Looking Back and Reflecting (blog audit)

Upon revisiting my previous blogs a number of themes became evident throughout my writing. In each of my diverse blog posts I touched on the theme of social inclusion as a way to reduce social inequities in the community. Recognizing the unique needs of different social and cultural groups would make people feel more empowered to take control of their own health while reducing the heavy burden on the health care system. By reaching people in the context of their everyday lives, we can shift our focus on the social determinants of health to meet the needs of community members and increase their quality of life. After all, healthy individuals= healthy communities. As a future dietitian, I think it is critical for me to learn more about the varying needs of difficult social and cultural groups. Growing up in Thornhill, everyone in the community was of the same cultural background and socioeconomic status. It was not until I came to Ryerson in the midst of downtown Toronto that I was exposed to different community lifestyles and the assets/needs that go along with it.


Looking back on my five blog posts, I can see a clear progression in my ability to incorporate critical thinking and analysis into my writing. For example, my first and second blog posts were highly based on current events in the news as well as personal experience. In these blog posts I wrote about two recent newspaper articles that I had come across that related to class concepts and theories I was learning. In my third blog post I began to reflect on and question what I was reading in the news which added to the argument I was trying to make about priorities in medical care for Canadians. This blogging experience allowed me to dig deeper into what I was writing about where I received positive feedback from the course TA. When writing my fourth blog post, I was able to integrate ideas and concepts from previous courses which I felt helped bring pieces of the puzzle together. This post introduced me to the inner workings of community kitchens which I was unfamiliar with before this course. For my fifth and final blog post I investigated the assets and needs of my community, living in the City of Vaughan. When I sat down to write this post I was actually surprised at how little I knew about the way my community had an impact on my overall health. Living in the same neighbourhood all of my life, I have become very comfortable and used to my surroundings and have never questioned what could be done better to improve the lives of the community members, even though there is room for improvement.

Creating a blog for this course was my very first blogging experience. Having never blogged before, I was a little nervous to get started but quickly realized that there was no “right or wrong” way to write a blog. I found that writing the weekly blogs supported my learning of the course content and helped to put all of the concepts and theories I was learning into context. Blogging allowed me to apply real life situations to what I was learning theoretically which made it more relevant and easier for me to understand. Being used to lecture, labs and note-taking, blogging gave me the opportunity to be creative and actually have some fun in my writing. Since the blogs were very informal, the flow of my writing became very natural and unscripted, which is something that I continue to work on professionally. In addition, I found it fascinating to read my classmate’s blogs as it brought forward different experiences and perspectives into what I was learning which enhanced my knowledge on the topic. At the present time, I do not wish to continue writing my personal blog once the assignment is complete but would like to revisit this possibility once the school year is over.

From the Inside Looking Out

After my seminar’s discussion on what makes a “healthy” community, I decided to take a drive through my neighbourhood and critically analyze the needs and assets of my community. To give you some context, I live in Thornhill a suburb North of Downtown Toronto. Thornhill is located within the City of Vaughan and is one of the fastest growing communities in the GTA. Thornhill is home to an ethnically diverse population, however is particularly known for its large Jewish community. Having lived in Thornhill all my life, I have seen the community adapt and change to better accommodate the changing demographics and diversity of its population. For example, T &T Asian supermarket was put into the Promenade Shopping Mall in the heart of the community to cater to the rising Chinese community members. I decided to base the needs and assets of my community of the themes of people, places and priorities from the community quality of life project we looked at in class.
Driving down my street, I immediately noticed that all of the houses are extremely far apart. It’s no wonder that I don’t even know who my across the street neighbours are. Besides a couple walking their dog, I did not see anyone else walking the streets .Thornhill is considered to be a “driving culture” where nothing is within walking distance. For example, I could not even walk to my local public high school which was only recently built. The streets are fairly well lit, however from a safety perspective; I would not feel comfortable walking alone at night. Thornhill is home to many outstanding parks and recreation centres as a result of community projects that were taken on including “Greening Vaughan” and “Communities in Bloom”. As you drive around the neighbourhood you will notice how impeccably clean the streets are and how well kept the city grass is which is one of my community’s key assets. Beautiful, open parks equipped with walking and bike paths, child playgrounds and even tennis courts reside in the core of the Thornhill community. These functional spatial units give community members a collective space to come together to engage in conversation with one another. Every September, community members look forward to the Thornhill Heritage Festival , a street festival which features crafts, music, food and a parade in celebration of the community. This festival represents a way that the community of Thornhill can take action and mobilize their resources to positively impact the culture, attitude and appearance of the community as a whole.
Despite the vital assets that my community features, I believe there is a growing need for more culturally diverse services in community and recreation centres. I feel that with the increasing immigrant and multicultural population, social activities such as community kitchens would allow an opportunity for skill building and social cohesiveness. Implementing these kinds of programs to a rapidly evolving community has the capacity for mobilizing positive social change and empowering community members to get involved in community programs. However, in order to be successful in our endeavours, we must have a clear understanding of the needs and wants of the community members.
Take a long at the short video below for an overview of the City of Vaughan and an overview of its rich history.

