Back to blogging – Victoria County Physical Activity Summit & Ideas Powered by Passion

It’s been a long time since I’ve blogged, but I’m going to get back into it now. Kind of a new year’s resolution, although I don’t really do new year’s resolutions. I’ll just promise to try to be better!

I’ll mention two events from a busy few weeks. I was excited to be part of the Victoria County Physical Activity Summit that took place on December 2nd at the Gaelic College. Victoria County has been doing some great work around creating a culture of physical activity, and the summit highlighted this dedication. The presentations and conversations focused on the most local of issues such as finding space for groups to meet, to province-wide initiatives such as the Blue Route bikeways project, to looking at how social determinants of health influence physical inactivity, as outlined in the Cape Breton District Health Authority’s Population Health Report.

Another motivating event was New Dawn’s Ideas Powered by Passion. Ideas is a series of talks and music organized by New Dawn with, in their words, this is mind:

“IDEAS is about innovation, courage, imagination, passion, action, change, possibility, fearlessness, thinking and dreaming outside the box. It’s about not waiting around for “leaders” to change the landscape, but about being the change we want to see. And it all stems from a little niggling deep in the heart… an idea.”

I was able to participate in their November event, along with Nicole Dixon who discussed the creative aspects of libraries, and Jonathan MacInnis, who filled the room with his vibrant voice.

My talk focused on using health as a lens that connects all of our work, as a way to join different sectors, such as healthcare, education, economic development, community organizations, and others. I also discussed the need to change the structures that create inequalities in society, the structures that result in some people being less healthy than others. I’d welcome any comments on the ideas I described. There was a great discussion after the talk, which is not part of the video.

That’s all for today! Thanks for reading and, hopefully, sharing your thoughts.

Cape Breton to Boston to Kolkata

I started the day in Kolkata with a random 3:30 am wake-up that led me to check twitter – I was soon wide awake reading about the bombings at the Boston marathon. The horrific nature of the event, the location somewhat close to home, knowing many who were running/have run that race, as well as the familiar scene of both being in and spectating at a grueling race, made the minute-by-minute play-by-play even more chilling.

I then went to work where people in the midst of their hectic, sweaty, dusty Kolkata commutes, had heard nothing about the bombings. When told, they were shocked, but yet could also name several bombings that had occurred in West Bengal and India in recent times, and one told me about the roadside bomb that killed eight people in Afghanistan yesterday

I then went to a small village about one hour south of Kolkata for a meeting of an HIV support group and a child club for kids in the village, including the ones who are children of an HIV positive mother. No one had heard of Canada, and looked at me unknowingly when I tried to explain that it was beside the United States. Needless to say, they knew nothing of the devastation in Boston.

Lessons from today –

• Loss of life in violent circumstances anywhere is a tragedy
• Loss of life slowly, through lack of income, food, healthcare, or other necessities is a traged
• The global news cycle is immediate – if you have the money and technological infrastructure to access it, the literacy to understand it, and the privilege to be able to think beyond your next meal to contemplate it. 

Mother and infant health

Maternal mortality rate. Infant mortality rate. MMR and IMR. Acronyms describing the most disturbing of phenomena – women dying due to pregnancy and birth-related causes, and the youngest of all human beings dying due to causes such as infection and malnutrition. About twenty percent of the world’s maternal deaths occur in India – that’s about 56 000 women every year. Half of Cape Breton. Most of those deaths are preventable. The infant number is perhaps even more tragic – 1.3 million infants die each year in India. More than all of Nova Scotia.

In Canada the infant mortality rate in 2012 was 5 infant deaths (under 1 year old) for every 1000 live births. In India there are 47 infant deaths for every 1000 live births.

Any mother or infant dying is a tragedy, but at least in Canada it is a relatively abnormal occurrence. Although even within the low Canadian rate there are differences – higher rates of infant death are seen in First Nations people and people living in poverty than in other groups in Canada. Those deaths represent a failure on many fronts, not just during the time of giving birth. Specifically for India, Dr. Anant Bhan and Bhavna Dhingra have co-written an excellent article on the comprehensive approach needed to address women’s health issues in India.

In India, I am working with an organization called the Child in Need Institute. This organization has been in existence for decades, started by a pediatrician, Dr. Samir Chaudhuri. CINI works in many areas, but primarily maternal and child malnutrition. CINI has been delivering programs, working with government and NGO partners, and influencing policies with the goal of improving the nutritional health of families. Beyond that, it has advocated in many areas relevant to health, such as education and housing. CINI also works extensively with HIV prevention. In 2003, it because the first community site (outside of a hospital) to offer HIV testing in West Bengal (the state in which Kolkata is located). Currently it has a network of community-based initiatives occurring across the state.

I have been working with CINI on a grant application for this initiative: Grand Challenges: Saving Lives at Birth. The intent of the proposed initiative is to build on CINI’s previous work in general maternal and infant health, and to create better linkages to the healthcare system so women and infants have quality medical care when it is time to give birth. All of this using a smartphone data system that will allow better tracking of the health status of pregnant women and create better links to the healthcare system.

The philosophy of much of CINI’s activities is similar to the Healthy Beginnings work done by public health health in Cape Breton. Healthy Beginnings staff work to deliver programs that support women, children, and their families to optimize the most influential early years of a child’s life – one way in which this can be done is through home visits or working with other organizations that provide care to families. There is also a focus on adopting and changing policies that help create environments conducive to child health – this could include seeking more accessible daycare options, or addressing legislation that unfairly disadvantages pregnant teenagers.

