My Journey Through MHST601 Evaluating Heart Disease

(Ackun, 2020)

Introduction

Over the duration of MHST601 I have learned many new concepts, developed myself professionally and gained a new understanding of my professional identity. As a critical care radiographer working in the Cath Lab, my interests lie in heart disease prevalence and prevention. Throughout this course, I have touched on a multitude of health topics that I applied towards heart disease. Some of these include health determinants, multilevel approaches to understanding disease, chronic disease prevention and management and disease in vulnerable populations.

This course introduced me to the concept of content curation and has provided me with the tools to properly find, collect and store relevant information. Digital content curation is defined as the process of strategically collecting, organizing, and archiving digital information for purposeful use (Deschaine & Sharma, 2015). I have also had the opportunity to learn new digital platforms such as Wix which houses my E-portfolio and Google Keep which I use for the curation of my resources. These tools I have gained over the last 13 weeks will stay with me professionally and academically.

Inter-professional Connectedness

In the first unit, I was introduced to the concept of content curation and one of the required tasks was to perform a professionalism and social media audit. Through these audits I reflected on my professional identity as a Medical Radiation Technologist (MRT), the professional organizations I belonged to and how my profession influences my social media presence. My takeaway from the audits is that it is always important to be mindful of your professional identity in all settings, including on social media. As a healthcare professional I am aware that what I say, post or share can reflect poorly on myself and my profession. However, I believe that there are always ways to communicate an opinion respectfully and professionally. It is through debates and discussions that people can grow and learn to see things from each other’s perspectives.

At the beginning of this course, I had a very small online presence. Upon searching my name on Google, only my LinkedIn profile showed. However, I have learned through this term that it is important to develop your online professional presence through the means of an E-Portfolio. An E-Portfolio can act as a digital resume, showcase your learning, act as a portal to connect with colleagues or classmates, and share pertinent information (Winchell, 2018). I have since created a public E-Portfolio which I plan to continue updating to showcase my academic journey.

Health Systems in Canada

In the second unit, I reviewed the Regulated Health Professions Act (RHPA) in Ontario in relation to my profession. Medical Radiation Technologists have their own Medical Radiation Technology act under the RHPA. We are governed by the College of Medical Radiation and Imaging Technologists of Ontario (CMRITO). Our professional college regulates the standards of practice, controlled acts, registration, quality assurance and disciplinary actions of all members.

Upon examining the Canada Health Act (CHA) established in 1984, it is evident that the healthcare services individuals need have changed substantially over the years. The CHA is extremely outdated and has not adapted to the population’s changing needs. Some ways to modernize the CHA would be to expand the coverage to include more services such as prescription medication (Flood & Thomas, 2016). Patients with a lower socioeconomic status often must choose between funding basic needs or purchasing medication. This has a lasting impact on both the health of the individual and the burden on our healthcare system.

Determinants of Health

In the third unit, the modern definition of health was defined as an individual’s capability to adapt, live a fulfilling life, and maintain one’s well being physically, mentally, and socially even in the presence of disease or disability. This contrasts with the 1948 definition by the World Health Organization that defines health as a state of complete physical, mental, and social well-being – which in today’s aging world is unachievable (Bradley et al., 2018). Our population is aging rapidly, and more people are developing chronic conditions. However, most people with chronic conditions can adapt and live a fulfilling active life through medication, treatments, and social support.

The health of an individual and the population are influenced by a variety of personal, social, economic, and environmental factors (Government of Canada, 2020). Below are examples of health determinants that contribute to the development of heart disease.

· Genetics – Family history of heart disease

· Co-morbidities – existing diabetes, hypertension (Lee et al., 2009)

· Obesity

· Unbalanced Diet

· Poor Lifestyle choices – smoking, excessive alcohol consumption

· Sedentary lifestyle

· Age & Gender

· Socioeconomic status – affects access to healthy foods, medical services (Heart & Stroke, 2021)

· Health Knowledge Deficits

· Language Barriers & Culture (Jin et al., 2020)

· Self-Efficacy

Multi-level Approach to Heart Disease

(Safe States, 2021)

In this unit I chose the social-ecological model of health to examine the interconnected determinants that affect one’s heart health on multiple levels. The model consists of four levels: individual, interpersonal, community and societal (CDC, 2021). The framework of this model can be used to better understand the causes of heart disease and develop prevention strategies at each level. Changes must be made on multiple levels to achieve improvements in health for an individual, community and the population.

