from left: Drs. Gaynor Watson-Creed, Claudia Sarbu, Daniela Kempkens, Jessica Jackman and Jennifer Cram.For Dr. Gaynor Watson-Creed, public health is like the air bag in your car. You don’t see it, but when you need it, it has to be there. “And when it fails, you really notice it,” she says.

As deputy chief medical officer of health for Nova Scotia, Dr. Watson-Creed is working to boost the profile of Nova Scotia’s medical officers.

These physicians look after the health of entire communities, not individual patients. “If community A is having low birth weights but community B is not, we need to figure out why. ‘Why’ is a public-health question,” says Dr. Watson-Creed.

Medical officers study the risk factors for disease and other issues relating to health: chronic and communicable disease prevention, injury prevention, environmental health, water and food safety, healthy development, emergency preparedness.

They also study hot-button issues like vaping, vaccination and Lyme disease. “Our job is to let local governments know what is needed, so that any interventions can be successful,” Dr. Watson-Creed says.

“The complexity of public-health issues is growing. New population threats are emerging at a pace we’ve never seen before in part because of climate change. As those threats become more prevalent, we need skilled professionals to handle these issues.”

But recruiting and retaining medical officers in Nova Scotia has been challenging, partly because the role requires physicians to take specialist training that’s not offered in Atlantic Canada.

For the past 18 months, Dr. Watson-Creed and her colleagues have been busy recruiting medical officers. There are now seven physicians in the role across the province.

Here are four of the new hires working on the front lines to help strengthen public health in Nova Scotia communities:

Dr. Daniela Kempkens, regional medical health officer, Eastern Zone
Dr. Daniela Kempkens was a physician, research fellow and medical officer of health in Germany before completing a public health and preventative medicine residency at the Northern Ontario School of Medicine. She joined the Nova Scotia team in September 2018.

She’s keen to explore how poor health is often rooted in poverty. “Poverty is one of the biggest barriers to health and Nova Scotia has the highest overall poverty rates in Canada, including child poverty,” she said. “So looking at the local situation more closely and determining what the role of public health can be in working toward the elimination of poverty is my North star.”

With so many Nova Scotians struggling to access primary health care, Dr. Kempkens says it’s key to focus on preventing disease and illness in the first place. “What is needed to make Nova Scotians healthier and keep them out of hospitals and physician practices? The emphasis must be on the prevention of the risk factors themselves, through changing social and environmental conditions. There is much work for us to tackle in public health and a long way to go.”

Dr. Jennifer Cram, regional medical officer of health, Western Zone
Practicing rural family medicine sparked Dr. Jennifer Cram’s interest in public health. “It taught me the value of preventative medicine,” she said. “I saw how many health issues are rooted in the social and structural barriers to health.”

Dr. Cram became a regional medical health officer in Nova Scotia in January 2019, after working for almost a decade in family medicine in communities across Canada. She completed her public health and preventative medicine residency with the University of Toronto.

Drawn to how public health works directly with communities to support healthier societies she holds a particular interest in lessening rural health disparities. “People may be surprised at the scope of our work,” she said. “It’s not only related to communicable disease prevention and supporting at risk young families through our Early Years program, but also influencing healthy public policy and being a voice for science in the public debate.”

She thinks that Nova Scotia is a great place to do that work. “Public health aims to tackle systemic issues facing the population, and there are definitely advantages to doing this in a province that is relatively small in both geography and population.”

Dr. Claudia Sarbu, medical officer of health, Central Zone
Dr. Claudia Sarbu studied medicine in Romania and trained as a public health preventive medicine specialist at the University of Ottawa. She joined Nova Scotia’s public health team in September 2019.

For her, public health is about improving the health and well-being of Nova Scotians over the long term, while also reducing the financial burden of health care. “Through public health and preventive medicine programs and partnerships, we can create supportive environments, increase awareness and help people built the skills that will enable them to adopt healthy lifestyles and to enjoy a high quality of life.”

In her new role, she is excited about promoting collaboration between public health, primary and acute health care, as well as partnerships with other sectors that can influence the health of the population.

“We all face the same overall challenge – to improve the health of the population,” she said. “And the best way to address it is by working together. While our fellow physicians approach this working with one patient at a time, public health can positively influence the health of the society as a whole by working with many partners, within the health-care system and from other sectors, to address the factors that influence health across the lifespan.”

Dr. Jessica Jackman, medical officer of health, Central Zone
Dr. Jessica Jackman studied medicine at Memorial University and specialized in public health and preventive medicine at the Northern Ontario School of Medicine. She joined Nova Scotia’s public health team in September 2018. “The medical community here is large enough that there are many resources to draw on but small enough to feel a strong sense of connection,” she said.

The prevention side of public health is what inspired her to pursue a career in the specialty. “My work is largely focused on working upstream to act on the social determinants of health and reducing health inequities,” she said.

Health inequities are differences in health that are unnecessary and avoidable, and considered unfair. They are often grounded in social and environmental factors, such as income, social status, and race.

Using that lens, Dr. Jackman’s practice is focused on communicable disease control, managing environmental health hazards and creating healthier communities. Public health is a team sport, and she works closely with public health inspectors, nurses, and other staff to achieve these goals.

“We are a resource not only to the public, but to other physicians,” she said. “When we are doing our job well, we can help keep people healthy and out of the acute care system, and create environments where there is equal opportunity for good health.”

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