Hold my Hand

On a snowy Wednesday afternoon, my class was fortunate enough to have two guest lecturers Jennifer and Yousra from the Access Alliance Community Health Centre. Having never volunteered or worked at a community health centre before, I was amazed at the range of services this centre offers to newcomers to Canada from all over the world. Having grown up in a suburb or “bubble” north of Toronto, I was unaware that these comprehensive services were even available. As Jennifer and Yousra spoke passionately about the diversity of care they provide and the community cooking programs they run, the value and significance of the social determinants of health began to come to life. Seeing the complexity of the patient case studies, I realized that being a community dietitian involves so much more than simply telling people what to eat.  I was reminded of what I had learned four years ago in FNP 100 about how dietitians must be able to take on multiple roles or “wear different hats” in different situations. Jennifer used the example of how she had once spent her entire session with someone teaching them how to use a can opener for the very first time. Teaching newcomers about Canadian food practices and practical cooking skills can empower them to experiment with new foods and not feel like they are outsiders in a foreign environment. To me, social inclusion is one of the most important aspects of overall health and one of the key ways in which we can bridge social inequities. Community kitchen cooking programs (such as the one offered as Access Alliance) reflects one of the ways that we can break down social and cultural barriers to help build social support networks and equality in the community.

In seminar, my group was talking about the difference between an educational and charitable model of health promotion. In first and second year of the program I volunteered at the Community Food Room, a student run food bank funded by the Daily Bread Food Bank at Ryerson University. The students who use the food room are incredibly thankful that this is service available to them and would often explain to me how much they appreciated my time and dedication to being there. Since the students were roughly my age, I could directly relate to them and understand the emotional barriers they had to overcome to resort to using the food room for their essential needs. However, even with the introduction of collectivist organizations such as community kitchens, there is still a stigma attached to using food banks. Despite their sincere gratitude to having this service available on campus, it was clear that some students felt ashamed to be using the food room, often coming alone or making their friends wait outside. For more information about the Community Food Room see http://www.foodroom.ca/.

As I reflect on the lessons I have learned from this week, all I keep thinking is...how would our society be different if these essential services did not exist?

Acheiving Global Impact at the Expense of Our Own

I am writing in response to the article "Shaping the future of health promotion: Priorities for action". This article written by the International Union for Health Promotion and Education (IUHPE) outlines the need to promote global health between and within countries around the world. In sticking with Medicare's Canadian values (fairness, equity, compassion and solidarity) health promotion must move beyond the health care system and focus more on the social determinants of health to enable people to take control of their health. The Ottawa Charter for Health Promotion has laid a solid foundation for the mobilization of health promotion, however new challenges and changing demographics create the need for health care reform and revitalization, in Canada and around the world. " As we move into the 21st century, health promotion researchers, practitioners and policy-makers must build on what has been learnt about effective health promotion in different parts of the world, putting widely into practice what works to ensure that all countries and regions fully implement the ambitions of the Ottawa Charter".

Despite these efforts of bridging health inequalities, the University Health Network in downtown Toronto has issued a $75 million five-year agreement with the Kuwaiti government to provide cancer treatment to their citizens at the Princess Margaret Hosptial. This bold plan highlights the underlying issue of Canadian hospitals: with limited public funds, hospital are now seeking new ways to generate revenue at a time when patients are waiting longer than ever for health care services. The details of this initiative were published in last week's Globe and Mail which drew the attention of some very angry reader's. "Our hospitals are jam packed. Specialists are limited and waiting lists for care are still far too long. No one should be able to buy their way to better treatment". To me, this undertaking goes against Medicare's values, particularly fairness and equity for all. How are we supposed to take care of our own citizens if patients in third world countries are the priority? To me, it all comes down to the lack of funding and limited resources given to health care.See http://www.theglobeandmail.com/news/national/ontario/ontario-hospitals-deal-with-kuwait-sparks-fears-of-queue-jumping/article1889648/ for the full article on this developing story.

Building on my section's seminar discussion, it is clear that there is a critical need for preventative health services in the community. Health services such as dental care, eye care and psychology are all privatized and therefore prevent people from getting the care they need, solely because they simply cannot afford it. In order to move forward with health care reform, policy makers must look beyond the health care system and focus in on the social determinants of health and the underlying causes of illness and disease. The changing demographics of our population pose additional challenges to current policy which must be adressed immediately to help alleviate the burden on the health care system.

See the link for a short video clip published in November 2010:
http://www.theglobeandmail.com/news/national/time-to-lead/healthcare/video-debates-part-1-can-private-clinics-fix-public-health-care/article1795031/

Health Care = Social Network?

