The challenges associated with epilepsy are becoming easier to identify and define as I’ve been researching more about health promotion. An unexpected difficulty with my health promotion project is the limited amount of recent scholarly articles dedicated to discussing social determinants of health and health promotion initiatives in epilepsy. I believe this is in part due to the lack of adequate funding for health promotion programs and epilepsy. Many of the studies about epilepsy, especially those examining correlations with income/socioeconomic status or regional distributions, focus on the UK or USA, which may not be generalizable to Canada. For example, there is a significantly high prevalence of epilepsy in Southern USA known as the “Epilepsy Belt” (Szaflarksi et al, 2020); however, differentiating between urban versus rural settings on epilepsy within Canada is poorly understood. The grey literature and advocacy organizations have been useful sources of British Columbia specific data, findings, and suggestions.
Broadly speaking, epilepsy research explores underlying causes and new pharmacological interventions (Rubio et al., 2021). There are relatively few recent scholarly articles addressing how to improve quality of life for people with epilepsy, particularly supporting mental health and eliminating stigma. Moreover, the vast majority of the literature examines the individual level, such as genetic factors or personal lifestyle choices, as opposed to the community or societal levels.
Viewing epilepsy from a socioecological framework, there are two prominent issues that are emerging to me. The first issue is the difficulty finding and maintaining employment when living with epilepsy. Being employed is not only important as a source of income, but also as a source of pride and purpose. Directing people with epilepsy to the relevant resources that are designed for neurodiverse individuals is important so they can discover flexible work solutions and suitable jobs (Back in motion, 2020). The second main issue is poor public transit systems which create a barrier to accessing care, which is especially relevant to this population since they may have driving restrictions (Saelens et al., 2022). Without accessible transit systems, people may not attend a health appointment or receive care.
Limited access to healthcare makes it difficulty to implement health promotion programs effectively. Moreover, it exacerbates health disparities between different populations. I’m fortunate to live in Vancouver due to its green design plans and pilot projects such as free one-zone TransLink Compass Card passes. Participants in this transit project included families who identified as low-income and did not own a car, lone caregiver-led families with single income households, families residing in Downtown Eastside and East Vancouver, mothers escaping intimate partner violence living in transition homes, low-incoming households with children under the age of 12, and multi-generational households (Single Mother’s Alliance, 2022). During my learning journey, I’m realizing that I benefit from living in a community that prioritizes health and makes it easy for me to make healthy choices.
Back in Motion (2020). About our Employment Services. Back in Motion. Retrieved February 22, 2023 from https://backinmotion.com/employment/
Rubio, C., Luna, R., Ibarra-Velasco, M. & Lee, Angel (2021). Epilepsy: A bibliometric analysis (1968- 2020) of Instituto Nacional de Neurologia y Neurocirugia “Manuel Velasco Suarez” in Mexico. Epilepsy & Behavior, 115, 1-7. https://doi.org/10.1016/j.yebeh.2020.107676 Saelens, B.E., Meenan, R.T., Keast, E.M., Frank. L.D., Young. D.R., Kuntz, J.L., Dickerson, J.F. & Fortmann, S.P. (2022). Transit use and health care costs: A cross-sectional analysis. Journal of Transport & Health, 24, 1-8. https://doi.org/10.1016/j.jth.2021.101294
Single Mother’s Alliance (2023). Transit for teens: Parental perspectives on the impact of free transit for youth 13-18 in BC. SMA Research Brief. Retrieved January 30, 2023 from https://www.canva.com/design/DAFO9aeV8ws/94VGK82r_7IjNhZY5AWXQg/view? utm_content=DAFO9aeV8ws&utm_campaign=designshare&utm_medium=link&utm_source
Szaflarski, M., Wolfe, J.D., Tobias, J.G.S., Mohamed, I. & Szaflarski, J.P. (2020). Poverty, insurance, and region as predictors of epilepsy treatment among US adults. Epilepsy & Behavior, 107, 1-7. https://doi.org/10.1016/j.yebeh.2020.107050
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