Blogging About Blogging

As we come to the end of our assignment I want to take a few minutes to reflect on the experience of blogging and what I have learned.   

When I first heard about the blogging assignment I was a bit worried. Formal essays and research-based papers are my comfort zone rather than the casual writing style required for blog posts. And who would ever want to read about my reflections and ideas anyways?

I think that over the course of this assignment my perceptions have changed. I remember feeling unenthusiastic when I was writing my first two posts and looking back I see that I hadn’t quite grasped the blogging concept. At the time I felt uneasy about the idea of having my opinions and ideas out there for my peers and strangers to read. In these first weeks I took the easy way out and built my post around other people’s ideas. By summarizing Picard’s article and reflecting on the comments of fellow Canadian’s on the CMA’s Health Care Transformation website, I didn’t really have to put myself out there. As the weeks went on I felt a bit better about my ideas and my writing. Around the time the 3^rd post was due, Jennifer and Yousra from Access Alliance came to our class to talk about community nutrition. For my third post I felt inspired to talk about my time as a volunteer at Access Alliance. This was a big step for me- it was my first post that focused on me and my experience without any other content to lean on. I was feeling pretty confident when I wrote my fourth post on Dennis Raphael’s article about poverty causing CVD. It was a huge surprise when he commented on my post not one but six times. Interestingly, his comments did not address my issue with his paper- that he didn’t back up his claim with solid and timely evidence. He has just repeatedly posted research to prove his point. My thought was that if there is so much evidence out there then why he didn’t include timely sources in the original paper? I felt like my fifth post on community was a great close to this assignment because it showed how far I have come as a blogger. In this post I decided to share my thoughts on the assets and needs of my community- the St Lawrence neighbourhood.  This was a really personal piece for me and I am pleased that I felt comfortable enough to share it. I now feel more at ease writing about my thoughts and opinions on my blog and I think this experience has helped me become better at casual style writing.  

I think that this blogging assignment was a positive and valuable experience. It made me reflect on the past week’s lecture, assigned readings and seminar discussion in order to come up with a topic and direction for each post. I enjoyed reading my peer’s blogs as well and I regret not commenting or ‘following’ any other blogs. I think that students could really benefit from reading and commenting on each other’s blogs and I wonder if there is a way to make this a requirement by incorporating it into the marking scheme. I’m not sure how it would work practically but I think that seeing multiple perspectives on a topic can really enhance one’s learning.

My Community: The St. Lawrence Market Neighbourhood

In our last seminar we discussed the Community Health Improvement Partnership and reflected on the assets and needs of our own communities.

I liked this exercise because it allowed us to put the theory into practice and it was subjective and personal.

I have lived in the St. Lawrence Market neighbourhood for the last two and a half years. I really like my neighbourhood because it has a feeling of a small community while being in the heart of Toronto. I am close to Ryerson, entertainment and a ten minute walk to union station where I can catch a bus or train almost anywhere in Southern Ontario. My neighbourhood has restaurants, theatres, grocery stores, churches, a community centre, elementary schools, George Brown College, as well as parks, playgrounds and green space. It also has high street connectivity and mixed land use (Smart Growth BC). But my community also has its share of needs. As with many downtown neighbourhoods, my community struggles with homeless, poverty and crime. 

Today in seminar my group discussed how in Toronto, high and low income areas often boarder each other. The transition between “good” and “bad” neighbourhoods can be very abrupt. In only a few blocks it’s almost like you’re stepping into another world. I can definitely see this in my neighbourhood. East of George Street, the St. Lawrence Market neighbourhood takes a turn for the worst. There is a transition from condos and apartments to cooperatives and subsidized housing. All the subsided housing is concentrated into a few square blocks. This area looks very different than other parts of the neighbourhood. There is more litter, less green space and the buildings are in poor repair. It seems like the people living in subsidized housing aren’t proud of where they live. Lawns and gardens are often unkempt and people keep garbage bins on their porches rather than patio furniture. If was to assess this community, I would say that one need would be making this area of subsidized housing more aesthetically pleasing. I realized that this seems superficial but I think that investing money into planting trees and flowers could help reduce some of the stigma that surrounds the area. I’m reminded of the video we watched today in seminar about healthy cities activist Jane Jacobs. Jane said “people don’t want to live in an undignified place”. Could the addition of gardens and green space improve people’s perceptions of this area of subsidized housing? Could they be a source of pride for the people who live there? Perhaps this is something the community as a whole could consider and discuss.  

