Public Health Intervention Program On Active Transportation (AT) And Mental Health In Canada

Benefits of Active Transportation (AT)

Discuss about the Public health intervention program on active transportation (AT) in Canada.

Active transportation (AT) as a form of public health promotion program involves the defined mode of transportation such as walking, cycling, and public transit (Saidla, 2017). Active transport has quite a number of measurable public health benefits attributed to it such as reduced risk of cardiovascular disease, obesity and diabetic among other chronic conditions as suggested by (Macridis et al., 2016). At the same time, there are environmental benefits including reduction in carbon dioxide emission which translates to reduced Air pollution and ease of traffic congestion. For example, in Canada research findings have established high physical inactivity as a result of a low number of individuals walking and cycling in communities as compared to use of the automobile as means of transport according to (Parkin et al., 2008).

World health organization classifies AT as healthy public polies (WHO, 2015), the same has been classified as health in all polies in Finland as suggested by (Chan, 2013). Such approaches have been taken to provide solutions to health determinants by focusing on clear considerations of health effects of strategies that are not regularly found within the health sector. According to (Newman et al., 2015), social determinants that are focusing on health advocacy have experience challenges to have their approvals rendered into the real implementable policies. Some of this challenges have been attributed to the fact that most of the researchers involved in the policy formulation are all from the health sector with little grasp on the public policy. Recommendation from different quarters has suggested that political scientists are involved in such policy formulation due to their knowledge of the theoretical framework as suggested (Bernier and Clavier 2011). For example, Advocacy Coalition Framework (ACF) has been recommended as the best approach to use for the analysis of social determinant-based health policies (SDH). ACF has been successfully used in mental health intervention related policies and tobacco control policies as suggested by (Swigger and Heinmiller, 2014).

The government Canada and non-government organization supported the active transportation as a way of public health intervention policy. Whereas, planning, design, and implementation was a sole responsibility for the municipalities and regional governments. Active transportation is an area of specific interest for health promotion for the Public Health Agency of Canada due to it would assist in increasing physical activity levels (Saidla, 2017). According to (World health organization, 2015), being physically inactive have been ranked fourth leading risk factor for cardiovascular diseases with highest mortality rates registered in the industrialized countries. Moreover, research has revealed that policies encouraging active transportation positively correlate with pedestrians and cyclist safety as suggested by (Saidla et al., 2017). AT public health policy promotion in Ottawa has adopted a theory of policy process as a model that focuses on factors affecting politics resulting in ultimate policy choices. Therefore the government of Canada opted for ACF adoption for the full analysis of the social determinants of health.

Challenges Facing Active Transportation (AT) Policy in Canada

However, there are challenges facing the active transportation policy in Canada, there are gaps in the way evidence and effective practices regarding the AT policy was shared a cross Canada. For example, to fill those gaps a project referred to as Mobilizing Knowledge for active Transportation (MKAT) was formed and championed by center for disease prevention a unit within Public Health Agency of Canada. MKAT played a key role in promoting effective approaches to active transportation. The overall objective for MKAT was to solicit for evidence based information that influenced the strategies used in active transportation in Canada as suggested by (Breton and Leeuw, 2010). The AT policy promotion in Ottawa through MKAT used different strategies in order to achieve its objective on information gathering in order to produce implementable policy. For example, information on current strategies and policies were gathered through interviews with regional government officials and internet search.

It is projected that persons with severe mental disorders (SMD) such as schizophrenia and bipolar die 10-20 years much earlier that the general population as suggested by (Liu et al., 2017). Moreover, high premature mortality rates for the SMD have been reported across different countries globally. However, despite such worrying trend there are no progress made to curb the high mortality rates from different governments around the world. In fact, new emerging empirical data revels that the gap has widened four times with recently published articles revealing standardized mortality ration that is greater than the earlier released as suggested by (Olfson et al., 2015). It is reported that most of the reported deaths among the individuals suffering from SMD are related to physical inactivity which is a risk factor for diseases such as cardiovascular disease. According to (Walker et al., 2015; Olfson et al., 2015), persons suffering from SMD have 2-3 times chances of dying of cardiovascular diseases than the general population according to.

