Atikokan, Ontario: A Rural Community Engagement, Planning, and Priorities Report

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Similar to many other rural communities within rural Ontario, healthcare needs in Atikokan, Ontario, have been subjected to be review by the Ministry of Health and Long- Term Care. I have prepared a report with the objective of improving healthcare services within Atikokan, Ontario. As part of achieving the goal of improving healthcare services, the committee aims to plan healthcare services to address issues children and youth, particularly in regards to obesity. A 2006 report issued by the Canadian Institute for Health Information (CIHI), was the largest survey of its kind focusing on the living situations and health status of rural residents in Canada, and showcased data that rural residents were more susceptible to being obese (Kulig & Williams, 2012). Research on immediate health effects has shown children are more likely to be predisposed to pre-diabetes and likely to have risk factors for cardiovascular disease if obese (Centres for Disease Control (CDC), 2014).  They are also likely to continue to be obese as an adult if preventative measures are not taken, thereby increasing their risk for more health problems later on in life. Furthermore, this report will aim to address the healthcare needs of Atikokan, Ontario, to combat childhood obesity and address the social determinants of health that often contribute to this phenomenon.

Guiding Principles:

Nine principles outlining the criteria needed to fulfill this multi-dimensional and inter-disciplinary approach to address the childhood obesity epidemic in Atikokan. It is imperative that all nine recommendations are connected to one another, as the causes and treatment of childhood obesity are complex and require the coordination of different groups of professionals and community members.

Community Engagement:

Much of the current research on the prevention of childhood obesity revolves around the encouraging children and families to adopt health lifestyle habits, such as health eating and physical activity. Thus, a study conducted by the Northwestern Health Unit (2014), was a prime method for measuring the health status of students in grades 9-12 and comprising 1,535 high school students at 6 high schools within the catchment area. The survey sought to provide baseline data in addressing youth health status and behaviours, such as tobacco use, physical activity levels, nutrition, obesity, and sedentary behaviours (Northwestern Health Unit, 2014).  Although the survey was not solely completed in the Atikokan area, future community engagement methods can continue to be used continue to provide our committee and community with valuable information that will allow us to determine priority areas that are needed to be focused on, and allow us to continue to build and work on a sustainable strategic plan each year. Our goal is to ensure our decision-making is based off of evidence, population health data, and demographics to help address the obesity epidemic Atikokan children are facing.

Flexible Local Planning and Delivery:

The town of Atikokan, Ontario has been noted to be struggling with the effects of childhood obesity. Current research on the childhood obesity outlines both the immediate and long-term effects on mental health and physical well-being that the condition has on a child’s future development.  As a committee, we recognize that an effective healthcare system revolves around the support of many different healthcare providers and community members to identify problems and design solutions in addressing the gaps of the local community. Interventions for obese children and youth in real world, clinical settings need to be re-evaluated because traditionally most weight management care has occurred in this setting. Our committee would recommend the use of one-on-one lifestyle coaching for managing adolescent obesity. In one study, findings from a pilot project showed that structured interventions have a positive, albeit modest impact on weight management. When supporting overweight and obese children, the need to optimize the initiation of care and develop multidisciplinary collaborations between healthcare professionals and community partners are required for long-term health outcomes. The study also recommended interactive group based activities, with many of the children referred to weight management programs in solely based in a clinical setting being unsuccessful due to their small social networks (Ball, Mackenzie-Rife, Newton, Alloway, Slack, Plotnikoff, & Goran, 2011).

Culturally and Linguistically Responsive:

Our committee will plan healthcare services related to children and youth to be responsive to the cultural and linguistic needs in relation to the community of Atikokan, Ontario.

Value:

Aside from the evidence indicating childhood obesity increases the risks of obesity in adulthood and other health impact, there has been significant research examining the economic burden that obesity has on society. Economic burden is often defined using both the terms direct costs (ex. Hospital care, physician care) and indirect costs (ex. value of economic output lost) (Public Health Agency of Canada, 2011). With the rising rates of obesity, there will be an increase in healthcare costs due to weight-related illnesses, and a risk of loss of productivity to the Canadian economy. In essence, as a health care system we want to offer best practice services at the right time, in the right place, and for the right cost. It is well known that Canada is in the midst of a childhood obesity epidemic, and thus Canada’s response to the epidemic will require the collaboration of the community, parents, schools, and government to reverse the trend. Obesity is rooted in a complex set of social, economic, and environmental forces, and best practices for treatment require a shift from solely the healthcare providers realm to champion the issue (Public Health Agency of Canada, 2011).

Integration:

Thus the basis of our report calls for the recommended use of services delivered in a team-orientated format within the community and integrated with other evidence-based programming to make best use of available resources. Our committee supports the notion that it is imperative that increasing and improving community leadership capacity is the key driver in any programming implementation and continuation. Strong leadership is a key factor in helping to improve the assessment of community health care access, primarily for young children at high risk of obesity.

