The Impact of Indigenous Mental Health on Healthcare Equity

Healthcare disparities among Indigenous communities are no foreign concept in Canada—these outcomes are deeply rooted in the determinants of health that must be addressed in order to build an equitable health system. 

“Equity” should not be confused with “equality.”  

It is worth noting that equity and equality are two entirely different concepts. While equity tends to rely on the ideology of fairness, equality promotes impartiality. According to Health Quality Ontario, “Health equity allows people to reach their full health potential and receive high-quality care that is fair and appropriate to them and their needs, no matter where they live, what they have or who they are… a high-quality health system recognizes and respects social, cultural and linguistic differences”. By definition, health care equity is a “sub-set of health equity” in which a health system is able to effectively provide equitable health care (Health Quality Ontario, 2019).

Indigenous Mental Health in Canada

The alarming rates of poverty, unemployment, child apprehension, poor education, and public services are all contributing factors to the declining mental health of Indigenous peoples. These communities are challenged with a “disproportionate burden of disparity” that comes with low income and substandard living conditions (Richmond et al., 2016). In a recent report from Statistics Canada, mental health disparities between the Indigenous and non-Indigenous populations in Canada have demonstrated to be directly linked to the intergenerational effects of residential schools, the forced relocation of communities and removal of children from families and communities, and mental health services gaps. The report also claims that the adverse mental health outcomes of the Indigenous have resulted from childhood adversity, trauma, discrimination, as well as social determinants of health such as unemployment, housing, poverty, and food security (Government of Canada, 2020).

Indigenous Mental Health and the Pandemic

According to Statistics Canada, 6 in 10 Indigenous participants report that their mental health has worsened since the onset of physical distancing (Arriagada et al., 2020). The COVID-19 pandemic has only amplified the mental health concerns of Indigenous communities as the inability to socialize in-person creates unfamiliar and stressful situations. The Public Health Agency of Canada (PHAC) also describes how factors such as geographical isolation, high levels of pre-existing health conditions and inadequate housing are associated with a higher risk of contracting or spreading the COVID-19 virus.

Understanding the Impact

A 2010 American research study indicates that patient race/ethnicity can influence physician interpretation of patients’ complaints and, ultimately, clinical decision making (Sorkin et al., 2010). Over time, these biases towards certain populations become rooted in healthcare systems and become significantly more difficult to eliminate. As such, it is crucial for healthcare institutions to prioritize Indigenous and other marginalized communities. In an era of healthcare transformation, moving towards a system that is equitable will help improve the quality of health services being provided and ultimately increase sustainability.

References

Arriagada, P., Hahmann, T., & O’Donnell, V. (2020, June 23). Indigenous people and mental health during the COVID-19 pandemic. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00035-eng.htm.

Government of Canada, S. C. (2020, April 17). First Nations people, Métis and Inuit and COVID-19: Health and social characteristics. The Daily . https://www150.statcan.gc.ca/n1/daily-quotidien/200417/dq200417b-eng.htm

Health Quality Ontario. (2019). Health Quality Ontario’s Health Equity Plan. http://www.hqontario.ca/portals/0/documents/health-quality/health_equity_plan_report_en.pdf.

Richmond, C. A. M., & Cook, C. (2016, July 20). Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy. Public Health Reviews. https://link.springer.com/article/10.1186/s40985-016-0016-5.

Sorkin, D. H., Ngo-Metzger, Q., & De Alba, I. (2010, May). Racial/ethnic discrimination in health care: impact on perceived quality of care. Journal of general internal medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855001/.

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently volunteers with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

Vaccination Hesitancy: Know Your Risks

Although vaccination hesitancy has been a great concern for decades, the COVID-19 vaccine rollout has increased speculation surrounding the likelihood of adverse and potentially fatal effects that vaccines may cause. In a recent Canadian study, vaccination hesitancy has been demonstrated to stem from individual safety, concerns with political and economic factors driving the vaccine rollout, having limited knowledge about vaccines in general, misleading and false information, as well as a lack of legal liability from vaccine companies. Moreover, there is a demonstrated level of mistrust due to health care institutions’ history of neglecting and ultimately marginalizing communities with fewer resources (Griffith et. al, 2021). According to the World Health Organization (WHO), one of the worst threats to global health is vaccination hesitancy. 

