In 2008 the provincial government of New Brunswick, Canada published its Provincial Health Plan 2008-2012. This plan identified several problems or challenges respecting the province's health care system, including "an aging population," high rates of chronic diseases linked to unhealthy lifestyles, a shortage of health care personnel, rising health care costs, and citizens' heightened expectations for health services delivery.
Sixty miles west of Portland, carved into the northern coastline of Oregon, lies Tillamook Bay. It is fed by five main tributary streams that drain from a watershed basin of approximately 540 square miles, and linked to the open ocean via one channel on its northernmost extremity. It is a smallish estuary, with an average depth of only 6 feet and a total span of about 13 square miles, yet it supports a diverse abundance of fish and wildlife.