Blogging about Blogging

When the ‘Infinitely Curious Blog’ assignment was explained to us in class, I was immediately filled with apprehension. I am a shy person, and since sharing my feelings in front of a large crowd (i.e. a classroom) is not something I normally do, I didn’t think I would enjoy the blogging exercise. However, sharing your feelings over the Internet is a completely different experience. I felt an extreme amount of freedom, like I could fully express myself each time I sat down to write...I felt liberated and this surprised me. I knew it was possible that people would disagree with my opinions and comment, but I was okay with that. Confrontation isn’t as scary when you know it will occur online, and it made me want to push the limits even more. I also enjoyed reading my colleagues blogs, getting to learn more about their thoughts and beliefs on the course material. Everyone wrote with such passion, allowing me to expand and reframe my own line of thinking.

When I thought of the title for my blog, I assumed I would be writing about “food, fun and fitness,” as these are themes that have interested me in the past. However, as the course began to unfold, I found that I was writing about programs that help the community, policies that help the population as a whole, and how to make a difference in the community. Essentially, I was only blogging about THE COMMUNITY. I was looking deeper into the health care system and smoking laws, which oddly enough, I had never really fully done before. I also realized how interested I was in community nutrition, as the Access Alliance guest speakers really touched me. As I wrote in my third blog, “A dietitian is far more than an expert in food and nutrition, but a health professional dedicated to understanding the complex interconnections between individuals and food.” Because of this course, this relationship now forms my comprehensive knowledge of nutrition and health. Furthermore, my last blog post was on the social determinants of health, and the importance of addressing them to overcome health inequities. I talked about a prenatal nutrition class I volunteered at last summer, and I am going to be re-visiting this idea in my Looking Project, as I strongly believe that more needs to be done to better educate teenagers on safe sex.

As my knowledge of the material grew, I found it got easier to reflect and write my blog. I can definitely see a notable increase in critical thinking from week to week. I also moved toward incorporating examples through YouTube (i.e. my post on “knowing vs. doing” incorporates BELL advertisements), and talking about what I’ve been exposed to (i.e. blogging about my experience in a prenatal nutrition class). I changed from researching health topics on the Internet (i.e. smoking) toward discussing my respect for community dietitians. I was most surprised by how easy the blogs started to come to me, and how much the words started to write themselves. I really immersed myself in the themes of the course, which is something I didn’t anticipate happening. The blogs allowed me to get outside my comfort zone, to let my mind wander and explore concepts on a whole new level. I usually write when specific instructions, themes and structure are given, but this exercise allowed me to challenge myself and see what I could accomplish. The blogging experience also supported my learning, as it forced me to go home and review the weekly topics. It allowed me to critically analyze the material, and not just take the themes at face value. Furthermore, as a future nutrition professional, I think blogging provides for the opportunity to express your opinion, learn insights from other dietitians, and it allows people to learn valuable information that they may not have gotten otherwise.

Although I may have had some questions, concerns, and worries along the way, I do not think I would change the assignment. Giving students the freedom to express their views on nutrition, health and the community gives them the chance to reflect, think and grow. However, since some weeks covered the same theme/topic, it would potentially be beneficial for students to blog every other week, just so that more material can be covered in class. I would definitely consider continuing a personal blog once the assignment is complete, as I found the experience both rewarding and enjoyable.  I know I won’t necessarily be able to write every week, but it would be nice to continue to share my thoughts and opinions of the nutrition field with my colleagues, as we all know there is A LOT of information to question in this industry.

Exploring the Social Determinants of Health

Last summer I volunteered at the Hincks-Dellcrest Centre, an organization that helps run several prenatal nutrition programs throughout Toronto. I worked with a team of health professionals to educate expectant mothers including teenage, Aboriginal and low-income women on the detection and prevention of risk factors contributing to developmental deficits. The teen program was held in the Jane and Finch community, and not only offered nutrition information, but also provided participants with a healthy dinner, subway tokens, food vouchers and access to food bank items.

