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  • Social Determinants of Health and Health Equity for Children:

    Developing a lesson plan in Sudbury

    Genevive Projean, Social Determinants of Health Public Health Nurse

    Dana Wilson, Health Equity Manager

    March 22, 2018

  • DISCLOSURE OF COMMERCIAL SUPPORT

    None of the presenters at this session have received financial support or in-kind support from a commercial sponsor.

    None of the presenters have potential conflicts of interest to declare.

  • Presentation Outline

    Awareness of the Social Determinants of Health

    Health Equity Communications

    Development of Lesson Plan Pilot Study

    Partnership with Laurentian Universitys Faculty of Education

  • Awareness of the Social Determinants of Health

  • Importance of the Social Determinants of Health Core social and economic factors that influence the

    health of individuals and communities

    Influence the extent to which a person possesses the physical, social, and personal resources to identify and achieve personal aspirations, satisfy needs, and cope with the environment (Raphael, 2016, p.3)

    Public Health Agency of Canada (2011) recognizes 12 key determinants

  • Evidence from Sudbury and Area

  • Related Evidence in Ontario

    Kenney and Moore (2013), in a study of secondary school aged youth in Kingston, Ontario revealed a similar trend, with lifestyle choices most commonly associated with health.

    Shankardass, Lofters, Kirst, & Quinonez (2012) found that 53-64% of Ontarians were aware of health inequalities based upon income.

  • Ontario Public Health Standards - Health EquityFour requirements:

    1. Assess and report

    2. Modify and orient interventions to decrease health inequities

    3. Engage in community and multi-sectoral collaboration with LHIN(s) and other relevant stakeholders

    4. Lead, support, and participate

  • Mandated Health Equity Standard Program Outcomes:

    That the general public, Local Health Integration Networks (LHINs), and other partners have:

    Increased awareness of local health inequities

    Increased awareness of the causes of health inequities

    Increased support (by everyone) for actions that decrease health inequities

  • Public Health Sudbury & Districts Health Equity Communications

  • Short-term Outcomes Intermediate Outcomes Long-term Outcomes

    Increased community

    readiness for health

    equity action

    awareness of SDOH

    and their impact on health

    awareness of local

    inequities in health and

    wealth

    awareness of realities

    of priority populations

    Increased community

    capacity for health

    equity action

    engagement with

    community partners to

    identify health equity

    actions

    collaboration with

    community partners and

    the public in taking

    health equity actions

    Increased health equity

    action

    equity focused

    decision making and civic

    engagement

    participation in

    compassionate activities

    and community

    involvement

    health equity

  • Communication Initiatives

  • Youth Taking Action on Health Equity

  • Development of Lesson Plan

    Established partnership with Laurentian Universitys Faculty of Education to pilot lesson plan materials with education students during their school placements in elementary schools

    Our Heath Equity Team developed a three-module lesson plan for junior elementary school students (grades 4-6)

  • Development of Lesson Plan

    Reviewed key Ministry of Education documents: Ontarios Well-Being Strategy for Education Discussion Document

    Well-being in Our Schools, Strength in our Society Engagement Paper

    Achieving Excellence: A Renewed Vision for Education in Ontario

    Ontarios Education Equity Action Plan

    Foundations for a Healthy School

    Incorporated / adapted materials from Grade 5 Puzzle activity

    Saskatoon Health Region

    Public Health Nutritious Food Basket data 2016

    Legislative Assembly of Ontario, Discovery Portal

  • Lesson Plan Goals

    1. Create awareness among students and adult influencers (i.e., education students) about the social determinants of health and health equity

    2. Encourage students to identify possible actions or solutions in their communities that can promote health equity

  • Lesson Plan Document Includes:

    Background Information for Teacher Candidates Low Awareness about the Social

    Determinants of Health Alignment with the Ministry of Education Sensitivity of Materials

    Curriculum Expectations

    Lesson Plans Health and Poverty The Social Determinants of Health

    and Health Equity Health Equity in Action

  • Activity C: Introducing Poverty and Budget Exercise

  • Activity J: Puzzle Activity on Health Equity Action

    First puzzle piece: One thing you can do tomorrow to make a difference in our community

    Second puzzle piece: One thing you can do next monthto make a difference

    Third puzzle piece: One thing you can do in the next yearto make a difference (Activity L)

