Board of Health Meeting Documents

ISSUE

The impact of household food insecurity on infant health is becoming increasingly apparent. Over the past few years, the Healthy Families department has observed several families struggle to afford adequate infant formula while experiencing breastfeeding challenges. The department’s multidisciplinary team works diligently to help clients optimize breastfeeding and improve access to infant formula, however, a collaborative strategy is urgently needed to address this public health issue at the population level.  

BACKGROUND

Local Prevalence: Food Insecurity, defined as inadequate or insecure access to food due to financial constraints (Li et al., 2023), remains a significant public health issue in Windsor-Essex County (WEC). Household food insecurity in WEC rose from 16.0% in 2019 to 19.8% in 2022 (Public Health Ontario, 2023). While the local prevalence of infant-specific food insecurity has not been formally investigated, it is likely significant considering that 1 in 7 children in Windsor-Essex County is living in poverty (Canada Census, 2021). Declining breastfeeding rates in WEC have created additional vulnerability, as infant formula prices rise and the formula supply chain remains unstable. Rates of exclusive breastfeeding at hospital discharge have steadily declined since 2015 and remain significantly below the Ontario average (45.7% vs 52.8%) (Public Health Ontario, 2023).  

Women in lower income households are also less likely to sustain breastfeeding for the recommended duration. Local infant feeding surveillance revealed that WEC mothers whose annual household income was less than $60,000 were 1.71 times less likely to continue breastfeeding until two months postpartum compared to mothers with higher household income (WECHU, 2019). This paradox was also observed in a larger Canadian study which reported that mothers experiencing food insecurity were significantly less likely to sustain exclusive breastfeeding past four months compared to their food secure peers (Orr et al., 2018).

Potential Impact on Infant Health: When household food insecurity results in unreliable access to breast milk or formula, both infant health and parental mental health are threatened. Undernutrition during infancy can lead to cognitive impairments, growth faltering, and health complications, which may have lifelong repercussions. In a meta-analysis, Corbett and Drewitt (2004) concluded that significant undernutrition during infancy (i.e., failure-to-thrive) is associated with adverse intellectual outcomes significant enough to be of importance at a population-level. Shankar et al. (2017) confirmed the positive correlation between household food insecurity and behavioral, academic, and emotional problems starting in early childhood. Undernutrition during critical periods of development impairs physical maturation and increases risk of acute and chronic morbidity (Martins et al, 2011), causing unnecessary personal suffering and strain on the healthcare system.

In addition to increased risk for malnutrition and its manifestations, infants in food insecure households are more likely to have a parent experiencing mental health concerns. Food insecurity has been consistently associated with parental depression, anxiety, and stress (Cain et al, 2022). In Ontario, maternal food insecurity was correlated with postpartum mood disorders and a greater likelihood of infants being treated in an emergency department (Tarasuk et al, 2020). Further, preliminary evidence suggests that maternal mental health issues negatively impact attachment with infant children (Barnes & Theule, 2019). These associations imply that there may be secondary impacts of food insecurity on infant development related to parental mental health.

Existing Infant Food Security Initiatives:  The Healthy Families department has implemented several initiatives to help low-income clients secure reliable sources of nutrition for their infants. These initiatives include reinstating the in-home lactation consultation program to reduce financial barriers to accessing breastfeeding services. The Healthy Babies, Healthy Children program also provides infant feeding education and helps clients access necessary feeding essentials. Unfortunately, no local organization consistently supplies infant formula or other infant feeding supplies to low-income families. In response, the department will pilot a breast pump loan program and has collaborated with the local social services agency to identify efficiencies in the Special Diet Allowance application process for clients who require formula due to inadequate breastmilk supply. While these initiatives help Health Unit clients access the products they need, an upstream strategy is required to adequately address this public health issue at the population level.

The Healthy Families Department is well-positioned to lead this strategy and monitor the efficacy of the associated work. The department already collaborates with many of the key stakeholders and will be relaunching the Windsor-Essex Infant Feeding Surveillance survey this year, which will include measures of infant food security. Initial work should include the formation of a Windsor-Essex Infant Food Security Working Group, including representation from each birthing centre and midwifery clinic, in addition to related community agencies and primary care providers. Key deliverables should include the implementation of community-wide strategies to screen for infant food insecurity and improve breastfeeding rates and infant formula access. The working group could also facilitate coordinated advocacy efforts to support equitable access to infant feeding products and services, such as the most recent Call to Action from Ontario Dietitians in Public Health and Food Allergy Canada (2023). This Call to Action would ensure equitable access to specialized formulas for children with a medical diagnosis requiring strict avoidance of standard soy and milk proteins. 

PROPOSED MOTION

WHEREAS improving household food security among families with infants is essential to protecting the health and cognitive potential of future generations.

WHEREAS immediate action is required to improve access to proactive breastfeeding education and timely, coordinated lactation support.

WHEREAS immediate action is required to improve access to infant formula and associated education for low-income families when exclusive breastfeeding is not possible. 

WHEREAS effective solutions to infant food insecurity require coordinated, community-wide policies and programs. 

NOW THEREFORE BE IT RESOLVED that the Board of Health at the Windsor-Essex County Health Unit will continue to advocate for more sustainable solutions to household food insecurity and will advocate for equitable access to infant formula and in-person breastfeeding support. 

AND FURTHER that the Board of the Windsor-Essex County Health Unit endorses the Call to Action: ODB Program amendments to support infants and children with a medical diagnosis requiring strict avoidance of standard soy and milk proteins (Ontario Dietitians in Public Health & Food Security Canada, 2023).

AND FURTHER that the Board of the Windsor-Essex County Health Unit supports infant food security by prioritizing the following initiatives:

1. The creation of a comprehensive strategic plan to improve infant food security in Windsor-Essex County, including targeted food insecurity screening initiatives and the creation of an associated referral pathway. 
2. Community mobilization to improve equitable access to infant feeding products, education, and consultation. Work will include the formation and leadership of an Infant Food Security Working Group, which will have representation from birthing centres, midwifery clinics, dietitians, primary healthcare providers, and related community agencies.
3. Surveillance of infant food security in WEC and the coordination of related advocacy efforts. The cost of formula feeding will also be monitored as part of the Health Unit’s annual Cost of Healthy Eating initiative.
4. The development or enhancement of internal policies and procedures to support equitable access to early nutrition. These initiatives will include screening for food insecurity during feeding and growth assessments and prioritizing associated internal and external referrals.

