Tag Archives: CHN

Chief Public Health Officer offers CHN postmortem

Okay, who has seen this? (Non-OA)

Butler-Jones D. (2008). Streamlining How We Deliver Public Health Information Online: From CHN to PHAC. The Serials Librarian, 55 (4): 625-627. DOI: 10.1080/03615260802282559

It came to me via the CANMEDLIB listserv, so I’m sure some of you who have access to to journal have also linked into it and taken a peek.

In the article, Dr. David Butler-Jones, first (and thus far only) Chief Public Health Officer of Canada, assures librarians that the closing of the Canadian Health Network (CHN) is not a loss, but

“rather, a change that consolidates resources and information into one website, that of the Public Health Agency of Canada.”

According to Butler-Jones, the primary reason for termination of the CHN was that

“The decision was made to incorporate some CHN materials into the Public Health Agency’s website to better reach both that professional audience [“teachers, health care providers, public health professionals and more”] as well as the general public.” (emphasis mine)

This, naturally, brings up the question of usage stats.  My understanding is that 40% of the CHN users were health professionals, although I’m not sure who all that includes and who the other 60% were. Is it teachers who were not using the CHN, but rather the PHAC?  The general public?  Some specific groups of health care providers?

I’d love to know who the users of PHAC are and who they were a year ago as well. It’s unclear from the Serials Librarian article which audience is considered to have been affiliated with which site, and whether those groups/individuals formerly using the CHN are thought to have actually migrated their use to the PHAC now. (I know I’m sure not; I have become reliant on the NLM’s MedlinePlus for most searches that would previously have been done first on the CHN. You?)

The secondary reason was that the PHAC website is “better equipped” than the CHN to take advantage of today’s online information searches, which use “advanced search engines.”

What do you think this one means?  Does PHAC have better metadata on its webpages than the CHN did? (The PHAC webpages I checked out do have rather sexy metadata, I must say.)  Are the webpages more accessible? More bandwidth to handle higher hit counts? A deal with Google to up pagerank? I’d love to know what this means, personally, so I can think about whether I think it’s a good reason to scrap rather than reform a website.

A third reason Butler-Jones lists as “[a]nother reality at play” was the necessity of making cuts to departmental budgets within government.

Ah, well, this is the one that has been discussed from the beginning.  In fact, this is the only reason we were getting back when things were actually going down. I still have not heard any official answer as to where the funds to launch the new (and relatively vapid) Healthy Canadians website came from, right when the CHN was being axed…have you?

We know the search mechanisms/indexing on the PHAC, Healthy Canadians, and Health Canada websites are inferior to that on the old CHN for consumer health research, and this is likely to be especially so for certain “hot” (controversial) topics. (Go ahead – try it!  And do let me know what you searched for and how the search went on the various sites.) We don’t know whether there is any interest in this matter on the part of the government, or any planning to address this on the PHAC site.

I am curious to know how much of the CHN content has now or will eventually be rolled into the PHAC website.  I know some of it has been appearing, but I believe there is also some that will not migrate. Anyone know more about this transition plan?

Butler-Jones asserts that the CHN and PHAC websites had the same goal and it was financially irresponsible to continue to maintain both sites. He alludes to better systems “in the end” without mentioning when that end will come or what the plan is for getting us there. And he thanks all of those who helped build the CHN, stating that he hopes

“the Public Health Agency of Canada can count of your continued involvement and support.”

Because, um, why wouldn’t health librarians want to pour time and effort into a new website when the one they’d spent the past decade nurturing into a success was just slashed?

As Andre Picard stated last December,

“The [CHN] affiliates don’t need hollow praise, they need cold hard cash to keep the much-needed service up and running.”

And now? Health librarians and information specialists still don’t need hollow praise. They need to be actively and seriously consulted and listened to when national health information infrastructure is being developed. I know sometimes hard questions about resources and budget cuts must be made; however I’m probably not alone in my appreciation of transparency, honesty, and consultation.

Are any of you library/info types out there who use to work on the CHN now working on the PHAC? If so, what are you doing and how is it going?  Is it same thing/different URL, or are there differences in the type of information you are providing now?  What library & information specialists is the PHAC consulting in order to provide accessible information and improve usability? I’m curious!

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Further thoughts on the POPLINE debacle: what went right?

Rachel Walden’s follow-up post on POPLINE has given me a kick in the pants to get moving on my own follow-up post. (Yes, the one that I alluded to months ago…)

I’ve been thinking about the POPLINE debacle. While Rachel rightly points out that all is not perfectly resolved, and we await more answers, in general I’ve been wondering about what went so darned right.

Yes,I know I’ve been one of many ranting about what went wrong – i.e. USAID anti-abortion policies interfering with access to information – but what went right is a different question all together. Considering the positive is something I don’t get to ponder a lot on this blog, so indulge me here.

To recap, for anyone not following along in April: A librarian noticed that abortion was no longer a searchable term in the database and sent out an email about it. The email was passed along on various health librarian and feminist listservs and public outcry was raised. Who-knows-how-many of us emailed the POPLINE admins and blogged it with outrage, and within two days the dean of the Johns Hopkins Bloomberg School of Public Health issued a public statement assuring the world that this would be rectified and investigated.

