Mojgan Kashefy
MHST
Master's of Health Studies Student
About Me
I have recently graduated from the University of Ottawa with an undergraduate degree in Biopharmaceutical Science. This has provided me with foundational knowledge in several areas of science, including the study of disease. I have developed an appreciation for the complexities of disease and the importance of health policies that improve the lives of the public.
I am currently enrolled in the Master’s of Health Studies program at Athabasca University as I seek to develop the knowledge and skills necessary to detect emerging health trends, while also further advancing my leadership skills in the areas of program planning, implementation, evaluation, and policy development. Concurrently, I am employed at Health Canada where I support the review process of scientific abstracts regarding current Canadian policies and programs. My role at Health Canada is providing me with first-hand exposure to policies and practices that improve public health. This has further piqued my interest in pursuing studies in the field of public health.
The purpose of this e-portfolio is to highlight and reflect upon my professional goals and achievements in an accessible and portable manner.
Education
WHAT I’VE LEARNED
Sept. 2022 – Aug. 2024
Master of Health Studies
Athabasca University (Online)
Sept. 2016 – May 2021
Bachelor of Biopharmaceutical Science
University of Ottawa (Ottawa, Ontario)
Experience
WHERE I’VE WORKED
Oct. 2021 – Present
Health Canada, Strategic Policy Branch (Ottawa, Ontario)
Student
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•Supported the review process of scientific abstracts. Engaged with abstract reviewers to assess abstracts for the Health Canada Science Forum and provided feedback to authors.
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•Led and supported the development of briefing notes for senior management and the Minister of Health. This included providing advice on COVID-19 health and safety protocols.
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•Stayed abreast of the latest public health developments concerning COVID-19.
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•Managed communications with Health Canada Science Forum participants and other external stakeholders.
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•Supported the development of a post mortem for the Health Canada Science Forum. Collected and analyzed participant feedback to outline areas of satisfaction and dissatisfaction to improve engagement at subsequent Forums. For example, analysis demonstrated the need to refine features of the virtual platform used to host the Forum for improved ease of use.
June 2016 - June 2017
Public Health Agency of Canada, Infectious Disease Prevention and Control Branch (Ottawa, Ontario)
Program Officer
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•Participated throughout all phases of talent engagement projects to support directors and senior staff in improving employee engagement at the Agency.
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•Experience applying project management techniques and organizational skills to support successful corporate project outcomes.
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•Supported the development of reports, including authoring a post mortem to guide future executive decisions regarding the implementation of key employee engagement initiatives.
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•Conducted secondary research, analysis, and stakeholder consultations to improve the effectiveness and knowledge of people. For example, conducted Agency and Branch level analysis of the Public Service Employee Survey, consulted other federal departments to identify best practices, and presented key findings to senior management.
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•Monitored project financials and coordinated with management to support the execution of projects within budget.
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Blogs
Coming Soon
Blog Posts
Blog Post 1
October 4, 2022
Professionalism and Social Media
Social media is an interactive method of sharing content online. There are a variety of advantages to having a social media presence today, including the ability to connect with individuals from various professions, remain well-informed on current events, and an opportunity to share knowledge. However, with these advantages, disadvantages also present themselves. This includes privacy/security threats, information overload, and perhaps more importantly, the risk of jeopardizing one’s career by violating ethical codes of conduct.
As an employee at Health Canada, I am responsible to comply with the Health Canada Values and Ethics Code. This requires that I use the values and behaviours stated in the code to guide my actions relating to respect for Canadian Parliamentary democracy, respect for people, integrity, stewardship when using public resources, and excellence in the design and delivery of tasks. Employees that do not abide by the Health Canada Values and Ethics Code may be subject to disciplinary measures. In the case of workplace-related issues, employees are protected by the Canadian Association of Professional Employees (CAPE). This federal public service union protects the rights of employees at Health Canada and provides guidance and professional representation to resolve conflicts.
It is important for individuals to understand the codes of conduct that relate to their profession and clarify any areas of ambiguity with their employer. If an individual is unsure whether a social media post will harm their career, it is best to refrain from posting it.
A social media presence also provides a means to maintain long-term contact with connections made in the workplace. For example, my role at Health Canada provides me with the opportunity to liaise with internal and external stakeholders, which is important as it ensures the team is incorporating diverse perspectives. I primarily support the planning and execution of the annual Health Canada Science Forum which involves engaging with scientific reviewers across the Health Portfolio to optimize the delivery of abstracts for the Forum. Furthermore, I engage with stakeholders to discuss best practices with respect to COVID-19 protocols. By having a social media presence, I am able to connect/follow these individuals on social media platforms such as LinkedIn to carry out these interactions long-term.
