Small steps towards a big problem: Addressing the social determinants of health at the community level

David Phipps (ResearchImpact, York) wrote the following guest blog post for “Health Policies” about a new initiative with UWYR that is focused on community solutions for community health challenges arising from the social determinants of health.

Health isn’t a problem.  Not being healthy is a wicked problem.  Wicked problems are persistent social problems characterized (among other things) by:

• Lack of clarity on all stakeholders associated with the problem
• Lack of clarity on the causes of the problems
• Lack of clarity on end points and outcomes
• Interventions change the nature of the wicked problem challenging evaluation

Social determinants of health (SDOH) are wicked problems.

There is an increasing amount of attention paid to SDOH at the international, national and local levels:

• International: The World Health Organization recently released the technical paper for the World Conference on Social Determinants of Health to be held in Rio de Janeiro in October 2011.
• National: National Collaborating Centre for Determinants of Health (NCCDH) is one of six NCCs funded by the Public Health Agency of Canada (PHAC). In 2010 it released an environmental scan of the role of public health agencies in supporting policy responses to social determinants of health in Canada.
• Local: On June 22 York Region’s Human Services Planning Board release their report, Making Ends Meet which identifies poverty and income insecurity as the single human service priority for York Region.  Health indicators and outcomes are included in the planning.

But how do you tackle such large, wicked problems.  According to WHO Commission on Social Determinants of Health, all you need to do is:

1. Improve living conditions
2. Tackle inequitable distribution of power, money and resources
3. Measure and understand the problem and assess the impact of action.

I’ll get right on that. I’ll also get right on solving the upstream political issues underlying SDOH that were pointed out in a previous Healthy Policies blog.

NOT (and therein lies the problem – where do you start with a wicked problem like SDOH?)

Social Innovation: Or is it? / De l’innovation sociale : vraiment ?

By Dale Anderson (ResearchImpact, UVic)

Dale Anderson, Knowledge Mobilization Coordinator at the University of Victoria, offers the some thoughts on social innovation.

Dale Anderson, coordinatrice de la mobilisation des connaissances à l’Université de Victoria propose quelques réflexions sur l’innovation sociale.

We hear a lot about social innovation these days. It’s talked about as the solution to modern problems, problems that just can’t be addressed unless something new or innovative is proposed, invented, produced. Indeed, it’s not just hip to talk about social innovation, it’s seen as backward if you don’t– and all the better if you establish centres and think tanks devoted to the subject. Lately, I’ve been wondering if it’s really necessary, as it seems to me that the ‘solutions’ (if we can call them that) to many of our modern woes already exist. Somehow, though, we’re just not seeing it.

Endless studies have called for fewer roads, more and better public transit and active transportation options (e.g., walking and biking), and better land-use planning as solutions to growing gridlock in major urban centres. As research shows, building more and larger roadways leads to more traffic, more congestion, and longer commutes. These in turn affect our economy (e.g., increased transportation time and costs, increasing costs for the provision of municipal services such as water, sewer, and waste pick-up), our health (e.g., reduced air quality due to vehicular pollutants, less time for physical exercise), and quality of life (e.g., reluctance to let children walk to school, increasing cost and time for commuting, reduced affordability of housing as urban sprawl is encouraged). The answer to all of these complex but related issues is to build more pedestrian friendly, mixed-use communities. And the answer to how is all around us.

Most of civilization lived before the invention of the car. Those charming, historic European cities we admire were built before the advent of the car. Here in Canada, the most sought-after neighbourhoods in Canada’s largest cities are all central, older neighbourhoods that were built before the car became king (think Kitsilano in Vancouver, the Glebe in Ottawa, or the Plateau in Montréal). So we’ve long known how to build pedestrian friendly communities. A better question is: if we know how to do it, how come we’re not?

Rethinking Research Impact / Repenser l’impact de la recherche

By David Phipps (ResearchImpact, York)

Some new thinking from researchers helps to refine our thinking about the impact of research and how we measure the “impact” (or “contribution”) research might have on policy and practice decisions.

De nouvelles réflexions de chercheurs nous aident à redéfinir notre compréhension de l’impact de la recherche et la manière dont nous mesurons « l’impact » (ou la « contribution ») que peut avoir la recherche sur les décisions en matiere de politiques et de pratiques….

Thank you Sarah Morton. Sarah Morton is co-director of the Centre for Research on Families and Relationships at the University of Edinburgh. She came to Toronto to visit ResearchImpact-RéseauImpactRecherche (York) for 2 weeks. During that visit she made a presentation to the Southern Ontario KTE Community of Practice, met with eight civil servants from Municipal Affairs & Housing, Health & Long Term Care, Education, Food & Rural Affair and Cabinet Office and with Ben Levin’s group at Research Supporting Practice in Education (RSPE). After a weekend in Barrie’s Bay, Sarah came back to Toronto and the world of KMb for a meeting with the International Alliance of Leading Educational Institutions, York’s KMb Expo and then the KTE CoP again where Sandra Nutley (Research Unit for Research Utilization, also the University of Edinburgh) also made a presentation.