  • Sensitivity of Materials

    Highly likely that education students will encounter children living in poverty during their placements and future careers

    Education students needs to be aware of the potential impacts lesson plan may have on students living in poverty since they will have firsthand experience with these issues

  • Current Status of Pilot Study

    64 education students were introduced to project during their regularly scheduled courses in October 2017

    Can use any/all of the 13 turnkey activities during their in-school placements

    Evaluation includes voluntary online survey and option of focus group interview

  • Next Steps

    Identify opportunities to continue piloting the lesson plan with the education students

    Identify opportunities for future collaboration and/or piloting of materials with our four local school boards in Sudbury

    Explore the possibility of translating the lesson plan in French

  • Conclusion New mandate for public health to focus on awareness

    of the social determinants of health and health inequities among public, LHINs, partners

    Local and provincial challenges of raising awareness

    Children and youth are a key target and are our future leaders

    Collaboration with key sectors is essential (e.g., Post-secondary institutions, local school boards, Ministry of Education)

  • References Institute for Social Research, York University. (2013). 2013 RRFSS cycles 13-15 (Jan-Dec), combined data from: Simcoe

    Muskoka District; Haliburton, Kawartha, Pine Ridge; Niagara Region; Middlesex-London; York Region; Sudbury District; Halton Region, Hamilton; Grey Bruce; Lambton; Leeds, Grenville and Lanark; Chatham-Kent & 2013 RRFSS cycles 14-15 (May-Dec), combined data from Durham Region and Brant.

    Kenney, K. & Moore, S. (2013). Canadian Adolescent perceptions and knowledge about the social determinants of health: an observational study of Kingston, Ontario youth. Biomed Central Public Health, 13:781.

    Ministry of Education. (2014). Achieving Excellence-A Renewed Vision for Education in Ontario. [published 2014; cited August 24 2017]. Available from: http://www.edu.gov.on.ca/eng/about/renewedVision.pdf

    Ministry of Education. Foundations for a Healthy School Promoting well-being is part of Ontarios Achieving Excellence vision. [published 2014; cited July 17 2017]. Available from http://www.edu.gov.on.ca/eng/healthyschools/resourceF4HS.pdf

    Ministry of Education. (2017). Ontarios Education Equity Action Plan. [published September 2017; cited September 12 2017]. Available from: http://www.edu.gov.on.ca/eng/about/education_equity_plan_en.pdf

    Ministry of Education. Ontarios Well-Being Strategy for Education Discussion Document [published May 2016; cited July 17 2017]. Available from http://www.edu.gov.on.ca/eng/about/WBDiscussionDocument.pdf

    Ministry of Education. Well-Being in Our Schools, Strength in Our Society Engagement Paper [published 2016; cited August 24 2017]. Available from http://www.edu.gov.on.ca/eng/about/wellbeingpdfs_nov2016e/wellbeing_engagement_e.pdf

    Ministry of Health and Long-term Care. (2017). Ontario Public Health Standards: Requirements for programs, services, and accountability.

    http://www.edu.gov.on.ca/eng/about/renewedVision.pdfhttp://www.edu.gov.on.ca/eng/healthyschools/resourceF4HS.pdfhttp://www.edu.gov.on.ca/eng/about/education_equity_plan_en.pdfhttp://www.edu.gov.on.ca/eng/about/WBDiscussionDocument.pdfhttp://www.edu.gov.on.ca/eng/about/wellbeingpdfs_nov2016e/wellbeing_engagement_e.pdf

  • References National Collaborating Centre for Determinants of Health. (2013). Lets Talk: Public health roles for improving

    health equity. Retrieved from: http://nccdh.ca/images/uploads/PHR_EN_Final.pdf

    Public Health Agency of Canada. (2011). What determines Health. Retrieved from: https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html

    Raphael, D. (2016). Social Determinants of Health, 3rd ed. Toronto: Canadian Scholars Press Inc.

    Raphael, D. & Sayani, A. (2017). Assuming policy Responsibility for health equity: Local public health action in Ontario, Canada. Health Promotion International, 1-12.

    Shankardass, K., Lofters, A., Kirst, M., & Quinonez, C. (2012). Public awareness of income-related health inequalities in Ontario, Canada. International J

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