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The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. Through CIHR, the Government of Canada invested approximately $45.9 million in 2005-06 in research on population health issues across Canada.
- Population health research takes a broad approach to understanding the fundamental determinants of human health at the individual, community and societal levels. Population health research focuses on protecting populations from hazards in the environment; preventing disease; and promoting health.
- Factors such as income and social status, education and literacy, employment, social support networks and social and physical environments are important determinants of health at the population level.
- Here are some examples of how these determinants can affect health:
- Low birth weight infants are at increased risk for developing many diseases later in life, as well as for delays in development. Low birth weight children from privileged backgrounds, however, still have a developmental advantage over normal birth weight children from under-privileged backgrounds.
- Smoking, obesity, high stress, low household income and low sense of community belonging all have significant negative effects on health status.
- Recent immigrants from non-European countries were twice as likely as the Canadian-born to report deterioration in their health over an eight-year period (1994/95-2002/03), according to the National Population Health Survey, despite the fact they are generally in better health than the Canadian-born population when they arrive in Canada.
- Families whose members are better-educated and have higher incomes eat a diet closer to nutritional guidelines than those with less education and lower incomes. Inadequate diet is linked to the development of many diseases.
- Individuals who lack control over their work environment are more likely to develop and die from cardiovascular disease.
Research Promoting the Health of Populations
- Air pollution sends poorer children to hospital with asthma more often than it does children from more affluent homes, according to research by CIHR-funded investigators including Dr. Yue Chen of the University of Ottawa. The team was examining the effect of gaseous air pollutants such as carbon monoxide, sulphur dioxide, nitrogen dioxide and ozone. Exposure to nitrogen dioxide was most harmful to boys in low socio-economic groups, while sulphur dioxide was most harmful for girls from this group. The risk of asthma is higher for people from low socio-economic backgrounds.
- Increasing the share of income to the poorest half of households in metropolitan areas (MAs) in Canada, Australia, Great Britain, Sweden and the United States by one per cent can result in a decrease in working-age (25-64) mortality of more than 21 deaths per 100,000 people, according to research by CIHR-funded researcher Nancy Ross of McGill University. Her study found a significant relationship between inequality and mortality, however, only in MAs in the United States and Great Britain, the countries with the highest average levels of income inequality and the largest populations of the countries studied. The research suggests that the more egalitarian countries of Canada, Australia and Sweden buffer the hypothetical effects of income inequality as a determinant of population health in industrialized countries.
- As part of a CIHR-funded survey, University of Victoria sociologist Mikael Jansson has been studying the homeless youth population in Victoria, B.C. The most common reason for living on the street is family instability, the survey found. Almost all participants reported earning money by selling drugs; most also use drugs on a weekly basis, with 75% reporting using marijuana, 45% drinking alcohol and 20% using crystal meth. Only 7% had a paying job and, while most wanted a job, lack of an address, a phone and work clothing stood in their way. The project also highlighted the inherent challenges of research involving hard-to-reach or hidden populations. Dr. Jansson and his team have followed many of the youth over the past five years, and hope to continue for another five years.
- Living in resource-reliant rural communities is good for your health, according to residents of two such communities in Alberta. Dr. Judith Kulig of the University of Lethbridge studied the two communities, together with a third, urban community, to determine what makes communities resilient and whether there is a link between resiliency and health status. Participants in the study perceived their rural communities as healthy and believed that living in their communities enhanced their health. Social interactions were seen as essential to health, although participants also expressed concerns about environmental health issues.
- Eradicating extreme poverty is one of the United Nations' eight Millennium Development Goals. A CIHR-funded project led by Dr. Theresa Gyorkos of McGill University and Dr. Martin Casapia of the Asociación Civil Selva Amazónica and Universidad Nacional de la Amazonía Peruana has developed a list of the top ten issues of health importance to a small, poverty-stricken community in Peru, including infant malnutrition, adolescent pregnancy, anemia, parasite infections, and lack of basic sanitation. The team, working with community members, has also developed health, nutrition and education interventions to help improve health and, ultimately, reduce poverty. Dr. Gyorkos has now received five-year funding from CIHR to implement and evaluate selected interventions to address the priorities.
In the Pipeline...
Designing Effective Interventions
How can cohesion and friendliness in neighbourhoods affect people's health? And how can you maximize factors that improve health? CIHR-funded researcher Dr. Penny Hawe of the University of Calgary is leading an international effort that focuses on the impact of social and physical environments on health. One of the first projects is focused on improving the social environments in high schools. Research from the World Health Organization has shown that alienation from school is the biggest predictor of health risks for youth, such as smoking, drinking or drug use.
Dr. Jean Shoveller - Passionate About Youth
Youth sexual health has usually been approached from the perspective of individuals' risky behaviour. But Dr. Jean Shoveller, an Associate Professor in the University of British Columbia's Department of Health Care and Epidemiology and a Scholar with the Michael Smith Foundation for Health Research, is taking a broader approach - and building key partnerships to turn her research into better health for youth.
"I'm more interested in understanding and addressing the structural factors that put young people at risk," she says. "We need to see more progress in this area. Young people deserve to have the opportunity to have positive experiences in relation to sexual health."
Much of her recent work has centred on understanding the experiences of young mothers in Prince George, British Columbia, in trying to continue their education, find adequate housing and employment, and enhance their parenting skills. Her partnerships with the Prince George School Board, teachers, social workers, the Northern Health Authority and, especially, the young mothers themselves have resulted in slow but steady progress in developing more and better options. She credits the commitment of community partners.
"They live it every day. What they do takes much more courage than being a researcher," she says.
Dr. Shoveller was recently awarded a CIHR Interdisciplinary Capacity Enhancement Team grant focusing on the impact of gender, culture and place on youth sexual health disparities in rural and northern communities - investigating how to transform structural forces in order to improve youth health and social well-being.
She also is excited about a pilot project funded by CIHR that is engaging youth as research partners, not merely the subjects of the research. The project is developing tools to enable youth to set directions for and carry out research addressing the social determinants of sexual health disparities. The youth co-researchers will gain valuable skills through their participation, as well as academic credit from the Prince George School Board.
"It is about young people being up front, in the driver's seat with us. This is necessary for making progress in this area."
The CIHR Institute
What makes some people healthy while others suffer from disease or disability? The reasons can vary, from biological to cultural to social to environmental. CIHR's Institute of Population and Public Health is studying these factors as the basis for sound programs, preventive practices and healthy public policies that will improve the health of people in Canada and around the world.
The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian healthcare system. Composed of 13 Institutes, CIHR provides leadership and support to more than 10,000 health researchers and trainees across Canada.
Canadian Institutes of Health Research
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