Seconds Anyone?

With Canada putting a pause on AstraZeneca distributions to new recipients, there has been recent controversy on whether those who have already received their first dose are at any significant risk. Public health officials have assured that those who have taken the AstraZeneca vaccine did the right thing at the time and should not feel remorse for acting quickly to receive their first shot (Arthur, 2021).

The real discussion, however, is what the next steps are for those who have already received their first dose—whether to proceed with their second dose of AstraZeneca or to mix and match with a dose of an mRNA vaccine such as Pfizer-BioNTech or Moderna. According to a recent Spanish trial of over 600 participants, those who had received the Pfizer vaccine after taking their first dose of the AstraZeneca vaccine demonstrated a significantly greater antibody response (Callaway, 2021). However, it is still unclear how these results will compare to the antibody response from combining two different mRNA vaccines. While researchers seem to agree that mixing vaccines could provide a better overall immune response, there is currently no concrete evidence on whether mixing vaccines in general is a better option than taking a second dose of the same vaccine.  

If you have already taken the AstraZeneca vaccine and/or have underlying conditions, it is in your best interest to consult with your primary physician to help determine what the best option is for you.

Weighing the Risks

A concept that many may find difficult to digest is that the risk of contracting severe COVID-19 is substantially greater than the risks associated with a COVID-19 vaccine. Long story short, it is highly recommended to get the vaccine if you are eligible and have the means to do so because, at this point in time, your chances of ending up in the ICU are much higher than experiencing severe side effects from a vaccine. With over 19 million Canadians already receiving their first dose of the COVID-19 vaccine, there appears to be a light at the end of the tunnel. That being said, vaccination hesitancy is still a growing concern and needs to be addressed through the implementation of public health interventions that work to educate, resolve concerns, and rebuild trust in our healthcare system. 

At the end of the day, all vaccines come with their own set of risks and side effects. While it is important to be well aware of these individual risks, it is crucial to understand that receiving a COVID-19 vaccine not only provides individual benefits but also alleviates stress on hospitals and benefits the population as a whole. If we want to #conquercovid we need to have as many people vaccinated as possible; the more people who are hesitant and choose to “wait”, the longer it will take to reduce the number of cases and return to normal. 

References

Arthur, B. (2021, May 12). Why pausing AstraZeneca was the right move – and why you probably were right to get it. thestar.com. https://www.thestar.com/opinion/star-columnists/2021/05/11/why-ontario-made-the-right-move-by-pausing-astrazeneca-vaccines-and-why-if-you-got-it-you-probably-did-the-right-thing.html

Callaway, E. (2021, May 19). Mix-and-match COVID vaccines trigger potent immune response. Nature News. https://www.nature.com/articles/d41586-021-01359-3.

Griffith, J., Marani, H., & Monkman, H. (2021). COVID-19 Vaccine Hesitancy in Canada: Content Analysis of Tweets Using the Theoretical Domains Framework. Journal of Medical Internet Research, 23(4). https://doi.org/10.2196/26874

Bibliography

Ferguson, R. (2021, May 11). Ontario pauses first doses of AstraZeneca over clot concerns. thestar.com. https://www.thestar.com/politics/provincial/2021/05/11/covid-19-vaccines-for-teens-coming-soon-but-adults-still-a-priority-ontario-says.html.

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently volunteers with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

The Barriers of Immunization

Although Canada’s vaccine distribution numbers seem promising, the inevitable barriers that come with wanting to immunize an entire country are yet to be completely addressed. Some of the most common challenges include lacking technological support and digital literacy, distribution inequities, language barriers, and an overall fear of vaccines that is instilled through misinformation and false news.

