Evidence map›Paper›PMID 41896487›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2026

Two decades of change: The evolution of Canadian public health organizations in chronic disease prevention, 2004-2023.

Katerina Maximova, Gilles Paradis, Elizabeth Holmes, Michelle Halligan, Greg Penney, David L Mowat, Teodora Riglea, Maryam Marashi, Jennifer L O'Loughlin

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Article in Canadian journal of public health = Revue canadienne de sante publique, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Katerina MaximovaMAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. katerina.maximova@utoronto.ca.ORCID http://orcid.org/0000-0001-9842-1927
Gilles ParadisDepartment of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.
Elizabeth HolmesCanadian Cancer Society, Toronto, ON, Canada.
Michelle HalliganCanadian Partnership Against Cancer, Toronto, ON, Canada.
Greg PenneyCanadian Public Health Association, Ottawa, ON, Canada.
David L MowatDalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Teodora RigleaCentre de Recherche du Centre Hospitalier de L'Université de Montréal (CRCHUM), Montréal, QC, Canada.
Maryam MarashiFaculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.
Jennifer L O'LoughlinCentre de Recherche du Centre Hospitalier de L'Université de Montréal (CRCHUM), Montréal, QC, Canada.

Funding

CIHR 170321
6 · The paper itself

Abstract

backgroundOver the past two decades, Canada's public health system has undergone transformative structural changes that may impact chronic disease prevention (CDP). PHORCAST is a unique national study of CDP organizations in Canada that documents trends in organizational characteristics, funding, and priorities across the public health system.

methodsPHORCAST conducted national censuses of CDP organizations in 2004, 2010, and 2023, including governmental and non-governmental organizations (NGOs) that develop and deliver CDP activities (classified as "resource" and "user" organizations, respectively). A standardized questionnaire captured organizational characteristics, populations served, staffing, funding, and activities. Descriptive statistics and stratified analyses were used to describe 20-year trends.

resultsData from 258 organizations in 2004 (92% response), 239 in 2010 (90%), and 267 in 2023 (89%) revealed: (i) a shift toward more centralized delivery of CDP activities, with fewer organizations serving local populations and more serving provincial/territorial or national jurisdictions; (ii) a growing role of NGOs, the presence of which increased from 39 to 62% among resource organizations and from 36 to 51% among user organizations; (iii) declining prioritization of CDP especially among governmental user organizations (from 43% in 2004 to 26% in 2023); (iv) reduced reliance on federal/provincial funding and increased reliance on municipal and private sources; (v) persistent gaps in evaluation with only 19-22% of resource organizations reporting adequate staffing or budget; and (vi) a broadened CDP focus, particularly among NGOs, to include mental health and underserved populations.

conclusionsCanada's CDP landscape has become more centralized, increasingly NGO-driven, and financially unstable, with shrinking government prioritization despite rising chronic disease burdens. Strengthening system-wide capacity, evaluation infrastructure, and stable, equity-oriented funding models will be essential for building a resilient and effective CDP system.

Indexed as

CanadaCentralizationChronic disease preventionHealth equityNGOsOrganizational characteristicsPHORCASTPublic health systems

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.