Picture this – you are walking down Main Street, Wolfville and you bump into an old friend from your high school days. They appear to be doing well but underneath it all they are suffering from a pay reduction at work and they . . . → Read More: Income and Social Status Effects]]> By: Nicole MacIntyre, Shelby DeVan and Ashley Higson, Nutrition and Dietetic Students, Acadia University

Picture this – you are walking down Main Street, Wolfville and you bump into an old friend from your high school days. They appear to be doing well but underneath it all they are suffering from a pay reduction at work and they can’t afford their rent payments. You can’t always see the effects of poverty on people in your community. Surprisingly, according to Healthy Eating Nova Scotia “close to 144, 000 Nova Scotians live in poverty”, which is over 15% of the population of Nova Scotia.
There are two types of poverty: absolute and relative poverty. Absolute poverty is a lack of basic material and necessities of life. Relative poverty is having an income that is less than 60% of the national median income. Poverty exists even in the richest of countries. Some things that people in both categories of poverty go without include, not being able to afford foods from all four food groups to make even two healthy meals a day, appropriate clothing and footwear for job interviews, transportation, or even being able to buy small presents for loved ones at least once a year.
Income and Social Status is the most important social determinants of health. It influences other determinants of health such as education, employment, health services, physical environment, personal health, social networks, stress level, psychological health, alcohol and drug use, food security and healthy child development. This is why it is so important to recognize income and social status as a social determinant of health in your community because it really is everywhere.

One of the most powerful things I learned from the Unnatural Causes video series is “research has revealed a gradient to health. At each step down the class pyramid, people tend to be sicker and die sooner. Poor Americans die on average almost six years sooner than the rich. No . . . → Read More: Hampers for Health!]]> By: Lisa Garand Community Health Board Coordinator

One of the most powerful things I learned from the Unnatural Causes video series is “research has revealed a gradient to health. At each step down the class pyramid, people tend to be sicker and die sooner. Poor Americans die on average almost six years sooner than the rich. No surprise. But even middle class Americans die two years sooner than the rich. And at each step on that pyramid, African Americans, on average, fare worse than their white counterparts. In many cases, so do other peoples of color.
“http://www.unnaturalcauses.org/about_the_series.php

What can we do in our communities… well in the Annapolis Valley, NS we have formed a poverty coalition which has hosted a Food Costing Media Release to talk about the affordability of food, we are drawing attention to the unique differences between urban and rural poverty and we are supporting community initiatives… one of those is the Hampers for Health Program
“Giving a hand up, NOT a hand out” by Family Matters Resource Center

The Hampers for Health Program is now available to families in Annapolis County providing necessities for families who are experiencing financial instability in Annapolis County. http://www.893krock.com/docs/test/hampers%20for%20health%20letter%202012.pdf
A wonderful example of a community driven initiative to address poverty. The most powerful thing about the group is the name… Hampers for Health–recognizing the link between poverty and health.

What can you do in your community to raise awareness?
What needs to happen at the policy level to provide health equity for all?

Gender matters in health and care. The point may seem obvious but it has only recently been acknowledged in health policy and research.” – Pat Armstrong, 2009

Gender alone, or accompanied by other social determinants of health has a big impact on an individual’s . . . → Read More: Gender Matters–health research proves it!]]> By: Rebecca Reardon, Meg Rector and Suyi Xu, Nutrition and Dietetic Students Acadia University

Gender matters in health and care. The point may seem obvious but it has only recently been acknowledged in health policy and research.”
– Pat Armstrong, 2009

