This paper introduces the reader to the context for the papers in this journal supplement by describing the background and task assigned to the authors, a short history of the development of the field of literacy and health in Canada, some recent developments and opportunities, some information on the nature and magnitude of the issue, and an overview of the supplement. The publication results from the Second Canadian Conference on Literacy and Health. Authors were asked to summarize what was learned at the conference, what we need to know, and what we need to do to move the field forward in relation to the themes of the conference. The four themes were: Building Best Practices in Literacy and Health; Focusing on Language and Culture; Building Knowledge in Literacy and Health; and Building Healthy Public Policy.
Recently, several Canadian professional nursing associations have highlighted the expectations that community health nurses (CHNs) should address the social determinants of health and promote social justice and equity. These developments have important implications for (pre-licensure) CHN clinical education. This article reports the findings of a qualitative descriptive study that explored how baccalaureate nursing programs in Canada address the development of competencies related to social justice, equity, and the social determinants of health in their community health clinical courses. Focus group interviews were held with community health clinical course leaders in selected Canadian baccalaureate nursing programs. The findings foster understanding of key enablers and challenges when providing students with clinical opportunities to develop the CHN role related to social injustice, inequity, and the social determinants of health. The findings may also have implications for nursing programs internationally that are addressing these concepts in their community health clinical courses.
The basis of the present study is a cohort of 1570 persons, all live births in 1940 of mothers then residing in Bergen. This birth-control was followed up in the compulsory school system at the age of 14 years. Information from the "parsons' lists" (birth registers) was gathered concerning the parents' social background, while facts about the students' recruitment to the compulsory school system in Bergen were obtained from the local files of the various schools and the files of The National Services for the Mentally Retarded. For the purpose of collecting more detailed information, a sample was taken from the birthcohort. This sample was formed on the basis of a stratification of the cohort according to type of school attended at 14 years of age. By supplementing the group comprising persons attending Special Schools for the Educable Mentally Retarded and the group including persons cared for by the National Services for the Mentally Retarded, a total sample of 262 persons was reached. It is found that recruitment to the school system varies considerably with socio-economic background. Children of higher officials were highly over-represented in Junior High School, while children of workers were noticeably under-represented at this type of school. Children of workers were over-represented in Continuation School, Elementary School classes for slow learners and Special Schools for the educable mentally retarded. However, a proportionally very similar representation of the social groups in the services for the mentally retarded was found.
The Northern Ontario School of Medicine (NOSM) has a social accountability mandate to contribute to improving the health of the people and communities of Northern Ontario. NOSM recruits students from Northern Ontario or similar backgrounds and provides Distributed Community Engaged Learning in over 70 clinical and community settings located in the region, a vast underserved rural part of Canada.
NOSM and the Centre for Rural and Northern Health Research (CRaNHR) used mixed methods studies to track NOSM medical learners and dietetic interns, and to assess the socioeconomic impact of NOSM.
Ninety-one percent of all MD students come from Northern Ontario with substantial inclusion of Aboriginal (7%) and Francophone (22%) students. Sixty-one percent of MD graduates have chosen family practice (predominantly rural) training. The socioeconomic impact of NOSM included new economic activity, more than double the School's budget; enhanced retention and recruitment for the universities and hospital/health services; and a sense of empowerment among community participants attributable in large part to NOSM.
There are signs that NOSM is successful in graduating health professionals who have the skills and desire to practice in rural/remote communities and that NOSM is having a largely positive socioeconomic impact on Northern Ontario.
The goal of this article is to outline the analytical perspectives of the concept of social capital regarding health and health management. Social capital, as defined in terms of social networks and resources, has a positive impact on a number of areas, notably the health, well-being, and social and economic development of communities. It is also a useful tool for implementing social policy, especially for marginal populations, the elderly, social assistance payments, etc. An action strategy based on the support and development of networks is the key to achieving the social development, health, and well-being of populations. The social ties promoted by these networks provide people with social, cognitive, and emotional support. This has a direct impact on their self-esteem and sense of personal achievement. They also facilitate access to social resources, including social advancement opportunities. In this paper, we examine the vitality, determinants of health, and health management of Canada's minority Francophone communities.
This concluding article comments on what we learned from the conference, what we still need to know, and what we need to do now. It describes what participants said about the impact of the conference and the follow-up steps that have been taken so far. In terms of what we learned, there was agreement on the importance of culture in understanding literacy and health literacy; the importance of context; the integral relationship between literacy and health literacy and the concept of "empowerment;" the value of efforts to improve health through literacy and health literacy; and the need for collaboration. We need more and better information on how our various efforts are working; the cost of low literacy; the links between health, education, and lifelong learning; the needs and strengths of Aboriginal people, and the perspectives of Francophone and ethnocultural groups. Specific topics worthy of pursuit are suggested. They are followed by a list of recommendations from the conference related to focussing on language and culture, and to building best practices, knowledge, and healthy public policy. The paper presents some findings from the conference evaluation, which suggests that the conference met its goals. It concludes by reporting on actions that have been taken to implement the conference recommendations, including the establishment of a Health Literacy Expert Committee and the submission of several funding proposals.