The Second Annual Conference on Gross National Happiness The Second International Conference on Gross National Happiness
Local Pathways to Global Wellbeing
St. Francis Xavier University, Antigonish, Nova Scotia, Canada
June 20 to June 24, 2005

June 22 pm Workshop Report 2219
People Assessing Their Health (PATH)

Lucille Harper, Antigonish Women's Resource Centre, Nova Scotia
Colleen Cameron, Nova Scotia
Susan Eaton, consultant, Nova Scotia

The presentation was a collaboration between presenters.

Rapporteur: Sarah Strapps
  Objectives of Workshop:
  1. History of PATH in Nova Scotia
  2. Introduction to the concept of People Assessing Their Health (PATH) Community Health Impact Assessment (CHIA) and the Community Health Impact Assessment Tool as a community development mechanism to empower communities
  3. Basic Methodology of the PATH process
  4. Uses for CHIA Tool and Impact of the CHIA
Promoting a broader, more holistic understanding of health and the elements that have an impact on a community / individual's health. The focus of PATH is the well-being of the community.

PATH in Nova Scotia:
PATH was initiated as a community response to the restructuring of the health care system in Nova Scotia. The purpose is to examine the networks and resources that affect people's health and to measure the impact of the restructuring and other policies on health.

Focus of PATH was on rural communities and the socio-economic changes that were occurring: decline in natural resources as a viable livelihood; rural exodus; declining infrastructure; an ageing population etc. The PATH network has worked in almost 10 communities in Nova Scotia and in India.

PATH Methodology:
  1. Contact with community and engaging a community representative
  2. Bring together relevant stakeholders for structured dialogue and storytelling
  3. Deconstruction of stories to draw out the factors that affect health in the community — often resemble Health Canada's Determinants of Health
  4. Develop a vision of a healthy community
  5. Develop a plan on how to achieve that vision
  6. Prepare the Community Health Impact Assessment Tool — basically a check list of the communities priorities and drawn from the vision of the healthy community
  7. Test the Community Health Impact Assessment Tool in the community and empower the community to use the tool to evaluate other programs/projects/policies that will impact their community.
Uses of PATH: PATH has been used in communities to evaluate the need for affordable housing; Sunday shopping; eliminating the distribution of infant formula at the hospital; and more. The PATH process provides the community with a tool that is informed by the experience of the people in the community and enables them to analyze issues of concern systematically.

  Questions from the workshop participants
Q Can the tool adapt to new situations?
A The PATH Network will be returning to a community in Nova Scotia where they worked 10 years ago and will be better able to judge if the CHIA tool has / will evolve.
Q Is the process of developing a greater understanding of what a healthy community is as important or more important than actually using the CHIA tool to evaluate policies?
A The process of developing the tool is empowering to communities and the evaluation process can inform future decisions of the community. Which aspect is more important is debatable.
Q When engaging in the process, how do you ensure that the group that is gathered is representative of the population?
A The process of promoting a more holistic understanding of the determinants of health is significant. Sometimes the process is focused on one element of the population and the process can be useful for that part of the community and can inform the community decision making process.
Q Does the Community Health Impact Assessment have an impact?
A It is hard to determine the impact a community development process has on policy development etc. In the local community, the tool has been used and has served to evaluate local programs and has informed the decision making processes. The purpose of the PATH process is to allow the community to develop a voice and to enable them to actualize their vision of a health y community.

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