Issuu

UNIT

Health Promotion

CONTENTS

CLASSROOM ACTIVITIES AND DISCUSSIONS..........................................................................3 Critical Thinking...................................................................................................................................... 8 First (refer to text page 11) ........................................................................................................................ 8 Second (refer to text page 26) ................................................................................................................... 9 Third (refer to text page 36) .................................................................................................................... 11 Fourth (refer to text page 39) .................................................................................................................. 11 Fifth (refer to text page 41) ..................................................................................................................... 11 Assess Your Learning ............................................................................................................................ 12 Resource Materials for Teaching........................................................................................................... 14

ANCILLARY MATERIALS ........................................................................................................15 Health Promotion: Getting Started Checklist ........................................................................................ 15 Medicare’s History: In Brief .................................................................................................................. 16 Some Practical Steps in Network Building for Educators ....................................................................... 16

ASSIGNMENT IDEAS .............................................................................................................18 TEST QUESTIONS ..................................................................................................................26 Terms from across Unit 1 ...................................................................................................................... 26 What Is Health? .................................................................................................................................... 28 Social Determinants of Health .............................................................................................................. 28 Canada’s Health Care System ............................................................................................................... 29 Changing Attitudes toward Health Care ................................................................................................ 31 Prevention and Health Promotion ........................................................................................................ 32 1-1

Health Promotion in Early Childhood Learning and Care Programs ....................................................... 34 Health Promotion Action Plan .............................................................................................................. 37 Networking with the Community ......................................................................................................... 39

HERE’S THE ANSWER—WHAT’S THE QUESTION? ...............................................................40

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Classroom Activities and Discussions Here’s the Answer—What’s the Question? (see handout, page 1-36) Divide students into four groups and have each group develop ideas for the three components of health promotion: In a high-density area of the city, hundreds of families are living in several apartment buildings side by side down the street. The park is five blocks away and it doesn’t have any playground equipment for children. •

individual problem solving and self-reliance (suggestions: parent and children walk to the park after supper and brings balls, etc., to use; enroll children in physically active programs before or after school; family moves)

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community action (suggestions: two or three families alternate taking all the children to the park or other facilities; tenants approach the landlord to renovate an empty apartment into an indoor play space and/or develop the rooftop; tenants from the various buildings approach the parks and recreation department, city hall, or a community service club to install playground equipment in the park)

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societal change (suggestions: architects recognize the importance of incorporating physical space outdoors, and perhaps indoors, for children and adults, into the design of apartment buildings; municipal zoning bylaws require a certain amount of park/playground space be allocated to apartment buildings by the number of units or neighbourhood density)

Other topics/issues students could integrate into the health promotion action plan: health promotion; smoking; drinking and driving; TV advertising to children; speeding; increasing adults’ physical activity; violence in society; products over packaging; or any number of environmental issues. For example: You are a family daycare provider with five children under your care. All the children live in your neighbourhood, which has smokestacks from two local factories. Three of the five children have been diagnosed with asthma over the past year. You are concerned about the impact of the environment on their health and want to do something about it. You are aware that four of the issues of greatest concern to children’s health are air pollution, lead, pesticides, and PVCs. Public health agency’s organizational structure: The agency should be able to provide you with a list of various health personnel (with or without names) working in the agency’s office, and the types of services available to programs, parents, children, and families in the community. This information will be useful not only for programs networking with public health on specific issues, but also for referring parents to health services.

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Invite a public health nurse, public health inspector, or nutritionist to come in and describe his or her role with programs in his or her area. Online posts to identify components of the health promotion action plan: Print posts (or view online) related to health issues that are currently appearing in the media. In their discussion of the issue (e.g., pesticides, food engineering, smoking, dangling curtain cords that have resulted in a child’s strangulation, etc.), most articles will include different components of action. The vast majority will at least discuss individual action and societal action (e.g., when a major food manufacturer recalls unsafe meat or the danger of small magnets that can be ingested). A number of media articles identify what consumers should be alerted to in regards to the meats they may have already purchased, and possible symptoms (individual problem solving). Most of these articles include the government’s reaction to this serious and widespread health occurrence, and what legislative changes need to happen to prevent recurrence (societal change). In addition to individual and societal action, there may be some discussion of the community action components of health promotion action; if not, it is interesting to brainstorm possibilities. Using current media information helps students to integrate their understanding of health promotion into “real” life and a way of thinking and acting. Identifying significant social determinants of health in early childhood learning and care (ECLC) programs: •

Download Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings by Best Start Resource Centre (2006) from https://www.beststart.org/resources/hlthy_chld_dev/pdf/hpaction.pdf

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Provide each small group with a program description. Each group will identify the most significant social determinants that their assigned program is promoting and provide rationale for their choices.