As a user of LinkedIn, I primarily use the platform to stay abreast of the latest announcements from Federal and provincial departments and agencies, in addition to viewing job postings; I do not have any personal posts on this account. In addition to LinkedIn, I have recently created a Twitter account and have started following news outlets to stay up to date on news and analyses. I also follow #MHST601 to interact with peers for graduate school.
Although my social media presence is not large, I aim to utilize social media to my advantage and further establish my professional presence through networking and knowledge building. I aim to do so in a manner that reflects my core professional values of fulfilling duties with integrity, respecting colleagues, and striving for excellence. These values have been guided through my ongoing work experience at the Government of Canada and are reflected in my desired professional identity of becoming an expert in the field of public health. I aim to pursue a career that focuses on combining advanced knowledge of health policies, human health trends, and advanced analytics to derive practical, evidence-based advice for policymakers, health professionals, businesses, and the public.
In conclusion, I believe that the level of a professional’s social media presence is subjective; depending on what an individual wishes to achieve from social media, their level of activity will differ. For example, if a professional wishes to use social media for the purposes of networking with others and following pages and people of interest to them, they may create accounts with minimal information about themselves and refrain from posting content. On the other hand, if the individual wishes to use social media for these purposes in addition to building a following and making an impact, they may choose to post their opinions and knowledge on their accounts. A working professional may choose not to use social media in any form if they do not see it as an advantage to their career and wish to avoid the risk of ethical misconduct of any kind. Overall, when utilizing social media, it is important for one to be well informed by their organization’s codes of conduct and ensure that their posts align with their professional values and identity.
Health Canada Values and Ethics Code. MySource. Retrieved September 12, 2022, from http://mysource.hc-sc.gc.ca/eng/ss/my-workplace/workplace-wellness/values-and-ethics/values-and-ethics-code/health-canada-values-and
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Support and representation. CAPE. Retrieved September 12, 2022, from https://www.acep-cape.ca/en/support-and-representation
Nations, D. (2021, January 26). Serious question: What exactly is social media? Lifewire. Retrieved October 3, 2022, from https://www.lifewire.com/what-is-social-media-explaining-the-big-trend-3486616
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Blog Post 2
October 11, 2022
What is health?
As described by the World Health Organization (WHO), "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (GOC, 2008). With changing demographics and patterns of disease, the relevance of this definition in today’s society has been questioned by various researchers, leading to the development of criticisms and suggested modifications.
Huber et al. (2011) express various limitations to WHO’s definition of health, one of them revolving around the use of the word “complete.” Such a stringent word leaves the majority of individuals labelled as unhealthy; this results in medical industries creating technologies that detect non-threatening abnormalities and pharmaceutical companies developing drugs for insignificant conditions. Brook (2017), on the other hand, explains that the definition lacks inclusion of acceptance and tolerance. With various situations of hatred presenting themselves in medical and clinical settings, it is important that there be criteria for individuals or populations to be acceptant in order to be labelled as healthy.
According to WHO’s definition of health, Sartorius (2006) emphasizes that three definitions of health exist today; the absence of disease, the ability to cope with day-to-day tasks, and a balance between social and physical environments. Issues arise with these three definitions, as an individual can be classified as having a disease without feeling ill, and balance between a person and their environment is subjective as they may be ill but able to maintain a balance between their society and environment.
Preserving health is an optimal way to acquire wellness (MediLexicon, 2020). This includes screening for diseases, managing stress, and having a balanced diet. As mentioned by Huber et al. (2011), the Ottawa Charter of Health Promotion was proposed to reform WHO’s definition to encourage individuals to take control over their health; however, this proposal was not implemented.
The range of limitations presented by WHO’s definition of health indicates the need for reformulations. Health is not a one size fits all; it is important for its definition to encompass this.
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Government of Canada (GOC). (2008, September 12). What is health? Canada.ca. Retrieved October 9, 2022, from 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.
Brook, R. H. (2017). Should the definition of health include a measure of tolerance? JAMA, 317(6), 585. https://doi.org/10.1001/jama.2016.14372
Sartorius N. (2006). The meanings of health and its promotion. Croatian medical journal, 47(4), 662–664.
MediLexicon International. (2020). What is health?: Defining and preserving good health. Medical News Today. Retrieved October 9, 2022, from https://www.medicalnewstoday.com/articles/150999#preserving-health
Canada, P. H. A. of. (2017, November 14). Government of Canada. Canada.ca. Retrieved October 9, 2022, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion.html
Blog Post 3
November 8, 2022
Health Disparities in the Canadian Aging Population from a Social Multilevel Model Perspective
The approach of using multilevel models of health focuses on multiple factors that contribute to health outcomes. The intent of this approach is not to evaluate a single health determinant on an individual basis, but rather multiple determinants that affect populations (Staniford et al., 2012). The rationale behind this method is that multiple influences impact health outcomes collectively (Galea, 2015). This allows for interventions to be developed at each level to effectively address health issues.
