January 9, 2009
By Brette Ehalt
Photo by Mark Ferguson
For some Saskatchewan kids, health means happiness.
This is one finding from the research Ph.D. Nursing student Hope Bilinski conducted in a rural school in central Saskatchewan last spring.
"There is limited information about the health of rural kids in Canada, and especially in Saskatchewan," says Bilinski. "And since we're in the midst of an obesity epidemic, I felt it was important to explore the meaning of health in a sample of school age children."
Exactly 99 children from grades one through seven participated in the quantitative component of Bilinski's study; they were weighed and measured for Body Mass Index calculations, and asked to complete a health questionnaire.
Additionally, a sub-group of 20 children between grades four and six, along with their parents, participated in two 20-minute interviews—the qualitative component of Bilinski's study. The aim here was to gain an in-depth understanding of the cultural meaning—the values, attitudes, norms and beliefs—of health for these children. Overall, "the prevalence of overweight and obesity was high," says Bilinski. "Thirty-four per cent of children in the sample were categorized as overweight (23.7 per cent) or obese (10.3 per cent), and a significantly higher proportion of boys aged six to eight years were categorized as overweight or obese compared to girls of the same age. Interestingly, though, the meaning of health was thematically congruent from children of unhealthy and healthy weights."
Bilinski notes that children were quite knowledgeable about factors that contribute to good health, like eating healthy and exercising regularly. After careful exploration, Bilinski says it became evident that the cultural meaning attached to their understanding of health was the integration of three themes: cognitive (a sense of knowing), physical (having particular characteristics), and emotional (feeling happy).
"Children identified the feeling of happiness as the most meaningful dimension."
Regardless of weight, happiness appeared to be fostered by valued relationships and enjoyable activities. "Children explained that feeling encouraged and supported influenced their actions and promoted a belief in their own abilities and decisions," explains Bilinski. "Subsequently, when they felt happy, they wanted to participate in activities, socialize, and even eat healthier."
This finding will hopefully, she continues, lead health professionals to ponder important questions: when we assess children's health and measure several characteristics, do we assess their happiness? When we plan interventions and health promotion programs do we consider if children are "happy" participating in them?
In her study, Bilinski also considered some aspects of rural living that create challenges for children's lifestyles, such as increased cost, fewer facilities, and less diversity of activities. Inactive transportation by car or bus is another aspect, as it increases sedentary behavior.
"Seventy per cent of children reported travelling at least one hour a week to and from activities, and 25 per cent reported spending about one hour every day travelling to and from school by bus. So, we may need to provide additional opportunities for rural children to be active so as to counteract the necessary commuting in this setting."
At the same time, however, Bilinski believes that the strengths of rural living should be capitalized. Both parents and children discussed the security, freedom, and safety of the area.
"If children love the ‘wide open spaces' of the prairies, then they should be encouraged to play in them!"
Hope is currently an assistant professor with the College of Nursing and teaches both theory and clinical components of primary health care in the community.
Brette Ehalt writes profiles of grad students for the College of Graduate Studies and Research.
Office of Communications, University of Saskatchewan