Gender alone, or accompanied by other social determinants of health has a big impact on an individual’s health. We have come to realize this through our research of gender. Though at first sight gender might just seem like the state of being male or female, there is really a lot more to it than that. One must also consider the characteristics and behaviours that define the roles of men and women. As a society we tend to stereotype based on gender. Men are viewed as being active, rational and aggressive, whereas women are viewed as passive, emotional and nurturing. Being expected to act in these certain ways has caused men and women to often stick to these stereotypical roles. After our enlightenment, we now have a new perspective on how much these stereotypes really play into our societal expectations. Are there any other gender stereotypes that you can identify from your own community?
Discrimination of gender is one of the major impacts on other social determinants of health. Income, education, culture and social support all affect men and women differently. For example women earn 20% less money than men. Have you ever felt discriminated due to your gender?
Although through research we discovered that women, on average, have a longer life expectancy than men, they are at a higher risk of suffering from illnesses such as depression, some chronic diseases, stress, eating disorders and violence. The reasons behind the shorter life expectancy of men are health issues such as cardiovascular disease, heart attacks, severe injuries, lung cancer and suicide. As well, men tend to eat higher calorie dense fatty foods, factors which can lead to cardiovascular disease and diabetes. Although many people don’t even realize that gender is a determinant of health, how do you think gender affects your life and health status?

It starts with your family connection. It’s what you wear. It’s how you communicate. It’s what you eat. It’s your way of life. Everyone is a part of a culture. Whether you are Aboriginal, an immigrant, a vegetarian, or have any . . . → Read More: What is Culture?]]> By: Kathleen Tozer, Kelsey Chase, Caroline T’ien, Dietetic and Nutrition students at Acadia University

It starts with your family connection. It’s what you wear. It’s how you communicate. It’s what you eat. It’s your way of life. Everyone is a part of a culture. Whether you are Aboriginal, an immigrant, a vegetarian, or have any other cultural ties; it can impact your overall health.

How can this be? The culture that you live in influences the choices you make, and exposes you to different situations, people, and ways of life, which may subject you to marginalization, stigmatization, and lack of support. In addition, language barriers can affect how a person communicates their health needs and therefore plays a prominent role in affecting your health.

Let’s look at this through the eyes of an immigrant. Imagine moving to Canada from another country and not being able to speak English or French. Will this person be able to contact a physician, locate a hospital, access support services, and do simple tasks like shopping for affordable, healthy food? Overwhelming isn’t it? We suspect that in this case mere survival surpasses the need to be healthy and that understanding health and illness, learning and accessing health information, promotion and prevention programs, and interaction with the health care system all fall by the wayside.

It has been well documented that the Aboriginal population has greater health issues than the rest of the Canadian population. These include higher rates of smoking, alcohol abuse and diabetes. Unfortunately, a social stigma has been placed on the entire Aboriginal population and does not take into consideration that there may be many Aboriginal people who do lead healthy lives. It is automatically assumed by many that Aboriginal people are unemployed, live in low-income housing and struggle with poverty. This assumption needs to be challenged, and we need to pay more attention to the root causes of poor health.

The first step towards improving the health of the entire population and all cultures is to ensure that social stigmatization of individuals is eliminated. More effort needs to be made to provide supports for equal health and health care regardless of cultural differences.

Think of your community. How many cultures are within it? What are your assumptions of people from cultures other than your own?

“If you wish to help a community improve its health, you must learn to think like the people of that community.”(Dreher,2006)

When considering personal health practices and coping skills, it is important to understand that there may be many reasons why we behave in certain ways. Everyone has different priorities and different opinions of what is healthy. Personal health practices and coping skills are interrelated . . . → Read More: What is Healthy?]]> By: Madison Boyd, Laura Morrison, Courtenay Vickers, Dietetic and Nutrition Students, Acadia University