Poverty—resources: •

See Resource Materials for Teaching, page 1-14.

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Campaign 2000 produces a yearly report card on child poverty.

Health policies: Bring in (or ask students to bring in) examples of health policies from various ECLC programs (if you believe that the agency name should be anonymous, bring in the health policies with the names removed). In small groups, students work with two or three examples, evaluating the following:

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What seems to be the most obvious purpose(s) of these policies?

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Are the policies family-positive and do they promote family-centred partnerships, or are they written in a way that sounds inflexible?

It may be interesting to compare the same policies and procedures from different programs. You may be able to incorporate a timely local or national health issue into this discussion and its impact on policies (e.g., West Nile, unsafe water supply). Consider if program policy changes were a result based on fact rather than an overreaction to the issue and unrealistic perception of risk (e.g., overuse of gloves for diaper changes, the use of products claiming antibacterial properties). Health Promotion Action Plan Strategies: How Can We Do the Best for Our Children? 10 minutes: Write a specific example, including relevant information such as targeted age group, whether family members are involved, level of community or government if applicable, etc. Member 1: Individual Problem Solving and Self-Reliance _____________________________________________________________________ _____________________________________________________________________ Member 2: Community Action _____________________________________________________________________ _____________________________________________________________________ Member 3: Societal Change _____________________________________________________________________ _____________________________________________________________________ Cultural diversity: •

In small groups, students can share some health practices that they experienced growing up.

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Were these experiences based on particular health beliefs and practices, and where did they originate?

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Some questions that could stimulate this discussion include the following: o How were colds treated? o How were tummyaches treated?

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o Were there particular illnesses that people were embarrassed to talk about? o What were practices that you did at home that were intended to keep you healthy (e.g., not going outside with wet hair)? o What were some beliefs that your grandparents or parents held about keeping healthy, and do you follow these now that you are an adult? Health promotion is the process of enabling people to increase control over and to improve their health. Health promoters include those who work to promote health regardless of professional designation, including people, organizations, and groups from various sectors. After reading this unit, do you recognize the role educators have as health promoters? Health promotion has been discussed in general terms in this unit. The upcoming units focus on specific content areas: occupational health, preventing illness, managing illness, nutrition, safety, healthy active living, preventing child maltreatment, and supporting children’s development. Before you delve into these units, identify at least one specific way educators can be health promoters in each of these areas. After you complete these units, revisit your response to this question and compare it with what you have learned throughout the course. Suggestions: Educators play an important role in the promotion of the children’s healthy development and contribute to the health of the children and their families. Here are a few examples: Units Occupational Health Illness Prevention Illness Management Nutrition Healthy Active Living Safety Promotion Preventing Child Maltreatment Supporting Children’s Development

Examples of the Role of Health Promoter Modelling good lifting practices, which benefits self and coworkers Teaching children how and when to wash hands Communicating your program’s exclusion criteria with parents to ensure the recovery of their child and limit transmission to others Creating a positive eating environment Active involvement and supervision in children’s outdoor play Director and staff stay current on issues around environmental health and safety; regularly monitor the centre for possible environmental hazards Ensuring that behaviour guidance is child-positive and promotes children’s well-being Creating a curriculum that supports the development of children’s learning about self: feelings, rights, and responsibilities

The community centre that houses your ECLC program is offering a community kitchen on Saturday afternoons. All families are welcome. The children will be cared for by paid 1-6

staff while the adults will cook together and bring home enough food for two evening family meals. Use the handout Health Promotion: Getting Started Checklist (page 1-14) as a guide to identify the determinants of health being addressed, and provide an example for how each of the features and values of a health promotion philosophy can be met in this scenario (refer to High-Quality Early Childhood Learning and Care Programs, text page 41). Suggestions: Here are a few examples: In What Areas Are We Taking Action? Determinants of Health Income and Social Status Social Support Networks Personal Health Practices and Coping Skills

How? Having the opportunity to make two meals for each week reduces their weekly food budget. The community kitchen provides opportunities for families to connect and offers mutual support. The community kitchen offers opportunities to increase knowledge of nutrition, understand the Nutrition Facts table on packaging, and gain cooking skills.

Features of Health Promotion Taking Participatory Approaches The community kitchen’s program requires and recognizes each person’s contribution in menu planning, introducing others to favourite recipes and unique fruit and vegetables. Values of Health Promotion Inclusion The community kitchen’s policy ensures that everyone has equal access to the program and necessary resources.

Referring to The Federal and Provincial/Territorial Collaboration to Deliver Medicare (refer to text page 13), have class discussions, either in large or small groups. The discussions can help students clarify their understanding of which roles and responsibilities the levels of government hold: •

In small groups, give students a scrambled list of the roles and responsibilities identified in the text, and ask them to place them under either a provincial or federal role/responsibility.

