The bio-psycho-social determinants of health: Reflections on the CIAR Population Health Program (1987–2003)

In the mid-1980s, a remarkable polymath, Dr Fraser Mustard, founded the Canadian Institute for Advanced Research (now CIFAR – https://cifar.ca/ ), as a unique way to develop, across Canadian and selected international universities, over a dozen multi-disciplinary groups of researchers tackling major intellectual challenges of that era. Among these groups was the Population Health Program (PHP), led for its initial decade by the brilliant Canadian health economist Prof Bob Evans. Over the next decade-and-a-half, the PHP met nearly fifty times with top international scholars in all types of health research. Out of these interactions, the Program’s membership formulated a set of ideas about how the health of entire human populations and societies is determined, as well as enunciated clear policy and program implications of those ideas. This paper summarizes, from the point of view of the author (a Scholar, then Fellow in the PHP) the main themes that the PHP enunciated during its initial decade, culminating in the widely read volume “ Why are Some People Healthy and Others Not”?. Finally, developments in the field of Population Health in the two decades since the “sunsetting” of the PHP are reviewed and commented upon.