COVID-19 is complicated. Booking a vaccine appointment shouldn’t be.  

It is common knowledge that technology has its drawbacks; however, it can be difficult to process how tedious such a “simple” task can become. From long waiting times to constantly refreshing booking sites in hopes of an empty time slot becoming available—not to mention the frustration of having your appointment cancelled and having to go through the process all over again. With ‘tech savvy’ individuals struggling to book appointments on their own, those who are unfamiliar with virtual bookings are left in the dark. 

While pop-up and walk-in sites attempt to resolve this issue, the hesitancy and/or struggle to receive the COVID-19 vaccine continues to persist. 

Fighting the Inequities of Vaccine Distribution

The World Health Organization (WHO) describes the global COVID-19 vaccine rollout as a “scandalous inequity”. According to WHO director-general Dr. Tedros Adhanom Ghebreyesus, the “small group of countries [including Canada] that make and buy the majority of the world’s vaccines control the fate of the rest of the world” (Nebehay, 2021). In the same interview, Dr. Tedros emphasizes that nobody should assume they are safe as long as the virus continues to exist elsewhere. 

The inequities of vaccine distribution are also prevalent at the provincial level. In Ontario, many of the ‘hot spot’ locations that were initially prioritized demonstrated a “lower-than-average pandemic burden” (Crawley, 2021). In early April, the CBC identified seven other postal codes that experienced a greater impact yet were not categorized as ‘hotspot’ locations. Each of these locations were located in the ridings of oppositional parties (Crawley, 2021). 

Overcoming the Language Barrier

Language barriers have always been a challenge for marginalized communities; living in a COVID-19 hotspot however only amplifies these challenges (Lampa, 2021). With over half of Canada’s Rohingya population residing in the Kitchener-Waterloo region, community leaders have claimed that the past year has been extremely difficult due to the Rohingya-English language barrier (Lampa, 2021). It is nearly impossible for many of the Rohingya to access vaccine resources as they are dependent on translators to help them understand COVID-19 protocols. In spite of the regions’ efforts to help the community by developing a video in the Rohingya language, it is not enough to overcome the divide between the non-english speaking Rohingya and the residents of Waterloo.

An ideal strategy in such scenarios would be to match patients with healthcare providers who either speak the same language or share a similar ethnic background. According to Anderson (2014), providing patients with a sense of familiarity in this context may help alleviate the concerns and questions they may want answered prior to receiving their vaccine.

Addressing Vaccine Conspiracies: Educating Gen Z

In an attempt to target Gen Z, medical worker Steven Ho utilizes his biting humor to address the common myths of the COVID-19 vaccine through TikTok (Pikett, 2021). Through this medium, Ho educates the younger generation in hopes of allowing them to teach their elderly caregivers who may not understand the notion of vaccines in general. In a particular video, Ho compares the COVID-19 vaccine to a birth control pill or a seatbelt—while all three of these entities provide a high degree of protection, Ho explains that there is a fine line between having a high degree of protection and 100% protection. Ho also sheds light on the theory that the COVID-19 vaccines contain tracking microchips and satirically claims that there is no need for a microchip vaccine as our cellular devices have already fulfilled the job.

When all is said and done

Immunization barriers will not go away on their own, and will continue to persist beyond the COVID-19 pandemic. Nonetheless, it is crucial that as Canadians we are aware of these barriers to help better understand the needs of marginalized communities as well as the privilege we have of being able to receive a vaccine at all.

References

Anderson, E. L. (2014). Recommended solutions to the barriers to immunization in children and adults. Missouri medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6179470/.

Crawley, M. (2021, April 13). Some areas not hard-hit by COVID-19 getting vaccination priority in Ontario, data reveals | CBC News. CBCnews. https://www.cbc.ca/news/canada/toronto/ontario-covid-19-vaccination-postal-code-hot-spots-1.5983155.