References: 

Barnes J, Theule J. (2019). Maternal depression and infant attachment security: A meta-analysis. Infant Ment Health J. 2019 Nov;40(6):817-834. doi: 10.1002/imhj.21812. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/31415711/ 

Cain KS, Meyer SC, Cummer E, Patel KK, Casacchia NJ, Montez K, Palakshappa D, Brown CL. Association of Food Insecurity with Mental Health Outcomes in Parents and Children. Acad Pediatr. 2022 Sep-Oct;22(7):1105-1114. Retrieved from:
https://pubmed.ncbi.nlm.nih.gov/35577282/

Corbett and Drewitt (2004). To what extent is failure to thrive in infancy associated with poorer cognitive development? A review and meta-analysis. J Child Psychol Psychiatry, 45 (3): 641-54. Retrieved from:   https://pubmed.ncbi.nlm.nih.gov/15055382/ 

Li T, Fafard St-Germain AA, Tarasuk V. (2023). Household food insecurity in Canada, 2022. Toronto: Research to identify policy options to reduce food insecurity (PROOF). Retrieved from https://proof.utoronto.ca/ 

Martins VJ, Toledo Florêncio TM, Grillo LP, do Carmo P Franco M, Martins PA, Clemente AP, Santos CD, de Fatima A Vieira M, Sawaya AL. (2011). Long-lasting effects of undernutrition. Int J Environ Res Public Health. 2011 Jun;8(6):1817-46. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3137999/ 

Ontario Dietitians in Public Health and Food Allergy Canada (2023). Call to Action: ODB Program amendments to support infants and children with a medical diagnosis requiring strict avoidance of standard soy and milk proteins. Retrieved from: www.odph.ca/advocacy

Orr S, Dachner N, Frank L, Tarasuk V. (2018). Relation between household food insecurity and breastfeeding in Canada. CMAJ, 190:E312-9. Retrieved from: https://www.cmaj.ca/content/190/11/E312

Public Health Ontario (2023). Household Food Insecurity Snapshot. Retrieved from: https://www.publichealthontario.ca/en/Data-and-Analysis/Health-Equity/Household-Food-Insecurity 

Risi A, Pickard JA, Bird AL (2021). The implications of parent mental health and wellbeing for parent-child attachment: A systematic review. PLoS One. 16(12):e0260891. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/34914730/

Shanker P, Chung R, Frank D (2017). Association of Food Insecurity with Children’s Behavioral, Emotional, and Academic Outcomes: A Systematic Review. J Dev Behav Pediatr. 38(2):135-150. Retrieved from:  https://pubmed.ncbi.nlm.nih.gov/28134627/ 

Tarasuk V, Gundersen C, Wang X, Roth D, Urquia M (2020). Maternal Food Insecurity is Positively Associated with Postpartum Mental Disorders in Ontario, Canada. The Journal of Nutrition, 150 (11), 3033-3040. Retrieved from: https://doi.org/10.1093/jn/nxaa240

March 21^st, 2024

ISSUE/PURPOSE

The Windsor-Essex County Health Unit (WECHU) administers the Healthy Babies Healthy Children Program as well as, the Pre-natal and Post-natal Nurse Practitioner Program (Collectively referred to as the Programs).  These Programs are funded entirely by the Ministry of Children, Community and Social Services (MCCSS).  The operating budget for the fiscal year April 1, 2024 to March 31, 2025, requires approval by the Board of Health prior to submission to the MCCSS. 

BACKGROUND

For fiscal 2024/25, these Programs support twenty-two and one quarter (22.25) FTEs comprised of one (1.0) manager FTE, one-quarter (0.25) director FTE, fifteen (15.0) public health nursing FTEs, one (1.0) nurse practitioner FTEs, two (2.0) family home visitor FTEs, one (1.0) social worker FTE, two (2.0) support staff FTEs.

Significant changes in the operating budget include the following:

• Net decrease in Salaries and Benefits $148,116 representing decreases of 2 family home visitor, 1 nurse and ½ of support staff. 
• Reduction in Professional development of $1,097 – The 2024/25 fiscal year reflects a proportionate decrease of professional development in the 2023/24 fiscal year and is predicated by the reduction of FTE’s.
• Reduction in Program Supplies of $17,877 – The fiscal 2024/25 budget contemplates a reduction in expenditures as a result of discontinuing a software for the upcoming fiscal year ($7,500) and a reduction in IT/phone hardware ($10,386).
• Increase in Purchased services of $5,000 – The fiscal 2024/25 budget contemplates expenditures being increase due to augmented demands in translation services.
• Increase Building occupancy of $162,090 – The fiscal 2024/25 budget contemplates expenditures being incurred on Building occupancy.

PROPOSED MOTION                          

Whereas, The Windsor-Essex County Health Unit receives grants from the Ministry of Children, Community and Social Services to fund the Healthy Babies Healthy Children and Pre-natal and Post-natal Nurse Practitioner Programs,

Whereas, the total budgeted expenditures for the Programs for the period April 1, 2024 to March 31, 2025 is $2,894,941, and

Now therefore be it resolvedthat the Windsor-Essex County Board of Health approve the operating budget as presented by Administration for the period April 1, 2024, to March 31, 2025.

ISSUE/PURPOSE

The Immunization of School Pupils Act (ISPA) R.S.O. 1990 is a law in Ontario that requires certain vaccines to be given, or for a valid exemption to be obtained, for a child to attend school in Ontario making sure that all school aged children are protected from vaccine preventable diseases. The Windsor-Essex County Health Unit (WECHU) reviews immunization records of students attending school in Windsor and Essex County (WEC) in accordance with the ISPA. Parents/guardians are responsible for reporting child immunizations to the WECHU. Health care providers do not have this responsibility, although often will support patients by sending copies of immunization records to the health unit or providing copies to families who are required to self-report but lack documentation. Interim solutions by health care providers such as faxing immunization records directly to public health or using other internet interfaces to report immunizations, result in increased workload for health care providers and public health units. Although the WECHU, and all local public health units provide multiple ways to make this reporting as easy and accessible for families as possible, it is recognized that more efficiencies may be possible through connected and streamlined reporting processes with health care providers. 

During the January 18, 2024 WECHU Board of Health Meeting, after discussing the complexities of ISPA enforcement and compliance practices locally, it was requested that a report outlining local public health recommendations on this matter be brough forward for board consideration and support. 

BACKGROUND

At the end of June in 2017, the newly elected Ontario government halted the implementation of a new rule, included in the previously endorsed Bill 198 -- Immunization of School Pupils Amendment Act, 2016, that would have required doctors and nurses in Ontario to report all immunizations administered to children directly to public health units. This rule would also have required the development of a province-wide computerized system for tracking children's vaccination records that seamlessly interacted with public health unit systems. It was widely recognized that this change would make it easier for parents/guardians to demonstrate ongoing compliance and reduce unnecessary suspensions due to out-of-date immunization records. The Bill was originally set for implementation on July 1, 2017, but was stopped in response to what has been described as concerns from the Ontario Medical Association and others that felt the Bill lacked proper consultation. 

PROPOSED MOTION                        

Whereas, vaccination is important for the health of each student and the school community and, 

Whereas, Ontario's immunization reporting system involves many redundancies and barriers for families and,

Whereas, a part of the mandate for all public health units in Ontario is to reduce inequities and increase access to opportunities and conditions that are conducive to health for all, including compliance with the ISPA.

