Politics, health systems and population health: An interview with David Levine

In an interview, David Levine, Adjunct Professor in the Faculty of Medicine at McGill University, and an Associate Professor in the Faculty of Public Health at the Universite de Montreal, talked about politics, health systems and population health. According to Levine, because of economic constraints, provincial governments have forced greater system regionalization and centralization in an attempt to increase political control. Health service providers and health systems are far less democratic than they used to be. The effects of increased political involvement have been negative for public health. Public health funding has decreased, and health systems remain hospital-centric. In primary care, they need public health practitioners more involved with family physician offices and with interdisciplinary primary care teams. Quebec's greatest success has been putting social services and health services together. They now have organizations that support both social and health needs in an integrated way. These organizations also better understand the needs of their communities, given the relationship between social issues and health status.