Lampa, N. (2021, April 15). ‘We feel like we are on an island’: Cultural, language barriers difficult for Rohingyan population living in COVID-19 hot spots. Kitchener. https://kitchener.ctvnews.ca/we-feel-like-we-are-on-an-island-cultural-language-barriers-difficult-for-rohingyan-population-living-in-covid-19-hot-spots-1.5389196.

Nebehay, S. (2021, May 24). ‘Scandalous inequity’: WHO says 75% of vaccines given out in just 10 countries. Global News. https://globalnews.ca/news/7888608/who-covid-vaccine-sharing-inequity/.

Pickett, J. (2021, February 1). Tiktok docs you should be following. stethoscopemagazine.org. http://stethoscopemagazine.org/2021/02/01/tiktok-docs-you-should-be-following/.

Bairavie Piravakaran (she/her) is a second-year undergraduate at the University of Toronto Scarborough. As a Psychological & Health Sciences student, she values the importance of sharing credible information and making health resources more accessible to the public. Her interests in population health, research, and design are also reflected in her non-academic pursuits—she currently with the Young Leaders of Public Health and Medicine (YLPHM) as a Social Media Manager for the Scarborough Chapter and is a Health Promotion & Analytics Member at Critical Health Innovations Lab (CHIL). At EMPOWER Health, Bairavie works closely with the Marketing Team in order to plan and execute strategies that help inform the public about current health-related topics.

Great Things Come in Small Apps

I’m just going to break the fourth wall for a second here, but as a relatively short person I’ve been perpetually pelted with the phrase “Good things come in small packages”. As a kid, that made me believe that I was destined to be awesome… but as I got older, I saw it more as something I’d just say to validate my human condition.

However, I’m starting to rethink it again, as this theme of small but powerful has been exploding in the modern technological world. From immense amounts of memory storage compacted into tiny micro SD cards, to the rise of mini-tablets, to entire libraries of books stored into one portable e-reader, it seems like that one thing my mom keeps telling me stands stronger as a prophecy than it does as proverbial solace to my woes.

iamsick.ca – A Digitally Small Package

Ever had to do the app-deleting rounds when your phone’s memory gets maxed out?

With the average app size of 50MB, and with higher allowable app sizes for both iOS and Android, apps are just going to keep getting bigger – eating away at the very finite memory space on our mobile devices.

Did you know that the iamsick.ca app is only 3MB on Android and 4MB on iOS?

That’s equivalent to the size of about 2 snapchat videos!!  By taking up such insignificant space, our app isn’t a thorn to your memory capacity’s side, but will not hesitate to be your hero in your time of need. At less than 10% of the average app size of 50MB, a strange echo begins to sound. It’s a small package… so it must be a good thing, right?

Well, of course! iamsick.ca is good because it’s small… and, it’s more than just “good”. Together with its convenience, functionality, and purpose, iamsick.ca is a great thing in a small package.

Greatness Lies Within

Well, what does iamsick.ca do?

First, it’s an app that helps you access healthcare whenever and wherever you need it.

What exactly does this mean though?  Well, first and foremost, our app uses your geographical location (or address/place you enter) to immediately show all of your nearby healthcare options! With a click on one of the icons (shown below), you’re immediately directed to the address, contact information, and hours of operation of all services (including holiday hours, which are updated regularly!).

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iamsick.ca scanning for all nearby emergency rooms, pharmacies, family doctors, and walk-in clinics

You can also use our filter to find the exact type of healthcare service you’re looking for. Whether you need to rush to an urgent-care centre or find a family doctor accepting new patients, you can find exactly what you need in just a couple of taps!

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Our filter system for healthcare options

Our additional filters increase the specificity of your search to include more information about that healthcare providers or service, whether you’re searching after-hours and are looking for a pharmacy that is “currently open”, a clinic that is wheelchair accessible, a walk-in clinic with e-booking, or a family doctor accepting new patients.

On top of all of this, iamsick.ca also includes a language filter with over 80 languages spoken by healthcare providers!

