That’s contrary to what most Canadians believe, says Raphael in his new book , which looks at who stays healthy, who gets sick and why. It’s written with the goal of educating the informed Canadian, as well as university students.

Most people think luck, treatment options and lifestyle choices shape whether they are healthy or not. After all, that is the current mantra – eating better and exercising will lead to a healthier existence – a mantra that Canadians have wholeheartedly internalized. But that’s only part of the equation, and not the biggest part, says Raphael, a professor in 91��ɫ's School of Health Policy & Management in the Faculty of Health.

“Decades of research and hundreds of studies in Canada and elsewhere tell a different story: the primary factors that shape the health and well-being of Canadians – the factors that will give us longer, better lives – are to be found not in those much-discussed areas, but rather in the actual living conditions that Canadians experience on a daily basis,” says Raphael in About Canada: Health and Illness.

These factors include whether people are wealthy or poor, employed or not, working conditions, access to quality education, health and social services, and the basics of food and affordable housing. These social determinants “are crucial factors in the health and well-being of Canadians,” he says.

“Contrary to the assumption that we have personal control over these factors, in most cases these living conditions are – for better or worse – imposed upon us in the normal course of everyday life.”

Left: Dennis Raphael

That’s in large part because of the policies, regulations and laws enacted by governments at all levels, which influence employment income, family benefits and social assistance, as well as the quality and availability of affordable housing, health and social services, and recreational opportunities. That includes “what happens when Canadians lose their jobs during economic downturns such as the one that Canada began experiencing in 2008,” says Raphael.

“Governments also determine whether our children have access to affordable and high-quality child care and better-quality schools, the working conditions that we experience, and whether as seniors we receive levels of public pensions that allow us to live in dignity.”

Raphael wants to see changes in public policy that will affect Canadians’ health in a positive way. Through About Canada: Health and Illness, he wants the average Canadian to understand the role social determinants play in shaping health and what can be done to improve the situation through better public policies.

Raphael is the editor of , co-editor of and author of . He served as an adviser to the California Newsreel documentary series and the Deveaux Babin Productions Canadian documentary .

By Sandra McLean, YFile writer

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin.

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Parekh is the winner of the inaugural Human Rights Prize for Master of Arts (MA) Major Research Paper in the Critical Disabilities Studies Program for her paper, "How Neoliberalism Impacts the Realization of Inclusive Education Both Internationally and Locally: A Study of Inclusive and Equitable Education Opportunities Within the Toronto District School Board". The award, created through donations from 91��ɫ Professors Marcia Rioux and Geoffrey Reaume of the School of Health Policy & Management in the Faculty of Health, was presented to Parekh on Tuesday. "It was an interesting paper to research," says Parekh.

Parekh earned her MA from 91��ɫ's Critical Disabilities Studies Program with an interest in international development and disability, as well as education.

Right: Gillian Parekh (left) being presented the 2010 Human Rights Prize

For her paper, Parekh initially looked at the connection between government prioritization of market ideologies and the subsequent waning commitment to inclusive practices, homing in on inclusive education policies under varying governments in South Africa. Although South Africa boasts of having highly progressive disability policies, over time the push for economic returns has taken precedence over the protection of the rights of students with disabilities, and segregated learning centres have been maintained and expanded.

"An analysis of the evolution of inclusive education policies from South Africa is documented to encapsulate a clear example of the hegemonic relationship between rights and market principles while the right to quality education for many hangs in the balance," says Parekh.

She then turned to the Toronto District School Board (TDSB) to see if the same was true here. She examined student demographics at 85 secondary schools and whether they correlated with the availability of specific programs and services. "Social factors such as poverty, disability, language and parental education are compared to increased or decreased access to programming and services that lead to future enhanced marketability for the student," she writes.

Although Parekh taught special education for several years at schools within the TDSB, the fourth-largest school district in North America, she was surprised by what she found. "Overall, the higher percentage of parents with a university education, the higher the likelihood their children would have access to elite programs within their public school. The higher the percentage of students from low income housing, as well as the higher the percentage of students using special education services, the fewer programs were offered at their school," says Parekh. She knows the TDSB has attempted to address issues of equity and continuously works to offer equitable services and programming to all students, however, the current state speaks to a much more powerful force at work.

In comparing demographics between schools offering French immersion programs, what Parekh calls one of the board's most elite programs, and those schools providing vocational training, she found the difference in incidence of low income, special education and parental education staggering. When she looked at where schools providing vocational training were located, she discovered that they were largely running in Toronto's lowest income neighbourhoods, she says. Whereas French immersion programs were more likely to be found within schools in more affluent areas with greater numbers of parents having been to university.

Access to some programming was definitely related to geography, says Parekh. "The education system continues to sustain inequitable learning opportunities between social groups. Policies addressing the issues of inequity have not yet achieved fully inclusive or equitable educational opportunities for all." And that is true in both Toronto and South Africa.

Parekh largely holds the government accountable for continuing to move towards a private model of market ideology within its public school systems in which more advantaged students are met with greater opportunity

"What bothers me the most is that this disparity is often normalized. Not enough people think significant change is required," says Parekh. It comes down to erroneous thinking that certain people in society are more deserving of academic opportunities than others, she says.

Republished courtesy of YFile– 91��ɫ’s daily e-bulletin.