Now therefore be it resolved that the Windsor-Essex County Board of Health request that the Ontario Government reconsider the requirement for all health care providers to report administered immunizations directly to public health, and

FURTHER THAT, the Ontario government dedicate resources to develop a seamless system for transferring vaccination records electronically from health care providers into public health databases across the province.

December 1, 2023

Dr. Kieran Moore,
Chief Medical Officer of Health,
Box 12,
Toronto, ON M7A 1N3

Dear Dr. Moore,

Re: Voluntary Mergers and Boards of Health Leadership

On behalf of the Association of Local Public Health Agencies (alPHa) and its Council of Ontario Medical Officers of Health, Boards of Health Section and Affiliate Associations, we are writing to provide advice on the voluntary mergers component of the Strengthening Public Health initiative that is currently underway.

We agree with your statement that, where it makes sense to do so, voluntary mergers  have the potential to address longstanding challenges in the public health system and improve optimization and coordination. We also appreciate the efforts that you have made to share information and discuss the process through meetings with local public health leadership over the past month.

Recognizing the aggressive timelines that have been imposed on this process, we are also cognizant of the fact that engagement opportunities are important for all parties, so it makes sense to use existing channels between your office and the medical leadership (e.g., the Public Health Leadership Table) and meetings with local public health staff via the regional engagement structures to drive the process forward. Our members have, however, identified targeted consultation with boards of health as a gap.

Mergers of this nature are fundamentally a governance issue and must be planned and executed by those with the authority to do so, grounded in the knowledge of the needs of the communities they serve. The final decisions will be made by local boards of health, so it is imperative there is direct and specific ongoing engagement and meaningful dialogue with local boards that includes information, clarity of process, and expectations so that they    are properly equipped with the information they need to make decisions on the future of local public health.

Although there are differences in the structures of Ontario’s local boards of health, it is important to acknowledge they will all be affected by the outcomes of this process. There are boards that are considering it, boards that are well into discussions, and boards that will remain as they are but nonetheless be subject to ripple effects of neighbouring mergers. The implications are too numerous to outline here, but there is a wealth of expertise and experience to draw upon from each group, which will be of tremendous benefit to the others.

We are therefore strongly recommending that you consider the development of a comprehensive strategy for direct engagement and dialogue with boards of health, as a whole and individually, that recognizes their primary authority in following through on new partnerships, taps into existing expertise at the local level, and ensures that all of the complexities and consequences of such an undertaking are fully addressed. alPHa would be pleased to work with you in this regard through our Boards of Health Section.

We look forward to working with you and would like to request an opportunity to meet with you and your staff. To schedule a meeting, please have your staff contact Loretta Ryan, Executive Director, alPHa, at loretta@alphaweb.org or 647-325-9594.

Sincerely,

Dr. Charles Gardner, President

Copy:    Hon. Sylvia Jones, Minister of Health, Deputy Premier
Elizabeth Walker, Executive Lead, Office of the Chief Medical Officer of Health
Colleen Kiel, Director, Public Health Strategic Policy, Planning & Communications Branch
 

BACKGROUND

Overview

• SafePoint opened on April 26^th, 2023, serving clients 7 days per week between the hours of 10:00 a.m. – 
  6:00 p.m. daily.
• In order to ensure transparency related to SafePoint operations, the Board of Health is provided with regular updates.

Application Status

• As of January 2024, the WECHU’s pending application to the province to fund SafePoint as a Consumption and Treatment Services (CTS) site remains on-hold. 
• As no timeline has been provided for the removal of the hold on the WECHU’s application, operations at SafePoint were paused effective January 1^st of 2024. 

CURRENT INITIATIVES

Operational Data

SafePoint operated for a period of eight months, recording a total of 1,257 client visits amongst 248 unique clients. Additional details about the services provided at SafePoint during the month of December are presented in Tables 1-4. 

Client Experience Narrative

Beyond the number of client visits recorded in the month of December, SafePoint continues to demonstrate that the services being offered are having a positive impact on clients, as highlighted through the following client experience narrative:

Anonymous Client

An individual walking by SafePoint knocked on the entrance door and was brought into the site by staff. The individual informed staff that they felt like they may be “going down” (i.e., experiencing an overdose) and asked for a naloxone kit. After receiving the kit, the individual proceeded to administer naloxone on themselves and staff monitored them afterwards to support their recovery.

NEXT STEPS AND FUTURE INITIATIVES

The WECHU, in collaboration with the SafePoint Advisory Committee, prepared and implemented a mitigation plan for the pause in services to support clients and the community throughout the period of transition. Strategies implemented through the plan were as follows: 

• Staff at SafePoint met with clients individually over the course of December to create plans for their care while services are paused and to support connections to other community agencies as needed. Clients were also provided with information about alternative harm reduction strategies and supports that they can continue to use during the disruption. 
• The WECHU connected with multiple community partners towards the end of 2023 to establish connections and increase accessibility to other health and social services in the area that clients can continue to use during the disruption. A list of these services was developed and posted to the SafePoint web page for the community to access: www.wecoss.ca/cts. 
• The WECHU developed plans in collaboration with Family Services Windsor-Essex (FSWE) to increase the availability of outreach supports in the areas surrounding SafePoint in the early months of 2024. The Mobile Outreach Support Team (MOST) van will be making nightly stops near SafePoint until the end of March to look out for those seeking the services of SafePoint and to provide harm reduction supplies and referrals to community services. Other relevant outreach strategies are also in development in partnership with FSWE’s Housing Outreach Workers. 
• Community partners involved in the Windsor-Essex Community Opioid and Substance Strategy were provided with a key messaging document to support conversations with their clients who use SafePoint about the pause in services. Partners were also encouraged to promote the National Overdose Response Service (https://www.nors.ca/) to anyone who might benefit from the services of a virtual safer consumption hotline.
• Messaging about the pause in operations and the other services available for support was also shared with those subscribed to the SafePoint email subscription list. Moving forward, this list and the SafePoint web page will continue to be maintained by the WECHU to share updates with the community about the site. To subscribe to SafePoint emails, individuals can visit www.wecoss.ca/cts. The SafePoint email inbox (CTSQuestions@wechu.org) will also continue to be monitored by the WECHU to respond to questions and concerns from the community.

While services are paused, ongoing communication will be maintained with the Ministry of Health for updates regarding the status of the WECHU’s CTS application, provincial funding, and a potential 
re-opening under the CTS model. The legal exemption required from Health Canada to operate SafePoint under this model was secured in July of 2023. 

PREPARED BY:

Communications Department

DATE:

November 21, 2023

SUBJECT:

November 15, 2023 – December 14, 2023, Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request

Media Exposure Overview Graph

Notes: From November 15 – December 14, we experienced three main peaks of exposure:

Nov. 20 – We saw a spike in media coverage following the Board of Health meeting in which the announcement of the pause in services offered at SafePoint was made.