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Can they identify specific examples of each of the National Principles of Medicare (five) “in action”?

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Can they give examples of the two levels of government working together to ensure that the National Principles of Medicare are met by Canadians?

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Discussion of the workings of transfer payments in your province or territory.

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Discussion of how the roles/responsibilities of the municipal government relate to the delivery of health care.

Discussion about Table 1.2: The Elements of Quality Early Childhood Learning and Care (refer to text page 43). Discussion about Figure 1.3: Groups and Individuals Who Interact with ECLC Programs (refer to text page 55). Can students identify specific examples in their community?

Critical Thinking First (refer to text page 11) Referring to the preceding discussion on the multipronged population health approach and the example of a community’s polluted water, let’s take a look at the ongoing discussion around another issue: harmonizing Canada’s immunization schedule. As you may or may not know, the provincial and territorial governments have responsibility for determining which routine immunizations will be recommended and funded. This results in a patchwork of routine schedules for infants and children, with possible serious health consequences. One example is the hepatitis B vaccine, where provinces and territorial programs vary widely in age of immunization. Some require it to begin at birth, whereas others have it available routinely as late as Grade 7. One major consideration that puts children in Canada at risk for inadequate immunization coverage is the reality that many families move from one province to another annually. Inconsistent immunization schedules result in infants and children missing doses, putting them unnecessarily at risk for certain contagious illnesses (Canadian Paediatric Society, 2018). Consider the following points to develop a population health strategy to harmonize the delivery of vaccines in Canada, which would address inequity and safety problems for children: •

Invest Upstream We have a national immunization schedule, yet the provinces and territories create their own and determine which vaccines are covered by their health plan (see The Federal and Provincial/Territorial Roles and Responsibilities, text page 13).

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Base Decisions on Evidence Science has demonstrated the effectiveness and safety of immunizing children and adults (see Immunization, text page 139). There are parents who choose not to immunize their children. There continue to be claims that immunizations are responsible for causing autism, yet science has proved that this is not true. Would these unfounded claims impact the lobbying effort to harmonize immunization and ensure that as many children’s immunizations as possible are upto-date?

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Apply Multiple Strategies to Act on the Determinants of Health If we were to snap our fingers and all the provinces and territories implemented the national immunization schedule tomorrow, the work still wouldn’t be done. What else would need to be done to support this program? (Examples include reducing the cost of

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vaccines, educating health care providers and the public on the national schedule, and catching up children’s immunizations.) •

Collaborate across Levels and Sectors The National Advisory Committee on Immunization (NACI) consists of a wide range of governmental, public health, and medical representatives. Aside from health care, who else in Canada may join the lobby nationally and locally to move to a harmonized program?

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Employ Mechanisms to Engage Citizens Ultimately, families are responsible for ensuring that their children are immunized. How does your strategy bring families into supporting the harmonization? Does the “one size fits all” approach work when developing educational material for families? If not, what factors do the writers need to keep in the forefront when developing material? (Some examples might be using social media or sending out reminders that a child is due for a vaccine using an automated phone and/or email system.)

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Increased Accountability for Health Outcomes What kind of research and feedback do you think needs to be shared with public health professionals and families as a harmonized program is rolled out and into the future? Suggestions: You may find these resources helpful for the discussion on immunization: •

Canadian Paediatric Society: https://www.cps.ca/en/documents/position/harmonized-immunizationschedule-Canada

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National Advisory Committee on Immunization, Government of Canada: https://www.canada.ca/en/public-health/services/immunization/nationaladvisory-committee-on-immunization-naci.html

Second (refer to text page 26) Serena, a young woman who spends most of her time on social media, sneaks away at work whenever possible and can’t wait for her next break time to check who has responded to her latest tweet or posted on Instagram. As coworkers stop talking to her, and friends only contact her on social media, Serena begins to realize that she has an addiction that has actually resulted in loneliness and isolation, rather than social wellbeing. Serena’s best friend, as well as her siblings, have told her that she doesn’t look or listen to anyone; she just stares at her phone. Her boss just gave Serena a final notice in writing that she will be fired if she doesn’t focus on her work. Give an example of a prevention strategy within a health promotion framework. Which of the social determinants of health could be affected by Serena’s addiction to social media? Suggestions: Serena must recognize the personal impact that her addiction to social media is having on a healthy life. Copyright © 2019 by Nelson Education Ltd.

