A reflection on a recent set of recommendations to the Ontario Government, regarding changes to policy to help tackle childhood obesity. I like how it talks about many recommendations which seem indirect, such as increase ion minimum wage and alterations to prenatal care support. I particularly agree with the inclusion of a quality, standard food program in our schools. The food I ate in my high school was terrible. Its such a great opportunity to reach out to kids.
On a family new years vacation this year I was reflecting on how to conclude this introduction to our journey to wellness. Just a few days earlier, on 26 December 2004, A vast tsunami had hit Southeast Asia and the news broadcasts were focused on the terrible tragedy. An event like this reminds us once again of our insignificance in the big picture, the overwhelming power of nature and the inability of any man made system to overcome its power. The number of people dead and missing was enormous, and there was little or nothing that money, power or research could do for these people.
The pictures of lives and families being destroyed and interviews with the survivors motivated people in all nations to support one of the largest humanitarian aid programs the world has ever seen, and yet it seems so insignificant compared with the person al loss for which no amount of material giving could compensate.
Yet tsunami-like events sweep across North America every year and we choose to ignore them. They take the lives of hundreds of thousands of people, and we cannot buy, give, or legislate anything that will stop the devastating tidal waves caused by alcohol, illegal drugs, smoking, diabetes, and obesity, among others. The solutions lies within each of us, and society must stop trying to be the saviour and recognize that its role is to support. Rescuing and saving only makes us more dependant victims. we must look to ourselves if we want to stop this death and destruction. The essential challenge is ours to undertake, not society’s.
Canadians are among the luckies people in the world to have a society that is committed to giving all people access to a basic level of health care. But this is only the beginning, and it is time to build on what Tommy Douglas and many others have given us. To continue our journey to wellness, individuals must accept responsibility for what and who we are, learn about our options, define what quality of life we want, make choices, and understand that all any of us can do is the best with that we have to work with.
Perhaps the greatest threat to our Canadian way of life is our obsession with illness care and our refusal to accept the limitations of what money can do to fulfill this obsession. Attempting to buy health by treating illness is beginning to have an overwhelming effect on all social programs. we must accept that if Canadians were to abandon all other social programs and invest every penny of tax revenue into the services we now cover in our universal illness-care system, everyone will eventually get sick and die.
The reality is that there is no universal solution to treating illness or supporting health, because both are ultimately determined by what individuals do for themselves, not what others do for them. We must accept this fact, define the limits of what our publicly-funded health safety net is expected to do to support the health of the people, and live within our means.
What makes this an even greater threat is that the decisions are being left in the hands of politicians, who have not gone through the process of developing a vision for health, and whose primary goal is to get elected. As a senior advisor to Ontario’s Minster of Health once told me, “the vision and leadership for health care reform can come only from the people.”
As a society we must start to inform, empower and support the people. Each of us is mortal. Most Canadians, die sooner because of what they will not do for themselves, rather than what others are not willing to do for them.
The challenge for society is not to create carriers so that all people are treated equally, but to support all people equality so they can all have the opportunity to pursue their highest potentials. There is nothing as a society we can do to make people pursue their highest potential.
The challenge for each of us is to become all we are capable of is personal, and the answer does not lie within a political party, a health provider, or new technology. the ticket for our journey to wellness is inside each one of us!"
— Dr. Vaughan Glover, Chapter 12 of Journey to Wellness (Hushion House 2005)
I’m pretty interested in solving healthcare problems in North America, because we have lots of them. But it’s crazy: there are places on this planet where people die every day because they don’t have access to food and water. In contrast, our problem in North America is that many people have chosen to neglect the healthy food available to them and let their health spiral downhill, leading to chronic diseases which burden our healthcare systems and ultimately lead to death. If you really think about it, our problem can seem pretty selfish; almost pathetic. I have a lot of respect for people who dedicate their lives to helping developing countries.