Lifestyle has no effect on the development of CVD? (blog #4)

One of our readings for this week was Social Justice is Good for Our Hearts by Dennis Raphael. Raphael explains in the article that poverty and social exclusion cause cardiovascular disease (CVD). Raphael even goes so far as to say that lifestyle only plays a small role compared to poverty and social exclusion. The following is an excerpt from the article:

“Yet like so many other public discussions of the causes of CVD, the risk factors discussed in that document are limited to age, gender, family history, unhealthy behaviours such as tobacco use and physical inactivity, and biomedical indicators such as high blood pressure and blood cholesterol. This is surprising as numerous studies indicate that while these medical and lifestyle risk factors contribute to heart disease and stroke, they account for only a small proportion in the variation in their incidence.”

I understand that the social determinants of health have a great effect on our health but I'm struggling with Raphael’s notion that lifestyle factors only play a small role. My perception was that lifestyle choices such as poor eating habits, physical inactivity, and obesity or overweight were known to be risk factors for developing CVD. I thought this was common knowledge. In FNN 301 we were taught that the modifiable risk factors for CVD were hypertension, management of diabetes, inflammation, smoking, weight and waist circumference, a sedentary lifestyle and high cholesterol and the unmodifiable risk factors were family history, genetics, age, gender and having diabetes. I guess this is the other side of the coin- all medical and lifestyle risk factors and no mention of social determinants of health. I can’t help but think that the real answer in somewhere in the middle.

I decided to look into the articles that were given as supporting the above Raphael quote. Although he states that ‘numerous’ studies indicate that medical and lifestyle factors play only a small role in the incidence of CVD, he only references three. The three studies he referenced were published in 1978, 1998 and 1989. Since Social Justice is Good for Our Hearts was published in 2002, Raphael was citing articles that were 13 and 24 years old. In addition, the articles weren’t focused on whether lifestyle or the social determinants of health cause CVD. They were titled “Employment Grade and Coronary Heart Disease in British Civil Servants”, “Socioeconomic Factors, Health Behaviors, and Mortality”, and “National Trends in Educational Differentials in Mortality”. If there are numerous studies that show that medical and lifestyle factors only play a small role in the incidence of CVD, why did Raphael use out-dated research that didn’t focus on what he was trying to prove? 

Test your knowledge: A healthcare quiz

I found a health care QUIZ on the Globe and Mail website. Find out how much do you know about the Canadian health care system!

A Look at Community Nutrition: Access Alliance

Last week Jennifer and Yousra from Access Alliance Multicultural Health and Community Services came to our FNN 401 class to give a lecture on community nutrition. I was really excited for their presentation because even after volunteering at at Access Alliance, I still wasn't clear about all the activities community dietitians are involved in. Jennifer and Yousra showed us a "day in the life" slide that was a snapshot of what they were doing for the month of January. I found it really helpful to see what things they are involved in on a daily basis. Based on their presentation, it seems like community nutrition is a very diverse field. 

Jennifer and Yousra put a lot of emphasis on the Newcomers Cooking Together program, which I have had the pleasure of being involved in. My role as a volunteer for the program was to record recipes, interview participants to get their biographies, help out in the kitchen and take pictures throughout. I think one of the reasons I enjoyed the program so much was because it was so different from any other volunteer experience I have ever had. For one, the population was very unique. Access Alliance focuses their services on recent immigrants and refugees and our group included men of all ages from Burma, Mexico, Afghanistan, Liberia, and Russia. 