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She needs to find ways to get support that will help reduce or fully stop this practice that is not only detrimental to her mental and social well-being but also may soon lead to a precarious (unstable) work-life situation. She is in serious danger of losing her job and her social support (family and friends). An example of a prevention goal is to completely stop sending tweets and posting on Instagram, using strategies that will help her focus on much more positive aspects of her life: •

Apologize to her closest friends and family members who are concerned about Serena’s well-being, and negotiate ways she can return to a more positive social life with them without the use of social media. For example, family may ask for Serena’s focus at the dinner table or other get-together opportunities where use of social media is off limits. Friends and coworkers may come up with suggestions to help Serena enjoy other activities, such as a walk with a work partner during the lunch hour or with a friend after dinner. There are many other ways that friends and family may be able to support Serena’s needs to stop her addiction, which will also help to improve her mental and social well-being.

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Ensure that her work ethic improves, including a focus on the responsibilities she has while in the workplace, so that she will not be fired.

When Serena’s goal to end her social media addiction is achieved, she will be on the way to improving her health. As is evident from Serena’s situation, the following social determinants of health could be detrimentally affected if her addiction to social media does not stop: •

Income and social status

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Social support networks

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Personal health practices and coping skills

See other suggestions to deal with social media addictions at

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“Addicted to Social Media?” in Psychology Today by M. D. Griffiths (May 7, 2018) from https://www.psychologytoday.com/ca/blog/inexcess/201805/addicted-social-media

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“6 Questions Help Reveal If You’re Addicted to Social Media” in The Washington Post by M. Griffiths & D. Kuss (April 25, 2018) from https://www.washingtonpost.com/news/theworldpost/wp/2018/04/25/socialmedia-addiction/?noredirect=on&utm_term=.808cbd5af28b

Third (refer to text page 36) For the education and literacy determinant of health, particularly health literacy, give an example of how an early childhood learning and care program can support newcomer families in promoting their health. Refer to the Canadian Paediatric Society’s Caring for Kids New to Canada website. Suggestions: In Section Four: Training & Resources (p. 41) of Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings by Best Start Resource Centre (2013), Early Learning Canada, which supports education and literacy, is summarized. Download from https://www.beststart.org/resources/hlthy_chld_dev/BSRC_HP_Action_June2013.pdf Fourth (refer to text page 39) Your program’s philosophy places a high value on helping children develop independence. However, one family in the program places a high value on interdependence (i.e., a long-term commitment to depending on one another, remaining close to family). How do the staff and parents compromise in the best interest of the child? Suggestions: Depending on the age of the child, different issues may arise. For example: Interdependence infants adult always holds toddlers adult always feeds preschoolers adult dresses child

Independence child encouraged to have more time on the floor child feeds self child tries to dress self

As long as the educators care for the well-being of the child and respect the child’s place in the family, most issues can be negotiated. For an infant—assure the parent that, although the infant won’t be held all the time due to their 1:3 ratio and because of the program’s philosophy, infants will be responded to and will never be left to cry. When an infant is not being held, an effort will be made to provide security and culturally relevant artifacts whenever possible. Younger infants are placed in a swing for short periods, familiar music from the child’s first language is played during floor time, and so on. If conflicts arise, try to negotiate—flexibility is an important role of the program. Fifth (refer to text page 41) Your main responsibility as an educator is to focus on each child’s healthy development and communicate updates with the child’s family on a regular basis. However, you may find that it is challenging for families, especially newcomer families, to focus on these discussions when they are facing immediate issues and problems. Refer to the most applicable social determinants of health to ECLC programs (see text page 27) to identify two relevant determinants that may be at the forefront of family concerns after arriving in Canada. Think of at least one positive, respectful way to support parents in becoming Copyright © 2019 by Nelson Education Ltd.

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more ready to discuss their child’s development with staff (see Growing Up in a New Land: A Guide for Newcomer Parents in the Resource Materials on the Nelson site). Suggestions: Although any of the social determinants of health may be of relevance to newcomer families to Canada, likely the following would be of most concern: •

Income and Social Status

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Education and Literacy

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Culture

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Social Support Networks

For positive, respectful ways to support parents in becoming more ready to discuss their child’s development with educators, we suggest referring to What’s Good for Children: A Multiethnic View (refer to text page 40). In addition, the Best Start Resource Centre has resources that are supportive to 1. Newcomer families with young children, such as Growing Up in a New Land: A Guide for Newcomer Parents: https://www.beststart.org/resources/hlthy_chld_dev/Growing_up_Parents_EN _online_Final.pdf 2. Staff in agencies working with newcomer families, such as Growing Up in a New Land: Strategies for Working with Newcomer Families: https://www.beststart.org/resources/hlthy_chld_dev/growin_up/growing_up_n ew_land_June2013.pdf Note: Although resources in these PDFs mostly include Ontario-based options, these can be substituted with those from your province/territory.

