The health-care needs of the people of Newfoundland and Labrador is an enduring topic of conversation throughout the province.
As part of the Gazette special feature on #FutureNL, we asked leaders from Memorial’s health-related faculties and schools to share their unique perspectives on the province’s health.
Deans from the faculties of Medicine and Nursing and the schools of Human Kinetics and Recreation (HKR), Social Work and Pharmacy all see challenges in our aging population and sedentary lifestyle and opportunities to improve health through interdisciplinary collaboration and health promotion.
Dr. Margaret Steele, dean of the Faculty of Medicine, says the biggest health-related challenge facing Newfoundland and Labrador is managing the needs of our aging population.
“By 2036, Newfoundland and Labrador will have the oldest population in the world and as people age, they are more likely to have more complex and chronic illnesses which places a burden on the individual, their families and the health-care system,” she explained.
Dr. Shawn Bugden, dean of the School of Pharmacy, agrees, while also acknowledging the challenge of the appropriate use of medication.
“We now spend more money on medications than on physicians.”
“It is true that we have substantial health challenges related to an aging population and lifestyle that are increasing the burden of chronic diseases, such as heart disease and diabetes,” he said. “However, we now spend more money on medications than on physicians. In my mind, appropriate management of medications is going to be a key component in managing health care now and in the future.”
With that top of mind, researchers in the School of Social Work are actively engaged in projects to better understand the supports needed to live well into old age, particularly in rural, under-served areas.
The research, funded by the Social Sciences and Humanities Research Council and by Public Engagement funds, has included the importance of informal systems of socio-emotional support in end of life care, and the need to proactively develop and support these systems.
Chronic disease management
In a 2011 policy document, the provincial government called chronic disease “the biggest threat to the health of the population and the sustainability of the health-care system.”
Dr. Alice Gaudine, dean of the Faculty of Nursing, believes a greater emphasis on family and community supports for residents living with a chronic physical or mental illness is needed.
“We need to look at solving problems upstream, before they become severe and chronic problems.”
One project in the Faculty of Nursing is investigating the role of family practice nursing. Family practice nurses are registered nurses who work in primary care settings delivering a broad range of health-care services to patients of all ages, including management of chronic disease. This initiative also has the potential to improve access to care in rural and remote areas.
Dr. Bugden sees a role for pharmacists in the management of chronic disease.
“Less than half of patients with a chronic disease continue taking their prescribed medication beyond a year, despite their physician’s direction. At the School of Pharmacy, we are working to foster the skills necessary for both new and practising pharmacists to help patients better manage their prescriptions.”
“We need to look at solving problems upstream, before they become severe and chronic problems, devastating individuals, families and their communities and escalating the cost of providing acute care and specialized health services,” said Dr. Gaudine.
“We need to be more active, but . . . society needs to change in such a way that physical activity is the norm.”
Low levels of physical literacy — our understanding of and motivation for incorporating physical activity into our lifestyle — is part of the issue.
“Physical inactivity and sedentary behaviour across the lifespan impacts everything from mental health and sleep to cancer, diabetes and heart disease,” said Dr. Linda Rohr, dean of the School of Human Kinetics and Recreation.
“The unique thing about HKR is that we can help the people of the province increase their physical activity levels across the lifespan and our researchers approach the issue from multiple perspectives.”
For example, children and caregivers can build physical literacy through the free Project Play, while the Recreation NL program Active for Life helps seniors in the province increase physical activity as a way to reduce their fall risk.
“We need to be more active, but in order to do that society needs to change in such a way that physical activity is the norm,” said Dr. Rohr. “The positive impact that daily physical activity has on health is extraordinary.”
A collaborative approach
All the health-care leaders agree that collaboration is key.
“The biggest need is to have a view of the health-care system that is as comprehensive as possible, including each of the complementary professions,” according to Dr. Ross Klein, interim dean of the School of Social Work.
Dr. Gaudine echoes this idea, saying that Newfoundland and Labrador should move from a system that focuses on illness to one that focuses on promoting wellness, with health professionals working together to improve the health of people and communities.
“Developing a robust provincial primary health-care system with interprofessional teams – that include the patients and their families – helps patients access the best care possible,” said Dr. Steele.
For Dr. Steele’s full profile on this topic, please visit here.