Towards More Robust and Locally Meaningful Indicators for Monitoring
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Towards more robust and locally meaningful indicators for monitoring health and the social determinants of health related to resource extraction and development across Northern BC A report produced as the result of a research collaboration between Northern Health, the University of Northern British Columbia and the BC Provincial Health Services Authority Cumulative Impacts Research Consortium Office of Health and Resource Development Indicators for monitoring the SDOH related to resource development in Northern BC ii January 2019 About this Report: This report is the product of a collaboration between researchers at the University of Northern British Columbia, and staff from both Northern Health and the Provincial Health Services Authority. This report was generously funded through a UNBC Health Research Institute-BC Public Health Service Authority-Northern Health Seed Grant that ran from May 2016-October 2017, with additional funding support offered by Northern Health. © 2018 University of Northern British Columbia, Northern Health, BC Provincial Health Services Authority Northern Health Suite 600, 299 Victoria St, Prince George, British Columbia, Canada V2L 5B8 Tel.: +1 (250) 565-2649, Fax: +1 (250) 565-2640 Contact: [email protected], Regional Manager, Health and Resource Development University of Northern British Columbia 3333 University Way, Prince George, British Columbia, Canada V2N 4Z9 Tel.: +1 (778) 349-4242 Contact: [email protected], Postdoctoral Fellow and Project Lead, Cumulative Impacts Research Consortium, University of Northern British Columbia Provincial Health Services Authority Suite 700, 1380 Burrard Street, Vancouver, British Columbia, Canada V6Z 2H3 Tel.: +1 (604) 675-7400, Fax: +1 (604) 708-2700 Contact: [email protected], Director, Population Health and Epidemiology, BC Provincial Health Services Authority Suggested citation: Buse CG, Cornisk K, Parkes MW, Harder H, Fumerton R, Rasali D, Li C, Oke B, Loewen D, Aalhus M. (2018). Towards more robust and locally meaningful indicators for monitoring the social determinants of health related to resource development across Northern BC. Report prepared for Northern Health. Prince George, BC: University of Northern British Columbia. Indicators for monitoring the SDOH related to resource development in Northern BC iii January 2019 Acknowledgements We gratefully acknowledge the extensive work of Katie Cornish in compiling data and information for this report. We would also like to acknowledge the work of Laura Lee, which resulted in the NH report titled “The social determinants of health impacts of resource development in rural and northern communities: A summary of impacts and promising practices for assessment and monitoring”(1), which this report builds upon and extends to identify indicators that can inform assessment practices for the social determinants of health. We also acknowledge the contributions of the following individuals: Core Investigative Team: Dr. Chris G Buse, School of Health Sciences, University of Northern British Columbia Dr. Henry Harder, School of Health Sciences, University of Northern British Columbia Dr. Margot W Parkes, School of Health Sciences, University of Northern British Columbia Katie Cornish, MSc Student, School of Health Sciences, University of Northern British Columbia (Project Research Assistant) Report Contributors: Dr. Raina Fumerton, Medical Health Officer, Northern Health Dr. Drona Rasali, Director, Population Health Surveillance & Epidemiology, BC Centre for Disease Control, Provincial Health Services Authority Crystal Li, Surveillance Biostatistician, Population Health Surveillance and Epidemiology, BC Centre for Disease Control, Provincial Health Services Authority Barb Oke, Health and Resource Development Regional Manager, Northern Health David Loewen, Lead: Community Engagement, Education, and Evaluation, Indigenous Health, Northern Health Melissa Aalhus, Health and Resource Development Technical Advisor, Northern Health Indicators for monitoring the SDOH related to resource development in Northern BC iv January 2019 Table of Contents Acknowledgements ...................................................................................................... iii Table of Contents ......................................................................................................... iv List of Tables ................................................................................................................. v List of Figures ............................................................................................................... v List of Acronyms .......................................................................................................... vi Executive Summary .................................................................................................... vii Background and Disclaimer ......................................................................................... x 1 Introduction ................................................................................................................ 1 2 Purpose ....................................................................................................................... 3 3 Research Methods, Data Sources and Analysis...................................................... 4 3.1 Data Sources .................................................................................................. 5 3.2 Extraction of Indicators and Inclusion/Exclusion Criteria ................................ 7 3.3 Data Coding and Reporting ............................................................................ 7 3.4 Analysis .......................................................................................................... 9 3.5 Limitations ...................................................................................................... 9 4 Results ...................................................................................................................... 10 4.1 Identification of SDoH and Health Indicators and Data Sources ................... 11 4.2 Indicator Origins ........................................................................................... 13 4.3 Coding Results for Indicator Characteristics: Causal Pathways, Level of Analysis, and Count vs. Proportion ..................................................................... 14 4.4 Coding Results and Scoring for EAO Attributes ........................................... 15 4.4 Qualitative observations made during the document reviews ....................... 19 5 Discussion ................................................................................................................ 20 5.1 General Observations on SDoH and Health Monitoring Practices from a Sample Review of EA Documentation ................................................................ 20 5.2 Moving Beyond Desktop Review Indicators of the SDoH ............................. 21 6 Conclusion and Recommendations ....................................................................... 25 6.1 Recommendation #1 – To further explore the applicability of current EA indicator selection criteria for monitoring social and health impacts to better inform existing and future regulatory and assessment processes. ..................... 26 6.2 Recommendation #2 – Future work should seek to clarify expectations and provide guidance on appropriate social science methodologies to help improve meaningful and inclusive community engagement practices that may assist with identifying, selecting, measuring and monitoring SDoH and health indicators in natural resource management processes. ......................................................... 28 Indicators for monitoring the SDOH related to resource development in Northern BC v January 2019 6.3 Recommendation #3 –A “parallel streams” approach should be considered for assessing and monitoring health and SDoH impacts, relying on a combination of publicly accessible standardized data and community driven and derived, locally important data. ......................................................................................... 29 6.4 Additional research opportunities and knowledge gaps ................................ 30 6.5 Conclusion .................................................................................................... 31 References ................................................................................................................... 31 Appendix A. List of extracted indicators, definitions and data sources ................ 38 Appendix B. Instructions for how to utilize Appendix A ........................................ 125 Description and Example .................................................................................. 125 Indicators without available data....................................................................... 126 Common Data Source Websites ...................................................................... 126 List of Tables Table 1. Description of sampled documents and their data sources 6 Table 2. Summary of indicator themes, sub-themes and counts and distributions 10 Table 3. Distribution of identified indicators on causal pathways by indicator source 13 Table 4. BC EAO Attributes of Indicators Coding Results 14 List of Figures Figure 1. Methodological approach for SDoH and health indicator identification and analysis 4 Figure 2. Origin of indicators in our sample by percentage