By Andrea Arnold

What do you think of when you think about northern health care spending?

The PLURAL photography exhibition was on display in Valemount and McBride over the Canada Day long weekend, showcasing photos that answered this question.

A group of residents from across northern B.C. used their creativity to show their experience of healthcare in the north and answer a research question. The exhibit is just one aspect of a collaborative UBC-UNBC health economics research project that began in 2019 seeking perspectives from northern residents on health care spending and resource allocations.

While a photo exhibit may not be the first thing you think of when you think academic research project, Principal Investigator Theresa Healy says the photography was an important part of the results and stems from a research tool known as photovoice.

“It’s been around for an awfully long time, and the idea is you use your eyes to answer the research question,” she said.

Unlike with a survey, she said photovoice allows people to express their perspective in a unique and ultimately more engaging way that can have a bigger impact on policymakers.

Healy, who is VP of the Public Health Association of British Columbia and an Adjunct Professor, at UNBC said she was surprised by some of the answers. 

“The northern health authority is the size of France. A strong theme in the answers was that there were positives for health from living in the north that are not recognized. If health care resources invested in these strengths instead of judging the north as lacking and deficit there would be better outcomes.”

For example, she said imposing solutions generated in and for the larger and urban centres in the Lower Mainland did not improve health outcomes or streamline services and save money. Instead, such solutions (close rural hospitals and centralize services in “urban centres”) resulted in delaying and complicating access to necessary health care. 

“While Lower Mainland residents may suffer under long waiting lists for necessary health care procedures, northern residents have no timely access because of climate/distance/shortages of staff.”

Valemount resident John Grogan was recruited by Healy to also be a part of the photovoice group. Grogan says the photography element can help plant a seed for social change. 

Healy concurs saying it’s a result that can hit policy makers on a gut level, a lot more than graphs and surveys on their own.

She pointed to one photo of a faceless painting done by a woman who works the streets in Prince George on her experiences in the health care system.

“It’s like a knife to the heart,” she said. 

She said the New Hope Society stretched their budget to last all summer, and women who worked the streets would come in and have lunch and work on this project. She said that entire summer they had no overdose deaths.

“After we left, two overdose deaths that month,” she said. “It’s not just that you get a voice you don’t have, but it also gives a purpose.”

Regarding the photovoice process, Healy said participants met in a workshop and were given a question and asked to answer it via photographs and captions: what perspectives do northern residents have on the allocation of healthcare service resources? They were provided with the following prompts to help: What helps you be healthy? What are the challenges in your community to achieving a healthy life?

Participants then had time to capture images and construct write ups to go with the photos explaining how the image related to the questions. 

The group met again to go through the collection of photos and writings before picking out those that would proceed. Healy says this gives more of a voice to the people as it is not a select group of researchers deciding what data gets used, but the people themselves.

In addition to photovoice workshops, they also conducted interviews and focus groups.

“We made sure we conducted research with a range of people, service providers, elected politicians, Indigenous people, marginalized folks, community members in all three research streams,” she said. 

The exhibit also contains commissioned photography by Attilio Fiumarella. Fiumarella travelled across Northern BC documenting his experiences. As he reflected while going through his photos back home, he arrived at a strong central theme; resilience. He took some of the images and transferred them, using water and chemicals onto other mediums.

“Transferring the image from one place to another allowed me to work with the photographs’ materiality and shape, interpreting a new visual identity for those landscapes and populations,” said Fiumarella in the book.

Healy said he was awed by the beauty of the north, but how many people saw the north through a skewed lens.

In addition to the exhibit that is traveling across Northern BC, the photographs and research methods have been compiled in a 140-page book “Through a Northern Lens.” 

“The book is intended for what researchers refer to as Knowledge Translation (KT), which I prefer to call knowledge transfer,” said Grogan. “It’s a means to share with others the knowledge gained by doing the research.” 

The book covers information from discussions with nine community members, three photovoice sessions, Indigenous contributions, New Hope Society members, and 31 decision makers representing 18 communities across Northern BC. The book will be distributed to policy-makers, participants in the study, and every public library in northern BC.

Valemount’s John Grogan created this banner to show his thoughts on northern health and healthcare./LAURA KEIL
The Prince George New Hope Society engaged street workers in the photovoice process to create a powerful banner. /LAURA KEIL