Multilevel models of health can include determinants such as social, biological, economic, and geographical (Galea, 2015). This constitutes the environment of populations throughout the course of life [Figure 1]. The relationships between these determinants are used to develop multilevel questions that address health disparities. With the old age population rising in Canada, the question can be asked: what factors contribute to health disparities among the aging population? To answer this, a social model of health can be used. This model can be implemented at a social, cultural, and economic level to identify barriers to health and maximize the quality of life of the aging population in Canada.
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Figure 1. Kaplan GA. What’s wrong with social epidemiology and how can we make it better? Epidemiol Rev., 2004; 26: 124-35.
What is a social model of health?
Determinants of health are influencers that impact the state of health of a population or individual. A social model of health incorporates a variety of health determinants, including social, cultural, and economic factors (CDHN, n.d.). This model builds from the medical model of health, which is centralized around measuring the presence and absence of disease to define the state of health of a population (Definitions of Health, 2015). This did not align with the World Health Organization’s 1948 definition of health, which states: "Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (GOC, 2008). The negligence of accounting for other influences on health in the medical model led to the development of the social model of health. With the social model of health accounting for a variety of determinants, a deeper level of understanding of health status is attained (Stuart, 2019). This allows for interventions to be developed accordingly, where the model focuses on incorporating community perspectives in the development and implementation processes (CDHN, n.d.).
How does a social model explain disparities in the health of the aging Canadian population?
Since 2001, a rise in the aging population in Canada has been observed. The number of individuals aged 85 and above has doubled, and continues to be a fast-growing population; within the next 25 years, the population is expected to triple (Hallman, 2022). A significant proportion of individuals in this age group experience health issues and require appropriate health care, housing, and transportation to accommodate their health-related challenges. This emphasizes the need for further government interventions to ensure the aging population is supported in the years to come. The social model of health can be applied to this problem to analyze the social, cultural, and economic determinants that contribute to the health status of people in old age, and develop interventions accordingly. The conditions that people are born, grow, and work shape their health in old age, in addition to their demographics and inherent factors. This can be summarized by the diagram below:
Social determinants of health relate to the impacts of an individual's societal position on their health (GOC, 2008). This encompasses factors such as racism, discrimination, and historical events that caused distress for specific populations. A study performed by Williams et al. demonstrates the correlation between racism/discrimination and mental and physical health. Based on factors such as ethnicity and nationality, individuals may face disadvantageous health outcomes due to poor physical and social conditions (Williams et al., 2019). Racialized communities may be indirectly formed due to differences in income and education among races, resulting in conditions of poverty. For example, poor housing may lead to health issues, in turn resulting in the inability to work and therefore failure to improve living conditions [Figure 2].
Figure 2. CDHN. (n.d.). Models of health
To further demonstrate the impacts of racism on health, a systematic review was performed on studies of the correlation between cancer and racialized communities; findings indicated that individuals in these groups face late diagnosis and lower survival rates (Williams et al., 2019). Correlates like this can be carried on into old age, where individuals who did not have access to early diagnosis, or quality housing as in Figure 2, face further health problems. Historic events such as war also contribute to social determinants of health (MSVU, n.d.). Those in old age who experienced traumatic experiences of war first-hand likely endure health disadvantages such as chronic pain and mental distress. This impacts their day-to-day life and results in the need for mental and physical support.
Nielsen-Bohlman et al. discuss how cultural influences can impact health literacy. Health literacy can be referred to as personal or organizational. Personal health literacy refers to an individual’s ability to make health-related decisions based on the information they find, understand and use, while organizational health literacy is the extent to which organizations enable this (CDC, 2022). Cultures can impact health literacy, and inturn health outcomes, due to factors such as different communication styles (Nielsen-Bohlman et al., 2004). Nielsen-Bohlman et al. provide the example of a non-English speaking senior enduring a health issue requiring medication. The senior visits the doctor and is accompanied by an individual to translate the information, however, the lack of fluency of the translator prevents the senior from fully understanding what the doctor has said and therefore does not properly consume the medication. The old age population who faces cultural challenges like this are put at a disadvantage as they cannot properly receive health care and therefore may face further health issues.
Economic factors such as employment and education may also impact the health of the aging population. Individuals born and raised in lower-income families or rural areas are more susceptible to poor health as a child due to a lack of quality healthcare (Urban, 2015). This can translate to health issues that persist in the individual in older age. For example, a child may experience an ear infection that cannot be treated due to inaccessible care. This can lead to a permanent loss of hearing, putting the individual in suboptimal health throughout life, including in old age. The working conditions that people experience throughout their lives also impact their state of health in old age. Certain types of work require more manual labor and exposure to health risks; this can predispose people to health issues later on. The nature of work that an individual experiences may be dependent on their level of education and accessibility to jobs based on location.
