What are the keys to good health? You might think of things like diet and exercise or access to a physician and other primary health care services.
These are essential, but with a recent survey led by the McMaster School of Nursing (SON), residents of three of Hamilton's north and east end neighbourhoods identified health issues that on the surface, may seem to have little to do with health.
In Health in the Hubs: Phase 1, citizens of the South Sherman area identified the beautification of their neighbourhood, focusing on graffiti, gardens, litter and alleys, as their priority in working towards a healthier place to live.
In Crown Point, the lower city bounded east-west by Kenilworth Avenue and Gage Avenue, residents want to develop a more walkable community by looking at traffic calming, safety and barrier-free walking.
And, residents in the McQuesten community west of the Red Hill Valley Parkway to Parkdale Avenue, will concentrate on social enterprise with such things as developing their community kitchen and a community garden.
"I find it fascinating, what's emerged,' said Paul Johnson, the City's director of neighbourhood development strategies. "We forget that much of health has to do with the community in which we live. Much of people's physical and mental health is affected by how people connect with other people and services in their neighbourhood.'
The SON, partnering with local planning teams from all three neighbourhoods; Wesley Urban Ministries and Homestead Christian Care, launched Health in the Hubs earlier this year. Resident coordinators and nursing students went door-to-door to survey 700 residents about health issues of concern. Consultations were then held with residents to identify key priorities to tackle in the second phase of the project, now underway. With funding from the Hamilton Community Foundation, the next phase will combine existing research evidence around the health issues with residents' views to come up with potential solutions.
Johnson called the information gathered "absolute gold' because "in going door-to-door, we see what the concerns are at the neighbourhood level, and it gives you real feedback you can use.'
The idea behind the project is that addressing the social determinants of health is crucial to developing long-term solutions to improving health. This echoes the Hamilton Spectator's Code Red series, which explored how where one lives in this city greatly affects one's health. While the SON's involvement with the community predates it, Code Red brought the issue of poverty in Hamilton's neighbourhoods to the forefront.
Dyanne Semogas, an assistant professor with the SON, said the initiative is a great example of "the University recognizing the assets the community already has at the table, and wanting to work collaboratively with them.'
David Derbyshire, a community development worker at Wesley Urban Ministries, applauded McMaster for "coming into this community to learn from the community, to learn with the community,' adding the nursing school "is just another tool in the chest to help the community move forward.'
The project is a "positive step forward for the School of Nursing itself in developing a means to learn about and develop the role of nurses in community development,' said part-time faculty member Steven Rolfe. "Achievement of the goals of walkability, social enterprise and mobilizing community assets to improve the physical environment will have a positive impact on the lives of people living in these neighbourhoods.'
All agree that these complex health issues will take time and resources to address, but Johnson is confident the City can help.
"We want to see change occur and we want to be a partner in that,' he said. "The healthier our neighbourhoods are and the stronger they are, the more prosperous they'll become.'