A Canadian Reflection on Health Promotion in Oslo

Are the only things separating Norway and Canada an ocean and an Olympic gold medal? If you answered yes, then you may be correct! Located in the northern hemisphere, misunderstood and constantly compared to our geographical neighbours, Norway and Canada may hold many similarities.  

Our International Public Health course at Oslo and Akershus University College introduced us to the concepts of social determinants of health and health promotion.  The World Health Organization (WHO) defines health promotion as «the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.» 

As students immersed in these public health teachings, we began to become more aware of the space around us. The information we learned in the classroom nicely complimented what we observed in the parks of Oslo: your environment has an impact on your health, in either a positive or negative way.  We learned that «95% of Oslo’s residents have a green space within 300 metres of their home» (Oslo City Government, 2002).  

Our observations confirmed that these parks were well attended.  Amongst us were locals young and old, students, pet-owners, fitness enthusiasts, business executives and families. It was a refreshing change to see people being active and enjoying the outdoors compared to sitting on a couch watching TV. The abundance of green space in Oslo can be seen as a health promotion effort, which has improved the health of the population.  

In North America, individual lifestyle factors are often perceived to be the strongest contributors to health status. It is common to hold a narrow view of the concept of health and believe that eating well and being active is what makes someone healthy. While these are important considerations in the health spectrum, the determinants of health encompass more than just personal factors.  

Social determinants of health are factors that shape people’s behaviour and have powerful effects on the health of populations. For example, the high price of alcohol in Norwegian establishments can encourage young people to drink heavily before going to bars (vorspiel) in order to save money. The cultural norm of binge drinking may negatively affect the physical and mental well-being of the young adult population.

In Oslo, we had many memorable conversations with local Norwegians, which often included talking about Canada, cultural differences and what we were studying in Oslo. An easy way for us to describe our course focus in International Public Health was to say, «We study the things that make you healthy and unhealthy.» While discussing this with local people, one Norwegian man surprised us all when his response was, «Oh, so things like eating good food and air quality and stuff?» 

We were awestruck. In his response he had included an environmental determinant of health (i.e. air purity) as well as a lifestyle factor (i.e. nutritious food). One of the most powerful lessons we realized in Norway is that it is possible for populations to support a more encompassing view of health.  Maybe Norwegians did deserve to beat Canada in the Olympics!  

When studying public health we also focused on the importance of culture and social inequality. Culture can be thought of as learned and shared patterns of thinking and doing. Ways that people live and participate within the groups where they belong.  Often times the role of culture is forgotten during the planning and implementation of new health promotion strategies. For example, those who perceive parks as being a place for delinquents and unruly gatherings may view instilling the Oslo lifestyle that surrounds outdoor spaces in a large North American city differently.  

Cultural considerations are important and require careful health promotion strategies for marketing within the specific social context of the country.  Our time in Oslo has inspired us to advocate for public health strategies that are both culturally relevant and look beyond individual determinants toward a more encompassing vision of health. We learned a phrase during our International Public Health course that summarizes what we have taken from this experience: Think Globally, Act Locally.  Takk for alt, Norway!

Here’s a link to the Blog we made while in Oslo: http://norway2013iph.weebly.com/1/archives/07-2013/1.html

This inuksuk was presented to Norway by Canada in 2005 as a gift of friendship celebrating Norway’s centennial and the close ties between our two countries.

Our group at Vigeland Sculpture Park.

References:

Oslo City Government (2002). Strategy for Sustainable Development: Environment and Sustainability Status 2002 Urban Ecology Programme 2002- 2014, Department of Transport and Environmental Affairs, Oslo.