NETHRNBC NewEmerging Team for Health in Rural and Northern BC'

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NETHRN-BC New-Emerging Team for Health in Rural
and Northern BC.

• The Social Dimensions of Rural and Northern
  Health in British Columbia

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New Emerging Team

• Aleck Ostry MA, MSc, PhD Canadian Institute
  for Health New Investigator and Michael Smith
  Foundation for Health Research Scholar
• Department of Healthcare and Epidemiology, UBC
• Investigators
• Amedeo D'Angiulli, PhD Canada Research Chair
  in Population Health
• Centre for Early Education and Development
• School of Education Department of Psychology
• University College of the Cariboo, Kamloops B.C.
  
• Greg Halseth, PhD Canada Research Chair in
  Rural and Small Town Studies
• University of Northern British Columbia, Prince
  George, B.C.

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Invetigators Continued

• Clyde Hertzman, MD, MSc Canada Research Chair
  in Population Health
• Director, Human Early Learning Partnership, UBC
• Stefania Maggi, MA, PhD 
• Associate Director, Centre for Early Education
  and Development
• University College of the Cariboo, Kamloops BC,
• James Tansey, BSc, PhD
• Senior Research Assoc/ Adjunct Pr
• Sustainable Development Research
  Initiative/IRES, UBC

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Collaborators

• James R. Dunn, PhD
• Research Scientist Inner City Health Research
  Unit ,     
• Assistant Professor, Department of Geography
• University of Toronto
• Neil Hanlon, PhD
• Assistant Professor
• Geography Program
• University of Northern British Columbia
• Prince George, B.C

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Outline

• The need to build research capacity in rural and
  northern health focused on the social
  determinants
• 1. Rural and urban health the
  historical dimension
• 2. Rural and northern health in Canada
• Current distribution of rural population in
  Canada
• Do the social circumstances of rural and urban
  Canadians differ?
• Are there differences in health behavior?
• Are there differences in health outcomes
• Aboriginal health in Canada

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• 3. Rural and northern health in British
  Columbia
• Social circumstances
• Health outcomes
• B) CIHR focus on rural and northern
• health
• C) Project overview

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1. Rural and urban health the historical
dimension(an English example)
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2. Rural population historical trends in
Canada
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Wandel, J. Presentation, Guelph Ont. 2003
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Source Wandel, J. Presentation, Guelph Ont. 2003
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At Present in Canada

• From one quarter to one third of Canadians live
  in
• rural or northern areas.
• Forty percent of Canadas exports are natural
• resources
• The most basic components for urban living (e.g.
• food, water, energy, and building materials)
• depend on rural communities.

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• While the health status of rural and northern
• Canadians tends to be worse (and in
• some cases dramatically worse) than for urban
• Canadians, the health and the social determinants
  
• of health in rural and northern populations
  remains
• under-investigated.

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• A recent survey of course offerings in higher
• educational institutions in Canada found rural
• health is under-represented as a topic of
  research
• education in the countries universities. (Kulig
  JC,
• Minore B, Stewart NJ. Capacity Building in Rural
• Health Research A Canadian Perspective. The
• International Electronic Journal of Rural and
• Remote Health Research, Education, Practice, and
• Policy. July, 2004.)

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Basic definitions of Rural Statistics Canada
Census rural everything outside cities/towns
of pop. gt 1,000 Rural and small town
everything outside the commuting zones of cities
gt10,000
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OECD Rural communities population density
lt150/square km Predominately rural more than
50 of people in the region live in rural
communities
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Rural and Northern Health in Canada

• How many Canadians live in rural/northern Canada
  ?
• What is their distribution?

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Rural and Small Town Canada Analysis Bulletin,
Vol.1, No.1 (1998)
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Rural and Small Town Canada Analysis Bulletin
Vol.5, No.4 (June 2004)
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Rural and Small Town Canada Analysis Bulletin
Vol.5, No.4 (June 2004)
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Do the social circumstances of Rural and Urban
Canadians differ ?
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Rural and Small Town Canada Analysis Bulletin
Vol. 2, No. 5 (March 2001)
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Rural and Small Town Canada Analysis Bulletin,
Vol. 2, No. 5 (March 2001)
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Rural and Small Town Canada Analysis Bulletin,
Vol.1, No.2 (February 1999)
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What about Health Behaviors?
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Rural and Small Town Canada Analysis Bulletin,
Vol 5 No 3, March 2004
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Rural and Small Town Canada Analysis Bulletin,
Vol 5 No 3, March 2004
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What about Health Outcomes?
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Rural and Small Town Canada Analysis Bulletin,
Vol. 4, No. 6 (October 2003)
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Rural and Small Town Canada Analysis Bulletin,
Vol. 4, No. 6 (October 2003)
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Rural and Small Town Canada Analysis Bulletin,
Vol. 4, No. 6 (October 2003)
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Aboriginal Social Circumstances and Health in
Canada
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Source Rural and Small Town Canada An Overview,
Statistics Canada 2000
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Rural and Northern Health in British Columbia
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Do the Social Circumstances of Rural and Urban
British Columbia Differ?
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Source BC Health Atlas First Edition (2002)
CHSPR UBC
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Source BC Health Atlas First Edition (2002)
CHSPR UBC
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Source BC Health Atlas First Edition (2002)
CHSPR UBC
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What About Health Outcomes in Rural BC?
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Summary

