Upstream Approaches to Canadian Population Health

Introduction

Many governments are preoccupied with reducing health inequities in the community. However, over the years, many of their public health programs have failed to do so because health inequities exist in many countries today (Feeny, Kaplan, Huguet, & McFarland, 2010). Nonetheless, some countries perform better than others do in this regard (Public Health Agency of Canada, 2014). Therefore, it is pertinent for public health officials, from poorly performing countries, to learn lessons from successful public health programs in countries that have made significant strides in reducing such inequities.

In line with this goal, this paper introduces the Higgins Nutrition Intervention Program that reduced maternal health inequities in Montreal, Canada. Similarly, it explains how American public health officials can learn from the program to minimize social inequities in the United States (US).

Describe a Public Health Intervention in Canada aimed at Improving Health Inequities

The Higgins Nutrition Intervention Program was a Canadian public health intervention that strived to increase infant baby weight and reduce intrauterine growth retardation. It targeted a group of low-income women living in urban areas (National Collaborating Center for Healthy Public Policy, 2010). Proposed as an adjunct to routine prenatal care, the program aimed to achieve its goals by introducing early nutritional interventions to expectant mothers.

Pioneers of the program assessed the risk profiles of the participants and used specific nutritional rehabilitation allowances to offset the risk of negative health outcomes after delivery (National Collaborating Center for Healthy Public Policy, 2010). Participants were second-time mothers. Their first babies acted as a control group. Therefore, the researchers compared the health outcomes of the second babies with their siblings to understand the efficacy of the public health program.

Description of Health Inequities and how the Intervention Targets Upstream Health Factors

Vafaei, Rosenberg, and Pickett (2010) define health inequities by associating the concept with health inequalities. In line with this reasoning, Kirkpatrick and McIntyre (2009) say that health inequities are avoidable health inequalities. The Higgins Nutrition Intervention Program acknowledged the effect that health inequities had on the maternal health of low-income women. Its proponents understood that they affected this demographic more than other socioeconomic groups (Dinca-Panaitescu et al., 2011). Based on this understanding, the Higgins Nutrition Intervention Program addressed upstream health factors of infant health by focusing on providing proper nutritional supplements, as a precursor for positive health indicators of infant health (Health Council of Canada, 2010).

Organizations Involved in Implementing the Intervention

The Higgins Nutrition Intervention Program started in Montreal, where its founder, Agnes Higgins, lived and worked. Based on her locality, Montreal-based organizations participated in her program. An instrumental health facility that started the first experiments of the nutrition program was the Montreal Diet Dispensary. It gave nutritional supplements to expectant mothers, as a measure of improving their maternal health outcomes (National Collaborating Center for Healthy Public Policy, 2010).

Was the Intervention Successful and what Lessons can we learn from it?

The Higgins Nutrition Intervention Program was successful because there was an overall improvement in infant health among the sampled group of new babies (born from the participating mothers). In detail, the program reported a 50% increase in birth weight among the experimental group (compared to the control group) (National Collaborating Center for Healthy Public Policy, 2010). Relative to this finding, The National Collaborating Center for Healthy Public Policy (2010) says the experimental children weighed 170gm more than the babies did in the control group. Overall, these findings show that the public health program was successful.

Public health officials can learn from the success of the Higgins Nutrition Intervention Program by understanding the efficacy of upstream health interventions on infant health (Public Health Agency of Canada, 2013). Many American states suffer from some of the issues addressed in the Higgins Nutrition Intervention Program. For example, low birth weight is a public health concern among residents of southern states (National Collaborating Center for Healthy Public Policy, 2010). Public health officials can borrow from the findings of the Higgins program by assessing the risk profiles of pregnant mothers and using specific nutritional rehabilitation allowances to offset them. This strategy would be an effective upstream health intervention to improve infant health outcomes in the US.

Conclusion

This paper introduces the Higgins Nutrition Intervention Program as a successful public health program in Montreal, Canada, that improved infant health outcomes among a group of second-time mothers. The program identified pregnant women who suffered a high risk of poor maternal health and provided nutritional supplements to prevent such outcomes. The reduced rates of low birth weight and intrauterine growth retardation among the experimental group shows that the program succeeded.

Public health officials in America could learn from the program’s success by understanding the need to focus on upstream public health interventions, such as providing nutritional supplements to help expectant mothers improve the health of their babies. Based on the efficacy of the same intervention in Canada, American authorities could implement the program on a wider scale (national scale).

References

Dinca-Panaitescu, S., Dinca-Panaitescu, M., Bryant, T., Daiski, I., Pilkington, B., & Raphael, D. (2011). Diabetes prevalence and income: Results of the Canadian Community Health Survey. Health Policy, 99(2), 116–123.

Feeny, D., Kaplan, M. S., Huguet, N., & McFarland, B. H. (2010). Comparing population health in the United States and Canada. Population Health Metrics, 8, 8–18.

Health Council of Canada. (2010). Stepping it up: Moving the focus from health care in Canada to a healthier Canada. Toronto, Canada: Health Council of Canada.

Kirkpatrick, S. I., & McIntyre, L. (2009). The Chief Public Health Officer’s report on health inequalities: What are the implications for public health practitioners and researchers? Canadian Journal of Public Health, 100(2), 93–95.

National Collaborating Center for Healthy Public Policy. (2010). Thirteen Public Interventions In Canada That Have Contributed To A Reduction In Health Inequalities. Web.

Public Health Agency of Canada. (2013). Key element 4: Increase upstream investments. Web.

Public Health Agency of Canada. (2014). Health Promotion. Web.

Vafaei, A., Rosenberg, M. W., & Pickett, W. (2010). Relationships between income inequality and health: A study on rural and urban regions of Canada. Rural and Remote Health, 10(2), 1430.