"It never ceases to amaze us how FOOD allows such a diverse group of people to find so many commonalities between us, while respectfully celebrating our differences"  - Jennifer and Yousra                                                      

After a couple weeks of the program I realized why the dietitians chose the cooking class format. First off, the participants built friendships. Food is something we all enjoy and it provides a common ground between diverse groups. Also, by providing a meal for participants we were feeding people who may have food insecurities. During the program each participant gets the chance to plan and cook their favourite meal for the group. This gives them the opportunity to share some of their culture, tradition and/or religion with the group. These weekly sessions also provide participants with the opportunity to build competency in the kitchen. Some of these men had never had to cook until they left their families and homes to come to Canada and this allows them the chance to learn to clean, prepare, cook and present foods. We were also always learning about new foods (like gari- have you heard of gari?) and new methods of preparing foods. Newcomers to Canada often need some introduction to our selection of foods as well as venues to buy food. This setting also allows us as dietitians and furture dietitians to sneak in some advice about healthy eating, Canada's Food Guide, portion sizes etc. And as Jennifer mentioned in the presentation, people will tell you their life stories over a meal. In the comfort of the kitchen the participants shared tragic stories about their lives before they came to Canada. My experience volunteering with Access Alliance was a memorable one and I would recommend that everyone seek out experience in a community setting. 

The longer you wait, the sicker you get?

Take a minute to read Crisis in the ER from the National Post. 

According to Dalhousie researchers, "prolonged waits in the ER put patients at greater risk of suffering 'adverse events', ranging from surgical complications, medication errors and c. difficile infections". 

Health Care Transformation

In seminar last week we discussed the Canadian Medical Association’s “Health Care Transformation” initiative. Through this initiative, the Canadian Medical Association (CMA) is asking Canadians to answer three questions on their perception of health and how our health care system should be in the future.

I found the third question posed by the CMA particularly interesting- Patients and their families play an important part in their health care. What do you think Canadian’s responsibilities are, now and in the future, regarding their health?

I think that when people talk about health care, it’s easy to play the blame game. As much as the Canadian health care system might need some work, I don’t think we have much to complain about. We only have to look to the U.S. to see a complete health care mess. I like this question because it really turns the tables and encourages Canadian’s to think about what they are doing to maximize their health.

I found some interesting answers to this question posted on the CMA comment board.

readsmartease wrote “I do feel that Canadians should take a more active role in managing individual health, HOWEVER we need to have a system that not only PERMITS this activity, but embraces and supports it.” 

I agree with readsmartease. This comment reminded me of the discussion in lecture about healthy public policy. We can’t expect Canadians to make healthy choices when our environments don’t support them. This idea of creating supportive environments to promote the health of individuals and communities is a health promotion concept.

kusyki wrote “Should someone who does not live a healthy lifestyle have [the same] access to major surgeries/therapies as someone who does follow [a] healthy lifestyle? [Should] a child in need of a lung transplant have to wait in line behind someone who smokes a pack a day?”

These are really difficult questions. Even though the majority of us understand that a healthy lifestyle includes eating well and exercising, this knowledge isn’t always put into practice. Many choose not to eat a healthy diet or get regular physical activity, and that’s our choice. But when is it too much? It seems like there needs to be a limit to the amount of health care dollars spent combating largely preventable illnesses that develop from lifestyle choices. It’s not like in the U.S. where people have to spend their own money on surgery to reverse the damage they have done. In Canada it’s taxpayer’s dollars paying for people to abuse their health and our health care system. Is it fair for tax payers to have to pay for the poor choices of other Canadians? What are your thoughts?

I will close with the wise words of Helene: “WE are the system, WE elect our representatives, WE make choices as a society and as individuals... Every person owes it to themselves to take care, make healthy choices, inform themselves and be pro-active. The system can only do so much - miracles are not part of their mandate.”