We know how to prevent chronic diseases: stop smoking, eat well: a balance of food groups, exercise (FITT- flexibility, endurance, strength), relax, socialize, monitor your blood pressure, live well, and listen to your body.
The Canadian Institute for Health Information published a report: Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada. In it Low Socio-Economic Status (SES) is identified as a barrier to good health.
WHAT IS A BARRIER?
Within the Ontarians with Disabilities Act (ODA), a barrier is defined as “anything that prevents a person with a disability from fully participating in all aspects of society because of his or her disability, including a physical barrier, an architectural barrier, information or communications barrier, an attitudinal barrier, a technological barrier, a policy or a practice” (ODA, 2001).
Barriers to access can also include:
- family issues - dysfunctional families
- communication deficiencies or disorders: language barriers, auditory, visual, cognitive disorders
- bias or prejudice - i.e., inaccurate statistics: women die of stroke and heart disease
- fears - of diagnosis or treatment
- patients who do not speak English
- poor or ineffective treatment plans
- cognitive disorders - delirium, dementia,
- mental health issues
- mistakes in diagnosis
- attitudes: i.e., discrimination, being treated as incompetent, expressive or receptive language disorders
- Primary Care workers who speak down to patients, or use acronyms, or complicated language
- wait times
- lack of staffing
- crowded hospitals
They quoted a figure of 40% of patients who stated they experienced mistakes in surgery, diagnosis, discharge plans or home care interventions.
For this reason they suggest several steps, some of which I have already mentioned, and some that do not apply to Canadian hospitals, to avoid medical mistakes.
- Prevent infection - see my post on Superbugs.
- Invite family or friends to come with you as an advocate, especially if you are a senior.
- Take notes while speaking with physicians.
- Keep a medical journal.
- Get all the information you can.
- Ask for copies of tests results or numbers, i.e., ask for your blood pressure reading each time it is taken.
- Be honest with your physician. They need accurate information for an accurate diagnosis.
- If you sense that something isn't right, get a 2nd opinion.
- Take a list of your prescriptions into the physician.
- Ask health care professionals if they have washed their hands (hand sanitizer isn't good enough!) and/or cleaned their stethoscopes.
- Seek a treatment plan that suits you, not the surgeon or oncologist.
- Ask about contraindications of medications, side effects, length of treatment, and other options. (Your pharmacist is a valuable person to speak to.)
- Know which medications you are supposed to take and the dosage.
- Avoid wrong-site surgery: label the site, as well as the 'do not cut' site.
- Do not chitchat before surgery - to allow health workers to stay on-task.
- Accessibility for Ontarians with disabilities Act, The Legislative Library Office of the Legislative
- Assembly of Ontario, S.O. 2005, c.11 Cong. Rec.(2004).
- Act to promote patients' rights and to increase accountability in Ontario's health care system, 181999 Cong. Rec.(2006).
- Health Care Consent Act, Ministry of Health and Long Term Care(1996).
- Substitute Decisions Act, Ministry of the Attorney General, 0-7794-2147-7 Cong. Rec.(1996).