The individual level consists of biological and personal characteristics that affect one’s health and risk of disease (CDC, 2021). Examples of these determinants were listed in the previous section. Changes at the individual level need to focus on enforcing heart healthy lifestyle behaviours such as consuming a healthy diet and being physically active. The interpersonal level focuses on social relationships and the effects that these relationships have on one’s heart health. A strong social support system has been found to have a positive impact on disease prevention through familial education and engagement (Pahn & Yang, 2021). The community level explores the settings where social relationships occur such as workplaces, schools, and neighbourhoods. Studies have found that disadvantaged neighbourhoods have higher incidences of heart disease (Diez Roux et al., 2001). Prevention strategies at this level focus on implementing heart health education and activity programs in the community. The societal level focuses on initiatives and policies that are put in place to encourage disease prevention. Heart health awareness campaigns can be shared through social media and mass media platforms as preventative measures for heart disease on this level (Jin et al., 2020).

Chronic Disease Prevention and Management

(Public Health Ontario, 2019)

Chronic diseases reduce an individual’s quality of life, life span and increases the financial burden on the health system. Heart disease is one of the most common forms of chronic diseases seen in Canada. It is also the second leading cause of death. (Government of Canada, 2017). Luckily, many of the primary determinants for heart disease are modifiable lifestyle factors that can be prevented. These include consuming a heart healthy diet, regular physical activity, and no smoking (Heart & Stroke, 2021). Ontario has implemented multiple preventative programs to target modifiable risk factors that contribute to chronic diseases. Some of these include:

· Heart Health Program - $17 million investment in raising public awareness of the three key lifestyle factors that can reduce risk of cardiovascular disease

· Active Living Community Action Project -a program focused on increasing physical activity levels of Ontarians through promotion of exercise opportunities in 250 communities (Ontario Ministry of Health, 2012).

Vulnerable Populations

It was evident through my curation of resources in this unit that many vulnerable populations have higher incidences of heart disease. For example, heart disease rates for Indigenous people are 50% higher than the general Canadian population (Heart & Stroke, 2021). This is due to factors such as low income, low education levels, impaired dietary options, and poor access to health care services (Reading, 2015). There is a large health gap between Indigenous and non-Indigenous people. Canada needs to work on providing equitable health care access to all Indigenous people and reduce income inequality. The Heart & Stroke foundation is advocating for changes in policies around indigenous health to improve heart health and lower the risks of disease.

Conclusion

With the challenges presented by COVID-19, the way healthcare is delivered has been changed. Since 2020, telehealth has become the primary method of obtaining medical care. This provides people with the convenience of seeing a physician in the comfort of their own home either through their smartphone, tablet, or computer. The Ontario Telemedicine Network found that the overall patient satisfaction with virtual care was very high, as approximately 98% of patients felt an e-visit was the same or better than an in-person visit (Green, 2020). Many institutions are jumping in with the trend and starting cardiac virtual care programs to monitor and treat heart disease. With the advancements in technology telehealth will only improve. Hopefully with the increased implementation of telehealth – the inequality of access to health care services can be resolved. This would allow for us to improve the overall population health in Canada even among those most vulnerable.