Innovation:

            In essence, this model will require a high degree of innovation to help interconnect the interventions geared towards reducing childhood obesity. As mentioned previously, treatment of childhood obesity goes beyond the realm of solely clinical practices. The community also needs to take an active role in reducing the prevalence of childhood obesity. Thus, schools can initiate a program such as “Screen Smart” to increase awareness among students of how much time they are spending in front of screen (Childhood Obesity Foundation, n.d.). This program was developed by a multidisciplinary group of professions in British Columbia, and recently was listed in the “Canadian Best Practices Portal” for its innovative nature, and positive results from a high quality evaluation (Childhood Obesity Foundation, n.d.). This program specifically is implemented in the elementary school system, with the intention that reducing screen times has many benefits including better school performance and improved well-being (Childhood Obesity Foundation, n.d.).

Connected and Coordinated:

To ensure a healthcare professional network always supports the residents of Atikokan, providing an enhanced telehealth support network will be essential to gaining access to outside resources. Thus, having this free service will ensure that children and their families are will continuously be able to access programs they cannot attend in person, or who may need additional support (Childhood Obesity Foundation, n.d.). Using a similar set up to Telehealth Ontario would ensure that these free services are able to reach out to children and their families to increase healthy eating habits and physical activity levels, while also ensuring they have access to a large support network as childhood obesity affects the majority of rural Canadian communities (Childhood Obesity Foundation, n.d.).

Evidence Based:

Evidence has shown, that northern communities often demonstrate higher than average rates of obesity compared to their southern counterparts, thereby indicating an overall lower health status (Ministry of Health and Long-Term Care, 2010). Best-practices have shown that the dietary and physical habits of children are highly influenced by many members of society, including the child’s family, community, schools, and medical care providers. It has been noted that schools play a particularly large role in establishing safe and supportive environments with the development of policies and practices that support healthy behaviours (CDC, 2014). It has been noted that although most weight management occurs in clinical based settings, current research supports the notion that to best support obese adolescents, multidisciplinary treatment methods are required (Ball, Mackenzie-Rife, Newton, Alloway, Slack, Plotnikoff, Groan, 2011). It has strongly been noted in literature that population-based prevention methods hold the greatest promise in reducing the onset of childhood obesity (Carpio & Genel, 2005).

Sustainable:

Our recommendation to create sustainable health care services requires the need to encourage local community leadership in applying for government funding and programs to improve access within the community of Atikokan. Hence, childhood obesity is a major dilemma for many communities across Ontario, thereby placing the issue on the Ministry of Health and Long-Term Care’s agenda. One possible source of funding could come from Ontario’s Health Kids Strategy, to help Atikokan implement community programs and activities focusing on healthy eating, physical activity (Government of Ontario, 2014). The government also provides funding to ensure training and other resources are available to the community through the implementation process (Government of Ontario, 2014).  Thereby, this will aim to increase community participation by encouraging residents to address the community’s local needs and ensure programs are tailored and designed to meet the specific population target.

Summary

            Childhood obesity and its impacts on health and the healthcare system are complex in nature, and can only be address through a coordinated treatment plan involving the government, community, healthcare providers, and family levels. In conclusion, it is with hope that these nine recommendations for addressing the childhood obesity in Atikokan will be implemented as a community-focused childhood obesity program. Thus, it is with hope that these nine recommendations will eventually provide families with access to these integrated and expanded health services to offer coordinated and ongoing access to counseling, family physicians, nutritionists, and other community partners.

Works Cited

Ball, G.D.C., Mackenzie-Rife, K., Newton, M., Alloway, C.A., Slack, J.M., Plotnikoff, R.C., &

Goran, M.I. (2011). One-on-one lifestyle coaching for managing adolescent obesity:

Findings from a pilot, randomized controlled trial in a real-world, clinical setting. Paediatrics & Child Health. 16(6). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328223/

 

Carpio, S. & Genel, M., (2005). Confronting the epidemic of childhood obesity. Pediatrics.

115(2). Retrieved from http://pediatrics.aappublications.org/content/115/2/494.short

Centres for Disease Control. (2014). Childhood obesity facts. Retrieved from

http://www.cdc.gov/healthyyouth/obesity/facts.htm
Childhood Obesity Foundation. (n.d.). Our story and mission. Retrieved from

http://www.childhoodobesityfoundation.ca/ourStory
Government of Ontario. (2014). Ontario’s healthy kids strategy. Retrieved from

http://news.ontario.ca/mohltc/en/2014/01/ontarios-healthy-kids-strategy.html
Kulig, J.C., & Williams, A.M. (2012, Feb 24). Health in Rural Canada. Vancouver, BC: UBC

Press
Ministry of Health and Long-Term Care. (2010). Rural and Northern Health Care Framework/Plan. Retrieved from http://www.health.gov.on.ca/en/public/programs/ruralnorthern/docs/report_rural_northen_EN.pdf

Northwestern Health Unit. (2014). Compass survey results 2014. Retrieved October 15, 2014, from https://www.nwhu.on.ca/MediaPressCentre/Documents/Compass%20report%202014%20w%20cover-website.pdf
Public Health Agency of Canada. (2011). Curbing childhood obesity: A framework for action to promote healthy weights. Retrieved from
http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/framework-cadre/index-eng.php