Dec. 1 – Media coverage on this date was focused on the media statement released regarding the changes to staff at the Windsor-Essex County Health Unit following the approved budget for 2024.  

Dec. 12 – On this date, high media coverage was related to the news release issued around Essex Fire and Rescue Services joining the Ontario Naloxone Program.

Website Overview Graph

Notes: During the timeframe of November 15 – December 14, we saw very similar website traffic patterns as the previous month, with no notable spikes in traffic. 

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month. Notes: Overall, our social media followers stay consistent, with gradual increases across the monthly timespan. 

DISCUSSION

The Communications Department completed a Social Media Audit for 2023 to serve as a benchmark for future years. The audit collected various metrics from organic social media posts on our four platforms (i.e., Facebook, X, Instagram, and LinkedIn). Metrics were collected quarterly, providing a succinct overview of followers, posts released, and various forms of engagement with our audience. 

The audit will allow the department to monitor changes on our platforms which can inform how we utilize each platform moving forward. For example, the 2023 audit revealed a steady growth in our followers on Facebook over the year, supporting our approach to prioritize this platform as our main social media outreach channel. 

As social media platforms evolve, so will the audit template. This information will guide our communication tactics to take full advantage of these channels to maximize public messaging. 

PREPARED BY: Oral Health Department

DATE: January 18^th, 2024

In early 2022, the federal government announced plans to enhance access to dental care for Canadian families with annual household incomes of less than $90,000 through the Canadian Dental Care Plan (CDCP).   One of the main objectives of the CDCP is to help bridge the gap in accessing dental care for priority populations across Canada. By providing financial support to Canadian residents who don’t have access to private dental insurance, the CDCP allows at-risk individuals including children, persons with disabilities and seniors to access affordable dental care.

DISCUSSION

On December 11^th, 2023, the federal government announced the launch of the second stage of the phased model, outlining the application and implementation process for Seniors 65 and older. 

The third phase of the model is anticipated to launch in June 2024, with applications opening at that time for persons with a valid disability tax credit certificate and children under 18. Ultimately, this program will be accessible to all Canadians who meet the below eligibility criteria:

• Have no access to private dental insurance. 
• Have an annual adjusted family net income of under $90,000.
• Be a Canadian Resident.
• Filed their income tax return in the previous year.

Those covered under the CDCP may start seeing Oral Health providers for care as early as May 2024 in local dental offices who enroll as participating treatment providers. Depending on the adjusted family net income of the applicant, some CDCP members making over $70,000/year will be required to make a co-payment for their care.

While clients with private dental insurance will not have access to the CDCP, those on previously established provincial, territorial, or federal social programs are still eligible. This includes the Ontario Seniors Dental Care Program (for eligible seniors 65 years and older) and Healthy Smiles Ontario Program (for eligible children and youth under the age of 18) which are operated by the Windsor-Essex County Health Unit (WECHU) locally. To address the potential overlap in services, the Ontario Association for Public Health Dentistry (OAPHD) has advocated for the following considerations from the federal government to avoid overlaps in services and care:

1. Streamline the coordination of all public dental programs to ensure simple and accessible processes for both patients and providers.
2. Build the capacity of the health and social system to improve oral health access and health equity.
3. Safeguard and sustain the capacity of oral health care through a mixed model system.
4. Promote wider participation by ensuring oral health professionals receive fair and equitable payments for oral health services across public programs.
5. Include a strong communication strategy and knowledge plan to enhance public and provider understanding and navigation of federal and provincial programs.
6. Foster relationships across levels, sectors, and communities to strengthen collaborative health care that includes oral health.
7. Continue to invest in Public Health to provide upstream health and oral services to all Ontarians.
8. Administer an effective oral health data framework and evaluation plan that measures and reports on process, quality of care, and outcomes.

The federal government has expressed that they are in dialogue with provincial and territorial ministries regarding their coordination of the CDCP. Additional information is expected to be released in January 2024. 

PREPARED BY:

Communications Department

DATE:

November 21, 2023

SUBJECT:

October 15, 2023 – November 14, 2023, Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request

Media Exposure Overview Graph

Notes: From October 15 – November 14, we experienced one large peak, and a handful of smaller peaks of exposure:

Oct. 16 – We saw a spike in media coverage following a news release confirming the first human case of West Nile Virus in Windsor-Essex County.  

Nov. 8 – 10 – Across these dates, a variety of stories were covered in the media including an event for the public to properly dispose of old medications, radon awareness, and the start of stories around the provincial pause on Consumption and Treatment Service site proposal reviews.

Nov. 13 – On this date, high media coverage was related to the Consumption and Treatment Service site proposal pause, and a news release issued by the WECHU regarding the Immunization of School Pupils Act and the current number of out-dated records locally.

Website Overview Graph

Notes: During the timeframe of October 15 – November 14, we saw very similar website traffic patterns as the previous month. 

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month. 
Note: We saw a drop in Followers on LinkedIn, which occurred on a specific day. This is assumed to have been a clean-out of the platform of spam accounts.

DISCUSSION

The Communications Department worked with the Chronic Disease & Injury Prevention team on a series of boosted social media posts, as well as digital and radio ads for Mental Health Awareness Month, taking place in October. 

While some of the components are still in market, the social media campaign has proved successful. The goal of these posts was to drive traffic to the website, specifically to a page of mental health support resources or a page of mental health education and promotion. In total, the boosted posts have reached 32,641 accounts, and have resulted in 676 link clicks.

BACKGROUND

Overview

• SafePoint has been open since April 26th, 2023, serving clients 7 days per week between the hours of 10:00 a.m. – 6:00 p.m.
• In order to ensure transparency related to SafePoint operations, the Board of Health is provided with regular updates.

Application Status

• As of December 2023, the WECHU’s pending application to the province to fund SafePoint as a Consumption and Treatment Services (CTS) site remains on-hold.
• As no timeline has been provided for the removal of the hold on the WECHU’s application, operations at SafePoint will be paused effective January 1st of 2024.

CURRENT INITIATIVES

Operational Data

It has been seven months since SafePoint opened on April 26th and there has been a total of 1042 client visits and 217 unique clients to date, with 3 overdoses reported and treated on-site. Additional details about the services provided at SafePoint during the month of November are presented in Tables 1-4. 

Client Experience Narrative

Beyond the number of client visits recorded in the month of November, SafePoint continues to demonstrate that the services being offered are having a positive impact on clients, as highlighted through the following client experience narrative:

Anonymous Client

A client was dropped off at SafePoint by their friends for wound care services. The client did not want to use other health services because of percieved poor treatment in the past. The friend did not return to pick up the client, so staff arranged for a taxi to bring the client back to a local shelter.