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Right: Megan Davies

Davies and University of Victoria Professor E. are in the final stages of a community-informed curriculum project that will provide middle- and secondary-school teachers in Ontario and British Columbia with a set of innovative, cross-disciplinary teaching units they can integrate into the classroom. The Youth & Mental Health project is funded by a Collaborative Faculty Incentive Grant from ResearchImpact, which is a 91��ɫ and University of Victoria initiative. The project is the result of a series of consultations with community groups, educators, and psychiatric survivors and it will offer students a wide range of perspectives on mental well-being. The goal is to facilitate critical thinking on this sensitive – and often controversial – topic, and to explore interrelated themes of diversity and social justice.

Davies got the idea for the project in an undergraduate class she taught at 91��ɫ over five years ago. Her students – inspired by the material they were exploring on the history of mental health in Canada – told her that mental health issues should be tackled in the classroom much earlier in a student’s education. “I really took that to heart,” she notes. “They were right; we need to talk to their younger selves.”

A series of community consultations were held in Toronto and Victoria. In September, Davies and Marshall presented four draft teaching units to middle- and secondary-school focus groups for feedback and criticism. Feedback from the groups was integrated into the units and the researchers began to develop a Web site that would house the teaching units and other resources. launched at the end of January and it is rich with lesson plans, hands-on activities, resources and helpful learning objectives.

Learners explore, across cultures and history, the shifting contours of what is, and what has been regarded as, normal mental health in the first teaching unit, Understanding, Experiencing & Equity. The lessons in the unit encourage students to consider where stereotypes about mental health come from, how they impact individuals and communities, and what can be done to combat these negative responses. In one of the activities, students are asked to discuss passages from the diary of a young woman named Lara Gilbert who lived in Vancouver during the 1980s and 1990s and struggled with depression. “The idea is to get students to think about what life is like for someone with mental health issues,” says Davies. “What better way to provoke discussion than through the writings of someone who has actually dealt with the challenges, the discrimination and the struggle for well-being.”

Traditionally, mental health patients in Canada were sent to live at institutions for extended periods of time, if not their entire lives. In the 1960s and 1970s, improved treatment options and a shift in ideology occurred; governments and health professionals started to advocate for the deinstitutionalization of mental health care. The idea was to integrate – rather than isolate – patients into the community. The second teaching unit, Self-Determination & Activism, provides a snapshot into the conditions of mental health institutions and explores what the shift in practice meant for those living with mental health issues.

As Davies notes, though integrating individuals into the community may have been a noble idea, it has been a difficult and flawed process. Insufficient community services, limited health care, and a lack of funding for resources have prevented mental health patients from getting the support they need. Instead, the most powerful force for positive change has often come from psychiatric survivors themselves who have united against discrimination and pushed for better living conditions. Students in the second unit examine patients’ rights and reflect on the mixed freedoms and hardships that community living can provide.

Housing, Homelessness & Poverty, the focus of the third teaching unit, asks students to think about complex questions such as: Why are people with mental health issues vulnerable to being homeless? Should safe, affordable housing be considered a fundamental right? Highlights of the unit include surprisingly grim figures about the state of homelessness in Canada and an activity that gets students to create skits that portray the real-life stories they’ve read in class.

The last teaching unit, Well-Being, Health Care & Treatment, looks at positive mental health strategies and resources. It also examines mental health care through the lens of human rights. Lessons are complemented by historical archives, cartoons and artwork.

“Each of the four teaching units draw heavily on personal experiences, historical documents, poetry and graphic art in order to help students gain a more comprehensive and personal understanding of the complex aspects of mental health,” says Davies. “The lessons are interactive and designed to encourage a deeper learning experience through personal reflection and engagement in classroom discussion.”

Davies, who teaches in the Health & Society Program in 91��ɫ's Faculty of Liberal Arts & Professional Studies, continues to exchange ideas with community partners on revisions for the teaching units. She hopes to develop more units in the future and to have them linked to curriculum in other provinces, translated so that they can be accessed by francophone students and reworked for aboriginal communities. Davies also welcomes suggestions for improvement from students. In fact, she says students played a key role in the overall success of the project. “A lot of the work was done by youth – from the original artwork on the Web site to data entry and research,” Davies notes. “This was very much a youth-centred project and it only made sense to involve them at each phase.”

The project has already attracted .

The curriculum project is part of a larger heritage initiative that is funded by the Canadian Institutes for Health Research. As part of that initiative, Davies has been active in the creation of another Web site, , which serves as a research, resource and educational hub on mental health issues.

For more information on Davies’ research, e-mail daviesmj@yorku.ca.

By Kristin Taylor, communications coordinator, Faculty of Liberal Arts & Professional Studies

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin

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Saskatchewan was panned Thursday over its high infant mortality rate by the author of ain the journal , wrote the (Regina, Sask.) Jan. 22.

In his article, “The health of Canada’s children: Part 1”, released Thursday, 91��ɫ Professor Dennis Raphael, of 91��ɫ’s , in the Faculty of Health, cites a 2008 Statistics Canada report pegging Saskatchewan’s infant mortality rate at 8.3 deaths per 1,000 live births, the highest of any province.

“Saskatchewan has this dubious distinction. The single best indicator to represent the health of the population is infant mortality,” Raphael said in an interview Thursday.

Factors affecting infant mortality include the growing gap between rich and poor and the child poverty rate, he said. The article also pegs Canada’s child poverty rate well below average.

Canada has 15 per cent of its children living in households with less than 50 per cent of the Canadian median income. Denmark, Finland, Sweden and Norway all come in at five per cent or less. “We are not doing well in terms of taking care of everyone,” Raphael said.

Republished courtesy of YFile – 91��ɫ’s daily e-bulletin.

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