However, despite the similarities, it is a change in mindset for me to be thinking of the most basic of mother and infant needs – how not to die while giving birth/being born. Being here with my son, with whom I’ve known nothing but pleasure and excellent healthcare through the pregnancy, birth, and infant stages, makes the contrast even more striking. All women and infants should be able to have that.

Two months in India

It’s been a while since my last post. I’ve been in transition between being a Medical Officer of Health and taking a 3-month leave from my job. I’ve come to Kolkata (formerly Calcutta), India, with my son, to work, visit family, and strengthen connections between my son and his history. May he be a step-dancing, Bengali-speaking toddler!

I’m going to continue to post while I’m on leave – some directly public health-related thoughts, and some travel/culture-related (also public health, but with a different slant). Although regular job-wise, I’m dedicated to Cape Breton, public health issues are global, with different priorities in different parts of the world – or even parts of Cape Breton island! So I hope the posts will continue to be relevant to readers, and, as always, comments are always welcome.

(I plan on adding photos too – still working through having inconsistent, weak internet access)

How Public Health is funded in Canada and why that needs to change – healthydebate.ca blog post

I wrote a blog post for healthydebate.ca called How Public Health is funded in Canada and why that needs to change. Please feel free to post comments on this page or on the healthydebate.ca site in response to the article.

If you want to know more about healthydebate.ca, below is their write-up from the “About” page. I’ve found it to be a great source of evidence-based information on a range of topics, and a forum for thoughtful debate from various perspectives.

Healthydebate.ca –

Our vision is: A high quality health care system designed by an informed population.

Our mission is: 1. To provide accurate, easily accessible information about health care to the public, practitioners, students, managers and policy makers. 2. To provide a forum for accessible and thoughtful deliberation about Canada’s health care system. 3. To increase the frequency with which health system leaders use evidence and informed public input when making policy and management decisions.

Our health and the health of our loved ones is more important to us than almost anything else. We all have stories about how Ontario’s health care system has provided excellent care, and how it has let us down.

Despite the personal and societal importance of health care, it is our belief, based on experience working with citizens, that many Ontarians are less informed about our health care system then they would like to be.

Ontarians want to know more about the health care system that they care about. There is currently no one place to go for factual, easy to understand information about the health care system.

Healthydebate.ca attempts to fill this gap by making every effort to provide unbiased information that will lead to debates and informed opinions.

Cape Breton Post Population Health article

I turned my blog post from the 9th into a Population Health article for the Cape Breton Post. Thanks to public health media and policy staff for helping me put together a more polished version!

The Population Health articles are regular features in the Post and consist of articles focusing on the factors that contribute to the health of our communities, including housing, food security, government policies, and many other areas.

We’re always looking for new topics to write about, so suggestions for future articles are welcome!

Changing the culture of alcohol use

I was in line at the grocery store last week before the big snowstorm was about to hit Cape Breton, and I overheard someone in line behind me say: “The liquor store is packed. No Cape Bretoner would be stuck in their house for two days without their alcohol”.

The comment seemed to illustrate the point being made in a recent Cape Breton Post article by Jean MacQueen titled Changing the Culture of Alcohol. In the article, the impact of alcohol is outlined, particularly for young people and youth. The consequences are many, from illnesses such as heart disease and cancer, to car crashes, to crime, to societal disruption, to death. There needs to be a shift in culture to move away from accepting harmful alcohol use.

The goal is not necessarily to eliminate alcohol use, but to minimize its harms. As is said in the article, “It’s not that we are drinking; it’s how we are drinking.” To support this approach, there are now Canadian low-risk alcohol drinking guidelines that outline ways to moderate alcohol consumption and decrease short-term and long-term negative impacts.

How municipal decisions impact health

The Cape Breton Regional Municipality (CBRM) starts public consultations on its budget next week – unfortunately the first two sessions had to be postponed because of the storm making its way to Cape Breton. The schedule for the sessions can be found here:

http://www.cbrm.ns.ca/dates-scheduled-for-public-budget-consultation-meetings.html

Municipal governments play a significant role in determining the health of its residents. For example:

1. They create a vision, which could include working towards being a Healthy City/Town, as described by the World Health Organization:

“A healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential.”

2. They can enact policies, such as smoke-free bylaws, the Municipal Alcohol Policy (which CBRM recently supported), breastfeeding friendly practices, and water fluoridation, that promote and protect health.

Explaining what makes us healthy

If you have forty minutes to listen to a podcast, this is a great one. Dennis Raphael, a well-known researcher and advocate, talks about differences in health and how those differences can be connected to the world around us. Our democratic system matters. Our social safety net matters. Our environment matters. What also matters is that all of those things can be changed, changed so that we can all enjoy healthier lives.

http://www.podsocs.com/podcast/health-inequalities/

Introduction

I started working as the Medical Officer of Health for the Cape Breton District Health Authority in August 2012. I moved here with my son from Ontario after working as the Deputy Medical Officer of Health for northern Saskatchewan for two years. It’s been a great five months of getting to know Cape Breton communities and the public health and healthcare systems.

My job is to work to improve the health of Cape Bretoners by gaining an understanding the issues that impact our health and working with others to try to address those issues. This can include a range of different activities, from looking at access to housing and nutritious food, to providing immunizations so that we are better protected from disease, to assessing industrial projects to ensure they don’t harm people’s health.

Public health wants to be part of ensuring that where we work, go to school, and live are places that contribute to our wellbeing. This means working with many people, organizations, and governments. Sometimes we support what others are doing, sometimes we may be leading initiatives, but our goal is always to address the needs of communities.

I hope to use this blog to share ideas about public health, to let you know what kind of work we are doing in public health, and to invite discussion on public health health issues.

Looking forward to talking with you!