Voices Lifting the Community with Kate Vsetula, Director of Community and Organizational Development

(Access show transcript) For this special series, Voices Lifting the Community, HIROC is partnering with the Alliance for Healthier Communities to highlight the work of several of the presenters at their online primary healthcare conference in June.

Show Summary

Today we’re talking with Kate Vsetula, Director of Community and Organizational Development at the Guelph CHC. One of the many programs Kate works on is ACEs which stands for adverse childhood experiences. Research has shown that those experiences are common and universal and can increase the potential for negative health outcomes later in life.

Together with her many community partners, Kate takes an upstream approach to ACEs that focusses on building resilience within individuals, the family and the community. It starts with how you pose the question – not by saying “What’s wrong with you?” but “What happened to you?”

Kate has been recognized with a Woman of Distinction Award, the University of Guelph Emilie Hayes Community Partnership Award, and The Alliance for Healthier Communities Health Equity Award.

Mentioned in this Episode

• Guelph CHC
• Kingston CHC
• Toward Common Ground 
• ACEs Coalition in Guelph and Wellington County
• Adverse Childhood Experiences (ACEs)
• Alliance for Healthier Communities

Transcript

Imagine you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers, and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to leaders about the joys and challenges of driving change and working with partners to create the safest healthcare system.

Ellen Gardner: Welcome to Voices Lifting the Community, a special series from HIROC. I'm Ellen Gardner with Philip De Souza. For this series, we're delighted to partner with the Alliance for Healthier Communities. Today, we're talking with Kate Vsetula, Director of Community and Organizational Development at the Guelph CHC. 

One of the many programs Kate works on is ACEs, which stands for adverse childhood experiences. Research has shown that those experiences are common and universal and can increase the potential for negative health outcomes later in life. 

Together with her many community partners, Kate takes an upstream approach to ACEs. The focus is on building resilience within individuals, the family, and the community. It starts with how you pose the question, not by saying “What's wrong with you,” but “What happened to you?” Kate has been recognized with the Women of Distinction Award, the University of Guelph Emily Hayes Community Partnership Award, and the Alliance for Healthier Communities Health Equity Award.

This interview was recorded before the Alliance Conference, which took place in June. 

Ellen Gardner: Welcome, Kate. Great to have you on Voices Lifting the Community.

Kate Vsetula: Thanks. I'm really happy to be here, Ellen.

Ellen Gardner: At the Alliance for Healthier Communities Conference, you and your colleagues from the CHC in Kingston are talking about taking action on ACEs. ACEs refers to adverse childhood experiences. Can you tell us about ACEs and why this is an important topic to explore?

Kate Vsetula: ACEs are experiences in childhood that can shape who we are and set the stage for who we will become. There's been a lot of research out there that called stressful or potential traumatic abuse, neglect, or household dysfunction, they're called adverse childhood experiences. And so, ACEs can increase the risk of negative health behavior and outcomes later in life.

Ellen Gardner: Can you talk a little bit about the negative impact? Is it something that you see that goes into adolescence and adulthood? Or how can we trace an ACE?

Kate Vsetula: Adverse childhood experiences can have negative and lasting effects on health and well-being throughout a person's life. There’s maybe just a little bit more about ACEs. So, they're divided into 10 categories that fall under three types. The term ACEs originates from the landmark, adverse childhood experiences study that was done through the Centre for Disease Control and others. It examined the link between adverse childhood experiences such as abuse, neglect, and household dysfunction, and health outcomes later in life. 

So, some of the things we know are that ACEs are common and universal and that there is a strong association between childhood adversity and negative health outcomes. And there's a strong dose response relationship between the number of ACEs and the risk of poor health.

Ellen Gardner: It almost seems as you talk about ACEs, Kate, that once you discover it, it's already happened. How would you tackle an ACE before it actually becomes a problem?

Kate Vsetula: There are so many answers to that. So tackling an ACE before it becomes a problem, one of the things that we're looking at in our community is to ensure that there's protective factors around children and around families to decrease the effects of ACEs and to decrease ACEs. That's all about building resiliency. So again, ACEs do not predict your future. It just raises the risk of potential lower health outcomes. 

When we look at how we can adjust for that, it's about building community resiliency right on down to a personal level with a person to the family resiliency and then throughout that community. So that's one piece, but another piece is around education and ensuring that people understand that traumatic experiences are something that can affect them, but not create who they are, and how to help them understand the effects that it will have on them and how to bounce back from those.

Ellen Gardner: How did you get involved with this work, Kate?

