Promoting and protecting the health of the public through advocacy, partnerships and education

Alberta’s organ and tissue donation rates rising

By: Erika Roy, APHA SCiP Intern, May 2017

Organ and tissue donation has become a major public health advance. Transplantation can both save and improve the quality of lives. In 2015, organ donors saved 380 lives in Alberta—an 11 per cent increase from the previous year.

Currently, more than 700 people in Alberta are on transplant lists. In Canada, there are more than 4,500 people waiting for a lifesaving transplant, and many more waiting for transplants which would result in a quality of life improvement. Blood transfusions are a lifesaving intervention for many Albertans, as well.

The need for organs, tissues and blood is a public health issue. Organ, tissue and blood donation are methods of combating this issue. Public awareness and education about organ and tissue donation leads to a greater number of donated organs and thus much better health outcomes for those in need of transplants.

Organ and tissue donations in Alberta run as an opt-in program, meaning that Albertans can register their consent to donate their organs and/or tissues. In 2014, Alberta created an online registry in an effort to increase the number of registered donors. Online registries allow provinces to track the number of people who have chosen to donate their organs. Over 350,000 Albertans have registered to be organ and tissue donors, or about eight per cent of the province’s population. By comparison, since Ontario created an online registry in 2011, 29 per cent of Ontarians have registered.

Organ donation involves the donation of an organ, such as a heart, lung, kidney, liver, pancreas, small bowel or stomach. Organ donors can be either deceased or living. Organ donations from deceased donors can occur if the donor has sustained severe brain damage, is no longer alive andhas been maintained on a ventilator until his or her organs are removed. Organ donations from living donors can occur if donating the organ will not harm the donor.

Tissue donation involves the donation of a tissue, such as skin, cornea, sclera, bone, heart valves, tendons or amniotic tissue. Tissue donation does not require the same conditions as organ donation. Tissue donation can occur once the heart and lungs have stopped functioning, and thus the donor does not need to be maintained on a ventilator. Tissues must be removed within 12 to 24 hours after the donor’s death.

Donated organs and tissues are then transplanted from the donor to the recipient. One organ and tissue donor can save up to eight lives, and improve the lives of up to 75 others.

Only one to two per cent of people who die can be considered for organ donation, while most people who die can be considered for tissue donation. A potential donor’s medical and social history can affect her ability to donate. Donated organs and tissues must be healthy. The donor must also be free of diseases that could harm the transplant recipient.

Albertans can register their consent for organ and/or tissue donation in one of three ways:

1.            By accessing the Alberta Organ and Tissue Donation Registry (AOTDR) [link: https://myhealth.alberta.ca/Pages/OTDRHome.aspx] and mailing or faxing a copy of their signed, dated, and witnessed donation form to Alberta Health.

2.            Visiting a Registry Agent office to register their consent.

3.            Signing the back of their Alberta Personal Health Card, and having the signature witnessed.

Should you wish to be an organ donor in the event of a tragedy, an essential component of ensuring that this can occur is talking with your family about your wishes for organ and tissue donation. In order for organs or tissues to be donated, a member of your family must sign a consent form saying they have been informed and agree with the donation process. In the event that an Albertan’s intention to be an organ or tissue donor is not recorded, their healthcare provider can contact their next of kin to discuss the option of organ and/or tissue donation.

In the event of a tragedy, knowing your wishes surrounding organ donation will help your family to feel better about any decisions they make surrounding organ or tissue donation. Thus, it is important for every adult to reflect on the enduring gifts of organ and tissue donation, and totell your family what you want to happen when you die.

For more information on organ and tissue donation in Alberta, please visit https://myhealth.alberta.ca/Alberta/Pages/organ-and-tissue-donation-topic-overview.aspx.

The APHA welcomes your feedback. Comments about this article can be sent to: apha.comm@gmail.com

Sources

  1. https://myhealth.alberta.ca/alberta/Pages/organ-and-tissue-donation-topic-overview.aspx
  2. https://myhealth.alberta.ca/alberta/Pages/organ-and-tissue-donation-consent-to-donate.aspx
  3. http://www.inews880.com/2017/02/14/alberta-organ-donation-rates-are-up-but-more-are-still-needed/
  4. http://www.cbc.ca/news/canada/edmonton/only-8-per-cent-of-albertans-registered-as-organ-donors-1.3927880

Alberta’s recent pilot project initiative to subsidize child care has potential to improve lifelong health of Albertans

Erika Roy, SCiP Intern

Early childhood development is critical to health and well-being later in life. “Experiences in early childhood (defined as prenatal development to 8 years of age) … lay critical foundations for the entire life course” (CSDH, 2008). Thus, healthy early childhood development is of great concern for public health.