Assess Your Learning Evaluate your options in each situation. 1. Your doctor hands you a prescription. When you ask him what it’s for and whether there are any side effects, he replies, “Don’t worry about it. Just take these pills and you’ll feel better.” Suggestions: The doctor’s comment is a clue that he has a paternalistic view of the physician–patient relationship rather than a partnership; if you don’t feel intimidated and feel comfortable enough, you could respond by saying that you don’t take medication without understanding what it is for, what it can do, and potential side effects; if he doesn’t take the time to answer your questions, ask him who can (i.e., pharmacists); consider changing physicians to one with a patient-centred philosophy; in a community with only one doctor, continue to ask questions, ask the receptionist to book you enough time to talk with the doctor 1-12

during appointments, inform yourself with books, and speak with your community’s public health nurse. Over time, perhaps you and other like-minded patients will change the doctor’s attitude. 2. Classes have been cancelled for the day to allow students to attend a child care rally at the legislature. You are tempted to skip it because you have to study for a test. Suggestions: When you consider the short- and long-term consequences, it should become clear that attending the rally is a better choice. Examples: •

You have the opportunity to see the political process at work and find out where the MLAs stand on the ECLC issue, as their decisions will affect your professional future.

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You will experience first-hand the passion that ECLC advocates bring to the political process and the emotions among all the participants.

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By cancelling classes for the day, the ECLC instructors are making a powerful statement, viewing students’ attendance as a valuable experience, an experience equal to going to class.

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If you skip it and study, you may improve your mark, but in the grand scheme of things, is this the priority? You will have time to study before and after the rally.

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You will be able to participate in the class discussion about the rally.

3. A parent is angry at pickup time because his daughter’s sleeves are damp from water play, even though she was wearing a smock. He believes that this is how someone gets a cold. He asks that his daughter never play at the water table again. Suggestions: Although you know that this is a commonly held myth, the parent is obviously concerned about his child. Acknowledge the parent’s feelings: “I can see that you’re angry about your daughter’s wet sleeves, but she really loves water play.” Negotiate options, such as her changing into a short-sleeved top before water play, or having another top in the cubby to change into if what she is wearing gets wet. If a number of parents hold this myth and others around illness, it would be beneficial to have the public health nurse or an infectious disease expert come in to speak at a parents’ night; be sure to access material written in the parents’ first language. 4. One of the parents of a child in the infant room says she doesn’t know what to do because she gets different messages at every turn. The information in her magazines and what she finds on the Internet differs from what her husband’s family tells her, and that differs from what the educators say and do in the ECLC program. Suggestions: Educators listen to the mother’s concern about mixed messages; mutual respect makes ongoing communication more effective; when parents Copyright © 2019 by Nelson Education Ltd.

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believe they are being heard, they are more open to problem solving; this process can reduce confusion and mixed messages; it may be helpful to recommend resources and keep in mind cultural values and practices. 5. A safety issue arises at the centre. None of the staff can think of a viable response, and you suggest that consulting with another centre may provide options. The director insists, “We can work this out ourselves,” and does not want outside interference. Suggestions: You are placed in an awkward position since you look to the director for guidance yet she or he mistakenly believes that programs should operate completely independently; perhaps this comes from a lack of self-confidence, or concern that staff are usurping the director’s authority, or other directors will think the individual is not an effective director; when concerned about the safety of the children or staff, do your best to communicate the urgency of the situation to the director—for example, “I know you’ve really tried to come up with a solution, but if an injury occurs because of this hazard, the program could be held legally responsible. We must consult with someone else who has experience in this issue”; talk with someone from the program’s board; as a last resort, contact the consultant from the provincial/territorial child care licensing agency.

Resource Materials for Teaching National Collaborating Centre for Determinants of Health’s Resource Library: http://nccdh.ca/resources/library/ Let’s Start a Conversation about Health … and Not Talk about Health Care at All is a video on the social determinants of health that have been adapted to meet the needs of different public health regions in Ontario. The links to the various health regions’ videos are on the website along with a link to their user guide: To download the user guide, visit https://www.youtube.com/watch?v=QboVEEJPNX0 Ontario Health Promotion Resource System. Health Promotion Foundations Course. This series of interactive modules introduces the field of health promotion in Canada. Definitions, concepts, milestones, models, theories, strategies, and more are covered in this self-directed course. Completion certificates are available for each module. To learn more about this free course and how to complete it, visit https://www.publichealthontario.ca/en/LearningAndDevelopment/OnlineLearning/Health Promotion/Pages/default.aspx “Social Determinants of Children’s Health in Canada: Analysis and Implications,” International Journal of Child, Youth and Family Studies (2014) by Dennis Raphael. To view the article, visit http://scholar.google.ca/scholar_url?hl=en&q=http://journals.uvic.ca/index.php/ijcyfs/arti cle/download/12899/3988&sa=X&scisig=AAGBfm3t2hcShQhWaN57NcrF8icHJ7q8g&oi=scholaralrt

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Ancillary Materials Health Promotion: Getting Started Checklist This checklist may help you determine where your program currently practises health promotion and where it might be possible to include or address health promotion more. Use the checklist as a launching point to identify if your program is aware of the determinants of health and the features and values of health promotion. It may help you see what you are already doing and in what areas you may need to take more action. In the last column, you can briefly note what next steps you can take.