When considering personal health practices and coping skills, it is important to understand that there may be many reasons why we behave in certain ways. Everyone has different priorities and different opinions of what is healthy. Personal health practices and coping skills are interrelated and different methods of coping may affect our health practices.
Here is a sample scenario: when dealing with stress, many of us choose to eat comfort food that is high in fat. Depending on the severity and frequency of stress, we may eat a lot of unhealthy food which we normally would not eat. Many unhealthy coping skills, like eating comfort food, provide momentary relief, but this is only a band-aid solution. Weight gain could result which causes even more stress and can lead us to have more comfort food.
Poor personal health practices and coping skills often lead to a downward spiral, which explains why certain behaviours can become addictive such as alcohol consumption or smoking. We may choose to do certain things that are unhealthy for the instant relief, but we may not understand that the solution is only a quick fix. This can make circumstances worse in the long run.
The good news is that this downward spiral can be reversed. If we decide to handle stress by exercising, we may feel good and lose weight. This could give us a positive attitude to make other healthy choices such as increasing fruit and vegetable consumption. This reversal may not be easy for all of us. For those who have never been at the “top of the spiral” the resources or motivation to make the changes that are necessary to improve their health and in turn, improve their life may not be available. For those who do not know what they are working toward, it is difficult to understand why certain health behaviours should be changed.
Motivating people may be one of the greatest challenges for health care professional. In order to do so, we must eliminate our biases and try to see things from the perspective of the population we are working with.

When you think of the determinant of health, social environment, what comes to mind? Volunteer organizations, family gatherings, community events, cultural celebrations, and support groups? Like us, you can probably appreciate how each of these contributes to a happy and healthy life. . . . → Read More: Social Environment: Asking the right people?]]> By Kathryn Holt, Ashley Cluett & Kielyn Jenkins, Dietetic and Nutrition Students, Acadia University

When you think of the determinant of health, social environment, what comes to mind? Volunteer organizations, family gatherings, community events, cultural celebrations, and support groups? Like us, you can probably appreciate how each of these contributes to a happy and healthy life. But did any of you consider that these are privileges enjoyed by some and denied to others? Have you considered that not having access to social supports can seriously affect your health?

Within a community, there are certain groups of people that are often denied these fundamental rights and consequently excluded from policy decisions. Some of these groups include Aboriginals, new immigrants, Canadians of colour, women, and those living with disabilities or in poverty. When a person finds themselves on the lower rungs of the social ladder, they become less likely to receive social supports. That person faces social exclusion.

Social exclusion creates the conditions and experiences that lead to greater incidences of mental illness, anxiety, depression, substance abuse, and chronic illness, such as cardiovascular disease and adult-onset diabetes. In addition, the stress and anxiety associated with the experience of exclusion and inequality tends to further affect the person’s health.

When you look around your community, how many people would you identify as being socially excluded? It’s probably more than you think.

When looking at the determinant of the social environment, the issue of social exclusion is arguably one of the most important. Health care professionals need to not only be aware of this issue, but to act as advocates for the inclusion of these people, as their experiences may be the most important to consider when making policy decisions.

Now that we’ve decided who to ask, how do we go about asking?

Health services as a social determinant of health focuses on secondary prevention and treatment. Health services are designed to prevent disease, maintain and promote health and also to restore health in Canadian populations. The Canada Health Act requires that each province provide health . . . → Read More: The Canadian Health Care System Is Designed To Protect Those With Low Income .. .Is It Working?]]> By: Lindsay Harris, Dianne Timmins and Christine Manning, Nutrition and Dietetic Students, Acadian University

Health services as a social determinant of health focuses on secondary prevention and treatment. Health services are designed to prevent disease, maintain and promote health and also to restore health in Canadian populations. The Canada Health Act requires that each province provide health services that are comprehensive (medically necessary services provided), universal (everybody has access to health care insurance on equal terms and conditions), portable (access to health services when out of province/country), and accessible (free of financial barriers) and provided by public administration (health care administration paid for by public authority). Although these requirements may be met on paper, how well are they actually working in a community setting and on a provincial and federal level? The Canadian health care system is designed to protect those with low income by spreading health costs across the entire society. With that being said, income is the biggest barrier preventing families from accessing certain health services, especially the services NOT covered by public health care insurance. For example, the costs of prescription drugs are not covered by public health insurance, resulting in families without private health care insurance to be less likely to fill these prescriptions and restore their health. The Medicare system in Canada only covers 70% of total health costs, so services such as long-term care and dental health are not covered. What does this mean for our aging population?
As proud as Canadians are in regards to our health care system, a more in depth look gives rise to questions concerning the adequacy of this system and what should be done to decrease the barriers of health services in our communities.
Is there a solution?

