This article addresses the issue of the interface between public health and clinical health within the context of the search for networking approaches geared to a more integrated delivery of health services. The articulation of an operative interface is complicated by the fact that the definition of networking modalities involves complex intra- and interdisciplinary and intra- and interorganizational systems across which a new transversal dynamics of intervention practices and exchanges between service structures must be established. A better understanding of the (...) situation is reached by shedding light on the rationale underlying the organizational methods that form the bases of the interface between these two sectors of activity. The Quebec experience demonstrates that neither the structural-functionalist approach, which emphasizes remodelling establishment structures and functions as determinants of integration, nor the structural-constructivist approach, which prioritizes distinct fields of practice in public health and clinical health, adequately serves the purpose of networking and integration. Consequently, a theoretical reframing is imperative. In this regard, structuration theory, which fosters the simultaneous study of methods of inter-structure coordination and inter-actor cooperation, paves the way for a better understanding of the situation and, in turn, to the emergence of new integration possibilities. (shrink)

It is no secret that one of the biggest public health challenges facing this nation is the obesity epidemic. Two-thirds of adults and one-third of children and teens are either obese or overweight. For adults, the number of obese has doubled since 1980, and for children age 6-11 the number of obese has quadrupled. The epidemic has changed what we thought we knew about medicine. For example, until fairly recently, type 2 diabetes was known as “adult-onset” diabetes. But doctors have (...) dropped this moniker as youth account for almost half of new type 2 diabetes in certain communities. Further, there has always been an assumption that life spans and health would improve with advancements in medicine and technology. However, obesity is related to over 20 major chronic diseases, and therefore obese children are more than twice as likely to die before the age of 55 compared to healthy-weight children. In other words, if trends are not reversed, America’s current generation of children are likely to have shorter life spans than their parents. (shrink)