Talking about the social determinants of health and “building healthy communities” in class these past few weeks got me thinking about my past volunteer experience. I took the initiative to further research the program, which is part of the Canadian Prenatal Nutrition Program (CPNP), hoping to complement the theory I learned in class and put my experience into perspective. I discovered that the top 5 reported risk factors among participants in the Canadian Prenatal Nutrition Program in 2007-2008 were: low income, living in Canada for less than 5 years, being a single parent with no income, having no or limited English language ability and having been hungry or skipped a meal. These findings display the extent to which the lack of access to the social determinants of health (specifically income and food security) pose risks to the health and wellbeing of participants and their babies.

The Canadian Prenatal Nutrition Program is statistically proven to be helpful. Upon evaluation, many participants reported that they started to breastfeed as a result of the helpful information and support that they received. Furthermore, a large majority of participants reported that they learned a lot about healthy eating, and will make changes in order to support the growth and development of their baby. However, will this information and guidance help them overcome their disadvantages? In class we discussed the importance of addressing the social determinants of health in order to overcome health inequities and move forward. Is teaching a pregnant teenager about healthy eating enough? Shouldn’t we dig deeper and investigate their socioeconomic status, and try to make changes to their diet that are feasible? We need to be mindful of factors that influence food choice like education, culture, money and the environment. Encouraging a healthy lifestyle is not necessarily enough... I think we need to start looking into the societal factors. For example, why are these teenagers getting pregnant? What can be done to better educate these teenagers on safe sex, to provide them with the tools they need to raise a healthy baby, and to make it so that teen pregnancy is not the “norm” in their community?

There needs to be more community initiatives to address food security status, income, and support services for immigrants. We need to address the underlying determinants of health through community service organizations, and we need to conduct targeted advocacy initiatives to federal, provincial and local decision makers. We need to take action in addressing the underlying issues that influence health, and translate them into public policy and programs.

Sources:

http://www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/cpnp-pcnp/index-eng.php 

http://www.connectionsprogram.ca/capc-cpnp/welcome-en.php

The Canadian Prenatal Nutrition Program (CPNP) Screening and Evaluation Resource Book

Knowing vs. Doing

Last week in class we watched a video of Malcolm Gladwell discussing the difference between Awareness and Doing. Here is the video:

http://www.tvo.org/TVO/WebObjects/TVO.woa?videoid?24640858001

At about 8 minutes and 45 seconds he talks about how the Unites States had a HUGE campaign trying to make people aware of the dangers of not wearing a seatbelt. There were advertisements and policies put in place, but yet NO ONE started wearing their seatbelt more. This is because the campaign was framed all wrong. When no change occurred, they reframed the campaign to say that if you have a kid under five, they MUST be in a seatbelt. And this amazingly enough had the biggest influence on change. Why you ask? Because these kids grew up and became advocates for seatbelts. The kids would say, “hey mom, I’m wearing a seatbelt, why aren’t you?” When the issue was reframed into an issue of family responsibility, seatbelt numbers increased.

Awareness is not effective. Telling people the facts does not make them change. It is hard to actually come up with a solution and cause a change, which is why we are seeing a gap between the knowing and the doing. The reason the seatbelt campaign worked in the end was because it changed from making people aware of the dangers of not wearing a seatbelt…to insisting that children wear a seatbelt, it changed to the doing. This video really opened up my eyes. To be honest, I had never really thought of “awareness” from this perspective. Malcolm repeatedly calls awareness “just a form of advertising,” and the more I think about it, the more I think he’s right.

Just recently BELL Canada launched a mental illness campaign, which encouraged Canadians to talk about mental illness:

The goal of the campaign is to overcome the stigma associated with mental illness, and to get people talking about it. The hope is that if people talk about it, they wont be afraid to seek out the help and treatment that they need. But is this ad going to help make a change? Or is it just making people more aware of mental illness without giving them an action plan of what to do about it?