• Many Canadians live in rural regions
• Approximately 40 percent of BC residents live in
  predominately rural regions
• Employment, income, and educational status is
  less in rural vs urban regions
• Health status of residents of rural regions,
  particularly Aboriginals less than in urban
  regions
• Complexity in defining and studying diverse rural
  situations
• Requires a multi-disciplinary social determinants
  approach and new research commitment

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B) CIHR and Northern and Rural Health Research
1. The Problem At present, rural health research
is fragmented, uncoordinated, and has little
impact on policy We need to cultivate an
internationally recognized rural health agenda
and a cadre of rural health researchers. By
encouraging the development of new
multi- disciplinary teams to conduct research in
rural and northern communities.

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• 2. The Solution
• Improve research capacity in rural and northern
• health by creating new interdisciplinary research
  
• This requires long-term investment in capacity
  building
• within the field of rural and northern health
• research by providing the opportunity to train
  new
• investigators and/or students within a multi-
• disciplinary team environment.

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• 3. NET Teams
• Initially consist of 3-6 independent
• investigators
• New investigators are encouraged to join the team
  
• during the first three years.
• At least two initial investigators must have an
• established research record in the field of the
• proposed research, but there is provision in the
• grant for the training of new investigators and
• students.

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• 4. Framed within a National Strategy
• To establish rural and northern health as one of
• the CIHRs first major cross-cutting themes,
• Developing a multi-disciplinary suite of rural
• research topics involving all thirteen CIHR
• Institutes

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• Develop a strong determinants of health approach
• to health research and rural communities.
• This approach must be the core ingredient of a
  health research agenda.
• The sustainability and socio-economic status of
  rural communities is intimately connected to
  health status and health service.
• Ensure that the Canadian Institutes of Health
• Research promotes rural health as a focus of
• research and as a unit of analysis

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• 5. Specific Recommendations
• Clarify definitions of rural /rurality for
  planning and
• delivery of health care.
• Improve access by researchers to rural
  populations
• and improve rural residents access to researchers
• Improve methodologies to incorporate the
• diversity of rural communities, and the
• heterogeneity of rural populations and health
• research issues.

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• Ensure adequate sampling of rural populations in
• national surveys
• Support comparative studies of urban and rural
• populations
• Strategies to organize and access rural research
• funding and rural data
• Increase research on the effectiveness of health
• promotion and prevention strategies in rural areas

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• 6. Specific Questions
• What are the key health issues for optimal
• development of children and youth living in rural
  
• and northern communities and what can be done
• to improve their health status?
• How have transitions in the economic base of
  rural
• and northern communities influenced the health
  of
• females and males across the lifespan? What are
• the health impacts of gender and paid and unpaid
• work-related risks on men and women?

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C) Overview of the Project

• The purpose of this project is to build, support
  and
• sustain research capacity through targeted
  training
• of young and talented investigators, in rural and
  
• northern health research in British Columbia.
• We will accomplish this by conducting a
• conceptually and methodologically integrated
• research program on the impacts of economic
• dislocation and changing community social fabric
• on health in 25 BC resource-dependent
• communities.

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• The project will focus on three domains that
• have traditionally been studied in isolation
• family
• workplace
• quality of civil society in rural communities

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• The research is conducted in two dozen
  communities in the province including
• Tahsis, Port Alberni, Nanaimo, Duncan, Youbou,
  Ladysmith, Chemainus, Powell River, Squamish,
  Williams Lake, Terrace, Ft. St. John, McKenzie,
  Tumbler Ridge, Clearwater, Kamloops, Barrier,.
• We are also beginning comparative work with
  Australian researchers in the state of Victoria

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• The project will use qualitative and
  epidemiological
• methods and is based on several unique data sets
• - census data from 1981 to the present
• - BC sawmill workers cohort
• - cohort of the children of these workers
• - BC Linked Health Database
• - Edudata
• - two waves of the Employment, Security, and
  Community Survey
• -surveys of study communities in 2006 and 2010
• - child and teen cohorts in selected BC
  communities