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A reflection on my learning journey in the course of MHST 601

  • Writer: Cynthia Yuen
    Cynthia Yuen
  • Dec 5, 2022
  • 6 min read

The MHST 601: Critical Foundations for Health Disciplines course at Athabasca University has boarded my understanding of the Canadian healthcare system and the various factors that impact the health of Canadians. By unpacking the key learning points throughout the course, I could further connect different health issues to concepts such as determinants of health and the multilevel model of health. Also, exchanging thoughts with my classmates through the weekly learning activities, looked at the same issue from different angles and challenged myself to research topics I had never explored before, such as mental health and vulnerable group. "Health issues" are beyond just the diagnosis or symptoms; they have become multidimensional due to the complexity of the interconnected factors. In this blog post, I will walk through the significant components and reflect on what I learned in this course.


Professionalism and Social media

At the beginning of the course, I had to define my professional identity as a registered respiratory therapist practising in Alberta. I follow the professional standards regulated by the College and Association of Respiratory Therapists of Alberta (CARTA, n.d.). These standards are set out by the Alberta Health Act, which outlines the expectations and responsibilities of the health system (Government of Alberta, 2022). I used to avoid exposing my professional identity on social media because I was uncertain about what I was allowed or not allowed to share. This course challenged me to step out of my comfort zone; I created this ePorfolio to document my learning journey and share the resources and insights. I have adapted the AHS's Code of Conduct (2016) when I determine what is appropriate to share online, and I have gained the confidence to share my resources and thoughts in my ePorfolio. After all, social media is a powerful tool for health education, promotion and advocacy.


Determinants of Health and Socio-Ecological Model

To further understand the health system, it is essential to understand what "health" really means. I first found the definition of health stated by the World Health Organization (WHO) in 1948 - "health" is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, n.d.). Healthcare sure has changed in the past 74 years; the WHO's health definition is also being challenged today. Misselbrook (2014) criticizes the WHO definition as a disease-focused biomedical model that insinuates that imperfections or abnormalities should be fixed. Also, Oleribe et al. (2018) argued that "complete" in the WHO definition of health is challenging to measure and that a person can't be without any physical, mental and social challenges. With the increasing population living with chronic health conditions in Canada, according to the WHO definition, these conditions must be healed entirely to be considered "healthy." The WHO definition does not necessarily reflect the health needs of Canadians in the 21 st century. The Government of Canada (n.d.) stated that each individual's health experiences can vary widely and vary across their lifetime; good health provides us with the physical and emotional resilience we need to cope with difficult times, regain our balance and live daily. Someone with a chronic health condition may feel that they are healthy as their pain is managed and they can participate in the group exercise program. The factors that impact people's health are called the Determinants of Health (Government of Canada, 2022). The main determinants of health are income and social status, employment and working conditions, education and literacy, childhood experiences, physical environments, social supports and coping skills, healthy behaviours, access to health services, biology and genetic endowment, gender, culture, and race /racism (Government of Canada, 2022). Social determinants of health (SDH) refer to a specific group of social and economic factors within the broader determinants of health, often related to an individual's place in society, such as income, education or employment(Government of Canada, 2022).


Video 1 Making The Connections: Our City, Our Society, Our Health - explains that social determinants of health are interconnected; one determinant affects another, like a big complex web. One small positive change can trigger a ripple effect that positively impacts the community.

Video 1 - Wellesley Institute. 2012. Making The Connections: Our City, Our Society, Our Health. https://www.youtube.com/watch?v=q-3mUiGi6bA


As the determinants of health are often interconnected and complex, using a multilevel model will help us to overlook and analyze the correlations or the cause of health issues. In my previous blog post, I applied Socio-Ecological Model to tobacco cessation. As in Image 1, the Socio-Ecological Model (SEM) organizes the SDH in individual (intrapersonal), interpersonal, community/organizational, and society/policy (Kalhkoran et al., 2018). SEM is a type of multilevel model. Using a multilevel model can allow researchers, clinicians, and policymakers to assess how a health issue is placed at different levels, allowing stakeholders to identify the root cause to make positive changes in providing services, education programs, laws and policies, and human resources to fulfill health needs for Canadians.


