Hi! I hope you have already explored my 'about' section if you're reading this so you can better understand what to expect from this page. But if not, and I were to be concise about my goals, I would say that as a future healthcare professional, I want to help eliminate misconceptions regarding mental health, harm reduction, and ultimately educate how systems in place promote health inequities.
Health inequities refer to the differences in an individual’s or populations’ health due to our social conditions. For example, income level impacts the quality of care one receives, which affects long-term health outcomes – someone who can’t afford a life-saving medication is at risk for worse outcomes than someone who is able to afford it (World Health Organization, 2018). That’s not fair. Yes, it’s how the world works, but why should we settle and let it continue to work that way when it could be better? Life can be better for everyone and I think that’s worth fighting for.
So, what does it mean to work upstream? This refers to interventions that address the root cause(s) of a problem so that they don’t continue to happen. I'll explain it how I've been taught throughout nursing school, the classic public health allegory credited to medical sociologist Irving Zola:
A witness spots a man stuck in the river current, nearly drowning. This witness runs to pull them out, and then sees that there are more people stuck in the current. After saving many of these people, the witness walks upstream to figure out why so many people fell in. Maybe a safety fence was missing that would have prevented people from falling in (National Collaborating Centre for Determinants of Health, 2014). This curiosity to explore what is happening upstream and a desire for justice are necessary to determine and address these root causes.
Too much of healthcare today is addressing issues downstream (responding to immediate health needs), without acknowledging the mounting evidence that an upstream approach will benefit us all.
I want to help show people, whether they are in healthcare or not, how a government and healthcare system that addresses the social determinants of health can drastically change the lives of Canadians for the better.
Moreover, I want to be transparent and acknowledge that I have a lot of privilege as a white, able-bodied Canadian citizen that will ultimately shape the way I think, but I am constantly working to reflect on my biases. I also want to acknowledge that I don’t speak for all members of communities that I am apart of (like being Jewish), and just because I am part of a community, my lived experience is not the same as all; my opinion cannot be "right." For these reasons, please leave a comment or message if I write something that could be said better, or maybe should not have been said at all. Creating these posts is also about starting a conversation, which is partially the reason for the associated Instagram account.
I hope you will join me on this journey.
Until next time,
Raquel
References
National Collaborating Centre for Determinants of Health. (2014). Let’s talk: Moving upstream. Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University. Retrieved from https://nccdh.ca/images/uploads/Moving_Upstream_Final_En.pdf
World Health Organization. (2018). Health inequities and their causes. Retrieved from https://www.who.int/news-room/facts-in-pictures/detail/health-inequities-and-their-causes#:~:text=Health%20inequities%20are%20differences%20in,right%20mix%20of%20government%20policies.
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