Educating Young People on Global Determinants of Health

Educating Young People on Global Determinants of Health Maria Bruselius-Jensen1, Kerry Renwick2, Jens Aagaard-Hansen3, Dina Danielsen3 1Aalborg University, Denmark; 2University of British Columbia, Canada; 3Steno Diabetes Center, Denmark Presenting Author: Bruselius-Jensen, Maria; Renwick, Kerry In a time that brings constant reminders that we are citizens in a shared world, the term ‘global’ is pertinent in contemporary society and, thus, to education. With influx of refugees, threats of global warming and financial crises, but also with our daily use of communication systems, that connect us across the globe within seconds, educationalists have a role in determining ways to educate people as global citizens. Building understandings about being global and health education is also increasing in need. For example, Marmot and colleagues (Wilkinson and Marmot 2003) through their work on social determinants, also named the causes of ill health and have been able to demonstrate how conditions for health are unequally distributed within and between countries (Marmot 2005). This calls for attention to issues of global health (Labonté and Schrecker 2007). But apart from identifying the need for creating ‘public awareness about these determinants’ in order to fight inequalities in health’ (Marmot et al. 2008), the overwhelming focus has been placed on health policy. We, however, believe that education has a strong role to play in reducing global inequalities in health. Inspired by Dewey’s (1939) conceptualization of the cosmopolitan person, we argue that educating young people to understand and act upon global social determinants of health, means building reflexivity on their own cultural roots, traditions and practices and simultaneously open their minds towards the world (Hansen 2009). Thus, education on global health must facilitate room for developing reflexivity about local as well as global health traditions and practices. In doing so it facilitates students being open to inspiration for what might lead to new and possibly better ways of living, and thus strengthen their health agency in a globalized world. Much in line with Dewey, Jensen coins the term Democratic Health Education (Jensen 1997), and argues that becoming educated about health entails ‘active involvement of students in constructing their own knowledge and action competences’ (Jensen 1997;419). Further it is something that cannot be obtained solely by giving information to students on how to behave healthily. By insisting on genuine participation by students, Jensen and Simovska (2009) have defined an approach to health education that must be open to multiple interpretations of health; that promote students’ insights into their own and others’ practices and conditions for health; and develop abilities to visualize new ways to be agents in health. Inspired by the concepts of the cosmopolitan person and democratic health education, this presentation discusses the primary school classroom as a setting for educating students to become health agents with a cosmopolitan outlook. The discussion is based on findings from the evaluation of the educational program MOVE|EAT|LEARN (MEL). MEL is a primary school based educational programme developed by teachers in Denmark and Nairobi. The programme facilitates cultural meetings, primarily Skype-based, between students from Kenya and Denmark, with the aim to promote reflections on differences and similarities in the everyday living conditions across cultures and nations, and their impact on health practices. Based on the findings this presentation will discuss the merits of this kind of education as a way to promote students health agency and understandings of global health conditions, and whether that, in a long term perspective, can support equity in health. Methodology, Methods, Research Instruments or Sources Used MEL is a collaboration between three Danish public elementary schools in an affluent Municipality north of Copenhagen, Denmark and one elementary school in a middle class neighbourhood in Nairobi, Kenya. The programme is aimed at grade 6. Each year three Danish schools participate with two classes each, and the Kenyan school participate with three classes, allowing a total of 9 Kenyan and 18 Danish classes to participate during the three years the program have been granted to run. Due to a much larger number of students per class in Kenya, the number of participating students approximately equals.  During a three year period teachers and researchers have developed an educational programme, based on different forms of intercultural communication. MEL is strongly inspired by the 3C approach (Larsen et al., 2014). The programme activities were integrated into English, Math and Home Economics lessons in Danish schools, and into English, Social Studies, Math and club time in Kenyan schools.  Findings from the programme consist of 18 focus group interviews: 12 groups of 6 Danish students and 6 groups 6 Kenyan students. With one group of girls and one group of boys from each participating class, making a total of 72 Danish and 36 Kenyan interviewed students. All interviews were made by the same research group. Interviews were recorded and transcribed. Focus was on students recalling the activities in the MEL-program and discussing what had been the most interesting, surprising or uninteresting and boring. Data has been studied with focus on students’ understanding and ability to identify determinants of health in their daily life and in that of their friendship class. But most importantly the analyses focussed on evaluating students’ outlook on differences and similarities in health practices and cultures as something to be inspired from to form visions and actions to promote the health of themselves and others.  Conclusions, Expected Outcomes or Findings Findings demonstrate that by participating in cross cultural meetings, through letter writing and Skype and through the collection, analysis and reflections on intercultural empirical data, students gain insight into the daily life of peers in Kenya and Denmark. Students report that cultural meetings awaken their interest in learning about other cultures, and their general engagement and ability to connect to and recall their learning is strong. In line with Jensen (1997), findings stress that taking departure in daily life practices makes learning approachable and relevant to students. Findings have produced examples of how the cross-cultural dialogues have facilitated spaces for students to gain insight into their own and their peers’ conditions for health. Students recall multiple situations where the dialogues made them aware of practices and conditions that are very different for the two groups. They mention different approaches to education, different food cultures, different patterns of gender and chores at home and a different family structure. Mirroring their own health practices in that of their peers from another culture appeared to support learning process of global health literacy. Thus, in line with Dewey’s (1939) cosmopolitan person, students become much more reflexive about their own health practices and conditions for health, while they simultaneously learn and become open to and interested in daily life practices and conditions for health in the other cultures. Thus, findings indicate that students become educated, not just informed, on social determinants of health and how they lead to unequal conditions for health. Even though findings also show that conducting cross-cultural dialogue is very resource demanding and that students are not always certain of what they have learnt, we still find promising qualities in the MEL-programme that can be used as inspiration to continue developing a focus of health education with a global outlook.  References Dewey, J. (1938). Education and experience. New York: Simon and Schuster Hansen, D. T. (2009). Dewey and cosmopolitanism. Education and culture, 25(2), 126-140. Jensen, B. B. (1997). A case of two paradigms within health education. Health education research, 12(4), 419-428. Jensen, B.B. (2000). Health knowledge and health education in the democratic health-promoting school. Health education, 100(4), 146-154. Larsen N, Bruselius-Jensen M, Danielsen D, et al. (2014) ICT-based, cross-cultural communication: A methodological perspective. International Journal of Education and Development using Information and Communication Technology 10: 107. Labonté R and Schrecker T. (2007) Globalization and social determinants of health: Introduction and methodological background (part 1 of 3). Global Health 3: 1-10. Marmot M. (2005) Social determinants of health inequalities. The Lancet 365: 1099-1104. Marmot, M., Friel, S., Bell, R., Houweling, T. A., Taylor, S., & Commission on Social Determinants of Health. (2008). Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet, 372(9650), 1661-1669. Simovska, V., & Bruun Jensen, B. (2009). Conceptualizing Participation: the health of children and young people. WHO, Regional Office for Europe. Wilkinson RG and Marmot MG. (2003) Social determinants of health: the solid facts: World Health Organization.  Intent of Publication We intent to submit a paper on the findings to Journal of Global Health