References

Ackun. (2020). The word 2021 written on a highway road in the middle of empty asphalt road stock photo [Image]. iStock. https://www.istockphoto.com/photo/the-word-2021-written-on-highway-road-in-the-middle-of-empty-asphalt-road-gm1283271579-380743612?utm_source=unsplash&utm_medium=affiliate&utm_campaign=srp_photos_bottom&utm_content=https%3A%2F%2Funsplash.com%2Fs%2Fphotos%2Fjourney&utm_term=journey%3A%3A%3A

Bradley, K. L., Goetz, T., & Viswanathan, S. (2018). Toward a Contemporary Definition of Health. Military Medicine, 183(suppl_3), 204-207. https://doi.org/10.1093/milmed/usy213

Centers for Disease Control and Prevention. (2021, October 22). The Social-Ecological Model: A Framework for Prevention. CDC. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html

Deschaine, M. E., & Sharma, S. A. (2015). The Five Cs of Digital Curation: Supporting Twenty-First-Century Teaching and Learning. InSight: A Journal of Scholary Teaching, 10, 19-24. https://doi.org/10.46504/10201501de

Diez Roux, A. V., Merkin, S. S., Arnett, D., Chambless, L., Massing, M., Nieto, F. J., Sorlie, P., Szklo, M., Tyroler, H. A., & Watson, R. L. (2001). Neighbourhood of residence and incidence of coronary heart disease. The New England Journal of Medicine, 345(2), 99-106. https://doi.org/10.1056/NEJM200107123450205

Flood, C.M., & Thomas, B. (2016). Modernizing the Canada Health Act. The Dalhousie Law Journal, 39(2), 397-411.

Government of Canada. (2017, February 10). Heart Disease in Canada. Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html

Government of Canada. (2020, October 7). Social determinants of health and health inequalities. Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html

Green, M. (2020, May 9). Virtual Care is the Future of Health Care. HEALTHCAREIMC. http://www.healthcareimc.com/main/virtual-care-is-the-future-of-health-care-delivery-in-canada/

Heart & Stroke. (2021). Coronary Artery Disease. Heart & Stroke. https://www.heartandstroke.ca/heart-disease/conditions/coronary-artery-disease

Heart & Stroke. (2021). Helping to close the gap in Indigenous health. Heart & Stroke. https://www.heartandstroke.ca/what-we-do/our-impact/helping-to-close-the-gap-in-indigenous-health

Jin K., Neubeck, L., Koo, F., Ding, D., & Gullick, J. (2020). Understanding Prevention and Management of Coronary Heart Disease Among Chinese Immigrants and Their Family Carers: A Socioecological Approach. Journal of Transcultural Nursing, 31(3), 257-266. https://doi.org/10.1177/1043659619859059

Lee D. S., Chiu, M., Manuel, D. G., Tu, K., Wang, X., Austin, P. C., Mattern, M. Y., Mitiku, T. F., Svenson, L. W., Putnam, W., Flanagan, W. M., & Tu, J. V. (2009). Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors. Canadian Medical Association Journal, 181(3-4), E55-66. https://doi.org/10.1503/cmaj.081629

Ontario Ministry of Health. (2012). Ontario Programs for Health Promotion and Disease Prevention. Ontario. https://www.health.gov.on.ca/en/public/publications/hpromo/hpromo.aspx#two

Pahn, J., & Yang, Y. (2021). Factors Associated with Cardiovascular Disease Prevention Behaviour Among Office Workers Based on an Ecological Model. SAGE Open, 11(1), 1-9. https://doi.org/10.1177/21582440211004163

Public Health Ontario. (2019). Causes of death, all causes and chronic disease causes, Ontario, 2015 [Image]. Public Health Ontario. https://www.publichealthontario.ca/-/media/documents/c/2019/cdburden-report.pdf?sc_lang=en

Reading, J. (2015). Confronting the Growing Crisis of Cardiovascular Disease and Heart Health Among Aboriginal Peoples in Canada. Canadian Journal of Cardiology, 31(9), 1077-1080.https://doi.org/10.1016/j.cjca.2015.06.012

Safe States. (2021). Social Ecological Model [Image]. Safe States. https://www.safestates.org/page/SRPFSEM

Winchell, Z. (2018, Dec 13). E-Portfolios and Their Uses in Higher Education. WILEY. https://ctl.wiley.com/e-portfolios-and-their-uses-in-higher-education/