Application of a social model of health to invoke change in the health of the aging population:
A social model of health can be used to improve the health of the aging population in Canada by analyzing social, cultural, and economic determinants and implementing change at each level. The interconnectedness between factors emphasizes the need for a multilevel model approach to address the issue in its entirety. Since a social model seeks to incorporate community-based perspectives in interventions such as policy development, decisions are more informed and therefore more likely to meet the needs of the public (Bates, 2022).
References:
Bates, O. (2022, April 27). 6 reasons why public participation and community engagement are important. Social Pinpoint - A Place to Engage Your Community. Retrieved October 31, 2022, from https://www.socialpinpoint.com/blog/6-reasons-to-participate-community-engagement/#:~:text=When%20these%20perspectives%20are%20shared,to%20make%20better%20public%20decisions.
CDC. (2022, February 2). What is health literacy? Centers for Disease Control and Prevention. Retrieved October 31, 2022, from https://www.cdc.gov/healthliteracy/learn/index.html
CDHN. (n.d.). Models of health - CDHN. CDHN. Retrieved October 31, 2022, from https://www.cdhn.org/sites/default/files/downloads/FACTSHEETS%201_Screen%20View%281%29.pdf
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Dahlgren G, Whitehead M. (1991). Policies and Strategies to Promote Social Equity in Health. Stockholm, Sweden: Institute for Futures Studies.
Definitions of Health. Definitions of health. (n.d.). Retrieved October 30, 2022, from http://www.med.uottawa.ca/courses/CMED6203/Index_notes/Definitions%20of%20Health.htm#:~:text=In%20its%20most%20extreme%20form,problems%2C%20de%2Demphasizes%20prevention.
Galea, S. (2015, May 31). The determination of health across the life course and across levels of influence. SPH The Determination of Health Across the Life Course and Across Levels of Influence Comments. Retrieved October 28, 2022, from https://www.bu.edu/sph/news/articles/2015/the-determination-of-health-across-the-life-course-and-across-levels-of-influence-2/
Government of Canada (GOC). (2008, September 12). What is health? Canada.ca. Retrieved October 9, 2022, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html
Hallman, S. (2022, April 27). A portrait of Canada’s growing population aged 85 and older from the 2021 Census. Government of Canada, Statistics Canada. Retrieved October 28, 2022, from https://www12.statcan.gc.ca/census-recensement/2021/as-sa/98-200-X/2021004/98-200-X2021004-eng.cfm
Kaplan G. A. (2004). What's wrong with social epidemiology, and how can we make it better?. Epidemiologic reviews, 26, 124–135. https://doi.org/10.1093/epirev/mxh010
MSVU. (n.d.). The trauma of war has lasting effects on health in older age. Mount Saint Vincent University. Retrieved October 31, 2022, from https://www.msvu.ca/the-trauma-of-war-has-lasting-effects-on-health-in-older-age/
Nielsen-Bohlman, L., Panzer, A. M., & Kindig, D. A. (2004). Culture and Society. Institute of Medicine (US) Committee on Health Literacy, (Health literacy: A prescription to end confusion). https://doi.org/10.1037/e515822006-002
Staniford, Breckon, & Copeland. (2012). Models and mechanisms of Public Health. Multilevel Interventions are for Behavior Change | Models and Mechanisms of Public Health. Retrieved October 28, 2022, from https://courses.lumenlearning.com/suny-buffalo-environmentalhealth/chapter/multilevel-interventions-are-for-behavior-change/
Stuart, G. (2019, July 27). What are social models of health? Sustaining Community. Retrieved October 31, 2022, from https://sustainingcommunity.wordpress.com/2015/06/02/social-model-of-health/
Urban. (2015). How are income and wealth linked to health and longevity? Urban. Retrieved October 24, 2022, from https://www.urban.org/sites/default/files/publication/49116/2000178-How-are-Income-and-Wealth-Linked-to-Health-and-Longevity.pdf
Williams, D. R., Lawrence, J. A., & Davis, B. A. (2019). Racism and health: Evidence and needed research. Annual Review of Public Health, 40(1), 105–125. https://doi.org/10.1146/annurev-publhealth-040218-043750
Blog Post 4
November 22, 2022
Individuals with Disabilities as a Vulnerable Group in Canada
As defined by the National Collaborating Centre for Determinants of Health, vulnerable populations are “groups and communities at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability.” (NCCDH, 2022). According to a study performed to evaluate the health disparities people with disabilities face in Canada, the vulnerable population faces issues when accessing health care services due to factors such as a lack of understanding of their conditions and disrespectful behavior from health care providers (Rajan, 2018). Furthermore, the vulnerable group faces employment disadvantages; individuals with disabilities may endure unhealthy workplace habits, such as going beyond their capabilities to avoid unwanted consequences. In turn, this leads to detrimental health effects. Issues with accessing income and disability support is an additional barrier faced due to unclear eligibility requirements and processes for acquiring support (Rajan, 2018). Housing issues and insurance acquisition are other common problems as a result of discrimination.