Wow.

So…as I asked before, what went right here? Why were we successful in calling attention to this issue, and getting it addressed so swiftly? Why did this work fairly well, when in comparison the Canadian Health Network was shut down after months of protest by health librarians, a petition, multiple high-profile newspaper articles, and various other media attention? I’ve been pondering this, trying to figure out what we can do in the future to make our information resources more like POPLINE and less like the CHN, and these are the elements that I’ve come up with thus far:

  • US vs. Canada: The US is generally more political & inflammatory, and Canadian librarians will jump on a US database issue, while 99% of the US generally forget that Canada exists or is within the scope of the ALA
  • POPLINE is housed at/maintained by a single institution with important people who could be embarrassed at the top of the chain of command vs. the CHN, which was, as I understand it, purposively built on a distributed model
  • Specific interest vs. general resource: It’s hard to argue than another resource could easily replace POPLINE, as there aren’t really other reproductive health focused databases like it (are there?), and – however their scope or quality (attirbutes understood by librarians but not everyone) may vary – there are other websites that aim to be broad consumer health resources. It may also be significant that POPLINE is not really for everyday use of the general public, but more for scholars and health professionals.
  • The scope of POPLINE, while specifically focused, had broad interdisciplinary appeal (while reproductive rights info access was damaged by CHN removal, as shown in my previous “ABC” post, POPLINE is obviously related to reproductive rights, and thus feminists signed on the campaign en masse: POPLINE was discussed on WMST-L, while the CHN never was)

I know there are more differences that may have been important in determining how things went down. Feel free to tell me what I am missing. My mind is now spinning on how future projects can be built in a way that helps a threat play out in a POPLINE manner, not a CHN one.

-Greyson

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Filed under censorship, gender, Health, The Profession

CHN Closure Part IV: Americanization or obfuscation?

In my non-librarian alter-ego, I teach women’s/gender studies at a college. The class of my heart (don’t most teachers have these – the one or two courses they just love the most?) is a women’s health course. I love it for multiple reasons. I find it fascinating to explore the intersection between two concepts – “women” and “health” – that both have strong roots both in biology and social construction. I love that everyone finds something personally relevant in the material we cover. I love that the material is always evolving and the class content will never be exactly the same twice. And I love that, even if some students don’t master all the feminist theory we cover, all students can still leave the class with an enhanced ability to understand health information and navigate health systems.

I was recently talking with one student about as assignment she’s working on. She is very interested in learning more about abortion in Canada, and the health issues surrounding abortion. Like many people, she has been exposed to a lot of propaganda/myths about alleged negative health impacts of abortions. Part of my job as her teacher (strikingly similar to my job in my other role as a a librarian) is to help her develop the ability to navigate all the information (and misinformation) out there on such a topic, in order to assess what is reliable and “true” to the best of our scientific knowledge, and to use her critical analytical skills to try to figure out what is going on when there is such apparent disagreement about the scientific “truth.”

One suggestion I have made to her, of course, is to always be aware of the source – and funding – of the information you are reading. That, in the case of, for example, the alleged link between breast cancer and abortion, political abortion websites (pro or anti choice) are not as good a choice for unbiased information as a reliable cancer information website would be. Thus for accurate and current consumer information on whether there is a link between breast cancer and abortion, one would have better results going to, say, the Canadian Cancer Society or the US National Cancer Institute, than following “Dr. Google” to the atrociously misleading and inaccurate top hit of “The Coalition on Abortion/Breast Cancer.” (the search was [“breast cancer” abortion])

I also talked with her about the challenges of looking at medical research as someone who is not an expert or even a health professional of any sort. Sometimes students will find A study on a topic and take its findings for truth, not fully understanding that one individual study is not usually as reliable as a set of studies, that small studies are usually less useful than very large ones, and not having the skills to critically assess the methods used in the study.

So where should she go for such information, particularly if she’s not someone who has the familiarity with the topic to know that there even *is* a Canadian Cancer Society? Good question.

In the past, my first answer for her would have been simple: try the Canadian Health Network. And this would have been a good answer, as a search there for [“breast cancer” abortion] gives one result:

Abortion and breast cancer
Provides the Canadian Cancer Society’s perspective on rumours that suggest having an abortion or miscarriage will increase the risk of breast cancer.
Source: Canadian Cancer Society (CCS)
Amazing! That link is exactly what I first thought of to recommend. Or not so amazing, as that link was put there by some health librarian or similar, who has the same values I do of promoting clear, easy access to accurate, impartial consumer health information.
However, the CHN homepage now has a “Thank You” notice on it:

A notice to Canadian Health Network users

The Canadian Health Network would like to thank its visitors for using this Web site as a health information resource since 1999.

Beginning April 1, 2008, Canadians will be able to access timely, trusted and credible public health information through a single source – the Public Health Agency of Canada’s Web site at www.publichealth.gc.ca. Accessed by over 10 million visitors a year, we invite you to bookmark this Web site as a valuable and unique source for information on healthy living, disease and injury prevention.