As someone from CRFR tweeted “@CRFRTweets: Sarah Morton’s met more knowledge translators in the last 2 days in Toronto than in 10 years in Scotland” (June 7, 3:45pm).

Two meetings stood out for me. Amanda Cooper presented work on evaluation of 44 knowledge intermediary organizations in education including RIR. I won’t preempt her publication by disclosing her results but her evaluation framework was made public at the Canadian Society of the Studies in Education meeting at Congress 2011 in Fredericton. She evaluated the websites of those 44 knowledge intermediaries and scored them on their presentation of their efforts for KMb products, KMb events and KMb networks. Because KMb is a people mediated process, events and networks get weighted more heavily than products in their evaluation framework. This is one of the first quantitative evaluation frameworks for a system of KMb – most frameworks measure the effects of individual KMb interventions. I look forward to Amanda’s forthcoming paper so we can have a fullsome discussion of this methodology and seek to test it in other settings.

KMb press release / MdC communiqué de presse

York University and United Way of York Region examine link between living conditions and health. Two funding announcements will move university research into communities.

L’Université York et United Way de la région de York examinent les liens entre les conditions de vie et la santé.  L’annonce du financement de deux projets va permettre à la recherche universitaire de rejoindre les communautés

First posted by York University.

TORONTO, June 15, 2011 −If where you’re born, live and work − and the healthcare system you access − determines a lot about how healthy you’ll be, what can local governments and community agencies do to improve your well-being?

The Canadian Institutes of Health Research (CIHR) has awarded York University and the United Way of York Region $93,000 to develop research initiatives that will examine how living conditions − the social determinants of health − affect health.

The funding, being announced today at York University’s fifth annual Knowledge Mobilization Expo at the Markham Convergence Centre, will be used for projects that will draw on the university’s strong interdisciplinary health research to respond to community needs and systemic social challenges identified by United Way of York Region.

“Social determinants of health are experienced where Canadians live − right in their communities,” said Ian Graham, vice-president of Knowledge Translation at CIHR. “University researchers and their partners in community health agencies, including those supported by the United Way, are critical to developing novel health services and health policies that have a direct outcome on the health of Canadians.”

“Collaborating and making research more accessible to our community partners and co-developing knowledge is a cornerstone of York University’s research enterprise,” said Stan Shapson, vice-president Research & Innovation. “For the last five years, we have collaborated with the United Way of York Region to connect researchers and graduate students with community and government organizations to find novel approaches that impact health and human services. York’s faculty members and our partners in community health agencies continue to work together to create innovative solutions that benefit the quality of life in our community.”

United Way of York Region is also announcing funding during the Knowledge Mobilization Expo. It is committing $150,000 through Change Inc., a social innovation incubator that it developed with York University to invest in new solutions to persistent social and health challenges faced by York Region residents. Based at the university’s research offices in York Region, Change Inc. was launched in October 2010. The United Way funding, through its Strength Investments will allow Change Inc. to provide socially-focused entrepreneurs, organizations and collaboratives with seed funding, physical space, shared administrative services and access to mentors, York researchers and graduate students.

YorkU’s KMb Expo 2011- there’s still time to register!

Join us next week on Wednesday, June 15th, 2011, when York University’s KMb Unit will host their annual KM Expo at the Markham Convergence Centre.

The theme of the YorkU KMb Expo 2011 is “Putting the Social in Innovation for York Region”. The 4th annual York KMb Expo will explore the relationship between knowledge mobilization and social innovation in York Region. The day will feature plenary discussions, networking sessions and optional workshops. Registration is free but space is limited to 80 participants. Attendees can sign up for the whole day or just for one of the afternoon workshops. Register now at kmbexpo2011.eventbrite.com

Overview – For four years York University’s Knowledge Mobilization Unit has been creating relationships between York University and agencies in York Region and beyond.  The outcomes of these relationships are social innovations that create new solutions to persistent social challenges. Knowledge Mobilization Expo 2011 will focus on these social innovations that are the outcomes of the knowledge mobilization process. Knowledge Mobilization Expo 2011 will start to create a vision of how we can collaborate on a system of social innovation in York Region.

Date: Wednesday, June 15th

Time: 8:30 am to 4:30 pm

Location: Markham Convergence Centre
7271 Warden Avenue, Markham (map below)

Postcards from Congress – Day 7

Congress by the Numbers

As I was reminded while attending Tuesday’s Aboriginal Leaders in Education session, it is appropriate to give thanks to the Maliseet people. It is their traditional lands we had the pleasure of visiting over the last week. This is a beautiful part of the country! Since today is the last final day of Congress, and the ResearchImpact -  Rèseau Impact Recherche (RIR) travelling road show winds down for another spring season (more to come on that!!), it is appropriate to reflect on the week that was:

5000 – The approximate number of delegates registered and visited Congress. This includes graduate students and a significant number of non-academic delegates

2750 – Round-trip mileage from York U to UNB/STU universities. (And I loved every moment of it!)