The already existing intervention public health promotion programs that are meant to curb the high mortality rates among SMD person’s faces numerous challenges. Some of those challenges include cultural believes and attitude of various stake-holders involved, limited resources and mental health experts, and the ability of the individuals suffering from SMD to access public health intervention programs. Whereas, at the policy level lack of priority is a major problem, which needs top-level incorporation and promotion of various intervention programs including mental health, nutrition and physical activity as suggested by (McPherson et al., 2017). For example, in Canada youth and children mental health system lacks proper funding and there is clear fragmentation as suggested by (Kutcher et al., 2015). Moreover, the problem has been worsened by the severe shortage of mental health experts within the rural communities in Canada. Geographical and professional isolation has been cited as a barrier to successful implementation of the public health intervention program in the rural parts of Canada and as a result it has hindered expert retention in those areas (Boydell, & Pignatiello, 2014). Within the urban areas the prevalent challenges facing mental health intervention policies fronted by the public health are structural related including lack of proper mental health facilities cost and transportation.

Public Health Intervention Policy on Mental Health in Canada

In Canada the use of technology to deliver mental health care services have been successfully utilized to reduce the barrier on the service delivery to the persons suffering from SMD living in the rural communities. The use of videoconferencing has been used for assessment, consultancy and delivery of therapy to the SMD patients, the measurable success has been filling the gaps created by geographical and professional isolation experienced in rural areas of Canada (Macnaughton et al., 2017). The government of Canada prioritized the effective approach of addressing social determinants of health (SDH) and health equity, as a key component of promoting public health policies on mental health (McPherson et al., 2016). The government of Canada has defined SDH in terms of economic and social environment that shape the health of persons, communities and authorities whereas health equity is defined as lack of systemic differences in health or in major SDH as suggested by (Raphael, 2009). It is worth noting that collaboration with different levels of government, local communities and other health partners such as NGO’s have been as been a key attribute of Canadian mental health intervention policy.

Involvement of different of level of leadership has been identified as a key ingredient to the successful implementation of the public health intervention program in the Canada case. For example leadership was well defined at different level that include individual, organization and systemic for the public health intervention program on mental health. Whereas, for the public health policy on active transportation (AT), the political goodwill has been cited as one of the factor that contributed to the acceptance of the policy through advocacy. At the same time, collaboration between government and other actors has been witnessed in both public health policies. Use of social determinant of health (SDH) has been exploited the government of Canada in order to achieve the objectives of the two public health intervention policies. Moreover, some of the challenges faced during the implementation of the two policies were avoided through the use of technology. General public are in danger of increased death from cardiovascular diseases in absence of the two public health policies.

One of the key contributing factor to the successful implementation of the Active transportation (AT) in Canada is good Transport system, whereas lack of good transportation within the local communities areas have been cited as a challenge foe successful for implementation mental health intervention program. Geographical and professional isolation has been cited as a barrier to successful implementation of the intervention program on mental health, whereas for active Transportation system there was no barrier due to such. There is lack of government commitment with regards to resource allocation for the public health interventional program for the mental health, the same is not witnessed in the active transportation program where the government resources have been cited as a major contributor for the successful implementation.

Challenges Facing Mental Health Intervention Policy in Canada

Conclusion

In conclusion it is evidence that leadership at different levels including individual, organization and systemic that is combined with social strategy and political goodwill have also contributed immensely to the success of the mental health intervention and health equity programs and active transportation (AT) in Canada. Leadership at an individual level include competencies such as skills and attitude that are necessary for effective policy advocacy; at the organizational level it entails funds allocation, human resource mobilization and adherence to external policies.

Reference list

Bernier, N. F., & Clavier, C. (2011). Public health policy research: making the case for a political science approach. Health promotion international, 26(1), 109-116.

Boydell, K. M., Hodgins, M., Pignatiello, A., Teshima, J., Edwards, H., & Willis, D. (2014). Using technology to deliver mental health services to children and youth: a scoping review. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 23(2), 87.