To better serve this vulnerable population in Canada, public policy and program action must be taken. Organizations may adopt anti-discriminatory policies to guide practices when dealing with individuals with disabilities and health care service providers could undergo training to minimize bias towards this vulnerable population (Rajan, 2018). Health care providers should also be encouraged to utilize the 2011 Canadian guidelines for the primary care of adults with intellectual and developmental disabilities (Sullivan et al., 2018). These guidelines allow primary care providers to make informed decisions with patients facing disabilities and their caregivers. Workplace initiatives should also be developed to encourage people with disabilities to seek accommodations for their limitations. To address issues with accessing income and disability support, eligibility requirements and application guidance should undergo reform for clarity.
As a vulnerable population in Canada, people with disabilities are subject to a variety of barriers that limit their health. From health care services, employment, housing, and insurance, these disadvantages are not faced by non-vulnerable groups in Canada. To address this and promote equality among all populations, policies and programs must be implemented and improved to ameliorate the overall wellbeing of people with disabilities.
References:
NCCDH. (2022). Glossary of essential health equity terms. Vulnerable populations | National Collaborating Centre for Determinants of Health. Retrieved November 21, 2022, from https://nccdh.ca/glossary/entry/vulnerable-populations
Rajan, D. (2022, January 18). Serious problems experienced by diverse people with disabilities: Western Canada. Government of Canada, Department of Justice, Electronic Communications. Retrieved November 18, 2022, from https://justice.gc.ca/eng/rp-pr/jr/pwdwc-phcw/index.html
Sullivan, W. F., Diepstra, H., Heng, J., Ally, S., Bradley, E., Casson, I., Hennen, B., Kelly, M., Korossy, M., McNeil, K., Abells, D., Amaria, K., Boyd, K., Gemmill, M., Grier, E., Kennie-Kaulbach, N., Ketchell, M., Ladouceur, J., Lepp, A., Lunsky, Y., … Witherbee, S. (2018). Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines. Canadian family physician Medecin de famille canadien, 64(4), 254–279.
Blog Post 5
December 4, 2022
The Health of Canada's Aging Population: Understanding to Action
The aging population in Canada is one of the fastest-growing populations (Hallman, 2022). Since 2001, the number of individuals aged 85 and above has doubled; within the next 25 years, the population is expected to triple [Figure 1]. A significant proportion of individuals in this age group experience health issues and require appropriate health care and assistance to accommodate their health-related challenges. This emphasizes the need for further public health interventions to ensure the aging population is supported in the years to come. To understand how to address this, this blog will examine seniors as a vulnerable population and the chronic disease they face, the federal and provincial health systems in Canada and the publicly funded care seniors receive, determinants of health, and future directions to improve health and healthcare for elders moving forward.
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Figure 1. Hallman. (2022). The Growing Number of Individuals Aged 85 and Older in Canada
Introduce health problem
Vulnerable Populations: Chronic Disease Prevention and Management
Vulnerable populations are “groups and communities at a higher risk for poor health as a result of the barriers they experience to social, economic, political and environmental resources, as well as limitations due to illness or disability” (NCCDH, 2022). The old age population in Canada is considered a vulnerable population due to the health issues they are predisposed to. The health conditions older adults face also places many in a position of economic vulnerability due the cost of care often being greater than income (Seniors First BC, 2016). A common chronic disease that the old age population is susceptible to is cancer (Cancer Research UK, 2021). According to Health Canada and the Public Health Agency of Canada, cancer risk factors include tobacco use, poor diet, alcohol use, drugs, genetic predisposition, radiation, etc. (GOC, 2019). To reduce the predisposition to cancer in old age, Canadians are encouraged to avoid smoking and alcohol consumption, maintain a healthy body weight, and enhance air quality (i.e., through proper ventilation in homes) (GOC, n.d.). The health of Canadians into old age is also promoted by Canada’s healthcare system through federal funding to provinces and territories for health care services.
Federal and Provincial Health Systems in Canada
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Provinces and territories are federally funded for healthcare through the Canada Health Transfer (GOC, 2016). Insurance plans that are developed by provinces and territories must follow the Canada Health Act and include the standards of public administration, comprehensiveness, universality, portability, accessibility. When deciding what services are publicly funded, the CHA uses a broad term of "medically necessary" to allocate funds for hospital services (Flood & Thomas, 2016). This is an area of the CHA that requires modernization since the term is not defined. As suggested by Flood & Thomas, an evidence-based approach should be implemented to determine which services and goods are insured for the public; this can be done by establishing a body responsible for prioritizing services, and individuals suggesting the funding of certain services. In doing so, uninsured services that are critical for the aging population may be funded to reduce the economic burden on this vulnerable population.