                In the words of Roy Romanow, “medicare remains one of the single greatest symbols of our uniqueness of Canadians” and it just got better. After this week’s lecture and seminar discussion, it is clear that health care reform is needed to relieve the burden on our health care system. With rising health care costs, longer emergency room wait times and barriers to access care (such as lack of timely services and poor communication between health care professionals) it is time to focus our attention to health promotion rather than the treatment of illness and disease.

                In March of 2006, Sunnybrook Health Sciences Centre was the first hospital in Canada to launch MyChart, an innovative electronic health records service which patients can access from their very own home. What started off as a pilot project for patients with osteoporosis has now become the way of the future in many downtown Toronto hospitals.  On Sunday, January 23, the Toronto Star reported on Nancy Leonardis, a 32-year old woman pregnant with twins who keeps track of her health from home while on bed rest for the next 3 months.  (see http://www.healthzone.ca/health/newsfeatures/article/926713--medical-records-at-the-click-of-a-mouse if you are interested in reading the article). This groundbreaking method of technology allows patients to access lab results, diagnostic imaging reports, review their prescriptions and connect with their health care providers and physicians. The implementation of this service has made the health care system more efficient and comprehensive to people, while empowering patients to take control of their health head on. This timely access to medical information focuses on a patient-centered care approach in keeping with the 10 Principles of Health Care Reform. In addition, this program provides clinical autonomy to individuals while integrating the health care system into their everyday life. This program allows increased communication and coordination between all of the patient’s health care providers at the convenience of the click of a mouse. Patients are never left in the dark as it reinforces a participatory model of health, moving from an ‘expert’ to ‘partner’ model of health care.

                However, as convenient and integrative this system may be, concerns have been raised over patients being bombarded with too much information and incomprehensible medical jargon.  Not everyone has the luxury of owning a computer which would prevent them from benefitting from this initiative. What are your thoughts on this program?

See the clip below for an outline of the benefits of this medical advancement:

http://www.youtube.com/watch?v=SfGKiaMn51c 

                Building on today’s seminar discussion, I strongly believe that the Canada Health Act should include the provision of long-term care to enhance the quality of the health-care system of the future. As the population ages, there is an increasing need for long-term care facilities and private care workers in the home, however these essential services come at no small cost. With insufficient funds being the main issue, money would have to be taken out of preventative care and put towards the care of senior citizens. The bottom line is, one area of health care will always benefit at the expense of another.

Moving Towards Equality....One Patient at a Time

Upon reflecting on the past two weeks of lecture and seminar, I was quickly reminded of a medical series I have been following in the Toronto Star newspaper. A 26-year old man living in Mount Forest, Ontario nearly died of a rare blood disorder called PNH before gaining access to a $500,000 a year drug treatment. Lucas Maciesza's fight for medical treatment drove provincial policy makers to reconsider the five principles of the Canada Health Act and the Ontario Public Drugs Program is considering the request to cover emergency and beyond-budget drugs. This policy change is meant to reinforce the value of equity in the Canadian values of Medicare, providing necessary care to all Canadians regardless of where they live and what services they require. Revising policy legislation, a vital health promotion strategy is a step towards a more comprehensive, accessible and universal health care system.
See http://www.thestar.com/article/926516--ontario-expands-coverage-for-compassionate-drug-access for more information on this story.

In seminar, the point was made that "fairness" one of Medicare's four values was extremely subjective. Growing up with both of my parents being health care workers, I myself feel like I am at an advantage when it comes to receiving adequate health care. My father being a radiologist, I have been able to "bud" the line on many occasions for diagnostic testing of any kind. One particular experience demonstrates how it is often "who you know" that will get you ahead.

In July of this past year I found myself in the emergency room of York Central Hospital where my father has worked for over 20 years. The sea of people waiting to be seen was incredible, the waiting room crowded to capacity, with everything from crying babies to bleeding wounds, my father forging ahead to show the triage nurse his hospital ID. From across the hall my father began waving at the ER doctor on-call and before I knew it I was in and out of the hospital in under 30 minutes. It was a bittersweet feeling of satisfaction and shame as I walked out, passing people who had been waiting over 5 hours to be seen in a much worse state than I was. In that moment, I realized that as much as we would like our health care systm to render fairness and equality for all, there are always going to be shortcuts along the way, and this time I was the one benefitting.

As nutrition professionals, I believe it is our duty as health care workers to embrace the strategies of health promotion in order to provide people with the skills they need to live a more healthy life. As agents of change, we must collectively strive for a healthy population through nutrition education and community health promotion. By reaching people in their everyday context, we can create a healthy social and physical environment including food and supplementation programs right in their own communities. Prevention and awareness are key aspects of community nutrition that can empower individuals to take control of their lives as well as reduce the burden on the health care system.