Breton, E., & De Leeuw, E. (2010). Theories of the policy process in health promotion research: a review. Health promotion international, 26(1), 82-90.

Chan, M. (2013, June). WHO Director-General addresses health promotion conference. In Opening address at the 8th Global Conference on Health Promotion Helsinki (Vol. 10).

Kutcher, S., Wei, Y., & Morgan, C. (2015). Successful application of a Canadian mental health curriculum resource by usual classroom teachers in significantly and sustainably improving student mental health literacy. The Canadian Journal of Psychiatry, 60(12), 580-586.

Liu, N. H., Daumit, G. L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P., ... & Gaebel, W. (2017). Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World psychiatry, 16(1), 30-40.

Macnaughton, E., Nelson, G., Goering, P., & Piat, M. (2017). Moving evidence into policy: the story of the at Home/Chez Soi initiative’s impact on federal homelessness policy in Canada, and its implications for the spread of Housing First in Europe and Internationally. Eur J Homelessness.

Macridis, S., Bengoechea, E. G., McComber, A. M., Jacobs, J., & Macaulay, A. C. (2016). Active transportation to support diabetes prevention: Expanding school health promotion programming in an Indigenous community. Evaluation and program planning, 56, 99-108.

McPherson, C., Ploeg, J., Edwards, N., Ciliska, D., & Sword, W. (2017). A catalyst for system change: a case study of child health network formation, evolution and sustainability in Canada. BMC health services research, 17(1), 100.

McPherson, C., Ndumbe-Eyoh, S., Betker, C., Oickle, D., & Peroff-Johnston, N. (2016). Swimming against the tide: A Canadian qualitative study examining the implementation of a province-wide public health initiative to address health equity. International journal for equity in health, 15(1), 129.

McPherson, C. M., & McGibbon, E. A. (2010). Addressing the determinants of child mental health: Intersectionality as a guide to primary health care renewal. CJNR (Canadian Journal of Nursing Research), 42(3), 50-64.

Mitra, R., & Buliung, R. N. (2012). Built environment correlates of active school transportation: neighborhood and the modifiable areal unit problem. Journal of transport geography, 20(1), 51-61.

Meurk, C., Leung, J., Hall, W., Head, B. W., & Whiteford, H. (2016). Establishing and governing e-mental health care in Australia: a systematic review of challenges and a call for policy-focussed research. Journal of medical Internet research, 18(1).

Newman, L., Baum, F., Javanparast, S., O'Rourke, K., & Carlon, L. (2015). Addressing social determinants of health inequities through settings: a rapid review. Health Promotion International, 30(suppl_2), ii126-ii143.

Olfson, M., Druss, B. G., & Marcus, S. C. (2015). Trends in mental health care among children and adolescents. New England Journal of Medicine, 372(21), 2029-2038.

Olfson, M., Gerhard, T., Huang, C., Crystal, S., & Stroup, T. S. (2015). Premature mortality among adults with schizophrenia in the United States. JAMA psychiatry, 72(12), 1172-1181.

Parkin, J., Wardman, M., & Page, M. (2008). Estimation of the determinants of bicycle mode share for the journey to work using census data. Transportation, 35(1), 93-109.

Raphael, D. (Ed.). (2009). Social determinants of health: Canadian perspectives. Canadian Scholars’ Press.

Richard, L., & Gauvin, L. (2017). Building and implementing ecological health promotion interventions. Health Promotion in Canada: New Perspectives on Theory, Practice, Policy, and Research, 84.

Saidla, K. (2017). Health promotion by stealth: active transportation success in Helsinki, Finland. Health promotion international, daw110.

Swigger, A., & Heinmiller, B. T. (2014). Advocacy coalitions and mental health policy: The adoption of community treatment orders in Ontario. Politics & Policy, 42(2), 246-270.

Walker, E. R., McGee, R. E., & Druss, B. G. (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA psychiatry, 72(4), 334-341.

World Health Organization. (2015). Global health observatory data repository. Prevalence of

Insufficient physical activity among adults. Data by country. Retrieved from:

https://apps.who.int/gho/data/view.main.2463