Integrated Understanding of Health in Context: Final Reflection
- cdekleva1
- Mar 30
- 6 min read
In working through this course, I have progressively built an ePortfolio that I am pleased to share. The ePortfolio can be found at the following link: Home | Candice Dekleva and includes a Home page, an About section which highlights my professional identity, my role with public health, my professional values, and my professional accountability. The Education & Resume page includes relevant work related education and a link to my embedded resume for anyone to view as they wish.
Initially, I had a Graduate Coursework page that included subsections of Links & Resources and Reflections, but when asked for feedback, a few colleagues suggested that it was too hard to navigate as a subsection setup. To incorporate the feedback, I made these separate main pages, and I hope the present layout is easier for the viewer to follow.
The Reflections section has been a work in progress but prior to this final post it includes 14 reflections on various topics as recommended in the MHST601 course content sections. The Link & Resources section features links to sources used to locate resources throughout the course and then sections with the various resources as suggested in course learning activities and based on my work at public health and with the government of New Brunswick (Candice Dekleva’ s ePortfolio for MHST601, 2025).
On review, the common thread or key health issue in most of the reflections and coursework done in MHST601 has been the determinants of health and their impact on individuals and populations (Determinants of Health, 2018). The various frameworks of the determinants of health seemed to bleed into almost all of the learning activities, the curated resources listed in the ePortfolio created as part of the course, and ultimately all of the components to the foundations of healthcare. This post lays out why that is the case (Candice Dekleva’ s ePortfolio for MHST601, 2025; NCCDH, 2024).
When examining the determinants I reflected that the choice I made to become a registered nurse and healthcare professional was impacted by a personal set of determinants. From experiencing some adverse childhood events to growing up in a single income household as a white female in rural Nova Scotia, my personal and professional identities were shaped and molded by genetics and lifestyle choices (Candice Dekleva’ s ePortfolio for MHST601, 2025).
Learning about the Canada Health Act and a post (Unit 1 Forum [Online forum post], 2025), about why it should be updated tied in with the need for healthcare that was accessible to anyone and everyone when they need it (Canada Health Act, 2017). Many Canadians would be unable to pay for healthcare without the coverage that the act provides due to their income and social status, and this reaffirms why the act was created many years ago-without its coverage many would go without care needed and thus would cause greater impacts on the healthcare system (Canada Health Act, 2017).
Defining health as an individual can be different based on who one is or how one has been raised, and I feel the determinants of health impact this. The curated resources I found about how health is defined talked about tolerance and on reflection, I noted that Brook talked about tolerance and its impact on one’s view of health or how a patient might be perceived by a caregiver (Brook, 2017; Candice Dekleva’ s ePortfolio for MHST601, 2025).
Weeks seven and eight of the course saw discussion on multilevel models of health and a comparison with a classmate in another province (Candice Dekleva’s ePortfolio for MHST601, 2025). This reflection and the articles curated for multilevel models of health noted the idea that multilevel modeling looks to understand all of the reasons why an individual might end up with a particular health condition or illness (Candice Dekleva’s ePortfolio for MHST601, 2025; Galea, 2015). Tying this to public health was easy as work done in public health is constantly looking at upstream and downstream determinants that can then be changed or mitigated in future work (Galea, 2015).
Comparing New Brunswick and Ontario was enlightening as well due to the vast differences in size and tax bases, and it was surprising to understand how population dense New Brunswick is and the differences in determinants focused on by each province in healthcare spending (Candice Dekleva’ s ePortfolio for MHST601, 2025). In another reflection the same two provinces were used to look at the impacts of community and policy level (Pawluk et al., 2024) determinants and the contrast again showed the degree of difference in a large and smaller province (Candice Dekleva’ s ePortfolio for MHST601, 2025). The idea that where you are born, whether that’s urban or rural, or what your provincial leadership decides is valuable to invest in as far as the determinants of health proves that they are key to access or one’s choice to access healthcare and what one receives when one chooses to do so (Determinants of Health, 2018).
Finally, the final five weeks of this course were completed by reflecting on chronic disease surveillance and management, taking a look at how Indigenous peoples are served in Canada, reflecting on how individuals who are homeless receive healthcare in Canada, and exploring a potential topic that would be influential in the future of healthcare (Candice Dekleva’ s ePortfolio for MHST601, 2025).
Two of the reflections in these final weeks compared New Brunswick and Ontario-one in chronic disease management and surveillance and the other compared the care of marginalized groups (Candice Dekleva’s ePortfolio for MHST601, 2025). Both provinces provide data to the Canadian Chronic Disease Surveillance System, but New Brunswick does not then have its own updated comprehensive website with data about chronic diseases where Ontario has more data accessible (Canadian Chronic Disease Surveillance System, n.d.).
In summary the key issue in the foundations of one’s health and of this course is that the way individuals perceive, receive, and access healthcare are impacted and influenced by the determinants of health. The use of the symbol of the tree and its roots when referring to the determinants of health is a helpful way to understand that there are often many things both visible and unseen that influence the way individuals and communities experience health (NCCDH, 2024). Whether it is where one lives, how one is raised, or what kind of home one grows up in, there are so many what ifs that can shape and mold the ability to then have a meaningful and productive life (NCCDH, 2024).
The importance of determining the key issue that surrounds the work done in this course is found in the understanding that health means different things to different people, and being able to reflect with a wide angled lens on all of the choices that can be made to provide equity and safety in how healthcare is provided is essential to ensure people get what they need when they need it. It sets the stage for the rest of the coursework done in this Master of Health Studies degree and allows for reflection on what this leadership journey can do to support the needs of the individuals and communities in this amazing country in all of its diversity and beauty.
References
Brook, R. H. (2017). Should the definition of health include a measure of tolerance? JAMA,
317(6), 585–586. https://doi.org/10.1001/jama.2016.14372
Canada Health Act. (2017). Justice Laws Website. Retrieved January 25, 2025,
Canadian Chronic Disease Surveillance System (CCDSS). Public Health Agency of Canada.
(n.d.). Canadian Chronic Disease Surveillance System (CCDSS). Government of Canada.
Retrieved March 9, 2025, from https://health-infobase.canada.ca/ccdss
Candice Dekleva’s ePortfolio for MHST601. (2025). Retrieved March 28, 2025, from
Determinants of Health. (2018). Health Canada. Retrieved February 10, 2025, from
Discussions. (n.d.). MHST601: Critical Foundations in Health Disciplines. Retrieved March 28,
Galea, S. (2015, May 31). The determination of health across the life course and across levels
of influence | SPH. Boston University School of Public Health. Retrieved February 21,
Huber, M. (2011). Health: How should we define it? British Medical Journal,
343(7817), 235-237. https://doi.org/10.1136/bmj.d4163
NCCDH. (2024). Let's Talk Determinants of Health.
Pawluk De-Toledo, K., O’Hern, S. & Koppel, S. A social-ecological model of working from
home during COVID-19. Transportation, 51, 1181–1208 (2024).
Unit 1 Forum [Online forum post]. (2025). MHST601: Critical Foundations in Health
Disciplines. Retrieved March 28, 2025, from
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