Integrated Analysis of a Health Issue in Canada

The MHST 601 course this semester covered various topics, from learning about social media and professional identity to exploring multilevel health and vulnerable populations models. This provided a comprehensive overview of health in Canada and enhanced my knowledge and understanding of the Canadian Health care system. As a registered nurse, specializing in cardiac care and aesthetics, the course has broadened my perspective on examining health issues within a multi-level context, using a holistic approach that considers individual, interpersonal, community and societal/organizational factors. It encourages me to consider the interconnectedness of the factors and their impact on Canadiens and their health. With these new insights, I will reflect on the topics covered each week and the key learnings I gained as a registered nurse specializing in cardiac care and aesthetics in this course.

Inter-professional Connectedness

The first part of the MHST 601 course had me reflect on my professional identity and values and begin to develop a way to curate and share digital resources in the form of a website. This unit helped me reflect on my professional identity and use social media as a tool for professional networking, education, and health promotion. As an aesthetic nurse, having a professional presence on social media is imperative to grow a clientele. Reflecting on my social media presence and whether it aligns with the profession’s values was a valuable lesson. I found various tools that outline principles nurses must adhere to when using social media. Reviewing social media principles outlined by the International Nurse Regulator Collaborative (INRC) has helped guide my social media posts as an aesthetic nurse (INRC, 2016). These principles can be found in a previous blog post and linked in the curated resources list. Following these guidelines, especially advertising guidelines is of utmost importance. By following these protocols, I can ensure that I maintain my professional integrity and values as a Registered Nurse. Developing a more robust professional identity during this course has helped increase my professional presence online. This unit helped me better understand how social media is a fantastic tool for professionally disseminating information.

Health of Canadians – Understanding Health and Determinants of Health

Another highlight of the course was the exploration of health definitions and determinants. We examined and critiqued the World Health Organization’s (WHO) definition of health. The World Health Organization (WHO) defined health 1948 as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (WHO, n.d.) This definition remains the official definition today. The definition has been criticized for having an unattainable goal of ‘complete health.’ More and more, the need for a more inclusive and functional definition of health is recognized. As our population lives longer, more people live with multiple chronic conditions. The WHO’s definition of “complete health” sets unrealistic expectations, especially for older adults, excluding them from being considered healthy (Kiernan & Karlawish, 2019). By examining alternative definitions of health, I can conclude that health is more than merely the absence of disease. As a cardiac nurse, I appreciate the need for an updated definition of health. Cardiac diseases such as coronary artery disease, hypertension and heart failure are considered lifelong diseases. When managed with adequate care, patients can maintain a full life despite their diagnosis.

Chronic Disease Prevention and Management

Chronic disease prevention and management were extensively covered. This is an essential topic, as one in three Canadian adults lives with at least one of the following chronic diseases: cancer, diabetes, and mood/anxiety disorders (Branchard, et al., 2018). Chronic diseases are prolonged conditions that generally cannot be prevented by vaccines or cured completely (Roberts et al., 2015). Chronic diseases such as cancer, heart disease, stroke, and type 2 diabetes are responsible for most deaths in Canada (UOHI, 2023). As a cardiac nurse, I am acutely aware that heart disease is the second leading cause of death in Canada and the leading cause worldwide (UOHI, 2023). It is a chronic disease that can lead to events such as heart attack, stroke, and death. Lifestyle factors are key influencers, and preventative measures are essential for reducing the risk of developing chronic diseases (UOHI, 2023).

