Public Health Association of BC Public Health Association of BC

Theresa Healy

A story from the north.

I have lived in Northern BC since 1994, when I took up an appointment at UNBC for one year and decided to stay here. Since then I have been so fortunate in working and learning alongside some of the best teachers in community development, healthy community development and health equity from the academic, community and health professional perspectives. I have worked in a variety of communities on a variety of issues always linked to the determinants of health. My PhD focused on gender and social policy and has been the bedrock for my work. I still have adjunct professor status at UNBC in the School of Environmental Planning and teach courses related to community engagement and participation.

My special area of interest and study is Action Research, the kind of research that does more than gather data but supports positive change and improvements in health and heath equity. Research as a public health intervention, if you will. For example, a focus group with Indigenous Fathers, leaving jail clean and sober and trying to turn their lives around talked of the difficulty of getting access and custody from partners still in addictions. By the end of the focus group, we had scripted a TV campaign to encourage Indigenous men to speak up about their health.

For the last ten years I have also worked for Northern Health, the Regional Health Authority in BC the size of France. I began with the Population Health program which, at that time, was only two people. Since then not only has the program itself quadrupled in size, the message of Population Health has been taken up by other two streams of public health (Public Health Protection and Preventative Public Health) but also it has been designated one of the strategic pillars in Northern Health’s Strategic Plan. This commitment to Public Health with a population health lens has been reinforced in the requirement that every manager must have a population health goal in their performance plans. I share this achievement not to claim any credit for this growth and success but speak to the steep learning curve on the challenges facing public health in a northern setting using a Healthy Community approach. For the last two years I have worked with the Indigenous Health program developing curricula for cultural safety training within NHA. We now have a completed curricula, pilot tested, and ready to be implemented, my next task.

An important part of my role is engaging and sustaining safer spaces for residents to be able to take up issues in their community and find ways forward together. This means taking on a role of cheerleader and coach, assisting communities or groups with innovative techniques and well established public participation approaches, methods and processes. My premise is that if we create the right space with the right tools in the right way, with the right people in the room, the right results will emerge. Many of the techniques used are deceptively simple. For example, I have designed a workshop which begins with an opening round questions. One example is the opening round questions might be “What is the most pressing health issue facing this community –and your answer cannot include the word doctor?” The answers, without fail, have generated concise yet comprehensive overviews of local circumstances. Risk factors, Determinants of Health, population groups, strategies, are all complied. By the end of the opening round, there is not just a warmed up group ready to go but also a complex but self-generated environmental scan of the community. The community members present have participated in shared learning process and created a solid body of data on issues and priorities, pertinent to their own community, on which to launch the remainder of the workshop. Sometimes the opening rounds align with what we have in our data – and sometimes they don’t. Accepting the opening “data collection” however, acknowledges local priorities which if not addressed will not garner support or buy in.

Many of these rooms hold a diversity of people, from highly educated to front line workers and including health care practitioners at these tables. Most of these practitioners have long standing relationships in community, are trusted by their community members and are members of the communities themselves. This means there are connections to sound evidence based practice and accurate clinical knowledge embedded in the group as a resource equal to all the other talents and skills at the table.

I tell this story this in some detail because this is the heart of my public health work – to find ways to have members of the public research and learn for themselves, and from each other. This engages people in a way that powerpoint presentations of our undoubtedly important data cannot. Further, given the many pressing demands on community members’ time, any exercise, such as this opening round has more than one objective or outcome.

My special area of interest and study, as you can see, is Participatory Action Research, the kind of research that does more than gather data but supports change and improvements in health and heath equity; research as a public health intervention. I am a hard worker and care passionately about the issues facing Public Health in the 21st century and the Fifth Wave. I hope that you will consider me a useful addition to the PHABC board.