The flood, fire and heat events of 2021 brought the health impacts of climate change into focus for British Columbians. New public health interventions are required to support effective adaptation, but especially for the most impacted population groups. The BC-REACH (BC Research for Equitable Adaptation to Climate and Health) project is a mixed-methods research platform to build evidence on effective and equitable public health adaptation to climate change. The project’s goal is to equip public health practitioners and residents of British Columbia (and beyond) with new evidence and interventions to enhance their preparedness to a variety of climate change-related health risks. Working in partnership with applied health system partners, this research will ultimately lead to the co-development and evaluation of novel programs and policies that have multiple co-benefits for populations that may be more exposed or physiologically sensitive, or lack the capacity to adapt to a changing climate. By centring equity in this analysis, this research will build knowledge and capacity to reduce population-level health inequities by ‘climate proofing’ the future of the health system’s responses to a wide variety of climate and health risks.
Research Pillar: Population Health
Bridging the Gaps: A One Health Communications Framework for Mobilizing Knowledge at the Nexus of Human, Animal, and Environmental Health
Health is connected and collective. Connections across species and geographies promote the spread of infectious diseases. Collectively, humans, animals, and environments face shared health threats like climate change. This concept of ‘One Health’ is a valuable lens through which to identify actions that support a healthy world. Yet, One Health’s major strength is also its largest challenge as it relies on bridging disciplinary silos — veterinarians and doctors, policy makers and public health practitioners, scientists, and the public. My community-engaged research explores a framework for mobilizing information at this nexus of health. Working with policy makers, health practitioners, and communities, I will identify communication structures that can be deployed at regional scales and across sectors. By understanding community knowledge and perceptions of three One Health issues (chronic wasting disease, avian influenza virus, and rat-associated diseases), I will resolve how health messages can be strengthened to promote public participation in disease surveillance programs. Engaging with knowledge users at all levels will help to improve data collection, monitoring, and inform government decision making and timely action.
Growing an Unlearning & Undoing White Supremacy & Indigenous-specific Racism Lab for population and public health in BC
First Nations, Métis, and Inuit Peoples have a right to health. Laws in BC affirm this right. Settler systems have not yet fulfilled our obligations.
The 2020 In Plain Sight report showed that Indigenous-specific racism in health is widespread in BC. This report, and others like it, outline clear instructions for health leaders. How should organisations responsible for population and public health in BC pick up these instructions?
We often hear, “what can we do?” This research aims to answer that question, plus: How can we get ready to do this work in a meaningful way? How can we change how we’ve been working in order to be anti-racist? What tools do we need? Is what we are trying working?
US anti-racism expert, Dr. Camara Jones, has given public health organizations 3 tasks to end the epidemic of racism:
1. Name racism
2. Ask, how is it operating here?
3. Organize and strategize to act
3 provincial organizations – BC Office of the Provincial Health Officer, BC Centre for Disease Control, and Provincial Health Services Authority – will work together, with guidance from Indigenous peoples, to build knowledge of how to change the population and public health system to uphold Indigenous rights and work in an anti-racist way.
Envisioning urban Indigenous-led pathways to mental wellness through community-based research in the interior of British Columbia and new partner engagement in the north
Colonialism, racism, and a lack of culturally safe care result in poorer mental health outcomes for Indigenous peoples in Canada. Indigenous-led services grounded in local values and priorities improve culturally safe care and wholistic health for Indigenous peoples. Urban (off-reserve) Indigenous peoples are, however, often excluded from mental health planning that affects them. This is especially felt by urban Indigenous peoples residing in rural and northern areas. Building on established partnerships with five British Columbia (BC) Interior Friendship/Métis Centres, and Interior Health, this research aims to change this. Together we will: 1) renew/strengthen existing relationships; 2) explore local mental wellness needs and priorities; 3) develop community-led pathways for promoting mental wellness; and 4) engage new community and health system partners in Northern BC. Local Elders, community research liaisons, and advisory teams will direct and facilitate information gathering and sharing. This may include surveys, talking circles, and community gatherings. Results will be community-owned, and shared with directions from communities.
Unravelling the complexity of familial influences that shape children’s obesity-related behaviors over time
The transition from elementary to secondary school is a challenging time for children as many obesity-related behaviors tend to worsen in this period. My research will examine how the familial environment can support a healthy transition; specifically, how parenting practices influence children’s choices with respect to diet, physical activity and sedentary time. I will first synthesize the published literature about how mothers’ and fathers’ parenting practices relate to children’s obesity-related behaviors. To gather real-world data, I will then use a combination of interviews, surveys, and wearable tech (accelerometers) with 150 British Columbian families to assess their parenting practices and children’s obesity-related behaviors daily for 14 consecutive days during elementary school, and again in secondary school. These data will be analyzed to identify how variations in parenting practices affect children’s behaviors day-to-day before and after the school transition, and the interviews will help understand more deeply how familial factors influence children’s behaviors. Together, my findings will guide the development of parenting interventions to help children maintain healthy behaviors during adolescence.
