & 2015 - The New Democratic Party wins Stroke Foundation of Canada, and Alberta Heritage Foundation for Medical Research. a majority in the provincial election. Her research interests involve environmental, community and policy interventions to 2016 - A forest fire in Fort McMurray promote healthy weights and prevent chronic diseases. She was president of the APHA prompts the evacuation of more than from 2010 to 2012. 80,000 residents. 34

support of guaranteed annual in- Notable APHA Resolutions, 2010s come, and, at the 2016 AGM, the  Supporting the creation of a wellness board welcomed two new members foundation in Alberta. (2012) from the social policy community in  Banning indoor tanning for youth Calgary. under 18 years of age. (2012) The APHA experienced a victory  Substance use. (2013) of the Alberta Historical Resources in 2012 when it successfully advo-  Fluoridation of drinking water. (2013) Foundation’s Heritage Preservation cated that the City of Red Deer con-  Reduce alcohol–related injury in Al- Partnership Program, this APHA his- berta. (2013) tinue its water fluoridation program.  Guaranteed annual income. (2014) tory project has allowed us to reflect The Red Deer City Council voted to on the past and look forward with maintain the program after the would be impossible to attribute optimism to the future. We also look APHA presented evidence in favour change to any one actor. There forward to the APHA’s upcoming of fluoridation. In addition, APHA have been, and are, many im- 75th anniversary in 2018. To convey supported policy development initia- portant players in public health in our optimism about the future, we tives related to Alberta’s ban on all Alberta, and the APHA is proud to close with some quotes from our flavoured tobacco, which ultimately be one. interviewees – pre-eminent leaders came to fruition in 2015 when the In closing, thanks to the support in public health in Alberta: exemption for menthol was lifted. Finally, in November 2015, APHA The Future of the APHA supported the Canadian Association for Physicians for the Environment’s Doug Wilson campaign regarding the phase out of “The APHA is a minor, sometimes more major, coal-fired electricity generation in player in a number of things. I think the APHA Alberta, which led to a commitment jumps in when it can and tries to support other organizations who take the lead. Or if they can, by the provincial government in take a lead themselves.” 2016. The APHA has continued to com- municate with its members by de- Ardene Robinson Vollman veloping and distributing a public “We have an NDP government that is very health e-newsletter. The association interested in public health. I think things bode has seen a small increase in mem- well for what APHA can do now. I think there’s bership, especially student member- opportunity to come out of this funk and start ship, which bodes well for the fu- moving forward.” ture. As undergraduate and gradu- ate programs related to public health grow, student engagement Richard Musto will be an important part of the fu- “The APHA and the CPHA have the opportunity to ture of public health in Alberta. advance particularly policy issues in a way that What impact has the APHA had maybe our professional associations don’t.” on public health policy? Certainly, there are examples of policy change in Alberta on issues where we know the APHA was involved, such as seat- Kim Raine belt legislation and indoor tanning. A “The public needs a voice. It’s hard to systematic assessment of APHA’s differentiate between the role of public health impact on policy was beyond the and the role of the APHA. The APHA is the sum of scope of our project, and would be a the collective members, but in terms of what we fascinating task for future work. visually see, the APHA is more. It’s maintaining the visibility, maintaining that voice. It’s keeping However, in reflecting on our re- government honest.” search, we acknowledge that it

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The contributors wish to thank everyone involved in this project who have contributed to its completion, especially:

Interviewees of the APHA History Project:

Ann Goldblatt Ardene Robinson Vollman Bretta Maloff Cathy Gladwin Doug Wilson Gerry Predy James Talbot Karen Mills Kim Raine Richard Musto Sharon Yanicki

Institutional Supports: Provincial Archives of Alberta Department of Community Health Sciences (Cumming School of Medicine, University of Calgary) Alberta Historical Resources Foundation O’Brien Centre for the Bachelor of Health Sciences Sandra Dewar and Erika Roy

External reviewers: Angeline Webb and Bretta Maloff

...and the dedicated members of the APHA who continue to make public health history!

Visit us at: apha.ab.ca

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