NEXT STEPS AND FUTURE INITIATIVES

• The WECHU is collaborating with its community partners to prepare for the service disruption, aiming to minimize impacts on clients as effectively as possible.
• SafePoint services will continue to be available daily from 10:00 a.m. – 6:00 p.m., up until December 31st  at 6:00 p.m. During this period, SafePoint staff will be meeting with clients to create plans for their care while services are paused and to support connections to other community agencies as needed.
• The SafePoint Advisory Committee has also prepared a mitigation plan for the pause in services, which identifies several strategies that will be implemented to support clients during this period of transition. The mitigation plans will be shared with the community to ensure that clients, partners, and other affected stakeholders are aware of the strategies and supports in place.
• While services are paused, the WECHU will continue to communicate updates about SafePoint to the community as new information becomes available. To stay informed, community members can subscribe to receive email updates at www.wecoss.ca/cts. The SafePoint website will remain up-to- date with current information and the online feedback form and SafePoint email (CTSQuestions@wechu.org) will continue to be monitored by the WECHU to address questions and concerns from the community.

Board Members Present:

Dr. Mark Awuku, Joe Bachetti, Fabio Costante, Fred Francis, Michael Horrobin,
Dr. Sardar Khan, Judy Lund, Hilda MacDonald, Robert Maich, Angelo Marignani,  Michael Prue, Rob Shepley

Board Member Regrets:

Renaldo Agostino

Administration Present:

Dr. Mehdi Aloosh, Dr. Ken Blanchette, Kristy McBeth, Eric Nadalin, Dan Sibley, Linda Watson, Konrad Farrugia (recorder)

WECHU Guests:

William Willis (Willis Law)

RECORDING SECRETARY: K. Farrugia

SUBMITTED BY: K. Blanchette

APPROVED BY: WECHU Board of Health

Steps toward Limiting Nicotine Addiction in Youth;
Local, Provincial, and Federal Restrictions on Nicotine Pouches

Date: Thursday, January 18^th, 2024

ISSUE/PURPOSE

The recent availability of Nicotine Pouches under the brand name “Zonnic” has triggered widespread concern from health organizations across Canada, including the Canadian Cancer Society, Heart and Stroke, and the Canadian Lung Association, who have issued calls for immediate federal action to regulate their sale to youth (von Stackelberg, 2023). Health Canada has approved the products under their Natural Health Products designation as a Nicotine Replacement Therapy (NRT) which can be used to quit smoking. Each package contains either 10 or 24 pouches with each pouch contains up to 4mg of nicotine, the equivalent of up to 2 cigarettes (Marsh, 2023). 

Nicotine is highly addictive and has permanent adverse effects on the developing brains of youth and concerns regarding the nicotine pouches are rooted in their marketing and distribution approach being attractive to young people. An approach which includes attractive colours and targeted promotions, fruity flavouring which includes sweeteners, and a lack of regulations which makes it legal for children and youth to purchase these products. The similarities in purpose, advertising, and the range of flavors offered by nicotine pouches relative to the already popular vaping products poses a significant risk of sparking a trend comparable to rapid uptake of vaping amongst youth. 

BACKGROUND

Nicotine pouches were approved for sale in Canada on July 18, 2023 as a Natural Health Product. The nicotine pouches are currently outside the scope of the federal Tobacco and Vaping Products Act (TVPA) and the provincial Smoke-free Ontario Act (SFOA) 2017 which regulate tobacco and vaping products by restricting their advertisement, display, and public use. As a result, the nicotine pouches are currently being sold at convenience stores and gas stations, placed alongside items such as candy and chips. The pouches are sold in vibrant packaging and various sweet and fruity flavours which are attractive to younger populations. 

The recent growth in popularity of vaping products serves as an example of the importance of moving quickly to mitigate the risk of these new products (University of Waterloo & Brock University, 2023). Although research on the health effects of using nicotine pouches is still emerging, the effects of using oral NRTs include mouth ulcers, mouth and throat soreness, and coughing (M. Jackson et al., 2023). For youth and young adults who develop a dependence on nicotine, lasting negative impacts on the cognitive abilities, growth, and development can also occur (Stein et al., 1998; Ren & Lotfipour, 2019). Most concerningly, given the highly addictive nature of nicotine, dependence can lead to further use of vaping product, tobacco products, or other drugs (Leslie, 2020). 

The Windsor-Essex County Health Unit (WECHU) has consistently engaged businesses, school administrators, students, parents, and municipalities to inform these groups about the health consequences of tobacco and vaping and has worked closely with them to develop policies, and enforce provincial regulations pertaining to smoking and vaping in public areas. The WECHU is committed to working closely with these same partners to better understand the best ways to keep residents, in particular young people, safe from these products however, until such time that a regulatory framework is established at the federal and provincial levels it is possible that the uptake of these products in Windsor and Essex County will escalate in a similar manner to vaping products. 

PROPOSED MOTION

Whereas, Health Canada has approved Nicotine Pouches for sale under a Natural Health Product designation which does not provide restrictions on advertising or sale to minors; and

Whereas, there is no evidence to demonstrate the efficacy of Nicotine pouches as a smoking cessation aid; and

Whereas, the emergence of nicotine pouch products produced by Imperial Tobacco Canada, under the brand name “Zonnic” has occurred rapidly without the same regulations applied to other nicotine products; and

Whereas, the marketing and accessibility of Zonnic Pouches raises concerns regarding its appeal to youth populations; and

Whereas, the Nicotine Pouches fall outside existing provincial regulations on tobacco and vaping products; and

Whereas, there are significant concerns regarding the risks to youth and young adults who do not smoke and parallels between nicotine pouch use and vaping.

Now therefore be it resolved that the Windsor-Essex County Board of Health strongly encourages the federal government to take immediate action to close the regulatory gap that permits the sale of nicotine pouches to people under the age of 18; and

FURTHER THAT, the Windsor-Essex County Board of Health strongly encourages the province of Ontario to take immediate action to embed restrictions on the sale, display, and promotion of nicotine pouches under the provincial Smoke-free Ontario Act, 2017; and 

FURTHER THAT, the Windsor-Essex County Health Unit works closely with local municipalities to review tobacco/vape-free public place bylaws to include additional nicotine products; and

FURTHER THAT, the Windsor-Essex County Health Unit works closely with local schools and boards to update policies to ensure products like nicotine pouches, and other emerging products that are tobacco or nicotine related are prohibited on school property.

