Looking Back to Move Forward: Canadian Occupational Therapy In Public Health, 1914-2019.
Kathryn E Lewis, Michelle J Lehman, Lynn Cockburn
PMID 33715464WHAT IT FOUND
A century of Canadian literature argues occupational therapy belongs in public health, yet the two fields remain separate.
Historical barriers include funding models favoring hospital-based care, professional identity conflicts, and a reactive medical approach that clashes with preventative public health goals.
Key findings
01Occupational therapy services remain largely distinct from Canadian public health initiatives despite over a century of literature advocating for collaboration.
02Structural factors, including Medicare funding incentives for hospital-based care and the profession's shift toward medically driven rehabilitation in the 1950s, historically pulled occupational therapy away from community-based public health work.
03Professional identity issues and a reactive medical approach in occupational therapy have hindered integration with the preventative focus of public health.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The review only included English-language sources, potentially missing significant developments in Quebec, where community-based occupational therapy is strong. Travel restrictions during the COVID-19 pandemic limited access to physical archives, which may have resulted in missed historical documents or context. As a narrative review, it is not systematic and may be subject to selection bias, though the authors attempted to mitigate this through transparent search strategies.
Declared interests
No specific funding or conflict of interest declarations are provided in the text.
The easy way to misread this
Do not interpret this review as evidence that occupational therapy is currently effective in public health settings. It describes a historical lack of integration and theoretical arguments for collaboration, not clinical outcomes or efficacy data.