Image 1 - Socio-Ecological Model (Kalkhoran, 2018)


Vulnerable Populations and Indigenous Health

NCCDH (n.d.) defines 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. Indigenous people are one of the vulnerable groups in Canada. Indigenous people have a higher burden of physical and mental illnesses among the Canadian Indigenous populations due to inequality in social determinants of health such as education, housing, socioeconomic status, and access to services; inequities that predispose them to experience poorer health outcomes compared to non-Indigenous populations (Lawal et al., 2021). I searched for the health services provided to the indigenous people in Alberta; how are these services from the non-indigenous health services? I specifically searched for mental health support for indigenous people in the province. I found that the services address culturally appropriate health care and support. Some services include counselling, psycho-educational group therapy, trauma-informed therapy for individuals, outreach program, resources including access to Traditional Wellness Counsellors, culturally safe patient and family-centred care, and education (AHS, n.d.a.). Some counselling centres offer ceremonies, traditional practices, smudging, and prayer (AHS, n.d.b.). I have gained an understanding of Indigenous Health, and I appreciate that Alberta Health provides culturally appropriate services. However, I also learned that system racism does exist, taking the"Sinclair's case" for example (CBC News, 2017). This case reminded me that no matter how good the health services or programs we provide, it would be meaningless if there was a system racism in place; we should serve the people with empathy and compassion.


Final Reflections

It has been a meaningful experience because this course has challenged me in many ways. I stepped out of my comfort zone of respiratory care and delved into unfamiliar topics, such as indigenous health and mental health. By learning about multilevel models, healthcare leaders should look beyond the definition of a health issue and research the associated factors and their correlations, which would help identify the root cause. Only by identifying the root cause and the barriers, the leadership can make positive changes to the healthcare system that accommodate the needs of our complex and diverse populations.


Reference


Alberta Health Services (AHS). (2016). Code of Conduct.


Alberta Health Services (AHS). (n.d.a.). Indigenous Mental Health Program.https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1017002


Alberta Health Services (AHS). (n.d.b.). Traditional Wellness Coordinator Services. https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1070611


Athabasca University. (n.d.). Critical Foundations in Health Disciplines.


CBC news. (2017). Ignored to death: Brian Sinclair's death caused by racism, inquest inadequate, the group says. https://www.cbc.ca/news/canada/manitoba/winnipeg-brian-sinclair-report-1.4295996


College and Association of Respiratory Therapists of Alberta. (n.d.). Standards of Practice.


Government of Alberta. (2022). Health Professions Act.


Government of Canada. (2022). Social Determinants of Health and Health Inequalities.


Government of Canada. (n.d.). What is health?


Kalkhoran, S., Benowitz, N. L., & Rigotti, N. A. (2018). Prevention and Treatment of Tobacco Use. Journal of the American College of Cardiology, 72(9), 1030-1045. https://doi.org/10.1016/j.jacc.2018.06.036


Kothari, A., Edwards, N., Yaniki. S., Hansen-Ketchum, P., Kennedy, M. (2007). Socioecolocigal Models: Strengthening Intervention Research in Tobacco Control. Drogues, santé et société, 6(1), Supplemental III 1-21.


Lawal, M. A., Shalaby, R., Chima, C., Vuong, W., Hrabok, M., Gusnowski, A., Surood, S., Greenshaw, A. J., & Agyapong, V. I. O. (2021). COVID-19 Pandemic: Stress, Anxiety, and Depression Levels Highest amongst Indigenous Peoples in Alberta. Behavioral Sciences, 11(9), 115. https://doi.org/10.3390/bs11090115


Misselbrook D. (2014). W is for well-being and the WHO definition of health. The British journal of general practice: the journal of the Royal College of General Practitioners, 64(628), 582. https://doi.org/10.3399/bjgp14X682381


National Collaborating Centre for Determinants of Health (NCCDH). (n.d.). Vulnerable Populations.


Oleribe O, Ukwedeh O, Burstow NJ, Gomaa AI, Sonderup MW, Cook N, Waked I, Spearman W, Taylor-Robinson SD (2018). Health: redefined. Pan African Medical Journal. 2018; 30:292


Wellesley Institute. 2012. Making The Connections: Our City, Our Society, Our Health.





 
 
 

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