Upstream journeys in public health


The image depicts a river naming upstream, midstream, and downstream.

Irving Zola’s upstream-downstream parable (or the metaphor) is a public health classic; it is a story of one individual who rescues drowning persons one by one; he spends all his time and laments not having time to search why these people fall into the downstream. This post discusses the metaphor’s origin and how it guides us in upstream public health practice.


Percentage of seniors in Ontario

By July 1, 2019, StatCan estimated that there were 14.5 million people in Ontario, Canada; of them, 17.3 per cent were seniors: aged 65 and above.

Homicide rates in Sri Lanka

Sri Lanka’s homicide rate has been much higher than many European countries including Canada but much lower than the USA.


Ottawa charter logo

The legendary Ottawa Charter for health promotion has travelled worldwide for 30 years from 1986 – 2016.


The image depicts a road with white and yellow lines in the middle as nudges

The “opt-out” default option is the strongest nudging strategy. It has brought many significant behaviour changes in all areas of our lives.

Do you want to know more about nudging? David Halpern introduces a simple tool for nudging: The E.A.S.T.


Paulo Freire

Paulo Freire, a Brazilian educationalist revolutionised adult education principles; these are still popular.