Multilevel Approaches to Understanding Health – Beyond the Individual

In this portion of the course, we examined the different determinants of health and how they impact health. The Office of Disease Prevention and Health Promotion states that the “social determinants of health (SDOH) are conditions in the environment where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (ODPHP, 2023). SDOH contributes to health disparities and inequities (ODPHP, 2023). We discussed how the different types of determinants of health are affected by behaviour, context, genetics, policy and social structure. As a registered nurse, it is important to target the social determinants of health in order to provide inclusive healthcare treatments for the entire population. I chose the social-ecological model to explore the prevention of cardiac disease in Canadian women. While medical research has made significant advancements in understanding cardiac disease prevention in women, it remains understudied, under-diagnosed and under-supported (CWHHC, n. d.). Women are more likely to experience delays in diagnosis and to have worse outcomes than men (Norris et al., 2020). The discrepancy is further compounded by sociocultural, biological and environmental factors that affect women’s cardiac health (CWHHC, n.d.). There are also socioeconomic, demographic, cultural, racial and ethnicity factors that reduce women’s adherence to therapies and limit their participation in research and clinical trials (Norris et al., 2020). The social-ecological model, a framework for prevention, considers individual, relationship, community, and societal factors (CDC, 2022). Cardiac disease is the number one killer of women worldwide and the leading cause of premature death in women in Canada; the social-ecological model can provide a holistic approach to addressing the complex factors affecting women’s heart health and help develop interventions to create positive change. In a previous blog post, I explored interventions that can help healthcare professionals create an environment that supports heart disease prevention at the individual, interpersonal, community, and organizational levels.

Office of disease prevention and health promotion (ODPHP). (2023). Social Determinants of Health. Retrieved from https://health.gov/healthypeople/priority-areas/social-determinants-health#:~:text=Social%20determinants%20of%20health%20(SDOH,of%2Dlife%20outcomes%20and%20risks.

Vulnerable Populations

The end of the course examined vulnerable populations and their impact on one’s health. Vulnerable populations include those who are experiencing homelessness, living in poverty and marginalized populations. Studies have found that individuals sharing homelessness experience higher rates of chronic illnesses and higher mortality than those with stable housing (Jaworsky et. al., 2016). Poverty has been deemed one of the significant societal determinants of cardiovascular disease. Low socio-economic status has been associated with the increased prevalence of cardiovascular risk factors such as smoking, uncontrolled hypertension, and an unhealthy diet (Jaworsky et. al., 2016). It has also been related to inadequate primary and preventative health care access. Furthermore, this population sees a higher rate of readmission due to being unable to adhere to medication regimes once discharged. As a cardiac nurse, I have seen this firsthand and come to appreciate the importance of social programs that can help this population afford their essential cardiac medication. Long-term solutions to reducing cardiovascular risk in this vulnerable population lie in preventing homelessness. It is essential to find ways to decrease disparities for low socio-economic and individuals experiencing homelessness in Canada.

Another vulnerable group in Canada that experiences health disparities is Indigenous groups. Indigenous populations have higher rates of diabetes, hypertension, kidney disease, diseases caused by environmental contamination, and infectious diseases (Vervoort, et al., 2022). Social and economic factors have directly and indirectly produced poorer health outcomes for indigenous populations in Canada. Contributing factors include historical oppression, racism, healthcare biases, and disparities in terms of the social determinants of health (Vervoort, et al., 2022). A common theme in my research is the lack of access to cardiovascular care for Indigenous peoples in Canada. Healthcare professionals, researchers and policymakers must reflect and educate themselves on the needs of the Indigenous population to reduce disparities and systemic barriers in the healthcare system (Vervoort, et al., 2022).

Future Directions

The final unit of MHST601 reflected on current and emerging health trends. A digital revolution is happening in healthcare around the world. From Telehealth to wearable technology, there are many advances in the Canadian healthcare system. Since the COVID-19 pandemic, there has been an increase in virtual care solutions. Implementing Access to health care is also a challenge for patients in rural and remote areas who must travel to urban centres for appointments (Kronfli, 2020). In Canada, out of 13 provinces and territories, 50% of the population lives in rural areas in three of them (Jennet & Andruchuck, 2001). Canada’s size, population distribution, and varied climate present challenges for equitable access to healthcare services (Jennet & Andruchuck, 2001). As previously mentioned, indigenous populations face difficulties with access to healthcare due to living in remote areas. Virtual care can help alleviate these challenges regarding access to health care. Telehealth solutions are critical in fulfilling this mandate and decreasing current health inequities found in accessing the health care system in Canada.

Reflecting on my journey through this course has allowed me to gain a deeper understanding of professionalism and social media, the concept of health and the impact of social determinants of health. I have gained a more profound knowledge of the Canadian healthcare system. In the future, I plan to update my ePortfolio to maintain a professional identity online. It is an excellent tool that can be used to keep track of education, achievements, and resources. I have also deepened my interest and new-found, more profound understanding of women’s cardiac health. With my engagement in this course, I have attended an education day and organized initiatives at my workplace to raise awareness of women's inequities regarding cardiac disease and care.