References

Government of Canada, & Health Canada. (2004, July 26). Natural Health Products Ingredients Database. Webprod.hc-Sc.gc.ca. https://webprod.hc-sc.gc.ca/nhpid-bdipsn/ingredReq.do?id=1518&lang=eng

Health Canada. (2023, October 17). Product information. Health-Products.canada.ca. https://health-products.canada.ca/lnhpd-bdpsnh/info?licence=80125630

Leslie, F. M. (2020). Unique, long-term effects of nicotine on adolescent brain. Pharmacology Biochemistry and Behavior, 197(173010), 173010. https://doi.org/10.1016/j.pbb.2020.173010

M. Jackson, J., Weke, A., & Holliday, R. (2023). Nicotine pouches: a review for the dental team. British Dental Journal, 235(8), 643–646. https://doi.org/10.1038/s41415-023-6383-7

Marina von Stackelberg. (2023, November 15). National health groups call on Ottawa to prevent sales of nicotine pouches to children. CBC. https://www.cbc.ca/news/politics/restrictions-nicotine-pouches-1.7028297

Marsh, S. (2023, June 23). How much nicotine is in a cigarette compared to a vape? The Guardian. https://www.theguardian.com/society/2023/jun/23/how-much-nicotine-is-in…

OSDUHS. (2021). The Ontario Student Drug Use and Mental Health Survey (OSDUHS). CAMH. https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.p…

Ren, M., & Lotfipour, S. (2019). Nicotine Gateway Effects on Adolescent Substance Use. The Western Journal of Emergency Medicine, 20(5), 696–709. https://doi.org/10.5811/westjem.2019.7.41661

Stein, E. A., Pankiewicz, J., Harsch, H. H., Cho, J. K., Fuller, S. A., Hoffmann, R. G., Hawkins, M., Rao, S. M., Bandettini, P. A., & Bloom, A. S. (1998). Nicotine-induced limbic cortical activation in the human brain: a functional MRI study. The American Journal of Psychiatry, 155(8), 1009–1015. https://doi.org/10.1176/ajp.155.8.1009

University of Waterloo, & Brock University. (2023). COMPASS: Windsor-Essex County Health Unit.

WECHU. (n.d.). Smoking and Vaping | The Windsor-Essex County Health Unit. Www.wechu.org. Retrieved December 13, 2023, from https://www.wechu.org/school-health/substance-use/smoking-and-vaping#:~…

October 11, 2023

The Honourable Sylvia Jones
Minister of Health
College Park 5th Flr, 
777 Bay St Toronto, ON M7A 2J3

Minister Jones,

I am writing to you about the urgent need for approval of the SafePoint Consumption and Treatment Services (CTS) site in Windsor. I previously wrote to you on March 1, 2023 regarding SafePoint and the dire need to fund this project quickly. The site has been operational under federal exemptions since April 26, 2023 and has already provided hundreds of services in my community through the prevention of overdoses and diversion from area emergency departments. The Windsor-Essex County Health Unit (WECHU) wrote to you on October 3, 2023 highlighting the urgent need to provide timelines for approval of their application. Until now, provincial funding has not been made available and timelines for approval have not been provided. Funding for this site has solely been provided through the WECHU which is unacceptable and further delays will impact my community.

I want to highlight the importance of SafePoint and the impact it has had in my community thus far. The WECHU’s recent letter stated, “since opening its doors on April 26, 2023, as a temporary Urgent Public Health Needs Site, “SafePoint” has had hundreds of visits from people in need of care. Dozens of referrals to addiction treatment, mental health supports, and social services have occurred in addition to primary care, wound care, and foot care on-site. The site has experienced no safety concerns, or issues requiring emergency response and has developed strong working relationships with the residents, law enforcement, and the business community in the surrounding area. In addition, the CTS site received municipal support in the spring of 2022 to proceed with the application that was later validated under the new municipal council. This work has been coordinated in large part by staff at the Windsor-Essex County Health Unit (WECHU), which led the application process and solely funds the operations of SafePoint. The site is operated by our regional experts in mental health and addiction, Hotel Dieu Grace Healthcare.” The WECHU have followed the necessary steps, ensured the application was completed correctly and that all information required was submitted. This has been confirmed multiple times by your Ministry.

As you are likely aware, Ontario has an opioid and overdose epidemic. The number of overdoses in my community and across the province are extremely high and very alarming. The funding needed to open and operate the SafePoint Consumption and Treatment Services site is vital and lifesaving.

I understand that safe consumption and treatment services sites across the province are under a critical incident review due to an ongoing investigation related to an incident nearby a CTS site in the Toronto area. I think everyone can agree that a security review following such a serious incidence is important.

The concern that I share with my community, WECHU and Windsor council members is related to the fact that SafePoint has met all requirements, including safety requirements, set out by provincial, federal and municipal governments and yet many months have passed without you or your government providing WECHU with any certainty regarding provincial funding. I will note that all CTS requirements laid out were met and WECHU began waiting for funding direction prior to the incident at the Toronto area CTS.

Further delays with funding and application status are unnecessary. Healthcare in Ontario is under severe pressure. People requiring mental health and addiction services face long waitlists and barriers to accessing care. Delays in accessing care can have deadly consequences. Providing ongoing, stable funding for SafePoint to continue operating with no delay is just one way to combat pressures on our healthcare system. Data shows that lives are being saved and SafePoint has been successful in connecting patients to critical wrap around supports and services such as housing, social services and other health care.

The WECHU has requested a response before October 13th as they prepare to set their 2024 budget, as are Windsor are Essex County councils. I ask that you respond in a timely manner to ensure SafePoint, the WECHU and Hotel Dieu Grace Healthcare can continue to provide the support and services that are both effective and necessary.

I look forward to your response.

Sincerely,

Lisa Gretzky, MPP Windsor West
Critic of Mental Health and Addictions

CC: Windsor-Essex Health Unit
The City of Windsor – Office of the City Clerk

October 27, 2023

VIA ELECTRONIC MAIL

Honourable Chrystia Freeland
Deputy Prime Minister and Ministry of Finance

Honourable Jenna Sudds
Ministry of Families, Children and Social Development

Honourable Lawrence MacAulay
Ministry of Agriculture and Agri-Food

Honourable Jean-Yves Duclos
Ministry of Public Services and Procurement

Dear Federal Ministers Freeland, Sudds, MacAulay, and Duclos:

Re: Support for a Funded Healthy School Food Program in Budget 2024 (Federal)

At its meeting on October 19, 2023, the Board of Health for Public Health Sudbury & Districts carried the following resolution #61-23:

WHEREAS a universal publicly funded student nutrition program can positively impact students’ nourishment, health and well-being, behaviours and attitudes, school connectedness, and academic success; and

WHEREAS the current provincial student nutrition program strives to offer a breakfast, snack, and/or lunch to students each school day, but not all schools have adequate financial and human resources to offer them; and

WHEREAS the annual monitoring of food affordability in Sudbury and districts demonstrates that some families may struggle to purchase food, and a universal fully-funded student nutrition program can help to ensure no child is left out of the program due to their family’s ability to pay; and

WHEREAS the Board of Health for Public Health Sudbury & Districts passed motion 02-20 supporting a universal publicly funded healthy school food program; and

WHEREAS although the Ontario government recently announced an additional $5 million this year in the provincial Student Nutrition Program and the First Nations Student Nutrition Program, more support is needed to ensure a fully-funded universal student nutrition program; and

WHEREAS the federal government announced its commitment to work toward the creation of a National School Food Policy to help Canadian communities access healthy food in the Food Policy for Canada; and

