Community Health turns 50
Impact of work evident, and continuing

February 5, 2010

By Kris Foster

In the 50-year history of the Department of Community Health and Epidemiology (CH&E), the face of public health has changed. Dramatically.

Putting this length of time into perspective, Nazeem Muhajarine, head of the department in the College of Medicine, said it was only about 50 years ago that smoking was identified as a critical health-risk factor. “Back then 50-60 per cent of people smoked,” he said. “Now it is closer to about one out of five people who smoke, a significant decrease.”

That is but one health issue faced by CH&E since being established in 1959—back when it was known as the Department of Social and Preventative Medicine. The list of major public health issues that have come and gone, or hung around, is long: cancer, heart disease, car and road safety, obesity, AIDS, pandemics, the birth control pill and workplace safety, to name a few.

Indeed, the development of CH&E has mirrored the health trends facing Saskatchewan, Canada and the world, while addressing many of them along the way. But Muhajarine points out three areas in the department that changed the most over this time: research, education and community engagement.

“In 30-50 years we have brought science and research to the level that it can benefit all people, not just the scientists doing it,” said Muhajarine. “By using research to address issues important to society, it has become relevant, understandable and compelling to the average citizen.”

The relevance of the work of CH&E is highlighted by the number of measures that have been put in place to protect the public—vaccines, immunization, water fluoridation, workplace safety codes, road safety. “(But) equally important is the link we have been able to make between public health and population health,” explained Muhajarine. “We look to population health for answers to determine causes of health or ill health. From what we learn from population health, we can then act on this knowledge in public health to protect our communities.”

Once the risk factors that lead to a disease or lack of health are known, work can begin on educating the public and changing behaviour, said Muhajarine. This starts in the classroom, where the graduate program at CH&E has grown from non-existent to one of the largest in the College of Medicine, with 45-50 students from around the globe enrolled.

“The diversity of students, including a large number of aboriginal students, allows us to build capacity in our own backyard and around the world. We have moved from being ‘health experts’ who bring expertise to local and international communities, to now working as partners with communities and policy makers around the world. The teaching, training and mentoring we do will allow us to continue to improve our knowledge, provide evidence and influence policy that can lead to healthier communities.”

Community engagement, through knowledge translation and transfer, is another emerging area of focus for CH&E. “By translating knowledge to the public and getting the information out to local, regional and national communities, we get action and we can influence the enactment of policy. We have all of this knowledge, but unless we can transfer it into relevant communities it often doesn’t get acted on. Improved information technology and increased connectedness of the world have certainly helped on this front.”

Muhajarine is optimistic that this type of work can successfully address obesity, a growing health issue around the world and one of his areas of research. He only has to look as far as the drop in the number of smokers over the past 50 years to see evidence of the impact that can be made when research and education translate into community engagement and policy change.

“If we don’t make strides in addressing diet and physical activity, and if current obesity trends continue in children as they grow up, we could experience a drop in life expectancy and in quality of life.”

But perhaps the largest problem on the horizon facing community health, one that Muhajarine calls “the number one cause of death,” is the inequality that exists within and between communities.

“It depends on whether you look at immediate causes of disease or root causes,” he said. “Lack of resources, education, infrastructure and power can be linked as a root cause to any number of health issues. Societies that are more equal are, overall, much healthier than those that are socially hierarchical.

“Consider why the infant mortality rate is twice the national average in some northern aboriginal communities. This is only one health issue that illustrates the importance of inequality as a root cause of poor health. A lot still needs to be done, but hopefully our work can contribute to a more equitable and healthier society for all.”

To mark its 50th anniversary, CH&E is hosting an event on March 26 to honour the past and celebrate the future. A public panel discussion will take place in the auditorium at St. Thomas More at 2:30 p.m. The remainder of the day’s activities, to be held at Albert Community Centre starting at 5:30 p.m., include a poster fair, and dinner and a dance for past and present CH&E students, faculty and staff.