Research Pillar: Population Health

Despite increasing technological advances, heavy industries remain physically demanding, with high back injury rates among workers. In BC, more than 17,000 compensation claims for back strain accounted for 25 per cent of all claims for 2001. More than a quarter of these claims come from employees in the forestry, wood and paper products, construction, transportation, and warehousing industries. Activities such as lifting, carrying or pushing objects subject workers to forceful exertions, repetitive movements and awkward postures, all of which can contribute to back injuries. Injuries are thought to be caused by both “peak” or maximal loads (such as lifting a heavy box once) and the total load over time (repeatedly lifting boxes throughout the day). However, most studies have focused solely on peak loads. Catherine Trask is conducting the first study to measure muscle loading over time among workers in these five heavy industries. Catherine is comparing how peak and cumulative muscle loads impact back strain, and whether total load is an important risk factor for back injury. The results may identify the maximum safe physical loads for workers in heavy industry, which would help reduce injuries, make industrial workplaces safer, and reduce claim costs.

There is growing recognition that many diseases and disorders, such as asthma, joint and tendon disorders, communicable diseases and some cancers can be caused, or aggravated by workplace exposures. Occupational health is one area where the translation of research findings into new policies and increased safety in the workplace can have an immediate and profound effect on work-related injury and disease. This process, known as knowledge transfer and exchange (KTE), involves the use of research knowledge in decision-making – for individuals setting workplace safety policy, managers supervising a workforce, or employees making decisions regarding risks in the workplace. While there is widespread recognition of the importance of communicating research knowledge to those who can benefit from it, there has been little research on the KTE process within occupational settings, and how this information can be effectively communicated outside academic circles. Research that focuses on KTE as a joint effort – where the expertise of both scientists and workers is considered and recognized – has yet to be examined within occupational settings. Dr. Anne-Marie Nicol is researching the process and context by which occupational and environmental research knowledge is exchanged from research scientists to policy-makers and to employees in the workplace. Her work includes analyzing the methods that occupational and environmental scientists use to promote their research knowledge, and examining what types of information the public and policy-makers use to make decisions about risk in the workplace. This research will help develop strategies to facilitate the effective exchange of research knowledge in a timely manner to people at risk from occupational and environmental exposures, and help ensure that the information people receive is useful and appropriate to their needs.

According to the World Health Organization, six out of the top seven risk factors for chronic illness are associated with a lack of physical activity, smoking and unhealthy eating habits. Adolescence is a critical period for establishing attitudes and behaviours associated with physical activity, eating, and tobacco use, yet little is known about the relationships among the health behaviours and the reasons for initiating or avoiding them. As a result, understanding and targeting adolescent behaviour can potentially have an important impact on health status across the lifespan. Catherine Sabiston is studying what influences adolescents’ decisions to engage in healthy or unhealthy behaviours. She is reviewing several social, cultural and individual factors—such as social support and relationships, gender-stereotypes, socioeconomic status, self-perceptions, competencies and values—that affect physical activity, eating and tobacco use. Catherine is also interested in how these factors affect boys and girls differently, and whether these factors influence adolescents of a variety of ethnic backgrounds differently. This research should help explain the onset of and relationships among multiple health behaviours. Catherine will use this information to develop a school-based intervention program to target health behaviour change in adolescents, with the goal of developing realistic recommendations towards improving the long-term health status of Canadians.

Effective antiretroviral therapies are enabling children born with HIV in developed nations to mature into adolescence and young adulthood. These children represent a unique group in the global HIV epidemic, because they have developed throughout their lives with access to antiretroviral drugs. Few Canadian studies to date have examined the lives of these children. As HIV-positive children mature, they face new medical and social challenges, and additional age-appropriate services are needed to support their development. For her MSFHR-funded Master’s work, Sarah Fielden explored the needs of older BC children born with HIV, in collaboration with the children, their family members, and their health care and community service providers. Now, Sarah’s goal is to develop health promotion programs to promote healthy development among these children. Sarah brings previous experience working with young people living with HIV in Zimbabwe, Africa, to this community-based study. She will also assess mortality, drug treatment trends and demographic profiles of BC children with HIV. The lessons learned from this research may be of interest to those working with children with other chronic diseases and the international HIV community at large.

The forested mountains and dry valleys of British Columbia’s southern interior make this region susceptible to summertime wildfires. During the unprecedented 2003 season more than 6,900 fires destroyed 343 homes, consumed 260,000 hectares, and exposed up to 640,000 residents to potentially harmful levels of smoke. Forest fire smoke has several similarities to urban air pollution. Both include tiny, airborne particles that can irritate the lungs and place stress on the entire cardio-respiratory system. However, since forest fires usually burn in sparsely populated areas with limited air quality monitoring, it has been difficult to determine whether smoke particles carry the same health risks as their urban relatives. Sarah Henderson is using computer simulations in combination with satellite data to estimate the daily smoke exposure of southern interior residents between July 1st and September 30th, 2003. She will correlate her results with regional hospitalizations to determine how the risk for respiratory and cardiovascular disease is affected by exposure to forest fire smoke. This study will help to explain the health effects of fire smoke and Sarah hopes that it will influence forest management policy in the future.

Aboriginal people in Canada, like indigenous people around the world, continue to experience persistently lower health status than other populations. Although researchers are tracking these health outcomes, there is a lack of enough detailed information about the specific processes that prevent Aboriginal people from meeting their health needs, and how the health service delivery system facilitates or hinders meeting those needs. This is an especially important question for children in view of the significance of the early years for future health. Silvia Vilches is working directly with parents, primarily women, within an aboriginal on-reserve community, to explore what parents and caregivers see as priorities and opportunities for enhanced health and well-being in their communities. Her work will take into account the interactions between federal health care funding and provincial health care systems, the continuing impact of colonization on aboriginal communities, and the desire for aboriginal communities to determine and express their own needs. Research has shown that Aboriginal people want culturally appropriate, holistic community health services. This type of project-based investigation could lead to better models of health service delivery planning for rural and marginalized populations that matches community priorities.