What’s the first thing that comes to mind when you think of health?
I recently asked a group of people this question and the most common answers I received was our health care. While health care is an important aspect of health, it’s only a piece of the puzzle.
Health care will always be one of the greatest challenges to the political agenda. Politicians are consistently promising changes to our system. A promise of shorter wait times in emergency rooms, enough beds for patients, an increase in family doctors in rural areas, etc.
While changes to our health care system are important and needed, what if they shifted some of the focus away from health care and towards improving the health of our entire community? By doing so, we would start to see a decrease the amount of health care required because people would be healthier.
It’s time for a different approach.
As a community, we must look deeper into our issues surrounding health. We need to demand an approach that focuses on all factors influencing our health, not just a few factors alone. Welcome Population Health the new buzz words that help define a refreshed approach for heath care.
Dr. Aaron Smith, a family doctor in Pictou County, completed his graduate studies in community health and currently sits on the board at the Aberdeen Health Foundation and the Population Health Committee. He says “Population Health is a different way of thinking about health than what most of us are used to; it’s a focus on the factors that help communities maintain their health and well-being as opposed to a focus on treating illness once it has already been diagnosed.”
Dr. Auylane Jeans, Director of the Aberdeen Health Foundation and Chair of the Population Health Committee, says “Population Health initiatives are directed toward improving the well-being of as many people as possible, and not just one, or a few, at a time; they also address the factors that keep us well. One of my colleagues uses the analogy of healthcare being like rescuing people from a river as they are being washed downstream; a Population Health approach also goes upstream to see why they’re falling into the river, and making changes to prevent it from happening.”
The main factors that influence our health are collectively referred to as the Social Determinants of Health or SDOH.
Dr. Smith states “the SDOH include factors that affect our lives, our health care, our biology, and our physical environments. The identified SDOH affecting our lives at community levels includes issues like income, early childhood development, education access, social inclusion, race, aboriginal status, food security, access to housing, employment, and gender.”
The Canadian Medical Association breaks down the factors affecting Canadians health like this:
• 10% are environmental things like air quality, or civic infrastructure.
• 15% come from biology like genetic influences.
• 25% is the quality and availability of health care.
• 50% have to do with our life circumstances – our income level, education, gender, race, aboriginal status, whether we have safe and nutritious food, our housing situation, our early childhood development characteristics and opportunities, whether we have a disability, whether we experience social exclusion, or feel a sense of community belonging, whether we have a job, and what sort of working conditions we experience, and whether there is a social safety net we can access when needed.
Dr. Jeans says “the social determinants of health have the greatest influence on our health and well-being, but we don’t always think of them in the context of health care. A Population Health approach considers all these factors.”
The Aberdeen Health Foundation’s Population Health Committee has a goal of supporting individuals and community groups to identify needs, and to enhance collaboration among various groups to implement programs that positively impact the social determinants of health for adults as well as children.
Dr. Smith explains in order to make the health of our community better “the first step is understanding that health in our communities is not primarily produced within the hospital or the doctors’ clinics. Health is produced and maintained in how we structure our communities from a social, cultural, and economic perspective.”
Like many rural areas in Nova Scotia, Pictou County is affected by high levels of chronic disease such as obesity, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease. Luckily, there’s a growing interest and discussions concerning Population Health in Pictou County. Many community organizations, municipal organizations, and funding organizations are starting to see the value in a population health approach.
Also, our provincial Public Health Department is now providing information and knowledge support to community groups, organizations, and municipalities seeking to pursue Population Health approaches in developing programs and infrastructure in their communities.
According to Dr. Smith he “would like to see municipalities have a firm grasp of this idea and start integrating strategic health planning into policy and funding decisions. By understanding the determinants of health we can truly start to build healthy communities.”
An example of a population health approach in Nova Scotia is the Annapolis County Alternative Transportation Society, which was designed after the Annapolis County Community Health Board noticed a number of community members were unable to access the health care system, access educational facilities, buy groceries or get a job. They discovered a lack of transportation was the root cause of the problems and put something in place to fix it.
Since many residents in Annapolis County were unable to access transportation, there was an increase in poor health, isolation and lowered self-esteem. The Annapolis Valley Transportation Society was developed to help with the transportation gaps. For an annual fee of $5 and a $5 donation, volunteer drivers offer reliable, affordable, accessible transportation.
Now more residents of Annapolis County are able to get jobs, attend more appointments, have access to healthier food, and attend educational facilities that were otherwise inaccessible, all because of reliable transportation.
The Annapolis County Alternative Transportation Society has played an important role in strengthening self-esteem, building social relationships and giving residents a sense of control over their lives.
Population health requires us to shift our thinking about how health is defined. Our health is not just about hospital care and the absences of disease, it’s a state of complete physical, mental and social well-being. This approach allows people to pursue their goals, to acquire skills and education, and to grow as a human being.
When people are given these opportunities, they are able to adapt and respond to the challenges they face in life. They become a better, healthier, more productive person, which creates a healthy, vibrant community.
There are a number of organizations in Pictou County collaborating on Population Health initiatives. Many of these projects are supported by local Community Health Boards
- Seniors Health Initiatives, creating social opportunities, and educating seniors on topics pertinent to them through’ Lunch and Learn’ events.
- Community Gardens and food mentorship programs that teach food safety and preparation.
- Community exercise programs.
- Programs promoting active lives.
- Health conferences.
- Programs that help to support the vulnerable people in the community. The Aberdeen Health Foundation has the ability to supporting local non-profit organizations and other groups, through the Children’s Aid Endowment Fund. The relatively new fund has a mandate to support transformation programming in the Pictou County region.
- The United Way is also supporting projects and organizations with Population Health components in the work they do.
- The work of non-profit and service clubs support many projects that identify as population health initiatives.