Early childhood experiences can impact a child’s development through programming, whereby future health happenings are encrypted into biology early in development (Davidson, 2015). Fetal and early childhood events can thus alter future health outcomes. Two hypotheses may explain the ability of early childhood experiences to predict future health outcomes—the Barker hypothesis and critical development junctures. According to the Barker hypothesis, low-birth weight, or limited infant growth and weight gain in the first few months following birth, predisposes children for future negative health outcomes. According to the idea of critical developmental junctures, certain biological events must be sequenced correctly and occur in the correct context, or they will never occur. 

Positive early childhood experiences depend on factors such as the health of the mother when she conceived; the mother’s activity level, diet, and health-related behaviour during pregnancy; socioeconomic status; social interaction; exposure to violence; and multiple other factors. Many of these factors depend on how well the mother is supported by friends, family, and access to services such as health care and child care.

There is potential to improve the health of the Albertan population by offering support during this crucial time of early childhood. This support could include “ensuring that the outcomes from pregnancy are positive, the infant is provided with care, sustenance, and stimulation needed for healthy development, and the child in the early part of his or her life is appropriately supported and raised in conditions conducive to his or her long-term well-being,” (Davidson, 2015).

A recent study estimates that only 17 per cent of Canadian families have access to registered child care (Mikkonen and Raphael, 2010). High-quality early childhood education positively affects all children, but particularly those living in socioeconomically deprived circumstances. As one study found, “High-quality early childhood education targeted at high-risk groups from a very early age (one year or earlier) can result in significant positive cognitive and academic achievement outcomes as well as greater adult self-sufficiency … The most successful programs combine intensive high-quality preschool with some home visits to improve the home-learning environment” (Geddes, Haw, and Frank, 2010). Thus, there is potential for accessible child care programs to positively impact the health outcomes of Albertan children, and, subsequently, adults.

The APHA has a history of supporting accessible child care initiatives. For instance, in 1986, the APHA passed the following resolution: “Be it resolved that APHA recommend that CPHA urge the Department of National Health and Welfare to initiate the development of a shared program with the provincial and territorial governments to provide a system of child care that is comprehensive and accessible to all Canadians and that this system provide standards for care.”

Recently, the Government of Alberta has implemented a province-wide pilot program, Early Learning and Child Care (ELCC) Centres, which provides child care for children aged 0 to 6 years with maximum fees of $25 per day. This program has created ELCC Centres, which provide supports for children with diverse needs and implement an early learning care curriculum. Some ELCC Centres were set to become operational on May 1, 2017, with others opening throughout the duration of 2017. For more information about this program, click here. The Alberta government’s recent initiative to subsidize child care could better ensure high-quality early education, and capitalize on this opportunity to improve the health of Alberta’s population.

This child care pilot program has the potential to improve lifelong health outcome for Albertans, and could thus improve public health in the province.

Sources

  1. Commission on Social Determinants of Health, 2008
  2. Davidson, A. (2015). Social determinants of health: a comparative approach. Don Mills, Ontario, Canada: Oxford University Press.=
  3. Social Determinants of Health: The Canadian Facts. Julia Mikkonen and Dennis Raphael
  4. Interventions for Promoting Early Child development for Health: an Environmental Scan with special reference to Scotland. Geddes Rosemary, Haw Sally, Frank John W.
  5. https://www.alberta.ca/early-learning-child-care-centres.aspx
  6. APHA Resolutions & AGM Meeting Minutes 1984-1999

Health benefits of outdoors not accessible for many Albertans

Access to parks and wild spaces is a public health issue because spending time in natural places can impart numerous health benefits.

Parks and other wild spaces provide a place to recreate and participate in physical activity. Alberta’s parks provide the setting for numerous physical activities, from walking, running and cycling to climbing and kayaking. Participation in physical activity has varied health benefits, such as strengthening of bones and muscles, and risk reduction for cardiovascular disease and type 2 diabetes.

Studies have found that simply spending time outdoors is beneficial for health. For example, research suggests that time outdoors may reduce inflammation, myopia and risk of an early death while boosting  the immune system, and can increase self-efficacy, mindfulness and well-being. Studies have also found that the duration of outdoor living may lead to improved short-term memory, restored mental energy, stress relief, improved concentration, and sharper thinking and creativity.

Since Alberta’s parks and wild places offer enormous health benefits, access to these places is a public health issue. The Alberta Recreation and Parks Association, an Alberta Public Health Association partner, helps addresses this public access issue by promoting the importance of outdoor recreation.

Parks and wild spaces have further importance from an ecological determinants of health perspective. The environment has a great effect on human health and the health of other species. As parks and wild spaces can offer such enormous health benefits, the preservation of wild spaces is integral to ensuring the health of individuals and communities in the future.