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Primary healthcare services are a main component of Canada’s healthcare system; this entails ease of accessibility and coordination of health care services to ensure continued and specialized care (GOC, 2016). Supplemental services are also provided to vulnerable groups such as seniors to allow access to services that are not normally publicly funded. This includes dental and vision care, prescription drugs, and home care. Based on the determinants of health of seniors, demands for these services will vary.
Determinants of Health
Determinants of health are influencers that impact the state of health of a population or individual; this includes social, environmental, and economic factors (GOC, 2022a). Multilevel models of health are used to portray multiple factors that contribute to health outcomes. This approach allows to evaluate determinants that affect populations (Staniford et al., 2012). To describe determinants of health for the aging population in Canada, a Social Ecological Model of Health can be used. The model accounts for individual (i.e., age, education, health history), relationship (social circle), community (i.e., schools and workplaces), and social (i.e., cultural and social norms) factors that contribute to health status [Figure 2] (CDC, 2015). When these factors are at suboptimal levels, inequalities are created in the health of populations. An example of a social determinant that can contribute to decreased health of the aging population is historic events such as war. Those in old age who experienced traumatic experiences of war first-hand likely endure health disadvantages such as chronic pain and mental distress. This impacts their day-to-day life and results in the need for mental and physical support. Racism/discrimination can also lead to impaired mental and physical health. Racialized communities may face disadvantageous health outcomes due to poor physical and social conditions (Williams et al., 2019). It is important to identify gaps in determinants of health and develop interventions to promote healthy aging for Canadians.
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Figure 2. CDC. (2015). The Social Ecological Model
Future Directions in Health and Healthcare
In 2021, a Virtual Stakeholder Symposium on the future of aging in Canada was held by the Federal, Provincial, Territorial Forum of Ministers Responsible for Seniors. This highlighted the role of technology to promote health, healthy aging, prevention of elder abuse, and best practices to support seniors facing social isolation. With the majority of seniors in Canada owning a smartphone, technology is a useful tool to promote an active and healthy lifestyle (GOC, 2022b). During the Symposium, smartphone-friendly technologies that can benefit the health of seniors were identified. To promote healthy aging, research networks have been established to develop insights on aging to inform policy decisions and the delivery of health services. The symposium also addressed the social issue of elder abuse, a determinant known to impact mental health. Analysis of the issue indicated the need raise awareness on how signs of elder abuse can be identified and how it should be addressed. The final topic covered best practices to help elders facing social isolation. This indicated the need for senior-serving communities that provide support services, such as housekeeping and meal preparation, and technologies that promote meaningful connections to reduce social isolation. Moving forward, it is important to take these recent findings into account and bridge the gaps that are needed to support healthy aging. Reflections from the symposium indicated the need for an “all hands on deck” approach that incorporates input from academia, government, industry, etc. to develop a comprehensive understanding of the aging population in Canada and formulate the appropriate interventions to promote health (GOC, 2022b). According to symposium participants, the future of aging will be supported, inclusive, and celebrated.
References
Cancer Research UK. (2021, August 11). Age and cancer. Cancer Research UK. Retrieved December 4, 2022, from https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/age-and-cancer#:~:text=Why%20does%20cancer%20risk%20increase,UV%20rays%20from%20the%20sun.
CDC. (2015, June 25). Chapter 1: Models and frameworks. Centers for Disease Control and Prevention. Retrieved December 4, 2022, from https://www.atsdr.cdc.gov/communityengagement/pce_models.html
Flood, C. M., & Thomas, B. (2016). Modernizing the Canada Health Act. Dalhousie Law Journal, 39(2), 396-411. https://doi.org/https://papers.ssrn.com/sol3/papers.cfm?