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This user is filtering healthcare options so that only those with healthcare professionals who speak Nepalese displayed

In light of the current Syrian Refugee Crisis, iamsick.ca also implemented a newcomer initiative (as highlighted by Huffington Post and TechCrunch), and many Arabic-speaking healthcare providers are being added to our database. Additionally, the website and mobile apps are also translated into Arabic (along with French, Spanish, and Chinese).

translate.JPG

How the website looks like translated. Translation on the mobile application is automatically synced to your language settings!

I know what you’re thinking. “All this, packed into ONE application?!”

Yes. That’s right. Good things come in small packages, but Great things come in small apps.

Check it out for yourself on Android, iOS, and Blackberry.

 

——

Sources:

http://www.ibtimes.com/heres-crazy-amount-cellular-data-snapchat-consumes-how-stop-it-1938313

How does your mobile app measure up to industry average?

 

 

 

 

 

 

Outdoor Safety

Outdoor Safety

Happy-family-father

 

Now that Summer has finally come to Canada (woohoo!), it means Canadians can enjoy the weather outside and do activities that are closer to nature such as camping, gardening and visiting parks. However, humans aren’t the only ones who enjoy the warm weather; warm weather also attracts ticks, mosquitoes and fleas. When enjoying outdoor activities, one must be careful of bugs such as ticks, which can transmit lyme disease and other infections. A study conducted in Nova Scotia found that more children are contracting lyme related arthritis and that the majority of documented case came from the past two years. Lyme disease is on the rise in Canada, especially since ticks are found in six provinces in Canada and is continuously spreading into various neighbourhoods.

What Are Ticks?

Ticks are closely related to spiders, feed on blood, and come in contact with animals and people through tall grasses and small bushes. Ticks are very small in size when unfed, therefore often goes unnoticed by people. Tick bites are painless, but some are infectious and may result in lyme disease. It’s possible for Canadians to encounter ticks and lyme disease almost anywhere in Canada since ticks feed on migratory birds that transports it to other areas.

tick

Symptoms of Lyme Disease

Early symptoms occur on average one to two weeks after a tick bite, but can occur as early as 3 days or as late as 1 month after the incident.

Some of the common symptoms include:

  • Fatigue, chills, fever, headache, muscle and joint aches
  • Skin rash that looks like a bullseye called erythema migrans
  • Facial or Bell’s palsy (loss of muscle tone on one or both sides of the face)
  • Neurological and sleep disturbances

bulls_eye

A typical bullseye rash. 

Around 60% of patients who were untreated would develop lyme related arthritis with severe joint pain and and swelling in the large joints such as knees.

Consult a doctor right away if bitten by a tick or if you exhibit any of the above symptoms.

Treatment

The most common treatments for lyme disease is oral antibiotics such as: doxycycline, amoxicillin, or cefuroxime axetil.

If the tick is attached to a person, it should be removed straight away using fine tipped tweezers. Grasp the tick as close to your skin as possible, and pull it out, gently but firmly. Thoroughly cleanse affected area with rubbing alcohol. You can bring the tick to your doctor or local healthcare providers to identify whether the tick is infected with lyme disease. Medical attention should be sought if any symptoms of early Lyme disease develop within 30 days of removal of the tick.

tick_removal

How to Avoid Ticks

  • Wear light-coloured clothes, long pants and a long sleeved shirt.
  • Wear closed footwear and socks.
  • Tuck your pants into your socks.
  • Use a tick repellent that has “DEET” (following the manufacturer’s directions for use).  Apply it to your skin and outer clothing.  Avoid your eyes and mouth, as well as cuts and scrapes.
  • Put a tick and flea collar on your pet and check them for ticks periodically.

Outdoor activities are enjoyable no matter if you’re with your family or friends. However, outdoor safety should not be ignore. Taking necessary precautions (e.g., downloading the iamsick.ca app when you travel) and knowing what healthcare options are available in the time of need will let you enjoy the Canada’s beautiful wilderness with peace of mind.

