Professionalism to the Future of Health in Canada: Learnings from MHST 601

In 2019 I decided it was time to further my education. With support from my family and friends I was accepted to the Athabasca University Master of Health Studies program. MHST 601 is the first course for this graduate degree. This blog will review the learnings gained from MHST 601. These learnings include interprofessional connectedness, how my profession fits into the Canadian health care system, understanding health & determinants of health, social epidemiology, chronic disease prevention & management, vulnerable populations, and future directions.

Interprofessional Connectedness

Creating a professional network allows a person to continually grow their knowledge and experience. Networks include your professional associations and social media. As a registered nurse (RN), I belong to and am accountable to the College of Registered Nurses of Alberta (CRNA). Before January 2022, the College and Association were combined, but due to legislation changes, they separated.

CRNA and Alberta Health Service (AHS) have created several resources regarding the use of social media. CRNA and AHS both emphasize that staff have the right to post, or not post, what they wish but need to remember that once posted, the information will exist forever (AHS, n.d., & CRNA 2021). The main learning from this unit included how to set up a professional social media plan and knowing the CRNA (2021) principles of social media e-professionalism shown in Figure 1.

Figure 1 The 6 “Ps” Principles of Social Media E-Professionalism

Note. CRNA (2021)

How does my Profession fit within the Canadian Health System?

As an RN I follow the College of Registered Nurses of Alberta standards and regulations. Working in the home care field RNs follow several other pieces of legislation. Federally the Accreditation Guidelines are followed, and sites are audited every 3-4 years. Provincially nurses follow several regulations and guidelines. These regulations include the Continuing Care Health Service Standards that guide our daily practice, and the Accommodation Standards which apply to any AHS owned and operated continuing care facility such as long-term care or supportive living sites. Learning about the standards and regulations is an important part of knowing how my profession fits into the Canadian health care system.

Understanding Health and the Determinants of Health

Svalastog et al. (2017) defines health as “a relative state in which one is able to function well physically, mentally, socially, and spiritually to express the full range of one’s unique potentialities within the environment in which one lives.” Furthermore, health and illness are on a continuum and fluctuate throughout one's life. This definition captures how a person’s state of well-being, of health, cannot be compared to anyone else, and it has the potential to change. Svalastog et al.’s definition made me aware to closely look at factors outside of the primary medical diagnosis when working with clients.

Determinants of Health

As outlined in Figure 2, the determinants of health encompass interpersonal and environmental factors that impact an individual’s health (Colleaga, 2022). The World Health Organization (n.d.) has identified that the determinants of health have more impact on an individual’s health than access to health care and lifestyle choices. McPeake et al. (2022) highlights financial health and social isolation are key factors impacting health. Suggestions to addressing the determinants of health require a system level screening tool, interdisciplinary team interactions, and strengthening post-acute support networks. Reviewing the determinants of health reminded me that there are many other factors that need to be addressed to prevent medical concerns from reoccurring.

Figure 2

Determinants of Health

Note. Colleaga, 2022

Social Epidemiology

The Socio-ecological model focuses on the individual and their environment, past and present. As seen in Figure 3, the model consists of five levels, starting from the individual and expanding outward. The individual level focuses on the client's physical characteristics (age, sex, race, and genetics), income, and education. Secondly, the interpersonal level centers on the individual's relationships and social networks. Organizations and groups that directly impact the individual, an example would be a person's workplace, constitute the third organizational level. The fourth level, community, focuses on the relationships between organizations. Finally, the public policy level focuses on provincial and national laws and regulations (Poux, 2017 & Lee et al., 2017). I found that having a set model made it easier to determine factors impacting health and was the best way to start addressing these factors.

Figure 3

The Socio-ecological Model

Note. Lee et al., 2017

Chronic Disease Prevention and Management

In 2009, Delon & MacKinnon summarized the learnings from Alberta’s integrated approach to chronic disease management. Several projects were created and implemented based on the expanded chronic care model. From these projects, there was a 17% increase in diabetes with A1c control, 19% decrease in COPD hospitalizations, and a 34% decrease in emergency department visits. Alberta Health Services offers several programs to educate patients, the public, and staff on chronic disease management. One of the programs offered is Better Choices, Better Health which I have personally taken and been trained as an educator. Having these free programs available for the public is a key management strategy. The Alberta Policy Coalition for Chronic Disease Prevention is a new resource that I was previously unaware of. Currently, this group is working on a chronic disease prevention survey to understand the public and policy influencers' views and beliefs on policy topics related to chronic diseases.

Vulnerable Populations

There are several vulnerable populations within Canada, including the Indigenous people. Etoway et al. (2021) shows that visible minority immigrants are less likely to report difficulties in accessing dental care, mental health care, or non-emergency surgeries. They are more likely to report difficulties accessing emergency services. Statistics Canada (2022), highlights housing concerns for vulnerable populations in Canada. House ownership for racialized persons is 7% lower than non-racialized groups.

Indigenous Health

McLane et al. (2021) showed that First Nations people make up 4% of the population and 9.4% of emergency room visits, also double the provincial average for leaving without completing treatment. First Nation women visit the emergency department 54.2% more than non-First Nations women. Education for health care providers regarding the Indigenous population is increasing, along with supports. The Rural Health Professions Action Plan (RhPAP) was created in 1991 by the Government of Alberta. Under Indigenous Health, RhPAP has several resources and provides a unique perspective on rural Indigenous health. Alberta Health Services has a webpage specifically for Indigenous groups and those that provide care for them. This webpage provides information, services, and resources in one stop. The focus on Indigenous health and vulnerable populations provided further insight to a topic that is a focus in Alberta Health Services and provided several resources for future use in my practice.

Future of Health in Canada

To improve the future of health in Canada we need to review our resources, funding, and future trends. Simpson (2010) discusses the taboo topic of what needs to happen to keep funding the Canadian Health Care system. The more money that is funneled into health care the less money is available for our other publicly funded programs. Simpson (2010), reviews six possibilities to maintain or increase the funding required to support our health care system long term. Speer (2018) provides an overview of the origins and the evolution of Canada’s federal government role in health care over the last 100 years. Speer (2018) also puts forward several recommendations on how the federal government can optimize their role for the future. The topic of future directions taught me that Canada needs to look at the health care system, identify future trends, and adjust funding accordingly.

Conclusion

For each topic in MHST 601 my knowledge increased. Interprofessional connectedness taught me how to set up a professional social media plan and to understand the CRNA principles of social media e-professionalism. Learning about the standards and regulations is an important part of knowing how my profession fits into the Canadian health care system. Reviewing the determinants of health reminded me that there are many other factors that need to be addressed to prevent medical concerns from reoccurring. The socio-ecological model and social epidemiology was a new topic for me, and I found that having a set model made it easier to determine factors impacting health and the best way to start addressing these factors. Chronic disease prevention and management is a topic I work with daily, but I did not realize all the Alberta and Canadian resources that are available for healthcare professionals and the public. The focus on Indigenous health and vulnerable populations provided further insight to a topic that is a focus in Alberta Health Services, and provided several resources for future use. Finally, the topic of future directions taught me that Canada needs to look at the health care system, identify future trends, and adjust funding accordingly. Each of these learnings will be implemented into my practice and academic studies.