There are numerous segments of the Canadian population who experience a disproportionate burden of ill health. A key issue in addressing this disparity is the early identification of those groups of people who are vulnerable to poor health outcomes over the course of their lifespan. Identification of these groups, and the factors leading to this vulnerability, is a priority for researchers. One area of interest is in identifying the early childhood determinants of health behaviours, such as a child’s health, stress in the family, economic conditions or neighbourhood safety. Dr. Stefania Maggi studies the extent to which early influences can predict which children will follow trajectories of health vulnerability throughout the lifespan. Her research uses a combination of administrative databases, national surveys, and longitudinal data collection to follow up on the same individuals over a number of years, spanning developmental phases from early childhood to adolescence and young adulthood. By identifying what factors in childhood increase the likelihood of unhealthy behaviours and/or poor educational outcomes during adolescence her research will inform early prevention efforts aimed at the social determinants of health.
Year: 2006
The role of Prostate cancer support groups (PCSGs) in health promotion
There is a significant body of research that describes the psychosocial, rehabilitation and health needs of men diagnosed with prostate cancer. These needs cannot always be met by professional health care services, particularly in the case of health promotion programs intended to help men with prostate cancer maintain and optimize their health and well being. While more and more men are accessing community-based support services such as Prostate Cancer Support Groups, little is known about whom these groups serve, what services they offer, and how they are funded.
Dr. John Oliffe is exploring the role of Prostate Cancer Support Groups in health promotion, and determining how men’s health and illness behaviours are informed and influenced through attending these support groups. Through a better understanding of how these groups operate, he hopes to develop recommendations about how best to support this type of resource, and identify potential ways to integrate the groups with professional health care services. This work will help inform future content, design and implementation of prostate cancer health promotion programs.
Impact of nutrition and physical education school policies on childhood obesity: Understanding the implementation process and its impact on behavioural and weight outcomes
The prevalence of childhood obesity is rapidly increasing in Canada, increasing fivefold for both boys and girls from 1981-99. As the genetic characteristics of the human population have not changed in the past 30 years, childhood obesity is thought to be caused by behavioural and environmental factors that predispose children to consume more calories than they expend. Obesity is also linked to a number of diseases, including cardiovascular disease, type 2 diabetes, and some cancers. Schools provide an ideal setting to intervene on children’s behaviours. Recently, policy strategies have been proposed to change the school environment to limit access to unhealthy food and to increase opportunities for children to be more physically active. However, these changes are taking place without the scientific evidence necessary to support these strategies. Louise Mâsse is examining the impact of school-based policies on changing nutrition and physical activity behaviours among children. In addition, she is identifying the factors that prevent from implementing healthy school policies and creating healthier environments. The results of her study will provide insightful information for policy-makers to improve the health of BC children
Social class and health: Innovative theoretical exploration and empirical confirmation
Two broadly-defined approaches to conceptualizing social class can be applied to the empirical study of health inequalities. In the first, social class is equated with the socioeconomic status of individuals, i.e., with individual-level measures of wealth, educational credentials and/or occupational prestige. Explanations for empirical relationships between health and this particular conception of social class generally address material, behavioural or psychosocial phenomena, such as housing conditions, lifestyle choices or perceptions of relative standing. In the second, social classes are social groups, defined by the nature of their relationships to the economic mode of production and forms of control wielded in the workplace (the perspective of the neo-Marxist theorist Erik Olin Wright), or defined relationally in social space by their possession and utilization of various economic, educational, social and cultural capitals (the perspective of the French social theorist Pierre Bourdieu). In this tradition, explanations for class-health associations attempt to simultaneously address individual-level and group-level factors in a complex mix of agency and structure. Dr. Gerry Veenstra is investigating relationships between social class and health and well-being in Canada, integrating individual-level models founded upon material, lifestyle and psychosocial explanatory factors with social-structural theoretical frameworks inspired by theorists like Bourdieu and Wright. Building upon his previous work in BC, Dr. Veenstra will engage in an ethnographic exploration of different class positions and then administer a questionnaire survey to randomly-selected Canadian adults, assessing possession of various manifestations of control and capital. He will apply linear-causal statistical techniques such as regression analysis and relational techniques such as multiple correspondence analysis to this survey data in an attempt to identify and explain factors underlying social class and health inequalities in Canada.
Health Care Operations Analysis to Reduce Attending Times for seniors presenting to the Emergency Department with a Fall
To examine the flow patterns in emergency departments when seniors present with falls, with the goal of improving care for these patients, reducing the time they spend in the ED, and to better understand the economic costs and the proportion of patients who receive health services to prevent future falls.
Informed Decision Making: The Interaction Between Sustainable Maternity Care Services and Community Sustainability
To examine the role of maternity care in the sustainability of rural and remote communities, with the goal of assisting decision-makers in understanding the implications for the community and to provide them with a framework for making challenging decisions involving changes to the provision of these and other health services.
Changing Prescription Practices to Limit Selection for Resistant Organisms: A Population and System Approach
To evaluate the effectiveness of a three-year BC pilot of “Do Bugs Need Drugs?”, a public and professional education program developed to reduce antibiotic use and the spread of resistant organisms.
Substance-Using Women and Experiences of Primary Health Care
To analyze the social, political, and economic determinants that influence health status and access to health services among women who use injection drugs and live in Vancouver’s Downtown Eastside.
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Measuring the Quality of End of Life Care Provided in Inpatient Health Care Settings
To explore differences in satisfaction with the quality of care received at end of life in different types of hospital wards/settings and to better understand the organizational barriers and facilitators that influence how well that care is provided.
Risk Reduction in Mental Health
Individuals with a major mental disorder are at heightened risk of committing acts of violence, being victimized by others, and harming themselves. These adverse outcomes – and the factors that contribute or mitigate them – are known to be interconnected. However, there hasn’t been a coordinated research platform that addresses all three outcomes together and identifies how different risk and protective factors affect each of these outcomes individually, and in combination, over time.
This team will link together researchers across BC and around the world to identify the most important dynamic risk and protective factors for violence, and determine the best techniques to measure and analyze their change over time. Because many individuals with a major mental disorder also have problems related to substance use, the team will also assess the relationship between mental health, substance use and violence.