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Happy Birthday 23rd Birthday WorldWideWeb – The best is yet to come!

birthday-cake-happy

Today, the World Wide Web turns 23 years old. The first web server was setup at CERN on May 17th 1991, and look what it has grown to become.

Millions of people around the world use the Internet on a daily basis. Many jobs and fields have come into existence only because of the public-facing World Wide Web.

This is the perfect example of how a concept can grow and change the way Humans live and interact.

More importantly, the World Wide Web has grown into something that is becoming a more important part of healthcare delivery. With patients seeking advice from “Dr Google”, or searching for others who share similar symptoms/illnesses. And, even making it easier for Doctors, Nurses, Pharmacists, and other healthcare providers to stay on top of the growing body of healthcare knowledge. The World Wide Web has also grown into a tool to help people remain aware on services available to them, to maintain an ongoing connection with healthcare providers/organizations, and ultimately making accessing healthcare easier.

I see the World Wide Web and related Internet/mobile technologies improving healthcare access & delivery beyond our wildest dreams. If it can leveraged in the right way, it can also hopefully improve efficient & appropriate access to healthcare, which could ultimately lower the overall cost of providing equitable healthcare for all.

Please support our Indiegogo crowdfunding campaign!

Take a look at our perks, be a “Hometown Hero”, pitch in, and help spread the word. We can’t do this alone!

Join our ongoing discussion:
What province would you like to see us in next?
What language should we translate our app to first?

https://www.indiegogo.com/projects/iamsick-ca-helping-canadians-access-healthcare/x/2655534#comments

 

– Ryan Doherty & the iamsick.ca team

Crowdfunding – Engaging the Community for Growth

What is crowdfunding?

crowdfunding_png_460x345_q85

We normally think of crowdfunding to support a large scope of activities such as disaster relief, startup fundraising, film/music production, prototype development, or app development. For iamsick.ca, our crowdfunding campaign is an opportunity to raise funds to cover the cost of expanding our free Ontario-wide healthcare locator app to every corner of Canada. However, it isn’t just about raising funds, we are also giving Canadians a voice. Everyone who supports our campaign will receive a vote to decide “where next?” We are hoping to bring together Canadians passionate about improving healthcare to create a movement that will lead to more accessible and efficient healthcare for everyone.

What is reward crowdfunding?

crowdfunding-1

Iamsick.ca is an organization with a cause. We are passionate about bringing first-class healthcare to all Canadians. But to get your donation, we know we should provide something, let’s say a little more immediate, in return. That’s why we have chosen the reward crowdfunding campaign, because we want to acknowledge the support we receive with creative perks.

Everyone who pledges as little as $1 will get a vote to decide which province we expand to next. With $25, contributors can choose between receiving a set of Get Well cards or Canadiana cards designed by local artists especially for this campaign. Donate $35 and receive a custom iamsick.ca t-shirt. With $60, we will send you a cure-the-cold care package, which include an all-natural soup made especially for our campaign.

get-well-card-combo

Canadiana

Custom Get Well & Canadiana card samples.

What are stretch goals?

These are goals set by campaign organizers that goal beyond the initial, official goal to raise more money to improve goods or services. In our campaign, the official goal is to raise $9,000 to expand the iamsick.ca app to a second province in July. Our first stretch goal is to raise $20,000 to expand the iamsick.ca service to two other provinces. Our ultimate goal is to raise $90,000 so we can grow Canada-wide by September.

stretch goal

Timeline of our crowdfunding campaign.

How you can help.

You want to help? Great! The easiest way you can help us create a better future for Canadian healthcare is by pledging. Every dollar can and will make a difference!

You can find out more about our campaign and how to support us by clicking this link: http://indiegogo.iamsick.ca

Word of mouth is the best way to get people involved. Aside from pledging, you can also share our campaign with friends, family, coworkers and help spread the word about our campaign. Lastly, it would also help if you download our free app onto your smartphone, visit the website and give feedback. We would love to hear about how we can improve the service to better serve you.

You can make an huge impact with just a click of a button. Let today be the day we revolutionize Canadian healthcare!