Health Promotion

Are We Aware of the Determinants of Health and the Features and Values of Health Promotion? DETERMINANTS OF HEALTH

In What Area Are We Taking Action?

In What Areas Do We Need Strengthening?

What Are the Next Steps to Consider?

Income & Social Status Social Support Networks Employment & Working Conditions Education & Literacy Social Environments Physical Environments Personal Health Practices & Coping Skills Healthy Child Development Biology & Genetic Endowment Health Services Gender Culture FEATURES OF HEALTH PROMOTION Taking a Holistic View of Health Taking Participatory Approaches Building on Strengths Addressing the Determinants of Health Using Multiple, Copyright © 2019 by Nelson Education Ltd.

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Complementary Approaches VALUES OF HEALTH PROMOTION Empowerment Respect Inclusion Social Justice & Equality Source: Best Start: Ontario’s Maternal, Newborn and Early Child Development Resource Centre. (n.d.). Putting Health Promotion into Action: A Resource for Early Learning and Child Care Settings, pp. 46–47. https://www.beststart.org/resources/hlthy_chld_dev/pdf/hpaction.pdf

Medicare’s History: In Brief The Evolution of Canada’s Medicare System 1867

The British North America Act (BNA) proclaimed Canada’s Confederation, which granted provinces jurisdiction over hospitals. Most hospitals were run by voluntary, charitable, or municipal organizations. Those who could afford to pay for services (fee-forservice) did so.

1935–1945

The federal government made two attempts at establishing a national health insurance program, but both attempts failed because the provinces viewed the program as an intrusion on their jurisdiction.

1947

Saskatchewan Premier Tommy Douglas introduced the first hospitalization plan in Canada, for all Saskatchewan residents. British Columbia, Alberta, and Newfoundland and Labrador soon followed with similar plans.

1957–1967

With the passage of the federal Hospital Insurance and Diagnostic Services Act (HIDS) and the Medical Care Act (medicare), respectively, the provinces recognized the advantage of a cost-sharing agreement with the federal government.

1972

All the provinces had now entered into this provincial–federal agreement. Health care for the territories and First Nations and Inuit communities is primarily the responsibility of the federal government. Transfer payments are made to each province, but each plan must comply with the national principles of medicare.

1984

The Canada Health Act abolished extra billing and user charges to ensure that all Canadians had equal access to necessary medical services.

Some Practical Steps in Network Building for Educators To Improve the Status of Early Childhood Learning and Care as a Profession 1-16

Actively participate in your local, provincial, or national early childhood education associations. Improve your own knowledge and skills through continuing education. Lobby for better working conditions and salaries. Demand better resource services. Support improved standards and insist that resources be made available to implement them.

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To Build a Local Network Exchange information with •

parents

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members of your board of directors or • parent advisory committee • coworkers • public health nurses • physicians •

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other health professionals social workers cultural centre representatives suppliers of goods and services politicians teachers

Seek help and advice from a wide variety of sources, such as universities, colleges, religious institutions, and bureaucrats. Make contact with local schools attended by older children and siblings of younger children. Open your centre to students in health care, social service, and education who express an interest in learning about ECLC. Offer your expertise to community groups. Present workshops at early childhood education and other meetings. Share information with other educators and interested professionals. Have open houses at centres. Write articles for local newspapers and professional journals. Invite a broad range of people to sit on your board of directors or parent advisory committee.

Assignment Ideas 1. Contact your public health department:

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Determine available publications and DVDs/videos, and in what language(s).

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Ask for the name of your medical officer of health.

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Inquire about the range of health services provided to programs in your area.

2. What is the range of health care delivery services available (i.e., community-based health centres; physicians who practise complementary medicine) in your community? 3. Divide students into six groups and assign each with one grouping from Figure 1.3 (refer to text page 55) to develop specific examples of those interacting with organizations associated with your ECLC program. Return and share with the class. 4. Health policies: Using copies of policies from ECLC programs (anonymously), have students answer some or all of the following questions (refer to Early Childhood Learning and Care Program Policies, text page 43): •

Does it contribute to quality ECLC?

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Does it outline good practice for educators?

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Is the rationale clearly explained?

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Does it define lines of communication and confidentiality?

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Is it up-to-date with health and ECLC research?

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Could it be revised in any way? If so, make the specific changes and explain how you have improved (i.e., strengthened, clarified, added rationale, updated).