WHEREAS the Ontario Public Health Standards requires boards of health to support and participate with other partners in advancing school food policy and programming using population health assessment and surveillance, policy development; and

THEREFORE BE IT RESOLVED THAT the Board of Health for Public Health Sudbury & Districts support the recommendations submitted by the Coalition for Healthy School Food to the Government of Canada as part of advance consultations for Budget 2024:

Allocate $1 billion over five years and collaborate with provinces, territories, and Indigenous partners to provide them with an initial $200 million as soon as possible to fund existing school food programs; and

Create a separate School Food Infrastructure Fund grants program of, at minimum, $50 million; and

Negotiate independent School Food Policy agreements with First Nation, Inuit and Métis leadership to ensure long-term and sustainable funding for Indigenous school nutritious meal programs; and

THAT the Board calls on the Federal Minister of Families, Children and Social Development for investment in healthy school food in Budget 2024, as presented in the House of Commons’ online e-4586 (Food and drink); and

FURTHER THAT The Board share this motion with relevant stakeholders, including Ontario Boards of Health and the Association of Local Public Health Agencies (alPHa).

Currently, Canada is the only G7 country without a national school food program in place. In Ontario, the current student nutrition program faces inconsistent year-to-year funding, posing barriers to stability and sustainability and impacting full implementation of the program, such that all students can benefit from proper nourishment. The patchwork of funding sources compromises the quantity and quality of food served, and the availability of adequate infrastructure and human resources to offer a student nutrition program where all children are able to benefit from.

In the Food Policy for Canada, the Government of Canada announced the intention to “engage with provinces, territories, and key stakeholder groups to work toward the creation of the National School Food Program”i. Despite this intention, there was no financial commitment made to establish a National School Food Program in the 2023 federal budget.

The Board of Health is pleased to join many leaders from across Canada in supporting a publicly funded universal school food program model that can positively impact student’s nourishment, health and wellbeing, behaviours and attitudes, school connectedness, and academic success. The proposed universal program model with leadership by Canada, and Ontario’s Ministries would enable all students to have the equal opportunity to eat healthy meals at school everyday, and that no child is left out due to their family’s ability to pay.

Thank you for your attention on this important issue. Given the impact of nutrition related children’s health and wellbeing, we trust you will advance this work quickly and so that no child is left out.

Sincerely,

Penny Sutcliffe, MD, MHSc, FRCPC
Medical Officer of Health and Chief Executive Officer

cc: Honourable Michael Parsa, Minister of Children, Community and Social Services
Honourable Stephen Lecce, Minister of Education
Honourable Sylvia Jones, Deputy Premier of Ontario, Minister of Health
Jamie West, Local Member of Provincial Parliament, Sudbury
France Gélinas, Local Member of Provincial Parliament, Nickel Belt
Michael Mantha, Local Member of Provincial Parliament, Algoma-Manitoulin-Kapuskasing
Viviane Lapointe, Local Member of Parliament, Sudbury
Marc Serré, Local Member of Parliament, Nickel Belt
Carol Hughes, Local Member of Parliament, Algoma-Manitoulin-Kapuskasing
Bruce Bourget, Director of Education, Rainbow District School Board
Danny Viotto, Director of Education, Huron Superior Catholic District School Board
Joanne Bénard, Director of Education, Sudbury Catholic District School Board
Lesleigh Dye, Director of Education, District School Board Ontario North East
Lucia Reece, Director of Education, Algoma District School Board
Paul Henry, Directeur de l’éducation, Conseil scolaire catholique Nouvelon
Sébastien Fontaine, Directeur de l’éducation, Conseil scolaire public du Grand Nord de l’Ontario
Sylvie Petroski, Directrice de l’éducation, Conseil scolaire catholique de district des Grandes Rivières
Debbie Field, Coalition for Healthy School Food
Carol Dodge, Executive Director, Better Beginnings Better Futures
Ontario Boards of Health

November 9, 2023

Fabio Costante, Board of Health Chair
Dr. Kenneth Blanchette, Chief Executive Officer
Windsor-Essex County Health Unit
1005 Ouellette Avenue
Windsor, ON
N9A 4J8

Re: Investing in a Sustainable Federal School Food Policy

Dear Chair Costante and Dr. Blanchette,

At the October 19, 2023 meeting, under Correspondence item d), the Middlesex-London Board of Health moved to endorse the following item:

Date: September 21, 2023
Topic: Investing in a Sustainable Federal School Food Policy
From: Fabio Costante, Board of Health Chair and Dr. Kenneth Blanchette, Chief Executive Officer, Windsor-Essex County Health Unit
To: Honourable Federal Ministers Freeland, Sudds, MacAulay and Duclos

The Middlesex-London Board of Health received a report in April 2023 titled “Monitoring Food Affordability and Implications for Public Policy and Action”. This report noted that local food affordability monitoring is a requirement of the Ontario Public Health Standards. It also provided an update on the Middlesex-London Health Unit’s 2022 Nutritious Food Basket survey results, which demonstrate that incomes, particularly when dependent on social assistance, are not adequate for many Middlesex-London residents to afford basic needs, and that food insecurity has a pervasive impact on health; and there is a need for income-based solutions.

A federal school food policy would support students in the Middlesex-London region, while also supporting families of those students navigating financial strain and inflation while purchasing food at the grocery store. It is noted that the correspondence from Windsor-Essex County Health Unit highlights that public health and many school communities do not have resources to support food programs at schools. The Middlesex-London Health Unit supports our colleagues from Windsor-Essex in advocating for a federal school food program that includes the following aspects:

• Serve tasty, nourishing, culturally appropriate foods;
• Ensure that ALL students in a school can access the program in a non-stigmatizing manner;
• Be a cost-shared model, including federal support;
• Be flexible and locally adapted to the context of the school and region, including commitment to Indigenous control overprograms for Indigenous students;
• Support Canadian farmers and local food producers;
• Provide conflict of interest safeguards that prevent programs from marketing to children; and
  Promote food literacy.

The Middlesex-London Board of Health supports the Windsor-Essex County Health Unit in advocating to the federal government for a federal school food policy for a universal, cost-shared school food program in schools. To view more resources, please visit the Middlesex-London Health Unit’s website page regarding Food Access in Schools.

Sincerely,

Matthew Newton-Reid
Board Chair
Middlesex-London Health Unit

Dr. Alexander Summers MD, MPH, CCFP, FRCPC
Medical Officer of Health
Middlesex-London Health Unit

Emily Williams BScN, RN, MBA, CHE
CEO, Secretary and Treasurer
Middlesex-London Health Unit

CC: Honourable Chrystia Freeland, Deputy Prime Minister
Honourable Mark Holland, Minister of Health
Honourable Jenna Sudds, Minister of Families, Children and Social Development
Honourable Lawrence MacAulay, Minister of Agriculture and Agri-Food
Honourable Jean-Yves Duclos, Minister of Public Services and Procurement
Board Member Skylar Franke

October 27, 2023

VIA ELECTRONIC MAIL

The Honourable Doug Ford
Premier of Ontario

The Honourable Sylvia Jones
Minister of Health

The Honourable Michael Tibollo
Associate Minister of Mental Health and Addictions

Dear Premier Ford and Provincial Ministers Jones and Tibollo:

Re: Public Health Strengthening and Chronic Disease Prevention

On behalf of the Board of Health for Public Health Sudbury & Districts, please accept this correspondence highlighting our commitment to health promotion and chronic disease prevention.

