Island Health: An opportunity to study civic leaders' perceptions of their impact on community health

I recently completed a University of Victoria, Master of Public Health (MPH) practicum with Island Health. My practicum supervisor, Dr. Paul Hasselback, a local Medical Health Officer, and my academic supervisors Dr. Catherine Worthington and Dr. Michael Hayes collaborated to provide me a challenging and valuable learning experience.

Relationships between the population of the region, civic leaders and the health authority impact the social determinants of health. My research was focused on one aspect of the relationship between Island Health and Cowichan civic leaders. Specifically, I wanted to understand how civic leaders viewed their role in affecting health. I was also curious how they viewed the relationship between themselves and Island Health given a recent history of change and challenges. My decision to proceed with the research project was grounded in my commitment to: 1) research community needs from a public health perspective and 2) understand how to improve the health of our population on Vancouver Island. I wanted to acquire skills and knowledge during the execution of the research, which would be useful to my ongoing work on supporting families with infants and young children.

I followed five steps to define and refine the practicum and the research.

1. Chose a topic. I contacted Dr. Hasselback well before the beginning of the practicum as the topic I was most interested in would fit well with his background and area of responsibility.
2. Articulated the purpose of the study. The intent was to look specifically at the relationship as it existed at a single point of time in Local Health Areas 65, 66 and 67; the geographic region of the Cowichan Valley Regional District.
3. Prepared a research proposal and obtained ethics approval. The University of Victoria/Vancouver Island Joint Ethics Sub-Committee approved my proposal in mid-February. The ethics team at Island Health provided valuable assistance in answering the clarifying questions, locating support, and generally ensuring timely approval.
4. Recruited participants, collected and analyzed data, and wrote a report. Within 2 weeks of receiving ethics approval, I had arranged and conducted two focus groups to gather information. The results were collated and the report prepared in the following 6 weeks.
5. Disseminated findings to key stakeholders. I shared my report with participants, with Dr. Hasselback, Island Health and at a culminating MPH program conference at University of Victoria.

There were five predominant themes that emerged from the research:

1. Knowledge levels about the social determinants of health and civic leadership. The participants expressed sophisticated level of knowledge about the social determinants of health, although not all participants were familiar with the specific language.
2. The downloading of responsibility. The participants expressed considerable concern and frustration at what they perceived as a change in local civic responsibilities without a commensurate increase in funding.
3. A request for education. All participants expressed a desire for increased education and knowledge-sharing opportunities.
4. A desire for increased collaboration. There was a unanimous appeal for increased collaboration between the health authority and the civic leadership.
5. Improved communication. The participants were frustrated by a lack of timely or useful communication between local government and Island Health.

I had an extraordinary research experience, however it is not possible to for me to know how this research has impacted the actions of either Island Health or the civic leadership.