But that being said, our problem, however selfish and sad it may seem, is still a problem. It’s one that has come naturally from the development of our society, and is a product of the choices (both right and wrong) that we have made along the way. It’s one that, as other populations develop, will most likely encounter as well, and so the experience we gain in solving that problem here will be valuable as other societies catch up.
So the point is, as someone who finds a lot of pride in my passion for solving ‘North American’ problems, it’s important to understand that the degree of the problem is all in context, and that other people will have different views, priorities, places they find are worth the time. But regardless, it’s still a problem, and if it’s what makes you happy, then hell, go for it.
Below is an excerpt from the Dr. Vaughan Glover’s book Journey to Wellness. One of the main points of emphasis of the book is that our perception of our control over and the importance of healthcare is distorted. As a service to us (a very important one, on that note), we have very little sense of empowerment over our healthcare, and this has helped us get to the very expensive and broken system we have today.
To emphasize the point, he proposes something called the ‘Canadian Auto Act’, meant to mimic the restrictions imposed by the Canada Health Act. The injustices become very clear when we take the restrictions and apply them to a context where we feel very empowered - car buying. If you felt as empowered over your ability to choose healthcare as you did over your ability to buy a car, would you be OK with the healthcare system we are in today?
The Canada Auto Act
- There will be a universal car.
- No options will be discussed. No one is entitled to a fancier car than the poorest person can afford or the government is willing or able to provide.
- All carmakers are equal in quality: therefore the same price will be charged for the car, and the government will set the price.
- The price is the same for each far regardless of the car’s comfort, convenience, safety, fuel efficiency or aesthetics; and regardless of the location of the dealership and the time the dealer spends with the client.
- If you get an option for a different level of service and the dealer accepts payment for this option or service, he or she will be fined up to $10,000.
- Although there is only one supposed level of car, wealthy athletes, car dealers, politicians and influential people inside the system can get a better quality car. The only difference is that they don’t pay for it (even though they can afford to pay for it, it is illegal). The result is this select group get the better quality car, but we all pay for this service from our taxes.
- If you are under a certain age, you may be able to buy a longer lasting car, but only if the politicians say so. People over a certain age cannot buy a longer-lasting, better-quality car because statistically they are not join to live as long or require the improved quality.
- If a different political party is elected, one of three things may happen: your choice of car may remain the same, it may be reduced in quality, or you may get a better quality car if the party decides to take money out of educational and social programming.
- If there is an economic downturn, or if interest rates go up on the public debt, the quality of car will dow down (unless the government decides to borrow money from your children to pay for your vehicle, with no obligation to repay the loan.
Some of the relations are a bit abstract if you have not read the book, and note that this is the Author’s opinion, but I think it is very effective in conveying the message that our healthcare system is based off of flawed fundamental regulations, and is in need of serious re-evaluation.
So I’ve become a big proponent of healthy eating. I think it’s a myth that it’s difficult/expensive to eat healthy as a university student. I also think it’s a myth that eating healthy is more difficult than what your normal habits would be.
I’ve decided to start posting photos of some of my meals, hopefully to inspire others to eat healthy, otherwise to share recipes with others who are interested.
Left is breakfast: granola and blueberries (3/4 blueberries, 1/4 granola), with banana pieces, hemp hearts and flax seeds, in almond milk.
Right is lunch: baby spinach and arugula with blueberries, grapes, hemp hearts, and raspberry vinaigrette.
It took about 10 minutes to make both of them, which is shorter than it has taken me to take the photo, edit it, write this description and publish it. This is why I need Instagram.
The link is to a Wall Street Journal article talking about how a new US study shows that healthy food is actually cheaper than junk food, when more than just calories are considered per price amount. I’m glad information like this is getting through. Personally, I’ve found this to be true. When you learn to eat healthy in a smart way, it becomes very inexpensive to feed yourself on fruit and vegetables! Check out the article, definitely worth the read.
