Health equity integrated into organizational practice and community engagement
Guest blogger: Vittoria Vecchiarelli, CPHI(C)
Senior Public Health Inspector, Health Protection Division
Regional Municipality of York
Looking back at the last 10 years I have worked in the field of environmental health, the most memorable and rewarding career moments all involved connecting with the public, educating others and effecting change. These are the moments that inspire me and motivate me to continue my career in public health.
Education and enforcement of the Health Protection and Promotion Act (HPPA) and its regulations come with its challenges because of the diverse population we serve including varied cultural backgrounds, language, literacy, education level, and socioeconomic status. These are the social determinants of health (SDOH) and health equity barriers that operators and clients may be faced with when trying to understand and comply with regulations. Ad hoc solutions in the field such as using translated education materials, using staff members/family members as translators, finding low cost solutions and prioritizing compliance timelines for changes that need to be made are some suggestions. By working through these challenges and barriers I find ways to connect and gain trust from the operators.
Having organizational and managerial support to address SDOH is important to motivate and encourage staff to integrate health equity into everyday practice. York Region Public Health created a Health Equity Program that facilitates a Health Equity Champions’ Network, including representation from all departments and various public health disciplines, including PHIs. As a result of staff need and interest, the Health Protection Division also formed its own Health Equity Committee which aims to integrate a health equity lens into environmental public health practice. I jumped at the chance to be part of this! I am really excited to start working on the Committee’s first project - adapting our Food Handler Certification Program for individuals with intellectual disabilities. We collaborated with two nurses from the Health Equity Program in the planning process using the Health Equity Impact Assessment (HEIA) tool. The project strives to impact participants’ lives in a positive way in addition to the achievement of food handler certification by providing the opportunity for employment in the food industry, interacting socially with peers, and enhancing independent living skills.
As I take a greater interest in health equity I find myself asking: How can our role as a PHI address SDOH and health equity in the world of mandated, regulatory, continuous quality improvement and disclosure programs? Can programs and services move beyond traditional campaigns and health promotion? Can we evaluate more than counting the number of brochures and people attending a service or conducting client satisfaction surveys? Does our evaluation seek to answer “Did we make a difference?” or “Is anyone better off?”
In a recent initiative called Clean Air at Home, we collaborated with social housing tenants, York Region’s Housing Services branch and community partners to plan and deliver a campaign to address indoor air quality issues within social housing communities. The purpose was to reduce exposures to environmental contaminants among children 0 – 6 years of age from low-income families. Social housing tenants acted as Clean Air at Home “community champions” and assisted with the planning, implementation and evaluation of the campaign. Community engagement objectives included engaging tenants to collaborate and lead campaign activities, working collaboratively with building support staff to implement the campaign, and supporting increased confidence, skills, relationship building, and trust among tenants. The community champions provided valuable feedback, ideas and opinions during the on-site meetings held throughout the different stages of campaign planning and implementation; this provided them an opportunity to build skills in teamwork, event planning, communication and meeting facilitation. They were also provided opportunities to attend York Region skill-building workshops at no-cost. At an event attended by York Region’s Medical Officer of Health (MOH) and management representatives from Public Health and Housing Services, the community champions were recognized by being presented with a signed Certificate of Recognition. The champions offered heartfelt testimonies about their experiences, including, “what I enjoyed most … was the opportunity to bring a sense of community back into the housing complexes”, and “I enjoyed the opportunity to share my ideas/opinions and feeling heard’.
An evaluation of the Clean Air at Home campaign is currently underway, and preliminary results show that the campaign was successful. But I believe that we helped this group of tenants to gain valuable skills that will support them, their families, and their community. The relationships and partnerships developed with our housing and community partners, and the community champions are the real success story!
In the area of environmental public health, I believe that PHIs, along with other public health professionals can play a significant role in addressing health equity issues in their communities. We can start with organizational and inter-agency support and resources and rethinking traditional health promotion campaign methods. Let’s share our stories and successes.
We would like to hear from you! What experiences have you had in addressing the SDH and health equity in your environmental health practice? Please send your stories to Dianne Oickle, Knowledge Translation Specialist and help us share your practice stories. Our colleague Karen Rideout at the National Collaborating Centre for Environmental Health (NCCEH) will be continuing to collect stories from health protection or PHIs/EHOs who have taken action on SDH or health equity through their work. She would love to hear from you too!
Please visit the NCCDH Resource Library for related materials, including:
- A guide to community engagement frameworks for action on the social determinants of health and health equity
- A conceptual framework of organizational capacity for public health equity action (OC-PHEA)
- Review summary: Community engagement to reduce inequalities in health
- The path taken: Developing organizational capacity for improving health equity in four Ontario health units