GOC. (2022a, June 14). Government of Canada. Social determinants of health and health inequalities - Canada.ca. Retrieved October 13, 2022, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
GOC. (2022b, August 8). The Future of Aging in Canada Virtual Symposium: What we heard. GOC. Retrieved December 4, 2022, from https://www.canada.ca/en/employment-social-development/corporate/seniors/forum/reports/future-aging-virtual-symposium.html#h2.9
GOC. (2019, May 21). Government of Canada. Retrieved November 7, 2022, from https://www.canada.ca/en/health-canada/services/health-concerns/diseases-conditions/cancer.html
GOC. (n.d.). Cancer in Canada. GOC. Retrieved December 4, 2022, from https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/fact-sheet-cancer-canada/fact-sheet-cancer-canada.pdf
GOC (2016, August 22). Canada's Healthcare system. GOC. Retrieved December 4, 2022, from https://www.canada.ca/en/health-canada/services/canada-health-care-system.html
Hallman, S. (2022, April 27). A portrait of Canada’s growing population aged 85 and older from the 2021 Census. Government of Canada, Statistics Canada. Retrieved October 28, 2022, from https://www12.statcan.gc.ca/census-recensement/2021/as-sa/98-200-X/2021004/98-200-X2021004-eng.cfm
NCCDH. (2022). Glossary of essential health equity terms. Vulnerable populations | National Collaborating Centre for Determinants of Health. Retrieved November 21, 2022, from https://nccdh.ca/glossary/entry/vulnerable-populations
Seniors First BC. (2016, August 11). Vulnerability. Seniors First BC. Retrieved December 4, 2022, from https://seniorsfirstbc.ca/for-professionals/vulnerability/#:~:text=Older%20adults%20are%20often%20economically,dependency%20and%20cost%20of%20living.
Staniford, Breckon, & Copeland. (2012). Models and mechanisms of Public Health. Multilevel Interventions are for Behavior Change | Models and Mechanisms of Public Health. Retrieved October 28, 2022, from https://courses.lumenlearning.com/suny-buffalo-environmentalhealth/chapter/multilevel-interventions-are-for-behavior-change/
Williams, D. R., Lawrence, J. A., & Davis, B. A. (2019). Racism and health: Evidence and needed research. Annual Review of Public Health, 40(1), 105–125. https://doi.org/10.1146/annurev-publhealth-040218-043750
Links & Resources
This section provides links to resources for an enhanced understanding of health in Canada. Resource topics are primarily related to influences on the health of Canadians and the healthcare system.
What is Health?
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The World Health Organization's definition of health has been criticized by researchers for its relevance in today's society. The peer reviewed articles below examine various definitions of health:
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The Meanings of Health and its Promotion
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This article discusses three main definitions of health and why a single definition cannot simply be adopted.
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This article examines modern definitions of health and discusses the benefits and disadvantages to implementing each.
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Determinants of Health
Determinants of health shape the quality of lives of individuals; contributing factors include genetics, social structure, and environment. The federal and provincial (Ontario) resources below discuss health inequalities that Canadians face as a result of health determinants along with methods to address this:
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Social determinants of health and health inequalities
The content on this page is provided by the Government of Canada and differentiates between determinants of health and social determinants of health. The former refers to personal, social, environmental, and economic factors impacting health, and the latter to the impact of an individual's societal position. This text also highlights the role that health inequalities play in one's ability to achieve a healthy lifestyle and differentiates the term from health inequity and health equity.
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This article by the Ontario Hospital Association (OHA) discusses the definition of social determinants of health and emphasizes its role in the health of individuals. An example provided includes Ontarians living in poorer neighbourhoods being more susceptible to avoidable deaths.
This article focuses on methods to broaden public knowledge on determinants and social determinants of health in the province of Ontario. Churchill et al. emphasize that health inequities are avoidable and societal factors play a key role in the determinants of health. Their findings indicate that showing Ontarians the negative effects of social determinants of health is a useful way to gain empathy and introduce interventions.
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Multiple Spheres of Influence on Health
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The concept of multiple spheres of influence on health is used to describe how various determinants of health come together to shape the lives of populations. The peer-reviewed resources below provide examples of this, specifically pertaining to elders with dementia, professional readiness of students, and the wellness of healthcare workers:
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With the increasing prevalence of dementia in the aging population, this article assesses the cognitive impacts of exercise in those of older age. Findings indicate low benefits on the cognitive function of individuals with all-cause dementia and more significant benefits in the aging population with Alzheimer's disease.
Socio-Psychological Determinants of Adolescent Health at the Initial Stage of Professional Education
With the goal of preserving health in the younger working population, Merkulova et al. aimed to evaluate the professional readiness of high school students through analysis of socio-psychological data. Their findings indicated a lack of awareness of health impacts and physical requirements of their professions of interest; this indicates the importance of thorough professional orientation for students.
Ethics and Spheres of Influence in Addressing Social Determinants of Health
To improve health, health equity, and the overall wellness of healthcare workers, efforts are made to address social determinants of health in the health care system; surrounding this, ethical issues are involved. DeCamp et al. describe the spheres of influence of clinicians, health care organizations, and the broader community to address ethical issues around social determinants of health.
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Cancer in Canada
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As a chronic disease, cancer affects the health of many Canadians; by understanding risk factors and mitigation strategies, the burden on Canadians can be reduced. The peer-reviewed and governmental resources below provide insight into the prevention and management of cancer for Indigenous people, the impacts of COVID-19 on cancer care, and Canadian cancer statistics:
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Decolonizing Cancer Care in Canada
This study by Beckett et al. highlights the disparities of cancer incidence and mortality between Canadian Indigenous and non-indigenous people. Authors highlight useful initiatives, including those that promote screening and accessibility of care, to decolonize cancer care.