Buddy Up for men’s mental health: Engaging men through mutual help and social connection
Approximately one in five men struggle with mental health challenges each year; however, men often experience unique barriers that prevent them from seeking help or accessing treatment. The COVID-19 pandemic has placed additional pressure on many men and efforts are urgently needed to tailor services and norm men’s mental health help-seeking. While asking for help may be viewed by some men as a sign of weakness, helping others is often perceived as a strength that aligns with masculine ideals. By emphasizing the benefits of mutual help, it may be possible to equip men with the skills and confidence to support other men’s mental health challenges, as well as their own. The aims of this research are to explore men’s mutual help for mental health challenges and develop an online intervention to promote mental health and social connection through shared activities (e.g. physical activity). We will conduct interviews with Canadian men and use the findings to inform the development of the e-intervention. Men will be recruited to test the intervention and provide feedback. Findings will provide important information about men’s mutual help for mental health challenges and opportunities to norm mental health promotion.
Defining optimal pregnancy weight gain ranges for Canadian women
Maternal weight gain is closely monitored during pregnancy because as weight gain increases, so does the risk of excess postpartum weight retention, diabetes, and high blood pressure. While lower weight gain may prevent these complications, it also increases the risk of poor fetal growth and stillbirth. Pregnancy weight gain recommendations that balance these risks are important. The goal of this project is to establish the optimal range of pregnancy weight gain for Canadian women. We will use existing medical records from approximately 560,000 women who delivered in BC between 2004 and 2018. We will obtain information on pregnancy weight gain, and link this with short- and longer-term health complications for mother and newborn, such as excess postpartum weight retention, maternal diabetes and heart disease, poor fetal growth, and stillbirth. We will use statistical models that enable us to consider all health complications at the same time, while accounting for the fact that some complications are more serious than others. Our findings could provide the basis for new public health recommendations on pregnancy weight gain, which could help to reduce overweight and obesity in Canadian mothers and their children.
The impact of olfactory dysfunction on social and mental health
Our sense of smell enriches our lives—from enhancing pleasures (e.g. aroma of coffee) to signalling danger (e.g. smoke). Loss of smell is related to a range of social and emotional impairments, including elevated rates of depression, social isolation, and relationship difficulties. The COVID-19 pandemic causes transient smell loss, providing a novel opportunity to study one of our least understood senses. My first aim is to examine pathways linking olfactory loss to social and emotional impairments. I will recruit a prospective cohort of adults with recent onset of olfactory dysfunction and no flu-like symptoms (N=300) as well as a control cohort (N=100). Participants will be assessed over eight weeks, covering the typical period for olfactory recovery in COVID-19 patients. This data will provide a first-ever look at how within-person changes in olfaction relate to changes in social and emotional wellbeing. My second aim is to develop a brief, behavioral intervention by conducting a randomized trial focused on the benefit to participants from an online intervention. After refinement, this intervention will be offered freely, and findings will inform efforts to improve mental health for people with olfactory dysfunctions.
Pain and healthcare experiences of sex and gender minority citizens living with chronic pain in Canada
One in four people in Canada live with chronic pain. These individuals experience poorer health outcomes, higher healthcare services use, and lower quality of life. Studies show males and females experience pain differently, for example differences in pain sensitivity and pain control. But little is known about pain experiences in people who identify as a sex and gender minority, meaning a person’s sexual orientation or gender identity differs from traditional societal views. Sex and gender minority persons report higher pain and experience unique life stressors (e.g. discrimination), which may lead to worsening of their pain. We aim to study 1) pain experiences and 2) strategies to improve healthcare experiences for individuals who identify as sex and gender minority living with chronic pain by collaborating with patient and public stakeholders to answer these questions. Involving persons who identify as sex and gender minority with chronic pain in research studies is important because it provides them with a voice to offer personal stories and perspectives. Community engagement will help researchers ask the “right questions” and guide research priorities to improve the lives of people who face similar health challenges.
Generating, co-creating, and implementing solutions and supports for older adults with cancer and their caregivers
The number of adults over age 65 in Canada is growing as baby boomers age. Older adults are the most likely to be diagnosed with cancer and likely to have other chronic health conditions. These health conditions may mean increased medications, medical appointments, and/or difficulties getting around, which combine to make the cancer experience more challenging. Older adults may also require help from family or friends to attend their many cancer and other health appointments (family doctor, geriatrics, and other specialists). COVID-19 has created additional challenges for older adults with reports of reduced or limited treatment offerings, and a sudden shift to virtual appointments.
My research responds to ongoing calls to rethink how we provide care for older adults with cancer. Specifically, we will partner with patients, community groups, health system leaders, and clinicians to co-create and implement tools to make cancer management easier for older adults. This work focuses on improving the processes rather than merely supporting individuals to navigate complex systems. This research will have important implications for health systems, clinicians, and researchers, but most significantly for older adults with cancer.