Pictured: Lori Kleinsmith (left) recieves the Lori Chow Memorial Award

Over nearly a decade working as a health promoter at Bridges Community Health Centre in the south of Niagara Region, Lori Kleinsmith has driven herself and others to find ways to impact public policy to support health and wellbeing. Last week, for her advocacy and dedication to her clients and community, Lori was awarded the highest honour for a health promoter in Ontario, the Lori Chow Memorial Award. We had a chance to speak to Lori about the key role health promotion plays in primary health care, and the importance that advocacy plays in allowing her and her colleagues to deliver on their vision of helping clients achieve their best possible health and wellbeing.

What does this award mean to you, particularly to be acknowledged by your peers in health promotion across Ontario?

It’s a great honour and privilege, even just to be put forward for consideration for an award like this. In the world of health promotion, we don’t do a lot of patting ourselves on the back for the work we do. We’re often quite content to work behind the scenes, being connectors, enablers, facilitators. So to be nominated, and then chosen as one of two recipients, it really is an honour.

How long have you been a health promoter?

I began work in this field in 1994 when I graduated from a university degree in health education and a two-year diploma at George Brown College. I originally started out doing health and wellness programming at a large corporate fitness centre, and then that morphed into doing work in substance use and misuse prevention for a number of years. After that, I joined Bridges CHC, and I’ve been there for nine years.

You’ve been involved in advocacy campaigns for public oral health programs and better income security. Why is advocacy such an important part of a health promoter’s role in your opinion?

I base my professional work on the Ottawa Charter for Health Promotion, the groundbreaking document developed in 1986. It was a new field then, and it took me a while to really see the importance of advocacy at first. It moves us health promoters a bit out of our comfort zones, and we can get initially really comfortable doing program delivery, promotion of health awareness and communications on their own. But when you really start to look at what the Ottawa Charter describes as strategies and actions for a health promoter, advocating for healthy public policy encircles all of the work we do.

When you really peel back the layers of what causes sickness and illness in the first place, I see my role as one that is grounded in public policy. In order for change to happen, you have to be involved in politics. That doesn’t mean you have to be partisan in any way. It means you have to be comfortable engaging and interacting with political stakeholders from all parties and all levels of government, as well as other partners in the community, whether you’re talking about affordable housing, food security, dental or any other area that impacts on the social determinants of health.

It’s impossible to work upstream without trying to have an impact on policy, right?

Yes, exactly.

How is health promotion different when it’s embedded in a Community Health Centre setting?

In a CHC, we know as health promoters that we have to be able to touch on all issues. That doesn’t mean we’re complete subject matter experts on every issue and challenge our clients are facing, but we do have to keep abreast of a number of things and recognize where we can have the most impact, or where the greatest need is. So for both myself and my colleague Ashley who works out of Bridges’ other site, we’re working with our municipal councils on housing, including housing planning, and encouraging the adoption of a housing action plan. I work with community and social services to help meet the needs of our clients as much as I work with public health. A lot of our work crosses over the traditional biomedical model of health and health care.

Do you find that working alongside clinicians has an impact on your work? What are some of the benefits of working closely as part of an integrated interprofessional health team?

I do still see clients for one-on-one appointments to support smoking cessation. Being involved like that is a great way to connect with other clinical staff on specific clients’ issues, and to understand their challenges better.

I had a client in a recent group for smoking cessation who expressed having been under a significant amount of stress. He was finding quitting smoking very challenging because all he’d been able to find were precarious work and piecemeal contracts in his field. So this was having a great impact on his physical and mental health. I hear examples and stories from our clinical staff all the time of issues like this that impact people’s health directly, from housing conditions to income security to a lack of health benefits. Knowing these stories gives me direction when I’m doing advocacy on clients’ behalf, and gives me a chance to give voice to their concerns. It makes my work more real, and more credible, I think.

What’s been the most rewarding part of your work? What keeps you motivated to advocate?

I think the most rewarding aspect of working at Bridges CHC is getting to work alongside so many like-minded people. It’s also been rewarding to find interesting opportunities to spur change. I never dreamed I would be involved in a research project with professors from Brock University and United Way staff on precarious employment and its health effects. I really love to see connections being made, and people working together to determine the direction people need to head to see change. It’s never boring, it’s never dull. It can be frustrating, because change happens so slowly, and sometimes we see regression.

How important is social media to health promoters and others trying to promote healthy public policy? (Follow Lori on Twitter @LoriKleinsmith)

I started up fairly early, in 2010, on Twitter. I found out very quickly that by following people who were working in my circle, or at other CHCs and other social service agencies, as well as political leaders and candidates, and news media on health beats, I would have a way to check in every day on key issues. It’s also been a great tool to continue connections with various people I’ve met at conferences, meetings, and other events over the years. There’s so much value in broadening your understanding of social and political issues, and understanding how to position your advocacy work by following things closely on Twitter. It allows you to see multiple sides of an issue, which helps to shape your messaging, your work, and who you might connect with or partner with to do advocacy work.

What does the future hold for health promotion as a role in comprehensive primary health care?

For health promotion, taking our work to the next level will mean finding ways to put an anti-oppression lens on things like housing policy and other issues. I did a webinar for Maytree, for instance, on bringing a human rights-based approach to access to dental care, talking about and asking questions using human rights language about access to health care, and why it doesn’t include dental. I still have a lot to learn in this area, but I want to encourage other health promoters to take up these challenges as they continue to do work in their communities.

Any words of wisdom for younger health promoters just starting out?

Health promotion is such a diverse, flexible, open profession to be in. It allows us to look for opportunities to do something that’s going to be impactful on issues that underpin health. And if we can get people thinking like that about public policy, asking, “How is this going to impact health?” and trying to get people to do things differently, working with partners they’ve never considered working with, testing new ideas – well, that’s how change happens.