This article analyzes the impacts of interrupted cancer screening in Canada due to the COVID-19 pandemic. Through the use of breast and colorectal cancer microsimulation models, researchers predicted a surge in advanced cancer diagnosis and additional cancer-related deaths once screening resumes.
The Canadian Cancer Society provides cancer statistics in Canada for the years 2020-2022. Province-specific data is included for 2022.
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Indigenous Peoples and Health in Canada
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As a vulnerable group in Canada, Indigenous peoples face disadvantages in health care. Peer-reviewed and governmental resources that discuss these gaps, their causes, and best practices are found below:
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Acute health care among Indigenous patients in Canada: a scoping review
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A literature review was conducted by Vigneault et al. on acute health care among Indigenous peoples to understand the gaps faced by this vulnerable population. Overall findings indicate inequalities when compared to non-Indigenous groups, including reduced access to health care and lower satisfaction with services. Authors emphasize the importance of including Indigenous perspectives in health care, as they are most aware of the limitations they face.
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Indigenous health care in Canada
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This resource provides an overview of federal, provincial, and territorial legislation and policies that promote Indigenous health. Details on the role of Indigenous Services Canada is also discussed; the department is responsible for providing services for Indigenous peoples that complement those that are provincially and territorially provided.
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Health of Indigenous Peoples in Canada
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The evolution of Indigenous peoples' health in Canada is discussed; a key influence includes the arrival of Europeans in North America as this imposed social, political, and economic changes. Social determinants of health of Indigenous peoples are also highlighted. Determinants discussed include food insecurity and poor housing conditions.
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Disabilities and Health in Canada
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Individuals with disabilities face disadvantages in their health as a vulnerable population in Canada. The resources below include peer-reviewed and governmental content discussing the barriers for this group and best practices that can be implemented to improve their health:
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This article discusses the process used when updating the 2011 Canadian guidelines for the primary care of adults with intellectual and developmental disabilities (IDD). Family physicians are primary health care providers for people with IDD; updating these guidelines supports these physicians in decisions made with patients.
Serious Problems Experienced by Diverse People with Disabilities: Western Canada
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This article discusses the health disparities people with disabilities face in Canada. A research study was conducted on people with disabilities living in British Columbia, Alberta, Saskatchewan, and Manitoba, where findings indicated issues with accessing health services. To combat these disparities, public policy action must be implemented.
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COVID-19 and people with disabilities in Canada
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This article discusses the risks that individuals with disabilities face in relation to COVID-19. This vulnerable population may face higher risks of exposure or infection with the virus. Interventions to reduce the risks that this population faces are discussed; this includes increasing accessibility to vaccines, physical distancing, and hand washing.
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The Current State and Future of Aging and Healthcare
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As the aging population in Canada continues to increase significantly, healthcare reform is needed to appropriately accommodate this dominating group. Resources on the aging population and healthcare in Canada can be found below and include content from a peer-reviewed journal, the government of Canada, and the United Nations:
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Ageing and Mental Health in Canada: Perspectives from Law, Policy, and Longitudinal Research
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With the aging population growing in Canada, along with the number of individuals in this group with mental health conditions, Cosco et al. explore the evolution of mental health law and policy. Gaps in this area are noted, along with best practices moving forward to improve the lives of older adults with mental health conditions.
The Future of Aging in Canada Virtual Symposium: What we heard
This document highlights key points from the 2021 Symposium on the future of aging in Canada. Areas discussed in this symposium include the role of technology to support seniors, healthy aging, prevention of elder abuse, and best practices to support seniors.
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With the population over 60 expected to double by 2050, and those over 80 expected to triple, the World Health Organization (WHO) discusses health conditions related to aging, influences of healthy aging, and the challenges when responding to the aging population. WHO's response to this growing population includes aiming to reduce health inequities and to better the lives of elders and their families.
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This article discusses the societal, policy, technological, and scientific changes that are likely to occur in the future aging population according to experts. Authors compare health and health care today to the future and hypothesize methods to bridge the gaps between the two.
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Affiliations
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The resources below include affiliated academic and professional links.
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Access the Canadian Association of Professional Employees (CAPE). This federal public service union protects the rights of employees at Health Canada and provides guidance and professional representation to resolve conflicts.
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This link provides access to Health Canada's Webpage, a federal department that aims to maintain and improve the health of Canadians.
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Public Health Agency of Canada
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This link provides access to the Public Health Agency of Canada's webpage. This federal agency supports the health of Canadians through preventing disease and injury, responding to threats to public health, and promoting physical and mental health.
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Access the main page of Athabasca University, based in Alberta, Canada.
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Access the main page of the University of Ottawa.