At its meeting on October 19, 2023, the Board of Health carried the following resolution #60-23:

WHEREAS the Board of Health for Public Health Sudbury & Districts is committed to ensuring it addresses the public health needs and health equity in its catchment area, as aligned with board of health requirements under the Health Protection and Promotion Act and Ontario Public Health Standards; and

WHEREAS Health Promotion Ontario’s White Paper on the Value of Local Health Promotion in Ontario recommends strong and sustained investment in local health promotion by public health units to ensure that health promotion is prioritized on an ongoing basis; and

WHEREAS the Board recognizes that there are opportunities for system improvements as part of the review of board roles and responsibilities announced under the government’s Public Health Strengthening initiative, including an assessment of its role in chronic disease prevention though health promotion interventions; and

WHEREAS chronic diseases are mostly preventable, are the cause of 75% of deaths in Ontario, and incur $10.5 billion in direct health care costs in the province; and

WHEREAS as the scope and intensity of infectious disease risks increase in the context of finite resources, there is a risk of under-resourcing public health actions that work on longer horizon chronic disease prevention;

THEREFORE BE IT RESOLVED THAT in the context of the Public Health Strengthening roles and responsibilities deliberations, the Board of Health for Public Health Sudbury & Districts urges all health system actors to remain committed to maintaining appropriate investments in health promotion and chronic disease prevention, while ensuring health risks associated with its health protection work are managed;

AND FURTHER THAT the Board request that the Chief Medical Officer of Health ensure proactive local engagement in the sector-driven review of the Ontario Public Health Standards.

Chronic diseases account for a substantial burden on the health of Ontarians and the health care system. They are the leading cause of death in Ontario, and they disproportionately impact populations who are socioeconomically disadvantaged, intensifying inequities. Chronic diseases are expensive to treat but they are largely preventable. Health promotion and chronic disease prevention work is critical to reducing the health and economic burden of chronic diseases.

The Board of Health respectfully urges the Provincial Government to ensure all health system actors, including local Public Health, are supported to invest in coordinated action to promote health and reduce the burden of chronic diseases, affecting so many Ontarians.

Sincerely,

Penny Sutcliffe, MD, MHSc, FRCPC
Medical Officer of Health and Chief Executive Officer

cc: Dr. Kieran Moore, Chief Medical Officer of Health, Ministry of Health
Heather Schramm, Acting Director, Health Promotion and Prevention Policy and Programs Branch, Ministry of Health
Susan Stewart, Chair, Health Promotion Ontario Executive Committee
Michael Sherar, President and Chief Executive Officer, Public Health Ontario
Matthew Anderson, President and Chief Executive Officer, Ontario Health
Brian Ktytor, Chief Regional Officer, Ontario Health North East & North West
France Gélinas, Member of Provincial Parliament, Nickel Belt
Jamie West, Member of Provincial Parliament, Sudbury
Michael Mantha, Member of Provincial Parliament, Algoma-Manitoulin-Kapuskasing
All Ontario Boards of Health

PREPARED BY:

Communications Department

DATE:

November 20, 2023

SUBJECT:

August 15, 2023 – September 14, 2023, Communications Update

BACKGROUND/PURPOSE:

Provide regular marketing and communication updates to the Board of Health.

Data Notes can be provided upon request

Media Exposure Overview Graph

Notes: Between August 15 – September 14, we experienced one large peak, and one smaller peak in exposure:

August 24 – On this date, a variety of news stories were released including beach water results, a boil water advisory for Kingsville, and a mental health / suicide awareness event to promote the awareness month of September.

August 30 – 31 – Across these dates, beach water results were shared, the WECHU conducted an interview on sexually transmitted infections, and stories around SafePoint funding approval.

Website Overview Graph

Notes: During the timeframe of August 14 – September 15, we saw similar website traffic patterns as the previous month. We did have a peak in web traffic on August 24, which corresponds with two big news stories – the boil water advisory as well as the weekly beach water testing results. 

Social Media Overview Graph

Lighter blue line represents the current month, darker blue line represents the previous month.

Note: Overall, we saw small increases in our follows on all platforms over the month.

DISCUSSION

The Communications Department worked closely with the Environmental Health Department on the Fight the Bite campaign which raises awareness on the prevention of vector borne illness, specifically West Nile Virus. The campaign was multi-faceted including, commercials on two local radio stations (Blackburn and AM800), digital billboards, and interior bus posters. A variety of online mediums were also used including organic social media posts, paid advertisments on Meta (Facebook and Instagram), and Google Response Display Ads.

The Google Response Display Ads ran for approximately 8 weeks, and had a total of 15,014 impressions (the number of times the ad was on a screen), which yielded 875 link clicks to the Fight the Bite webpage. Paid advertisements on Meta had a total reach of 13,452 (number of people who saw the ad at least once), which yielded 175 link clicks to the Fight the Bite webpage.
 

BACKGROUND

Overview

• SafePoint officially opened on Wednesday, April 26th, 2023, serving clients 7 days per week between the hours of 10:00 a.m. – 6:00 p.m.
• In order to ensure transparency related to SafePoint operations, the Board of Health will be provided with regular updates.

Application Status

• In July of 2023, Health Canada authorized the WECHU’s exemption request to operate SafePoint as a Consumption and Treatment Services (CTS) site. 
• The approval from Health Canada was shared with the Ontario Ministry of Health to complete the provincial application to operate a fully funded CTS site. 
• The Ministry of Health application for CTS funding continues to remain under review. An announcement was made that a review of the safety components of all operating sites is underway and that until such time that this is completed, all pending applications for funding will be placed on hold.

CURRENT INITIATIVES

Operational Data

It has been six months since SafePoint opened on April 26^th and there has been a total of 859 client visits and 182 unique clients to date, with no overdoses reported on-site to date. Additional details about the services provided at SafePoint during the month of October are presented in Tables 1-3.

Client Experience Narrative

Beyond the number of client visits recorded in the month of October, SafePoint continues to demonstrate that the services being offered are having a positive impact on clients, as highlighted through the following client experience narrative:

Anonymous Client

Staff from SafePoint, Canadian Mental Health Association’s Safe Beds Program, Hôtel Dieu Grace Healthcare’s Withdrawal Management Service, Family Services Windsor-Essex, Windsor Regional Hospital, and the Toldo Neurobehavioural Institute (TNI) all coordinated to ensure a client’s successful access to the TNI for stabilization and substance use support.