Quand les chiffres ne racontent pas toute l'histoire
Investissements en santé publique au Québec et ailleurs au Canada
There are several definitions of public health. In Canada, provinces have considerable latitude in deciding which programmes are part of public health, making interprovincial comparisons very difficult. Recent analyses by the Canadian Institute for Health Information (CIHI) suggest that Quebec spends the least on public health. But is this really the case?
In a CIRANO study (Jacques et al., 2025), the authors offer a new perspective on the public health efforts of Ontario, Alberta, British Columbia, and Quebec. The other provinces do not publish their public health budgets and the distribution of funding with the same level of detail as Quebec, which limits the possibility of a perfectly harmonised comparison. Based on a meticulous conceptual reclassification of the definition of public health and using publicly available budget data, the authors arrive at an estimate of public health expenditures in Quebec that is close to the amounts reported by CIHI. In the case of the three other provinces, and again based on this reclassification, the analyses reveal public health expenditures that are much lower than the amounts reported by CIHI. The differences in public health expenditures among the provinces are thus much smaller than CIHI's analyses suggest. This study highlights the importance of a standardised definition of public health and illustrates the difficulty of comparing public expenditures among Canadian provinces.