Since my class is possibly the only consumer health training my students will ever have, and the CHN is still slated to go *poof* in three weeks, I didn’t recommend it to my student who was researching breast cancer and abortion, even though it would be an ideal starting point for any similar searches she wanted to do in the future.

Seeing as the CHN website refers users to PHAC, the Public Health Agency of Canada, as a replacement resource, I decided to head over there and try the same search on the PHAC site. Rather than a link to one resource to answer the question, we got ten hits, beginning with:

· 1. CYAC 2006E.vp

unopposed estrogen Breast cancer Uterine cancer Ovarian Endometrial cancerSarcoma Early age at menarche or irregular menses ?*36 ? *187, 128, 183, 63, 140 URL:http://www.phac-aspc.gc.ca/publicat/cyac-cjac06/pdf/cyac-cjac-2006_e.pdf
Modified:
2006-09-12 | Size:1456.4K |Language:English

and continuing down a list of references that are, for the most part, equally unintelligible to the average consumer health information seeker. None of the ten citations listed look promising for answering our question.

This is where I started to get angry.

It’s one thing to take away a really great consumer health resource.

It’s another to take it away and leave a pointer referring people to an other resource that is virtually useless for the same type of information seeking!

Okay, I thought. I’ll try Health Canada, then. They do everything; they must have the info there. Well, as we all know, having everything is not what makes a useful library for most regular patrons. Looking for info on abortion and breast cancer at Health Canada is like looking for Harriet the Spy at the Library of Congress by only using a keyword search in the catalogue. There have got to be a lot of books about adolescent girls and journals out there, ya know? Similarly, at Health Canada, our [“breast cancer” abortion] search returns us 76 pages of results, several of which have the same ambiguous title/description:

1. Canada-U.S.A. Women’s Health Forum Commissioned Papers
Canada-U.S.A. Women’s Health Forum Commissioned Papers…

This is not what my student needs.

Just for kicks, I hop across the virtual border and conduct the same search in MedlinePlus. Here, I got 32 hits, with the top one being:

Can Having an Abortion Cause or Contribute to Breast Cancer? Abortion and breast cancer are both topics that can an Abortion Cause or Contribute to Breast Cancer? Abortion and breast cancer are both topics that can bring out strong&# … http://www.cancer.org/…abortion_cause_or_contribute_to_breast_cancer.asp?sitearea=cri

This is the U.S.American version of what the CHN gave us from the Canadian Cancer Society. The results that followed were all reasonably closely related as well, being decent consumer health webpages about either breast cancer or abortion. For this topic, the U.S. and Canadian information is basically the same, so from an information standpoint there should be little qualitative difference (the Canadian Cancer Society might differ in opinion, though, now that they will no longer be getting the web traffic from CHN). However, for, say, breast cancer treatment, the U.S. information would definitely not be the same, or even equivalent to the Canadian, due to different drug approval systems and healthcare delivery systems.

So where does this leave my undergraduate researcher/young woman trying to find out some health info? Really, she has three main choices now, if she is savvy enough to question the verisimilitude of the abortion-breast cancer propaganda in the first place:

  1. Ask a professional (teacher, librarian, doctor…)
  2. Use non-Canadian sources (if US sources, often similar to Canadian info, but sometimes quite different)
  3. Give up: either be confused by the seeming garbledygook on Health Canada/PHAC, or accept the “facts” according to the top hits on an internet search.

I guess I still just don’t understand the idea behind closing the CHN. Is it merely to obfuscate, or is the intent to Americanize?

-Greyson

See previous posts on the CHN here, here and here.

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Filed under gender, Health, Uncategorized

CHN Part III – Petition Deadline

The Friends of CHN have put out the word that they are planning to ask the PM and Minister of Health to “have a heart” by delivering their petition to save the Canadian Health Network on Valentine’s Day, Feb 14.

The Conservative government has pulled the funding from the CHN as of March 31, 2008. For info on why the CHN is a valuable and unmatched resource, see previous posts here at SJL CHN Part I – Pulling the Plug on a Success Story and CHN Part II – Replacement Resources?

Excerpt from the petition:

We the undersigned support the Canadian Health Network. We demand that the funding cut required of the Public Health Agency of Canada be rescinded, that full, stable funding for the Canadian Health Network be restored immediately, and that this valuable Canadian health information resource continue to be developed to become the best of its kind in the world.

Their goal is 5,000 signatures and as of today they have 2,219 – lets to go.

If you haven’t signed yet, and wish to do so, the petition can be found here.

-Greyson

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Heads up: More on privatization of Canadian health information/care

Mark Rabnett has a lovely post up on his blog, Shelved in the W’s, on Tennyson, the CHN shutdown and two-tiered health systems.

Just as we have tiers to our health care system here in Canada – “medically necessary” care for all, but increasingly also pay-for-priority care for those who can afford it – so have we tiers to our health information system.

-Greyson

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