The concept of change is a common thread in our course readings and discussions. Change can reflect personal, career, economic, and institutional growth. Aspects of change can be frightening but necessary. They are our methods to advance ideas and concepts, learn from our peers and communities, and understand our failures. Let us take the concept of change and apply it across this course. The impact is seen through my understanding of professionalism, leadership, and methods of curating resources and using those as a foundation to understand the change required in our current healthcare system concerning marginalized communities such as First Nations, Inuit and Metis (FNIM).
In my current role, I have access to various data and government resources on the many barriers to accessing health care in our region. I did not expect two things: my methods of acquiring and saving this information would evolve, and the type of resources I used would require an overhaul. What positive outcomes can come from using different sources to better understand the FNIM community and their needs? Firstly, acquiring more knowledge about the needs of on-reserve versus off-reserve Indigenous peoples is integral to creating impactful initiatives. Secondly, preparedness when meeting Indigenous partners and stakeholders to discuss their community’s needs with validation and accountability. In collecting a variety of resources, from peer reviews to videos and working in collaboration with the FNIM community, we can review successful initiatives as well as those that have failed to promote discussion of what elements we can take to reconfigure them to work in today’s healthcare system to benefit the community.
The importance of organizing and saving resources to one format and location is vital in my role as a health promotion coordinator. It allows future coordinators to review the data previously collected, meetings with community stakeholders, past initiatives, and synopsis of events to ultimately enable them to build on these past initiatives, reach out to current and new stakeholders and create new initiatives based on current and future data patterns.
Continuing with the concept of change, we see how even the definition of health has evolved. From the World Health Organization’s 1948 definition of health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity” (Huber, 2011, p.235) to the current definition by Health Canada that includes going beyond one’s physical health and incorporates the importance of “social, economic and environmental” factors (Health Canada,2008) we see the significance of looking at a broad topic such as health in a non-linear way. Government agencies, provinces and regions now understand that the needs of the individual, community and specific population groups should be included when defining health and healthcare.
How can redefining health impact healthcare? Overall, the Canada Health Act (CHA) provides an excellent foundation with a focus on “universality [and] accessibility” (Flood & Thomas, 2017, p. 400). Using this definition, current institutions collect data appropriately, create adequate funding for healthcare programs and incentivize the medical community to implement them according to the needs of their population. This will ultimately modernize the CHA to “evolve alongside Canadians’ changing health care needs” Flood & Thomas, 2017, p. 400).
For the FNIM community, the above reflects a provincial cancer strategy. Cancer Care Ontario (CCO) developed the First Nations, Metis, Inuit, and Urban Indigenous Cancer Strategy, 2019-2023. There was a need to address and change how the FNIM community accesses chronic disease and cancer prevention programs in Ontario (Cancer Care Ontario (CCO), n.d.) due to the historical “lack of integrated services in a single location and a distinct gap between mainstream and traditional approaches” (Ahmed et al.,2015). The provincial government and key Indigenous stakeholders created this strategy to disseminate to all Provincial Regional Cancer Programs with the goal that they will connect, develop, and work with their respective FNIM communities to implement chronic disease and prevention strategies and initiatives.
The collaboration of government institutions and FNIM “community-based partners” to create programs and initiatives reflective of Indigenous natural and traditional holistic treatments (Ahmed et al., 2015, p. 423) to reduce the gap in health inequities is a crucial example of the effective use of the social-ecological model of health. Once a population’s social determinants of health are identified, we can assert that an “individual’s good and bad behaviour can be influenced by several factors, including social, cultural, organizational, community and policy (Early, 2016, p. 1). In this case, the FNIM community experiences a rise in chronic illnesses such as chronic respiratory disease, cancer, and obesity; the social-ecological model can utilize the first-hand knowledge from community leaders and knowledge keepers to collect data appropriately, disseminate resources and implement initiatives with the support of community leaders; “recognizing the importance of the interpersonal connections between [FNIM] individuals, organizations, and communities (Early, 2016, p. 2).”
One of the valuable resources that Cancer Care Ontario and members of the FNIM community created is called Path to Prevention - Recommendations for Reducing Chronic Disease in First Nations, Inuit and Métis. This report educates regional programs and healthcare institutions and impacts change in Ontario policy. It focuses on several key topics related to chronic illness prevention: commercial tobacco use, alcohol consumption, increasing physical activity and maintaining a healthy diet. The report acknowledges the importance of its collaboration with FNIM communities and leaders to “effectively achieve equity in access to primary care” and “promote the delivery of First Nations, Inuit and Métis health promotion programming in communities” Cancer Care Ontario (2016). Reports and resources such as this are integral in policy and program implementation. Infographics are also used to outline the need for chronic illness prevention by using appropriate data, imagery and lifestyle changes that community members can initiate. Below is an example of a Metis-specific infographic discussing chronic illness and cancer prevention.
What happens when we don’t evolve? Can we be effective in our healthcare roles when stagnation and complacency come from a fear of change? The healthcare system we knew before COVID-19 no longer exists. We are faced with a new system with new rules and new standards, and with that, new opportunities for change based on the current needs of our population. This realization prepares one for leadership roles by seeing the importance of developing community partnerships and assessing previous data, initiatives, and programs. From these resources, one can analyze what worked and what didn’t, and show a willingness to create and initiate future changes. Marginalized communities such as the FNIM deserve change and innovation in health care programs that prolong the health and well-being of the community members.
References:
Ahmed, S et al. (2015). Disparity in cancer prevention and screening in Aboriginal populations: Recommendations for action. Current Oncology, 22(6), 417–426. https://doi.org/10.3747/co.22.2599
Cancer Care Ontario. (2016). Report: Path to Prevention - Recommendations for Reducing Chronic Disease in First Nations, Inuit and Métis.
https://www.ccohealth.ca/en/report-path-to-prevention
Cancer Care Ontario. (n.d.). Cancer in the Métis People of Ontario: Risk Factors and Screening Behaviours. https://www.cancercareontario.ca/en/statistical-reports/cancer-m%C3%A9tis-people-ontario-risk-factors-and-screening-behaviours-0
Cancer Care Ontario. (n.d.). First Nations, Inuit, Métis and Urban Indigenous Cancer Strategy 2019–2023.
https://www.cancercareontario.ca/en/cancer-care-ontario/programs/aboriginal-programs/indigenous-cancer-strategy#:~:text=of%20Indigenous%20people.-,The%20First%20Nations%2C%20Inuit%2C%20M%C3%A9tis%20and%20Urban%20Indigenous%20Cancer%20Strategy,of%20cancer%20and%20other%20chronic
Community for Health Living. (2017). Ecological Model. Retrieved from: https://www.youtube.com/watch?v=e9UyplfevyQ
Early, J. (2016). Health is More than Healthcare: It’s Time for a Social Ecological Approach. Journal of Nursing and Health Studies, 1, 1-2.
https://Doi:10.21767/2574-2825.100002
Flood, C. M., & Thomas, B. (2017, January 28). Modernizing the Canada Health Act. SSRN. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2907029
Health Canada. (2008, September 12). What is Health?. https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html
Huber, M. (2011). Health: How should we define it? British Medical Journal, 343,(7817), 235-237. https://doi.org/10.1136/bmj.d4163 (link http://www.jstor.org/stable/23051314 - available through the library)
World Health Organization (WHO). (2012, June 16). The Ottawa Charter for Health Promotion. https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference
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