Determinants of sexual and reproductive health care for im/migrant women: a community-based mixed methods study to realize comprehensive primary care in BC

Primary care is key to a working health care system. Good primary care is based on relationships with a provider who knows a patient over time and sees the whole person in context, so they can address social needs that particularly impact the health of marginalized groups. Although im/migrants are a big part of the population in Canada, they have less access to good primary care. We use ‘im/migrant’ including all people that arrive in Canada from another country, including refugees, economic and undocumented im/migrants. Some groups (refugee claimants, precarious status) have even more limited access to primary care and may face worse health. This is especially true for im/migrant women of reproductive age. An important feature of primary care is sexual and reproductive health (SRH) care, like contraception, cervical cancer screening, and pregnancy care. We can learn about and improve primary care for im/migrant women by looking at their experiences with SRH. Guided by im/migrant women, this project uses interviews and information from the health system to describe their SRH within primary care in BC. This will produce collaborative solutions for SRH in primary care that promote equity for im/migrant women and families in BC.

Genome-wide screen to identify genetic modulators of glucocerebrosidase activity

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Despite PD affecting millions of people worldwide, no disease-modifying treatment is available yet. As the progress of the disease is closely related to aging, improving our knowledge of the mechanisms and factors leading to PD is of great interest. Mutations in the gene GBA, which encodes the enzyme glucocerebrosidase (GCase), are the greatest genetic risk factor for PD. The link between GCase and PD however, remains poorly understood. Here, we propose to use a chemical genetic screening approach to identify new genes that affect GCase activity. As a pilot study, we will target known PD-associated genes and evaluate their effects on GCase activity using a new GCase activity-based assay in live cells. A complementary approach using genome-wide screen will be carried out to identify candidate genes in an unbiased way. Candidate genes from these screens will be validated with downstream experiments leading to two valuable outcomes. First, the discovery of new genes that regulate GCase could provide new targets for potential treatments. Second, we expect these findings will uncover new fundamental understanding regarding the mechanisms contributing to PD.

Mental health in later life: A stakeholder-informed approach to health and technology interventions for older adults

Feeling down or worried happens to everyone, but for some people these feelings are very strong, long-lasting, and can be damaging to them and their families. Mental illnesses, such as depression or anxiety, may include feelings of hopelessness, helplessness, guilt, or even suicide. Worldwide, mental illness affects one in five people aged 60+.

However, problems faced by older adults impacting their mental health are often overlooked, such as loneliness, loss of a spouse, or ill-health. We need to change the way we treat mental health, with services that consider older adults' specific needs and situations.

To this end, we will bring together an advisory board of older adults to help inform the project, providing insights into what contributes to their mental health and what sorts of technologies promote better mental health. Using these insights we will identify factors that contribute to older adults’ poor mental health. 

Additionally, we will work with older adults to test technology-driven interventions, for example mobile apps, that best suit the needs of older adults in improving their mental health.

Healthy Children, Healthy Communities: Co-Benefits of Children’s Action on Climate Change and Mental Health

Problem: British Columbia is being increasingly impacted by climate change and therefore the health and wellbeing of children in this region are at risk, and will be throughout their lives unless action is taken.

Overview: Conducted for, by and with children, this research will answer 2 questions: How is children’s health being impacted by climate change? Can taking action on climate change through community projects, strengthen and build resilience in children, even in the age of climate change? A central focus of this work will be on mental health and wellbeing.

Outcomes: After filling a significant scientific knowledge gap about the public health impacts of climate change on children in BC, evidence gathered will be used to help develop community projects that tackle a local impact of climate change.

Impacts: This research will identify why and how certain community projects on climate change protect, and even improve, the mental health and wellbeing of children and make recommendations for how other communities can use this information to build their own healthy children, healthy community projects. These successes will be shared with decision makers to support the choices they make around climate change and health.

Real-time Combined Genomic and Epidemiological Monitoring of COVID-19 in British Columbia

Viruses accrue small amounts of genetic variation over time. By sequencing the virus, we can see this variation and use it to understand where an individual virus likely came from and how it is moving through a population. This helps public health teams to estimate how many cases are due to local transmission as opposed to imported cases. In this proposal, we will establish ways to use virus sequences to understand transmission in a high-resolution way that is not possible with epidemiological or virus sequence data alone. To do this, we will combine viral sequences with epidemiological data in new ways, establishing high-resolution pictures of transmission. We will operationalize the use of these combined datasets for real-time COVID19 public health use in BC.

Preventing and Mitigating the Impacts of COVID-19 Among Im/migrants in British Columbia: Rapid Mixed-Methods Data to Inform Policy and Programmes.