I look forward to strengthening my professional identity and growing my skills to address cardiac issues in women in the future.

References

Branchard, B., Deb-Rinker, P., Dubois, A., Lapointe, P., O'Donnell, S., Pelletier, L., & Williams, G. (2018). At-a-glance - How Healthy are Canadians? A brief update. Aperçu - Quel est l’état de santé des Canadiens? Brève mise à jour. Health promotion and chronic disease prevention in Canada : research, policy and practice, 38(10), 385–387. https://doi.org/10.24095/hpcdp.38.10.05

Canadian Medical Association. (2019). Virtual Care in Canada: Discussion paper. Retrieved from https://www.cma.ca/sites/default/files/pdf/News/Virtual_Care_discussionpaper_v2EN.pdf

Centers for Disease Control and Prevention (n.d.). The Social-Ecological Model: A Framework for Prevention. https://www.cdc.gov/violenceprevention/about/social- ecologicalmodel.html


College of Nurses of Ontario (CNO). (July 1, 2023). What should I consider before administering cosmetic injections? https://www.cno.org/en/learn-about-standards-guidelines/educational-tools/ask-practice/what-should-i-consider-before-administering-cosmetic-injections/

International Nurse Regulator Collaborative. (2016). Social Media Use: Common Expectations for Nurses. https://www.cno.org/globalassets/docs/prac/incr-social-media-use-common-expectations-for-nurses.pdf

Jaworsky, D., Gadermann, A., Duhoux, A., Naismith, T. E., Norena, M., To, M. J., Hwang, S. W., & Palepu, A. (n.d.). Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada. Journal of Urban Health, 93(4). https://doi.org/10.1007/s11524-016-0065-6

Jennet, P.A., Andruchuck, K. (2001). Telehealth: ‘real life’ implementation issues. Computer Methods and Programs in Biomedicine. 64(3) 169-174 https://doi.org/10.1016/S0169-2607(00)00136-X

Jones, C. A., Perera, A., Chow, M., Ho, I., Nguyen, J., & Davachi, S. (2009). Cardiovascular disease risk among the poor and homeless - what we know so far. Current cardiology reviews, 5(1), 69–77. https://doi.org/10.2174/157340309787048086

Kiernan, C. & Karlawish, J. (July 17, 2019). It’s time to change the definition of ‘health’. STAT. Retrieved from https://www.statnews.com/2019/07/17/change-definition-health/

Kronfli, C. (2020). Realizing the Full Potential of Virtual Care in Ontario. Ontario Chamber of Commerce. Retrieved from https://occ.ca/wp-content/uploads/COVID19-Policy-Brief-Virtual-Care-final.pdf

Norris, C., Yip, C., Nerenberg, K., Clavel, M.-A., Pacheco, C., Foulds, H., Hardy, M.,

Gonsalves, C., Jaffer, S. (2020).State of the science in women’s cardiovascular disease: a Canadian perspective on the influence of sex and gender. Journal of American Heart Association. 9(4). https://doi.org/10.1161/JAHA.119.015634

Office of disease prevention and health promotion (ODPHP). (2023). Social Determinants of Health. Retrieved from https://health.gov/healthypeople/priority-areas/social-determinants-health#:~:text=Social%20determinants%20of%20health%20(SDOH,of%2Dlife%20outcomes%20and%20risks.

Roberts, K. C., Rao, D. P., Bennett, T. L., Loukine, L., & Jayaraman, G. C. (2015). Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. Health promotion and chronic disease prevention in Canada : research, policy and practice, 35(6), 87–94. https://doi.org/10.24095/hpcdp.35.6.01

University of Ottawa Heart Institute (UOHI). (2023). Diseases and Conditions. Retrieved from https://www.ottawaheart.ca/patients-visitors/diseases-and-conditions

World Health Organization. (n.d.) Social determinants of health. Retrieved April 1, 2021, from https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

Vervoort, D., Kimmaliardjuk, D. M., Ross, H. J., Fremes, S. E., Ouzounian, M., & Mashford-Pringle, A. (2022). Access to Cardiovascular Care for Indigenous Peoples in Canada: A Rapid Review. CJC open, 4(9), 782–791. https://doi.org/10.1016/j.cjco.2022.05.010

Copy