There couldn’t be a better time to get outside as admission to all national parks, national historic sites and national marine conservation areas is free through the end of 2017 as part of Canada 150 celebrations.

As we come to understand the health benefits of time spent outdoors, it is important to consider whether access to such places is equitable across the population. Numerous barriers to spending time recreating outdoors exist. For example, the ability to spend time outdoors may require time off from work, transportation, specialized gear, and disposable income for admission fees, etc. Certain outdoor activities require technical skills and knowledge of outdoor safety. Health-related factors relating to accessing wild spaces may pose barriers to people with disabilities or health conditions. As well, wild spaces often become farther away as Alberta increasingly becomes overwhelmingly urban.

Visiting and recreating in wild spaces require resources, knowledge, and abilities that are not equally distributed across all segments of Alberta society. Thus, we must do more to address socioeconomic, knowledge and health factors so more Albertans can reap the health benefits of getting outdoors.

Sources
  1. https://www.theatlantic.com/health/archive/2017/06/how-to-harness-natures-healing-power/531438/
  2. http://www.businessinsider.com/scientific-benefits-of-nature-outdoors-2016-4/#1-improved-short-term-memory-1
  3. http://arpaonline.ca/about/
  4. http://www.sciencedirect.com.ezproxy.lib.ucalgary.ca/science/article/pii/S014019711600049X

Alberta’s opioid public health crisis

April 2017. Written by Erika Roy, APHA SCiP Intern

In Alberta and across much of the rest of the country, opioids fentanyl and carfentanil are causing a rapidly increasing number of deaths. In Alberta in 2016, 343 individuals died from an apparent drug overdose related to fentanyl. For comparison, in 2015, there were 257 fentanyl-related deaths.

Fentanyl and carfentanil are powerful synthetic opioid analgesics. Fentanyl exists both as a prescription drug and in illicit form. Illicit fentanyl is highly potent. It is often diluted with substances such as powdered sugar before it is sold or consumed. It is also mixed into other drugs, and sold under street names such as China white, China girl, and Apache. Fentanyl can be severely harmful or fatal, with death usually caused by respiratory failure. Carfentanil is a much more powerful analog of fentanyl. Drowsiness, difficulty breathing, and slowed heartbeat are symptomatic of a fentanyl overdose. A dose of fentanyl the size of a seed is enough to cause an overdose.

In the face of the fentanyl crisis, harm reduction measures have a capacity to help save lives. For instance, naloxone is an antidote to opioid overdoses. It can block or reverse the effects of opioid drugs such as fentanyl. Naloxone injections can be used to treat fentanyl overdoses in emergency situations, and can provide vital extra minutes before emergency medical care arrives. Naloxone has been on the World Health Organization’s list of essential medications since 1983. It is available under the brand name Narcan and in several generic forms.

On March 22, 2016, Health Canada amended the Prescription Drug List (PDL) to exempt from prescription status the emergency use of naloxone outside hospital settings for opioid overdose. As a result, naloxone is now an unscheduled drug, meaning that Albertans can obtain it without a prescription. It can be obtained free of charge from all sites registered with the Alberta Health Services (AHS) Take Home Naloxone program. This may help to combat the crisis posed by the fentanyl.

Alberta has recently expanded its naloxone program. For instance, Alberta now allows firefighters to administer injectable naloxone, and is providing injectable naloxone kits as an addition to fire apparatus, which increases live-saving potential in the event that firefighters respond to an overdose call. Making naloxone more widely available to individuals and organizations, especially those in high risk environments, also has live-saving potential.

Naloxone alone is not enough to combat the fentanyl crisis—opioid dependency treatment measures are needed as well. The Alberta government is moving ahead with the opening of an opioid dependency treatment clinic in Grande Prairie. Recently, opposition MLAs in Alberta have called upon the government to open more addiction treatment beds and offer more access to outpatient services.

The Alberta government is also moving ahead on other measures to counter the opioid crisis, including the provision of grant funding to agencies in several communities working to establish supervised consumption services. Alberta has not to date declared a public health emergency.

We welcome comments on this article. Please send comments to apha.comm@gmail.com.

Sources

  1. http://www.health.alberta.ca/documents/Opioids-Substances-Misuse-Report-2016-Q3.pdf
  2. http://www.theglobeandmail.com/news/investigations/a-killer-high-how-canada-got-addicted-tofentanyl/article29570025/
  3. http://www.ccsa.ca/Resource%20Library/CCSA-CCENDU-Take-Home-Naloxone-Canada-2016-en.pdf
  4. http://www.albertahealthservices.ca/info/page13663.aspx
  5. https://www.alberta.ca/release.cfm?xID=4623401E1FFAF-C647-0DE1-3DC0E9D72AA4CB74
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