Kate Vsetula: At the Guelph Community Health Centre, we really look to creating the conditions for optimum health and well-being for community members. For me personally, I like to look at upstream approaches to solving big system problems because we can look at the analogy – there’s a river and there's a bunch of babies at the bottom of the river and people are pulling the babies out and making sure they're okay, but why are the babies in the river in the first place? I mean, that's sort of a crude example, but if we go up the river and see, oh, somebody is putting babies in the river, then we won't be catching them downstream. And so when we look to upstream approaches and take a really comprehensive approach to change, we can see that we can change the trajectory of not only a person's life, but a community sense of well-being.

And so for me, I'm quite passionate about this work because the priority population that the Guelph Community Health Centre serves are those that have the most barriers to health and well-being. When we take the time to ask the question, not what's wrong with you, but what happened to you, we can often see that increased risks of mental health or increased use of substance or other barriers such as low education, or self-harm, mental health issues. 

These things can be connected to the experiences someone has had in their life. Helping them understand that and regulate around that and build their own resiliency and their own protective factors is something we want to explore. I have experience with ACEs in my life and I have lots of people around me that have had those experiences. And I see that ensuring protective factors and building communities that can support people through this is a really great long game.

A little bit more about our Coalition. So, we are a group of organizations in the Guelph and Wellington area that aimed to prevent and reduce the effects of ACEs in our community by building resiliency at the individual family and community level. So I represent the Guelph Community Health Centre at the Coalition, but the secret sauce around the work we're doing in our community around our collective impact approach is that the school board is at the table, public health is at the table, our neighbourhood group association called the Guelph Neighbourhood Support Coalition is at the table. Our other social services partners and early childhood partners are at the table. We are informing the work together to take a real system response.

Ellen Gardner: Can you talk a little bit about some of the highlights of how you and the Kingston CHC came up with some strategies that led to positive outcomes?

Kate Vsetula: In the Guelph area, really our approach, as I shared, is that collective impact approach and making sure that we have the conditions for success with collective impact. Some of those conditions are that we have a shared agenda. So, for example, we're really excited about a training, a five-series training module that's free on the ACEs Coalition website. And that is something that we're closely evaluating. We had hoped to have before the pandemic 400 people trained up on it in-person on our work to do in the community. And since the pandemic struck, we went to a virtual version and we now have over a thousand people trained and another thousand that are working through the modules. So, really exciting in terms of how that will turn the tide and measuring that as we go. 

The other thing that creates the conditions for success is mutually reinforcing activities. So for example, at the Guelph Community Health Centre, we have a really innovative program called the Parent Outreach Worker Program. So these are social service staff that are embedded right in community, meeting families where they're at, literally standing at the bus stop some days and connecting families to service, networking communities together, connecting families to resources, whether that be food, bus tickets, a new bike for their kid from the bike program, you name it. 

So that's our program, but there's other programs in other organizations that would be mutually reinforcing to our work. And lastly, I think most importantly for us is some of the backbone support that we have through an organization called Toward Common Ground, which is allowing the partners to come to the table and work together.

Ellen Gardner: You alluded earlier to having personal experience with ACEs and seeing ACEs. How extensive a problem is it? How widespread is it? It’s probably been around for a long time, but is there just more awareness of it now?

Kate Vsetula: What we know is in our community that according to a local study we did as a coalition that 81% of adults in the Guelph Wellington area have experienced one ACE and that 31% of people have experienced four or more. We know that to be very similar to other studies in Canada and throughout the world. So ACEs actually are quite prevalent. It’s helping people understand that their ACE score, as it's known, doesn't determine their future, but what they can do with that and helping parents as they raise young kids know how to mitigate the effects of a potentially traumatic situation.  So for example, I know of not in our region, but in a divorce court somewhere, they ensure the parents understand that this could be a traumatic experience for their children and that they should carefully negotiate the steps forward and keep the children at the centre of their concern and the ways they make decision in divorce court. I think that's really quite forward-thinking.

Ellen Gardner: What have you learned through just working with ACEs and just being so closely involved with this kind of experience?

Kate Vsetula: I have learned so many things. I have learned that increasing a community's resilience is part of the long game. I have learned that education can really shift perspective. I've learned that ACEs and traumatic and stressful experiences are really hard to talk about and that it takes trust and it takes a relationship whether that be with your healthcare provider, with your coach, with your teacher, for somebody to feel that they can open up about that. Certainly, I've learned that a collective impact approach to making change in a community has the potential to really shift trajectory for a community. I didn't know a lot about the potential for long-term health impacts, including things like increased risk of heart disease, COPD, suicidal ideation, cancer, diabetes. These things are all directly tied to toxic stress in early childhood.