Here is another advertisement from BELL Canada that I found, but that I haven’t seen on TV:

What I like about this one is that BELL is not only making Canadians more aware of mental illness, but is also explaining ways in which they will be helping the initiative - BELL will be investing in 4 mental health pillars, one being enhancing access to care. Enhancing access to healthcare is the goal, and now this campaign is making people aware of this…which could help make a difference.

What are your thoughts on BELL's campaign? Do you think awareness is a bad thing? 

Helping the Community

In class this week we had two guest speakers from Access Alliance, a multicultural health and community service organization, come and tell us a little bit about what it means to be a dietitian in the community. The overall goal of the program is “to promote health and wellbeing and improve access to services for immigrants and refugees in Toronto by addressing medical, social, economic and environmental issues.” It was extremely interesting to learn about a dietitian’s role and responsibility within the community, and it became fairly obvious that there is a lot of variation from day to day. The interesting thing about community nutrition is that you can perform clinical one-on-one counseling as well as community work, allowing for so much diversity. I think that community nutrition is sometimes overlooked in our Food and Nutrition program even though there are so many opportunities, and I am extremely happy that I got to hear about it from people who experience it first-hand.

An interesting point that the guest speakers made was that even though clients will be refereed to them for nutrition, it is not always about nutrition management. The program is enriched in the determinants of health, and it is important to always remember the client’s experiences, priorities and changes they will be willing/able to make. If someone is referred to the program because they are hypertensive, but they come in for one-on-one counseling and start talking about how they are depressed, you cannot ignore them. And sometimes it may happen that “food” doesn’t even make it into the conversation.

It got me thinking about all the classes I’ve had to take at Ryerson, and it started to put them into perspective for me. As a transfer student, I often wondered why I had to “waste” my time taking courses on communication techniques, the determinants of health and family dynamics, as I wanted to practice as a clinical dietitian. But as my graduation approaches and I reflect on the program, I realize how important all these classes are and how they all interconnect and make up the term “nutrition professional.” Being a dietitian is not only about food, as it is equally as important to be personable, compassionate and an active listener. A dietitian is far more than an expert in food and nutrition, but a health professional dedicated to understanding the complex interconnections between individuals and food, and it is this relationship that now forms my comprehensive knowledge of nutrition and health.

Usually when people learn that I am studying to be a dietitian the first thing they say is, “I need you to put me on a diet,” or “Can you help me lose weight?’ Programs like the NCT at Access Alliance remind me of why I wanted to go into dietetics, and it wasn’t just to help my friends lose weight. I want to help people understand the connection between food and health, and help teach people to eat well in order to prevent and manage disease.

You can look on the Access Alliance website to learn more about the NCT (Newcomers Cooking Together).

http://accessalliance.ca/services/nutritionprograms

I think it’s such an amazing program, and I definitely want to try and get involved. Is anyone else interested?

Public Policy: A Ban on Smoking

“Patients and their families play an important part in their health care. What do you think Canadians responsibilities are, now and in the future, regarding their health?”

This question was brought up in seminar as part of our discussion on the future of the health care system. The government has been desperately trying to reduce the burden on the health system; however, the majority of funding is still allocated to “downstream” strategies. This means that people believe treatment is the most important aspect of health care. I believe funds need to be better allocated to target promotion and prevention of disease in order to improve health care in the future, but it can’t just stop there. We need to enable each other to take control of our own health, and think about how our actions can affect other people.