The Institute for Clinical Evaluative Sciences just published a report titled Regional Measures of Diabetes Burden in Ontario (title link), which ended up on the front page of The Toronto Star’s GTA section.
The report shows shows the correlation between Diabetes and demographic location, which is thus related to the ethnic populations in that region (this is also quite thoroughly discussed in the Toronto Star article).
First, looking at the Ontario-wide breakdown we see increased Diabetes throughout Northern Ontario, which speaks to the unfortunate difficulties that our native population is having with their health. Note that Diabetes (type 2, which accounts for 95% of cases) is strongly correlated with obesity and poor lifestyle habits.
Then, if we look at the Toronto and GTA breakdown (sections 7 & 8 respectively), we see vast differences in diabetes incidences by ‘region’. It is well known that although Toronto is extremely diverse as a whole, there are strong ethnic groupings by region, particularly in the GTA. High diabetes ratings can often be related to the ethnic background of the population within that region. Medically, some ethnicities are more ‘gentically pre-disposed’ to being affected by Diabetes, based on the body’s tendency to store fat, etc. Personally, I think the large cultral differences associated with the ethnic breakdowns in regions are much more interesting. Culture affects lifestyle, which affects habits and choices, which affects health, which affects Diabetes.
As someone interested in applying technology to solve problems like this (chronic disease pandemics), these maps are a good reminder of the complexity of large-scale consumer health solutions. Cultural and genetic differences in people can completely invalidate solutions that work for the people right next door. Solutions must be able to adapt to these factors that fundamentally affect how and why people live, and provide the appropriate tools that accommodate these pre-dispositions. Only when this happens will a solution be able to deliver effective health awareness and habit change on a scale large enough to help slow the chronic disease pandemic we are currently seeing.
I’m currently just wrapping up a four-month work term at NexJ Systems Inc in Toronto. I’m a Product Manager co-op on the healthcare team. Essentially, we design enterprise software (software for hospitals, clinics, etc.) that helps both providers and patients better manage their health.
A project which I’ve taken strong interest to and have worked on at NexJ was recently released publicly, so I thought I’d share and simultaneously give some insight into why I think what I do is so awesome.
We’re currently working on implementing an electronic version of the Passport To Trust program. Passport To Trust is a tool developed by the Beth Israel Deaconess Medical Center (a Harvard Medical School affiliate) aimed at encouraging patient-provider interaction and understanding, while lowering the barriers to health.
The philosophy of the program is simple: the provider structures and writes down the information that’s given to the patient according to a template that looks like this, and the patient can take that template home with them. Many people forget most of the information they’re told in a visit within a few minutes of leaving. By writing it down, patients retain and can refer to that information. Patients can also reflect upon it as they carry out their treatment, and bring new questions/insight back. It is astounding to see the impact which this simple process has had on a patient’s level of satisfaction with the level of care received.
Long story short, at NexJ we’re digitizing the process. It’s been very motivating working on a project with the potential to have such a profound impact on a patient’s quality of care.
Here links to the press release and another article written up about the project, which might help you get a better understanding of what we’re doing, if you’re interested:
So, what’s the ‘so what’? Have you ever felt dissatisfied with the level of information or explanation you received from a doctor’s visit? Ever left feeling a bit confused as to what you were diagnosed with, and you’re taking, and why you’re taking it? I have. First, understand that your dissatisfaction is real: I personally would just shrug it off as a personal issue or a fact of life. Not understanding your doctor’s visit is a pretty bad thing. Second, do your part to help change that. The Passport To Trust Template is a great way of structuring your visit, and organizes the information you have to cover and need to know, very well. Print one off, and use it as a reference for what info you need to communicate to your provider, and what information you expect to get back. Better yet, just print one, bring it with you, and fill it in as you go! Patient awareness, initiative, and demand for excellence will be major factors in redefining western healthcare systems. Help us take the first step.
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