All posts by Nicole Haywood

Associate editor for the IJHS. Bachelor of Health Sciences, class of 2014, University of Ottawa.

Mortality prediction with a single question

“On a scale from 1 to 5, how would you rate your own health?”

Self-reported or self-rated health status (SRH) is a commonly used indicator in both clinical epidemiology and population health. It is a subjective measure of health that is thought to reflect an individual’s integrated perception of the domains of health, including biological, psychological, and social dimensions. The World Health Organization considers SRH to be a reflection of population health and healthy life expectancy within countries1. It is assessed either by a questionnaire or by a single question which asks subjects to rate their own health, usually on a four or five-point scale from poor to excellent. SRH has been used as a health indicator in epidemiological studies since the 1950s, and has been found to predict future health outcomes independent of physical, socio-demographic, and psychosocial indicators2-5. It is widely considered to be a valid indicator of health status.

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Choice in childbirth: VBAC

Childbirth is a ubiquitous experience among mothers. Birth can occur in many ways, from medication-free natural labour, to cesarean section. Mothers in Canada can, for the most part, choose how they want to deliver. However, women with a prior cesarean section have a more difficult choice to make. They can choose to have a repeat cesarean section, or to attempt a vaginal birth after cesarean – a VBAC. How do women make this decision, and how can healthcare providers support them?

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Ins and outs of cancer screening

 

It’s estimated that approximately 2 in 5 Canadians will develop cancer during their lifetime, and that 1 in 4 will die from the disease1. Cancer affects or touches almost everyone in this country in some way, and a lot of research has gone into preventing and treating the disease. The overall 5-year survival rate for all cancers in Canada was 63% for 2006-20081. It’s well known that cancers that are caught early have a higher chance of successful treatment and survival. One of the ways that we can diagnose these early-stage cancers is through screening.

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Bangers and mass confusion: do I have to give up bacon?

On October 26, 2015, The World Health Organization announced that processed meat is carcinogenic, and red meat probably is too.1 They defined processed meat as ‘meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavour or improve preservation’. Before you decide to pass on the bacon or defiantly include it in every meal, let’s break down the report to understand the risk.

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Access to abortion in Canada: will RU-486 make a difference?

On Wednesday, July 29, 2015, Health Canada officially approved the pharmaceutical agent RU-486 (Mifegymiso). This drug can cause medical abortions, and is used as an alternative to surgery for early abortions. It will be marketed as Mifegymiso in Canada and as approved, contains two active ingredients – mifepristone and misoprostol. Mifepristone blocks the production of progesterone, which is required to sustain a pregnancy. Misoprostol causes uterine contraction. Studies show that the combination drug Mifegymiso is 95-98% effective in causing a miscarriage (1).

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Fundamental connections: how employment influences health

A person who is employed full-time spends one third of his or her day at work, five days a week. This significant time commitment can affect one’s health. Working conditions and job-related stress can negatively impact health, while unemployment and underemployment are also associated with adverse health outcomes (Public Health Agency of Canada, 2015).

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Medically Assisted Dying

On October 15, the Supreme Court of Canada heard a case for physician-assisted suicide. Two and a half weeks later, terminally ill 29-year old Brittany Maynard ended her life in Oregon under the jurisdiction of the Death with Dignity Act in that state (Cavaliere, 2014). The legality of end-of-life decisions is high in public awareness right now.

There is also a sense that in Canada social mores have shifted since the last time this issue was brought before the Supreme Court, in 1993. Public opinion polls show that the majority of Canadians (68-84%) favour the right to a medically assisted death, provided there are proper safeguards in place for vulnerable people (Dying with Dignity Canada, 2014).

Canada is not alone in struggling with this issue, as many jurisdictions internationally are seeking to enact legislation to manage the demand for this ethically problematic service. The accompanying table presents a summary of which types of medically-assisted dying are available in which parts of the world.

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Global health priorities: health systems strengthening and Ebola

Ebola has been prominently featured in the news for the past several months. The outbreak continues to grow in number and geographic scope of cases, and many people are wondering how it got so out of control in the first place. The hardest-hit countries are Liberia, Guinea, and Sierra Leone, with a total of 8376 confirmed, probable, or suspected cases reported up to October 10 (World Health Organization, 2014).

The current epidemic began in Guinea, a developing country in West Africa. Poor public health infrastructure made this an ideal location for the outbreak to spread. There are only 0.1 doctors per 1000 people in Guinea, compared to 2.07/1000 people in Canada (CIA World Factbook, 2014). Approximately $67 per person is spent each year on health in Guinea; in Canada, this number is $4676 per person per year (World Health Organization, 2014). It is clear that poverty is a factor here. Guinea’s health system was simply not able to contain the initial Ebola outbreak – but let’s scratch beneath the surface to find a more nuanced explanation.

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Education and Literacy

“An additional four years of education lowers five-year mortality by 1.8 percentage points; it also reduces the risk of heart disease by 2.16 percentage points, and the risk of diabetes by 1.3 percentage points” (Cutler & Lleras-Muney, 2006).

Education has a strong positive relationship with health status. Its effect is facilitated through several different pathways. Let’s explore them.

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