The TOPO survey falls within my legal mandate: To take stock of Montrealers' health to preserve and improve the health of the population.

As interim director of public health for the Montréal region, I am charged by the Minister of Health and Social Services with:

  • informing the population on the general state of health of Montrealers, its major health problems, as well as on the groups most at risk, the main risk factors, and the interventions considered the most effective; 
  • monitoring the evolution of the overall state of health of Montrealers and conducting any studies or research required for that purpose; 
  • identifying situations which could pose a threat to the population's health and acting to ensure that the necessary protective measures are taken; 
  • providing expertise in preventive health and health promotion and advise the Agence de la santé et des services sociaux de Montréal on prevention services that serve to reduce mortality and avoidable morbidity; and 
  • identifying situations where intersectoral action is necessary to prevent diseases, accidents and injuries, or social problems that have an impact on the health of the population, and, where appropriate, taking the measures deemed necessary to support such action.

What is public health?

In 1952, the WHO defined public health as "the art and science of preventing disease, prolonging life, and promoting mental and physical health and efficiency through organized community efforts for

  • the sanitation of the environment; 
  • the control of communicable infections; 
  • the education of the individual in personal hygiene, 
  • the organization of medical and nursing services for the early diagnosis and preventive treatment of disease; and 
  • the development of social machinery to ensure to every individual a standard of living adequate for the maintenance of health. 

In Montréal, the public health department (DSP) works day in and day out to protect and improve the health of the population by means of promotion, prevention and protection.

At what level do we intervene?

Health status, that is, the nature of health problems, their distribution, their significance (extent) and their evolution. We can distinguish three levels of health status:

  • Overall health status 
  • Physical health status 
  • Psychosocial and mental health status 

Health determinants, that is, the individual and collective factors that influence the health and well being of the population, including the following:

  • Global context (e.g. demographic, economic, social and cultural) 
  • Social environment (e.g. family environment, school and daycare environment, work environment, local community and neighbourhood) 
  • Systems (e.g. urban planning, health and social services system)S 
  • Individual characteristics (e.g. lifestyle habits and behaviours, socioeconomic characteristics)