As part of a Community Nutrition class at Acadia University, we explored the topic of education as a social determinant of health. Today, we want to share a few of the key points about what we have learned:

What is education and why does . . . → Read More: Does Education Matter…. More Than You Think..]]> By Dawne Olafson, Kai Svirida, and Yu Zhang, Nutrition and Dietetic Students Acadia University

As part of a Community Nutrition class at Acadia University, we explored the topic of education as a social determinant of health. Today, we want to share a few of the key points about what we have learned:

What is education and why does it matter?
Education is the act or process of giving or learning knowledge, developing powers of reasoning and judgement, and preparing one’s mind for mature life. Education provides many skills, including the ability to read, write, do math, and make sound decisions. It takes many forms, including classroom, apprenticeship, and on-line learning.
Education matters because it provides people the opportunity for better employment options and job security, knowledge and skills to make healthy choices, and to actively participate in their community. Beyond knowledge and skills, people learn to feel that they belong somewhere, participate in activities with others, and to feel important. In this way, education reduces stress and social exclusion.

How can education impact health?
A person with more education becomes more able to recognize the factors that shape their health, and they are more likely to have the skills to support their health. Research shows that people with lower education levels experience greater risk for chronic disease, such as smoking, physical inactivity, unhealthy weight, and unhealthy diet.

How are we doing in Canada?
Canadians receive high levels of education compared to other countries. Canadian children receive elementary and secondary public school education. Many continue on to pursue post secondary studies in colleges, universities, and trade schools. About 50% of Canadian adults have some post secondary education, but because of the high costs associated with pursuing post secondary studies, many Canadians who want to do so can not afford it.

According to ‘The Canadian Facts’ (www.thecanadianfacts.org):
In Canada, parental education is the best predictor of a child’s education. This is partially due to the ability of parents to pay for their child to attend post secondary schooling. In Sweden, however, post secondary education is available for free, making it possible for people from lower income families to pursue higher education.

Education has many direct impacts on a person’s quality of life, their ability to make good decisions, to participate in their community, and to find and keep good employment. As a society, what actions should we be taking to support education for all people in Canada?

Housing, clean air, water quality, parks, and playgrounds all combine to create our physical environment. Our daily interactions with the many different aspects of our physical environment shape our experiences and influence our choices. Ultimately, the physical environment can impact all other . . . → Read More: The Physical Environment: the Foundation for Determining Health]]> By Glen Butt, Laura Bockus-Thorne, and Amber Fernie–Nutrition and Dietetic Students Acadia University

Housing, clean air, water quality, parks, and playgrounds all combine to create our physical environment. Our daily interactions with the many different aspects of our physical environment shape our experiences and influence our choices. Ultimately, the physical environment can impact all other determinants of health, both directly and indirectly. How, you ask? Let us focus on housing to illustrate our idea.

Imagine a family that has to spend more than 50% of their income on housing.

With most of their income going toward shelter, the family has less money to spend on utilities, food, recreation, and transportation. Looking at this thought further, we realize there is little money left over for the family to purchase quality food, budget for the kids’ sports, and pay for transport to and from workplaces, schools, and healthcare facilities.

Our biggest learning about this determinant was how fundamental the physical environment is in relation to the other determinants. When housing costs are more than half of the household budget, a family has to juggle their priorities in order to pay for other expenses. Knowing what foods are healthy may not matter by the time other bills are paid as, “Access to good, affordable food makes more difference to what people eat than health education.” This quote from ‘The Solid Facts,’ showed us that eating healthy is about access first, and our knowledge base coming in second.

The Social Determinants of Health are all linked and there are many factors that impact what we have access to within our physical environment. Where we live and the type of housing we choose can be dependent on factors such as income, social status, employment, and level of education. As you learn more from the other social determinant blog posts, we ask you to keep in mind how the physical environment we live in can affect your everyday choices.

Has something in your physical environment (clean air, safe playgrounds, bus routes, etc.) affected your health or access? Share your thoughts with us by commenting below!