In BC, migrants make up >25% of residents and are overrepresented in crucial roles as essential workers (eg, temporary foreign workers), yet may be disproportionately impacted by COVID-19 and face barriers to healthcare access. Despite purported shifts to ‘universal’ coverage for COVID-related care, many im/migrants report severe ongoing inequities, including gaps in healthcare coverage, unsafe living/working conditions, and confusion about how changes are put in practice. Rapid transition to virtual service delivery may also compound inequities due to language or technology barriers. We will use health system data and interviews to understand migrants’ experiences with COVID-19 related care and health services coverage to ensure “no one is left behind” in the COVID-19 response and beyond.

“Blind Spots”: People in Prison and Precarious Housing During COVID-19

Prisons and substandard housing pose serious risks to individuals and communities during the COVID-19 pandemic. Limits on physical distancing are associated with disease outbreaks in shelters, camps, and prisons. The high prevalence of pre-existing illness in the settings places people at risk for medical complications. This project will generate evidence of ways to reduce the spread and impact of COVID-19 by analysing hospitalizations among people who were in custody or inadequate housing during the first wave of COVID-19 in BC. The project will also develop recommendations on the use of mandatory testing. The project team is drawn from established networks of researchers, decision-makers, service providers, and people who have experienced homelessness and time in custody.

A Spatial Approach to Exploring Vulnerability in the Context of COVID-19 in British Columbia

Maps are an excellent way of simply communicating complex ideas. We will create maps that use sophisticated analysis techniques and draw on multiple information sources. Our maps will tell decision-makers where in BC they should focus COVID-19 mitigation efforts and other interventions. Drawing on population and location factors, our maps will show where in BC people are vulnerable to developing COVID-19 infections, where people are vulnerable to experiencing challenges to accessing ICU care for complex COVID-19 cases, and where people are vulnerable to experiencing health-related secondary impacts of the pandemic. We will work with officials to identify ways to improve our maps and integrate new evidence. Will also make maps they request to support their decision-making.

Building Capacity for Surveillance and Policy Development: Health Impact Assessments of Air Quality in Northern British Columbia

In Northern British Columbia, a region rich in natural resources, there has been a rapid expansion of resource extraction projects across the region in recent years. While generating economic growth for local communities, this has also led to concerns among health practitioners and community members about the potential health risks associated with declining air quality due to increased industrial emissions. In the BC Northwest, in particular, projections indicate that sulphur dioxide emissions will likely increase in the Kitimat airshed due to multiple new industrial projects and expansion of existing projects.Timely information about air quality and associated health risks is important for developing public health policies, to prevent potential negative health impacts, and for planning at both local and regional levels. The objectives of this project are to 1) conduct a health impact assessment of impacts of SO2 emissions on human health in the Kitimat region; 2) make recommendations for development of effective surveillance tools to assess air quality health impacts in the region; and 3) review how local and regional policy makers use environmental health impact information for decision-making.This project will directly support Northern Health's organizational impact goal of healthy people in healthy communities, through promoting and protecting healthy environments, and through helping to build regional capacity for conducting health impact assessments and surveillance.

Building on Strengths in Supported Housing and the Treatment of Mental Illness in BC

Research co-lead: 

  • Julian Somers
    Simon Fraser University, At Home Project, Homeless Intervention Program, Inter-Ministry Research Initiative 

Research user co-lead:

  • Darrell Burnham
    Coast Mental Health

Team members: 

  • David MacIntyre
    BC Non-Profit Housing Association
  • Dominic Flanagan
    BC Housing
  • Taryn Walsh
    Ministry of Mental Health & Addiction
  • Elenore Arend
    Ministry of Public Safety & Solicitor General
  • Colin Ross
    City of Vancouver, BC Justice Summit
  • Stefanie Rezansoff
    Simon Fraser University 

BC research has examined the effects of supported housing on mental illness, addiction, crime, public safety, community integration, quality of life, and total public expenditure. Local and international studies show that increased spending does not necessarily result in significant improvement for people with complex needs, and that effective interventions require specific coordinated approaches to service delivery. At present, no central source of support exists to ensure that relevant research is available to inform practices in BC.

This project will convene provincial partners who are responsible for addressing homelessness, mental illness, and addiction, and identify priorities for cross-sector coordination, implementation of best practices, and evaluation. Identified priorities will be reviewed with additional provincial stakeholders (e.g., municipal government, community-based housing & health service providers, patients & family members). Priorities and recommendations will be finalized by the project team along with recommended next steps and made available to the public via SFU web-based media and communications.

 Results will inform a multi-year plan for applied research addressing housing and mental illness in BC.