Ellen Gardner: You've been involved in several different kinds of community health projects. You worked in the area of food sustainability. You helped develop a community response to the opioid crisis in Guelph. And congratulations on the many awards you've received for your work. Your personal mantra seems to be, ‘This is the problem, how do we solve it?’ So, what do you enjoy about getting involved in public health issues and finding ways to reduce harm?

Kate Vsetula: Oh, so much. What do I enjoy? I guess one quote that I have in my office. I've actually brought it to my home office now that I'm working at home is that I believe that every system is perfectly designed to receive the results it gets. That we need to backsolve on our systems, whether that be about our colonial systems that are in place or our systems that don't actually work to support those most marginalized or our education system that doesn't understand the impacts of trauma, you name it. We're going to see the results of an inadequate system, whatever that is.

So, that's what really jazzes me about this work and gives me the passion and the grit to continue with this work. Also, I really strive to be a constant learner and a critical optimist and know that we can continually do better in our systems that are here to ensure that communities are resilient and strong and that we have optimized health and well-being for all in those communities. So, that's some of the excitement that I feel around this work and other sorts of community-based work that I do on behalf of the Guelph Community Health Centre.

Philip De Souza: The passion in your voice, Kate, it truly epitomizes what this series is called Voices Lifting the Community. And in this case, it's definitely not only your voice, but the voice of your colleagues and for example, that coalition. It just sounds so amazing. And I love the fact that learning all about resiliency and if even the education aspect is very key. 

One thing I wanted to ask you, Kate, is if other subscribers, no matter what or where they are, health care organizations, CHCs, whatever they may be, if they wanted to follow your lead and think about how they can find solutions and solve those big system issues, in your opinion, what would be one or two things they should start with to get the ball rolling, to start that conversation with their teams?

Kate Vsetula: Well, I think one thing to get the ball rolling would be to come to our workshop at the Alliance Conference if they are interested in hearing about our collective impact approaches and what we're doing related to adverse childhood experiences and bolstering resiliency. So, that's one thing. Another thing, we're going to be launching at the Alliance Conference this year is a provincial community of practice. And this is related to adverse childhood experiences. So not only CHCs, but other organizations can be involved in this community of practice where we will learn together. We will explore the way forward together and we'll share resources and network. So, we're really excited to be launching that. That's all from a call to action last year at the Alliance related to increasing the understanding of adverse childhood experiences.

But I would say stitching together a conversation, having a focused conversation with community partners, perhaps looking at some really great resources that are out there, including I would highly suggest they check out our Toward Common Ground website and our ACEs Coalition website in Guelph and Wellington County to learn a few things. 
And we're always open to helping communities along on their journey as well. That’s some of the work we've been doing. We've been doing that with Kingston and London and others. We look forward to working together with other communities.

Philip De Souza: Oh, that's fantastic and thank you for sharing those resources. And if someone is listening to this episode after the conference, the provincial community of practice definitely caught my attention. How can they access it or join it if they've missed your session?

Kate Vsetula: I would suggest that they go to the Alliance for Healthier Communities website, and they will be able to look up the various community of practices that are being supported with backbone support from the Alliance and they'll be able to find out more information on how to get involved.

Philip De Souza: My last question would just be from a personal perspective. Like I said, I can totally hear the passion in your voice and I know you kind of feed your energy from supporting the community and lifting others. But where do you personally draw your passion and inspiration from?

Kate Vsetula: Another one of my mantras is work hard, play hard. So, I do try to strive for work-life balance. And I love to fill myself, fill my bucket up with things like gardening and playing music and biking and having really awesome conversations and learning new things. And I believe that a continual learning journey and aligning my work with the values that are really important to me. That’s why I'm so fortunate to do this work and work at the Guelph CHC because my work actually feeds my soul and helps me keep my passion going.

Ellen Gardner: Thank you, Kate. You've really helped us see how you stay motivated and just the importance of being resilient and looking after yourself, taking moments for self-care, and feeding your soul. I think Philip and I can definitely take a lesson from that.

Kate Vsetula: Yes, thanks so much. I really appreciated our little chat, Ellen. Thanks so much for having me. I look forward to seeing all the participants at the conference and I really appreciate this opportunity.

Ellen Gardner: You have just been listening to Voices Lifting the Community, a special series produced by HIROC and the Alliance for Healthier Communities. Today, our guest was Kate Vsetula, Director of Community and Organizational Development at the Guelph CHC. Stay tuned for more episodes of Voices Lifting the Community.

Thank you for listening. You can hear more episodes of Healthcare Change Makers on our website HIROC.com and on your favourite podcasting apps. If you like what you hear, please rate us or post a review. Healthcare Change Makers is recorded by HIROC's Communications and Marketing team and produced by Podfly Productions. Follow us on Twitter at @hirocgroup or email us at communications@hiroc.com. We'd love to hear from you.