194 – Visits to the RIR booth, including numerous visits from researchers from our Network institutions.

100 – I imagine this is how many hits we contributed to the 35 million views of Maple Bacon Dog on You Tube!! (I acknowledge this may be a conservative estimate)

63 – Number of scholarly associations present at Congress in 2011

9 – Total duration of Congress (days), including travel time.

7 – New project opportunities presented to RIR brokers while at our booth. Astonishing, given this is the first Congress in which anyone has shared a project opportunity with us.

5 – This is the 5th annual Congress which RIR has attended. We are always grateful for the booth location we are provided, set between the Federation, SSHRC, and across from CIHR

3 – Conferences within the last month – CU Expo, CAURA, and Congress. It is important for RIR to network and promote the work of its member institutions in delivering effective KMb service.

1 – Successful Tweet-up! RIR co-hosted with the Federation a conversation on Twitter about Why SSH Research Matters to Canadians.

But not all aspects of a memorable week are captured quantitatively. There are friendships – old and new; lilacs; lobster; grants; Tim Horton’s breakfast sandwiches; shiny beaver; fiddle music; fog; Picaroon’s; and great KMb conversations!

On behalf of the entire RIR network, our sincere thanks to the staff of the Federation, the great people of Fredericton, and our hosts at University of New Brunswick and St. Thomas University! See you next year in Waterloo, Ontario.

Post Cards From Congress – Day 6

There are not many people who do not like music.  Music has an ability to entertain, inspire and relax people.  Similarly, so has Congress this year in Fredericton.
So in honour of my 13.5 hour car ride I am pleased to share with you these tunes from my iPod – a real compilation of Congress moments for ResearchImpact!

Even in the Quietest Moments – Supertramp

The bookfair is not always a steady stream of conversation, but in 6 days it has produced incredible dialogue at the ResearchImpact booth, often when least expected!  In our six days we have had 170 visits to the booth and over 100 conversations about knowledge mobilization, including students and community leaders.

Ordinary Day – Great Big Sea

Perhaps a more appropriate title would be Extraordinary Day.  Maritime hospitality has been in full display at UNB.  I am certainly looking forward to our next visit to Fredericton!  And, if you’re looking for a more authentic maritime music experience, check out www.brollachan.org

Space Between – Dave Matthews Band

Whether it’s SSH and S&T, or KMb and Social Innovation, or perhaps broader community-university engagement, knowledge brokers from RIR are active in navigating the space between.

And now that my day is done, it’s time for…

One Bourbon, One Scotch, One Beer – George Thorogood and the Destroyers

OK, maybe two beers, one water and an early wake up call… Day 7 awaits!

Post Cards from Congress – Day 5

The trick to an eight day conference is likely similar to a 14 day inclusive vacation… pace yourself!  Today is Day 5, and don’t ask me what day of the week it is!  Fact is, these are the dog days of Congress.  This is not to be disrespectful, for new delegates arrive every day and for them it’s their Day 1!   I like the dog days of baseball because you can count on baseball to be there when it’s late in the summer and you can pull yourself away from the distractions and activities of the summer season.  Such is Day 5 of Congress.

And with the nice weather of the past couple days, it’s been nice to recharge the batteries and get ready for someone’s Day 1!   Today, for example, I arrived at 7:15 and have had 5 visits to the ResearchImpact booth before the power was turned on in the bookfair!

Work hard, yes.  Play hard, definitely.  And find those moments to rest, enjoy and recharge!

PS  – And for your listening pleasure (OK, mine!) here is our unofficial mascot, Maple Bacon Dog!!

post cards from congress – day 4

Day 4 started out with Chad Gaffield, President of SSHRC speaking about Research On the Digital Economy.  Researchimpact-RéseauImpactRecherche actively tweeted his remarks (a portion of which are shown below) throughout his talk which was followed by presentation from a number of the principal investigators of grants from the SSHRC Synthesis in the Digital Economy program.  These researchers presented their findings and recommendations for a Canadian digital economy. Stay tuned to SSHRC for a synthesis of the syntheses and for all the syntheses to be posted.  In the meantime, see the synthesis paper that involved David Phipps of ResearchImpact-York.  The last chapter of this paper reviewed the intersection of digital technologies, knowledge mobilization and the engaged campus.

The afternoon featured a tweet up of some KMb/Congress/RIR tweeps including @jovanevery, @mcshanahan and @qui_oui (left to right in the picture below) with @Kmbeing joining by skype.  Thanks to @qui-oui for organizing this.  Don’t forget the KMb at Congress tweet chat June 1 at noon Eastern.  More information can be found here.

After 42 visits and 24 substantive KMb conversations we headed to the Lobster cook and Kitchen Party.  Good music, good lobster and great company with friends from SSHRC and Johanne Provencal from Simon Fraser University who was co-author of the synthesis paper linked above. Great end to an invigorating day.