It turns out that the more advantaged our lives are, the longer we live and the healthier we are from birth to old age. Is this right? Correct, yes. Right, not so much.
In our health region we have significant disparities in health outcomes that are not simply explained by income or poor personal choices. Though it would be so much easier if it were, the fact is that a number of factors come together to determine a person's health over a lifetime.
The health of a community is determined by factors like the social, economic and physical environments in which we live, our personal health practices, nutrition and physical activity, our development during early childhood, and our access to quality health services. These are the social determinants of health we have often discussed, and they are the basis for a population health approach.
The Vancouver Coastal Health (VCH) region is one of the healthiest in Canada, yet there are worrying disparities. To identify these and to devise strategies for improving the overall health of the region, VCH has established a population health team. A report published in 2008 sets out the challenges faced, and links strategies for dealing with them.
But if we are such a healthy region, why would this matter? Because not everyone experiences the same health outcomes. The disparities are clearly reflected in varying life expectancy depending on which part of the region you live. In particular, consider that in some areas of VCH people expect to live, on average, ten years longer than in other areas! Specifically, life expectancy in Richmond is 84.81 years. In South Vancouver, it is 83.45 years. Howe Sound/Sunshine Coast, 81.03; Powell River, 79.09; downtown eastside: 75.01 years. The average for all of BC is almost 81 years and for VCH, 82.4.
The VCH Population Health report sets out three priority areas: child and family poverty, early child development, and food security.
In support of the first two priorities, VCH is focussing on raising awareness and advocacy. They are working with the BC Health Officer's Council and community partners to make people more aware of the health impacts of child and family poverty and are working to advocate for healthy public policies. Surveillance includes monitoring school readiness of children across the region and helping by creating programming in support of that goal. Partnerships and expanding relationships in the community are part of this plan, all in the interest of children's development.
Food security is the third priority expressed in the report. Described as the situation in which all community residents obtain a safe, nutritious diet through a sustainable food system. Food security embraces the full range of food chain activities from agriculture to processing and distribution to nutrition and public policy.
Since much of the work on food security is done locally, VCH is supporting communities doing the work, including helping with resources, leadership and advocacy. VCH is also helping to build the case for food security with education, research and partnerships.
Population health is about whole communities, but in the end, it is about individuals, too. If we can improve the global health of the region, it also means that more people are benefiting. To learn more about the VCH Population Health Report, go online to www.vch.ca/population.
Dr. Paul Martiquet is the Medical Health Officer for the Sea to Sky.