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How would the staff and parents be advised of the change in policy?

5. Debate: “CPS position on Natural Health Products” STUDENTS READ ARTICLE : https://www.cps.ca/en/documents/position/naturalhealth-products (Note: Link available in NELSONstudy, Resource Materials (Unit 1): Printed Matter and Online Resources ) “The use of complementary and alternative medicine (CAM) in Canada has grown exponentially in recent years” – opening sentence in POSITION STATEMENT (Canadian Paediatric Society): “Children and natural health products: What a clinician should know” Copyright © 2019 by Nelson Education Ltd.

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IN CLASS, EITHER FULL CLASS DISCUSSION, OR SMALL GROUPS OF 6 STUDENTS, WITH EITHER 2 DISCUSSING ON EACH SIDE (positive, negative, neutral) OR 3 DISCUSSING ON EITHER POSITIVE OR NEGATIVE SIDE (with some discussion from instructor re: neutral) AN INTRODUCTION TO STUDENTS SHOULD INCLUDE A REMINDER THAT THEY ARE NOT DOCTORS NOR NURSES; THE PURPOSE OF THIS ASSIGNMENT IS TO BRING AWARENESS THAT MANY FAMILIES MAY USE COMPLEMENTARY AND ALTERNATIVE MEDICINE INSTEAD OF OR IN ADDITION TO THEIR FAMILY DOCTOR’S PRESCRIPTIONS OR ADVICE. Educators need to have a nonjudgmental attitude- and avoid lack of sensitivity or concern for the family’s perspective. Additional resource: https://www.caringforkids.cps.ca/handouts/natural_health_products_and_children If instructor wants written work from each group: Blank table with 2 or 3 columns and at least 3 rows with examples of why positive, negative (or neutral), to be handed in with students’ names at the end of the discussion. Positive side

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Negative side

Unsure ( or ‘neutral’)

6. Example:

Positive side

Negative side

Unsure (or ‘neutral’)

Natural Health Products

There is considerable

Findings confirm what

have been used for

variation in the purity and

paediatricians have always

generations. These practices

potency of products, and

known: children are not

thrive within the

contamination is a major

small adults. Children are a

multicultural milieu of North

concern (e.g., heavy metal

special population by virtue

America. Each cultural

poisoning from traditional

of their small size, immature

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heritage is quite aware of

Chinese medicines has been

physiology and ongoing

which plants are poisonous

reported several times)

growth and development

and how to prepare them in a nontoxic manner. Moreover, these cultures have given us many drugs that are currently used (eg, reserpine, digoxin, vincristine) No doubt that these practices will lead to continued discoveries.

7. Health promotion action plan: You may want to combine this major assignment with the English department, which has a couple of advantages: •

Students complete this one assignment for both courses.

•

The ECE and English instructors are able to work collaboratively to give the students more comprehensive feedback.

This assignment provides students with the opportunity to think about a health issue in a way that makes it evident that most health concerns are multifaceted, and to explore the different parties’ perspectives and interests. We would suggest having students complete this assignment near the end of the course, which provides them with the opportunity to revisit the action plan found at the end of all units before they begin this assignment. There are many ways to adapt this assignment, including expanding the topic areas. We have chosen environmental and occupational health and safety topics because we haven’t been able to devote as much classroom time as we would like to these areas. However, there are endless possibilities. Students can make their selection from the list of topics you provide when the assignment is introduced. If students prefer to select a topic not listed, it is advisable to have them seek your approval before they begin to ensure its relevance. Environmental Health and Safety Topics 1-22

People in Canada are becoming increasingly aware of environmental health and safety from a personal perspective, at the community level, and globally. Identify one environmental health and safety issue that may impact upon the health of children, parents, and program staff, and explore how many perspectives this one issue may have. Here are a few examples: •

organic foods

•

hormones in meat and food additives

•

pesticides

•

climate change

•

product packaging

•

safe drinking water/bottled water

•

garbage disposal/waste management (e.g., diapers)

•

lead poisoning

•

air pollution

•

radon levels

Note: the discussion on Environmental Contaminants in Unit 7: Safety Promotion (refer to text page 444) and the Canadian Partnership for Children’s Health and Environment: http://www.healthyenvironmentforkids.ca/ Occupational Health Topics Our workplaces’ physical attributes contribute to our well-being either positively or negatively. The way in which work responsibilities are organized and the style of management, along with the skills and abilities of employees, can have a significant impact on our health. Identify one health issue that is common in ECLC programs and directly affects staff and may indirectly affect the children and families: • • • • • •

physical injuries use of cleaning and sanitizing products infections (e.g., respiratory, gastrointestinal, blood-borne) physical environment educators who are pregnant premenstrual syndrome

• • • • • •

issues for male educators stressors of working with different age groups turnover job advancement salaries access to post-diploma education