An example of an “upstream” approach to health would be tobacco control in Canada. In 2006, smokers in Ontario and Quebec were forced to smoke outside as laws in both provinces banned smoking inside any public place. As a non-smoker, I can vividly remember the smell on my clothes and hair after a night out in Montreal in first year-university (before the law took effect). It was disgusting! Friends of mine would insist on showering at 3 am because they couldn’t imagine getting into their clean sheets smelling like smoke. Even when I could get over the terrible odor that stained my clothes, I could not rationalize all the second-hand smoke that I was exposed to every weekend. The problem was that I didn’t have a choice. If I wanted to go out with my friends on the weekend and socialize at a bar or club, I was going to be surrounded by smokers.

I think that Canadians need to take care of each other. The concept of collectivism implies that people belong to extended families or ingroups, and that one should take care of others before him/herself. It’s a “we” or group orientation. When people smoke inside, they are not thinking of other people; about other people’s values, beliefs and concerns about health. We need to start thinking about our role in society. When the “no smoking” law took effect, people were outraged and concerned about how the change would affect them. To name a specific example, two bar owners in Montreal tried to launch a legal battle. They were concerned that the law would cause job losses because more people would stay at home, costing their business money. This is an individualistic view. Is this the view people should be taking? In my opinion, the smoking regulations positively impacted both smokers and non-smokers through reduction of exposure to second hand smoke. Never mind the fact that it reduced the amount of laundry and showers that needed to be taken after a night out on the town! We all need to start looking at the bigger picture. We need to start thinking about our future and the responsibility we have to each other to make it as healthy as possible.

What else can Canadians do individually to improve the country’s health as a whole?

Sources:

http://www.cbc.ca/canada/story/2005/09/14/smoking_challenge_20050914.html#ixzz1CfZTKM1B

http://www.ctv.ca/CTVNews/TopStories/20060530/ontario_quebec_060530/

Marry Me!

After our discussion in class last week, I was immediately reminded of a recent Grey’s Anatomy episode (as a TV fanatic, this is not surprising). The cardiologist, Teddy, meets a dying man who doesn’t have the insurance he needs for continued treatment. Because he needs surgery to save his life, Teddy offers to marry him so he can get on her insurance plan. She is a doctor, and this is the only way she can save his life.

Click here for a clip from the Grey's Anatomy episode.

Unlike the United States, Canada’s health care system provides coverage to all Canadian citizens. I am thankful for this, as I believe that it is the duty of the government to provide health care, and that everyone should be entitled to this service. Medications, check-ups, surgeries, visits to the doctor are essential to survival. People who are sick need access to health care in order to get better, and I don’t believe help should be provided based on someone’s socio-economic status. People who are less fortunate deserve to be treated for medical problems just as much as people who are more fortunate.

However, Canada’s health care system is the subject of much political controversy and debate.  People question how efficient the current system is in its delivery of treatment in a timely manner, and some advocate adopting a private system similar to the United States. For example, a Canadian citizen in need of an MRI will wait an average of 100 days until they can receive the service. In the United States, the privatized market drastically decreases patient wait times, which can be an essential life saving feature. However, there are worries that privatization will lead to inequalities in the health system, allowing only the wealthy to afford certain treatments. This is the case in the Grey’s Anatomy example.

Canada’s health care system is a work in progress, and changes have been made and will continue to occur as a response to growth in medicine and throughout society. We must remember that no system is perfect, and we are never going to be happy with our health care if we don’t accept its values - Fairness, Compassion, Solidarity and Equity. It is clear that these values do not represent all Canadians, as people are pushing for a two-tiered system. The transition is becoming more apparent due to the implementation of private clinics, and the use of personal connections to help people jump waiting lists. I believe that Canada must stay as a public health care system and not move to the private sector despite faster waiting lists. We must stop looking at health care from an individualistic perspective and start being responsible for each other. If we adopt a privatized system, health care will not be universal, and innocent people will die because they don’t have enough money to pay for their treatment.  We must remember the basics of the health care system, “universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay.”


Sources: 
http://www.hc-sc.gc.ca/hcs-sss/index-eng.php
http://www.debbieschlussel.com/6607/obamacare-a-canadian-wait-time-preview/