Healthy People, Healthy Communities: Using the Population Health Approach in Nova Scotia

1
Healthy People, Healthy Communities Using the
Population Health Approach in Nova Scotia

• Presented by Heather Christian
• alPHa OPHA Conference Determining Health Through
  Public Health Action - November 22, 2005

2
Overview

• Goals of the population health approach
• Key elements of population health
• Nova Scotia- what did we do?
• Enablers
• Challenges
• Learnings to pass on

3
Social Determinants of Health

• Aboriginal status
• Early life
• Education
• Employment working conditions
• Food security
• Housing
• Health care services
• Income its distribution
• Social safety net
• Social exclusion
• Unemployment employment security
• (Raphael, 2004)

4
Goals of the Population Health Approach

• To address the broad range of factors that
  determine our health status
• To maintain and improve the health status of the
  entire population or sub- population/reduce
  health disparities
• To use sound evidence about the determinants of
  health and the potential impacts of interventions

5
Key Elements of Population Health( Public Health
Agency of Canada-www.phac-aspc.gc.ca)

• Focus on the health of the populations
• Address the determinants of health and their
  interactions
• Invest upstream
• Base decisions on evidence
• Apply multiple strategies
• Collaborate across levels and sectors
• Employ mechanisms to engage citizens
• Increase accountability for health outcomes

6
What did we do ?

• Enhanced our community partnerships
• Department of Health adopted a population health
  approach in fall of 2001
• Built internal capacity re population health
  approach
• Conferences In-services Presentations
• Key elements of the population health approach
  incorporated into the business planning process

7
Principles of Business Planning (Nova Scotia
Department of Health Business plan 2005-2006)

• Balance the greatest good for the greatest number
  
• Equitable opportunities to achieve positive
  health status outcomes
• Equitable quality of health services
• Evidence and research- based decision making
• Sustain plan for todays and tomorrows needs
• Broad Perspective engages community and
  stakeholders in planning
• Transparency

8
What did we do?

• Job postings in Public Health at the provincial
  and the district levels require staff to possess
  strong skills in population health.
• Orientation and ongoing continuing education for
  all staff in public health has a focus on
  building capacity in the key elements of
  population health.

9
Enablers when using a population health approach

• Strong Leadership leadership within the DOH
  system for the use of a population health
  approach
• Modeling concrete examples of how we have used
  the population health approach in planning,
  implementation and evaluation
• Development of Sexual Health Resource for Youth
• Development of a Framework for Youth Sexual
  Health in Nova Scotia
• Evaluation of Youth Health Centres
• Pre and Postnatal Guidelines
• Diversity and Social Inclusion Initiative
• Health Literacy Awareness Initiative
• Healthy Eating Strategy

10
Healthy Sexuality- Evidence- Target youth-
Invest upstream- Address factors

11
Healthy Sexuality- Multiple strategies-
Collaborate- Increase accountability- Engage
citizens

• Nova Scotia Roundtable on Youth Sexual Health
• Sex? A Healthy Sexuality Resource
• Youth Health Centres
• Sexual Health Coordinator

12
What resources support our work?

• Community Counts (www.gov.ns.ca/communitycounts.ca
  )
• Healthy People Healthy Communities Document
  (www.gov.ns.ca/health/publichealth)
• Community Development Policy/ Lens
  (www.gov.ns.ca/econ/cdpolicy)
• Offices of Acadian, African Nova Scotians,
  Aboriginal Affairs
• Health Promotion Clearing House
  (www.healthpromotionclearinghouse.ca)

13
Keys to Success

• Modeling
• Never relent
• Strong partnerships at all levels
• Government
• Community
• Academia
• Identifying champions

14
Challenges when using a population health
approach

• Beware! People use the language but may not
  comprehend
• Determinants of health ? population health
• Resistance/lack of capacity to move from a
  individual to population based approach

15
Challenges when using a population health
approach

• Belongs to no one, and everyone
• Research on accountability and trust
• Systems are not designed to support collaborative
  action
• Time, time, time patience required
• Health Disparities are hard to think about, and
  it is even more difficult to know what to do
  about them.

16
Learnings to pass on

• Everyone seeing how they can contribute
• Common goals
• Communities telling stories
• Dedicating resources
• Having Strong Leadership

17
Learnings to pass on

• Breaking down silos and taking action
  collectively for the health of the population
• Letting go
• Building Capacity
• Public health
• Other sectors and all levels of government

18
Learnings to pass on

• Working with Community
• Drawing on the tools , research and experience
  of others that are on this journey

19
Words of encouragement

• You really can change the world if you care
  enough - Marion Wright Edelman
• Tell me and I forget show me and I remember
  involve me and I understand    - unknown

20
Questions?
21
Thank You!
Heather Christian Coordinator, Population Health
NS Department Health /Health Promotion
christhe_at_gov.ns.ca