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One: Submit a preliminary plan to both instructors, which is due two or three weeks after the assignment is introduced to students. (This ensures that you know that the student is on the right track and you can provide each with your feedback before completing the assignment.) As well, you can allocate a portion of the final mark to this component. This plan includes: •

the key questions about the issue/topic the student has selected. At least one of these questions must deal directly with early childhood education. (Provide students with the following list of general questions, which will help them think about their specific issue.) For example: Questions to think about as you select your issue, conduct your research, and develop the assignment: o How is this issue a problem for you as well as for children, parents, and staff in the program? Put yourself in each of the players’ shoes. o What is currently being done, if anything? If something is being done, how effective is it? What possible alternatives exist, and how will that help? To gain insight and the various viewpoints of each of the players, ask yourself who benefits from each alternative. o How is this issue dealt with from the perspectives of prevention, management, and the promotion of appropriate attitudes and policies by the community, the program you are referring to, the various levels of government, institutions, and society at large? o What, if anything, could the other possible players do? o What approach(es) to health is/are being taken: a medical approach, a behavioural approach, or a socio-environmental approach? o Could this issue be incorporated into health curriculum for children? If so, choose either preschoolers or school-agers and describe.

Two: An annotated bibliography. Include at least 10 sources/references that you will use during the research of this assignment (e.g., academic journals, magazine and newspaper articles, online posts, books, TV programs, DVDs/videos, names of organizations, interviews with key informants, or surveys that you may want to conduct). (Provide students with an example of the style for citations, the bibliography, and direct quotes and explain how to avoid plagiarism. If you are collaborating with the English instructor, ideally both she or he and you can discuss this information with the students and provide them with a handout.) Three: The final assignment: 1-24

a) will be 1200 to 2000 words in length and typed or neatly written (doublespaced) b) will clearly and concretely identify the issue/topic c) will refer to the list of questions you submitted in the preliminary plan d) for each of the three components of the health promotion action plan, will indicate specific suggestions for action e) will include a complete bibliography (add any additional resources used after the preliminary plan was submitted) f) will be submitted to your ECE instructor, and another copy of the assignment to your English instructor 8. Report on a health story in the news. From a newspaper, magazine, or online post, each student selects a story covering a current health issue (at least 600 words in length). You could stipulate that the issue be related to children, but often students more fully understand the components of the Health Promotion Action Plan when using examples that are personally relevant. The following is a suggested grading scheme: Complete the following questions in a report format and bibliography: a) Summarize the article in 200 words or fewer, identifying the health promotion issue and the players. (graded on clarity and relevance to health promotion) Marks: 0, 1, 2, 3 b) Identify and briefly describe two components of the health promotion action plan (i.e., individual, community action, societal change) discussed in the article in 200 words or fewer for each level. (graded on correct identification and clarity of description) Marks: 0, 1, 2, 3, 4 c) For the health promotion action plan component that was not identified in the article, make a specific suggestion for action in 200 words or fewer. (graded on relevance of action to issue and creativity) Marks: 0, 1, 2, 3 9. Social determinants of health: •

Students are instructed to select one of the five social determinants most applicable to ECLC settings (refer to text page 27).

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•

Give a 100- to 200-word introduction describing the determinant.

•

Relate it to one of their practicum placements (approximately 500 words).

10. Cultural diversity: The goal of this group assignment is to have students become familiar with the culturally relevant resources that are available in their community on a variety of health issues. This can include public health information, communitybased health clinics, agencies that serve particular ethnocultures, government services, and immigration services. Have each group of students research and document the materials available, how they are accessed, languages they are available in, and resources that they find on their assigned topic (e.g., infection control, dental health, immunization, nutrition, physical activity, short-term illness, asthma, allergies, etc.).

Test Questions Terms from across Unit 1 For each statement (1–14), fill in the blank with the most correct term from the following list (A–S): A. complementary (or traditional) health practitioner B. cultural safety C. culture D. developmental health E. health F. health policies G. health promotion

H. health promotion action plan I. interprofessional collaboration

N. prevention O. primary health care system P. public health system

J. national principles of medicare

Q. quality of life

K. natural health products

R. social capital

L. networking

S. social determinants

M. population health

1. _____ refers to the degree to which an individual enjoys the important dimensions of her or his life, including the fulfillment of physical and emotional needs, social belonging, and the realization of goals, hopes, and aspirations. (Q. quality of life) 2. _____ is the extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs, and, on the other hand, to change or cope with the environment. (E. health) 3. _____ is the process of enabling people to increase control over and to improve their health. (G. health promotion) 4. _____ A wealth of evidence supports the view that the social, economic, and physical environmental circumstances of individuals and groups are equally or more important to our health status than medical care and personal health 1-26