Program Standards | The Windsor-Essex County Health Unit

The programs and services provided to the public by the WECHU are listed as Program Standards under the OPHS. These Standards detail the mandate of the WECHU and provide the framework for service delivery and budget development. These areas should consider the local context including areas of need, opportunities for partnership, and alternative service providers.

Chronic Disease and Well-Being

Under the Chronic Disease and Well-Being standard, the OPHS requires boards of health to consider a range of topics based on local need, and provide interventions aimed at reducing the burden of chronic disease and improving well-being for residents. Priorities under the Chronic Disease and Well-Being standard include improving mental health and increasing healthy eating and physical activity. The following statistics influence local program development and workplan interventions:

Cardiovascular disease is the leading cause of chronic disease mortality in WEC, followed closely by cancers (WECHU, 2023).
WEC residents have higher rates of diabetes and hypertension compared to the province (PHO, 2020).
In 2021, mental health and mental illness were the fourth leading cause of emergency department visits in WEC with a rate of 6.49 per 100,000 residents, higher than the provincial rate of 4.99. This rate is significantly higher in residents of low socio-economic status.
In 2021, the rate of mental health related hospitalizations in WEC was 10.4% higher than the province.
In 2021-2022, 18.9% of households in WEC were food insecure, and WEC food insecurity is higher than the provincial average (CIS, 2018-2020; PHO, 2021-2022).

Below is a summary of planed work to address program requirements and local needs:

Mental Health

Collaborating with strategic partners (e.g., CMHA-WECB) to implement best practice interventions and address local needs.
Developing mental health resilience strategies and programs that meet the unique needs of priority populations.
Creating resources for young adults (18-34 years) to reduce mental health stigma, increase mental health literacy, and increase uptake of mental health services.

Healthy Eating Behaviours

Delivering food literacy and food environment workshops to community service providers who work directly with priority populations.
Implementing a local food strategy project that addresses food insecurity, food access, and food affordability in Windsor-Essex.
Training WECHU staff and community partners who serve priority populations to screen clients for food insecurity and provide referrals for assistance.

Physical Activity and Sedentary Behaviour

Providing physical activity education, resources, and skill building activities to priority populations.
Developing a community wide physical activity strategy with a focus on making physical activity opportunities safer, more accessible, and more affordable to priority populations.

Menu Labelling

Conducting initial compliance inspections and follow up on all complaints for all premises that are required to have menu labelling.

Tanning Beds

Conducting initial compliance inspections for new tanning salon premises, and complaint-based inspections for non-compliance to legislative requirements (e.g., age restriction and mandatory signage).

Food Safety

Activities under the Food Safety standard aim to prevent and/or reduce exposure and transmission of food-borne illnesses. Examples of local data that influence program implementation include:

WECHU inspects approximately 2,900 food premises annually, including home-based, institutional, rental, and temporary transient premises. Almost half (47%) of the food premises are considered high or moderate risk, including long-term care facilities and childcare centres.
The WECHU responded to 205 food safety complaints in 2022 that triggered an investigation and/or an inspection.
In 2023, 6 closure orders were issued under the Health Protection and Promotion Act (HPPA) due to pest infestation, lack of hot water and due to fire.

The OPHS and the Health Protection and Promotion Act (HPPA) dictate minimum requirements for inspection, enforcement, surveillance, and reporting under the Ontario Food Premises Regulation; and for monitoring, reporting, and responding to suspected and confirmed food-borne illnesses or outbreaks. The Board of Health is also required to provide food safety education, training, and certification. The WECHU promotes food safety throughout the region through two programs and their related interventions. Below is a list of each program along with examples of work included under each.

Food Safety

Operating a 24/7 on-call system for receiving and responding to food-borne illnesses/outbreaks or regulation non-compliance. This also includes emergency response to floods, fires, power outages, or other situations that may affect food safety.
Conducting routine inspections and re-inspections of food premises, including those that cater to the seasonal worker population, local special events, and seasonal premises.
Maintaining an online public information disclosure portal detailing the results of complaint-based inspections.

Food Handling Practices

Providing food safety awareness, education, training, and certification which includes operating the local Food Handler Certification Program.
Zero Tolerance enforcement for food handler certificates at food service premises.
Maintaining an online disclosure website for the public to verify that food purchased from home-based businesses is produced in kitchens that have been inspected and approved by the WECHU.

Healthy Growth and Development

Under the Healthy Growth and Development standard, the OPHS directs boards of health to consider a range of topics based on an assessment of local need with the goal of achieving optimal newborn, child, youth, parental, and family health. Some examples of data related to the local priorities include:

Low birth weight (LBW) impacts 6.9% of infants born in WEC.
Prenatal maternal mental health concerns were self-reported for 18.4% of WEC births in 2021. This rate has more than doubled since 2012 (9.1%).
In 2017-2018, 1 in 4 (28.1%) kindergarten students in WEC were vulnerable in at least one of the five developmental domains assessed by the Early Development Instrument, an increase from 2013-2014 (24.9%).
Only 45.7% of infants born in 2021 were exclusively breastfeeding by hospital discharge, which is more than 15% lower than 2015 (61.6%) and remains significantly lower than the Ontario average (52.8%).
In 2021-2022, 18.9% of households in WEC were food insecure.
In 2017 1 in 4 parents of kindergarten students experienced some degree of difficulty affording food to feed their children.

Priorities under the Healthy Growth and Development Standard include breastfeeding, growth and development, positive parenting, and healthy pregnancy and preparation for parenting. A strong focus has been placed on pregnant women and families with young children with the following risk factors: socioeconomically marginalized, newcomers, single parents, young parents under 21 years old, and parents with mental health concerns.

Breastfeeding

Partnering with local hospitals and midwifery clinics to align practice and improve transition of care. This partnership includes nurse breastfeeding education, and the creation of pro-breastfeeding protocols, policies, and educational resources.
Providing perinatal breastfeeding education and lactation consultation services.
Educating departmental staff to ensure all staff can effectively support informed decision-making regarding infant feeding and counselling to assist with breastfeeding.
Distributing key nutritional supplements (e.g., Vitamin D) for socioeconomically disadvantaged families.
Reducing barriers to breastfeeding for socioeconomically disadvantaged families (i.e., prioritizing Lactation Consultant in-home services, piloting a breast-pump loan program).

Growth and Development

Partnering with local health care providers to improve developmental screening rates and timely access to associated referrals.
Providing growth and development workshops for families with young children in Best Start neighborhoods with poorest Early Development Instrument (EDI) scores.
Increasing awareness of the effects of Positive and Adverse Childhood Experiences (PACEs) and implementing strategies to prevent and/or mitigate their impact.
- Phase 1-Collaborating with internal departments to develop and implement an organization wide education and communication plan to share PACE knowledge and application.
- Phase 2 – Initiating collaboration with key community organizations to increase awareness of the effects of PACEs, identify local priorities, and implement efficient and effective strategies.
Assisting childcare centres with policy development and implementation of Ministry of Education nutrition and feeding guidelines.
Launching a food insecurity screening system for departmental clients to prioritize services that can reduce the severity of early infant food insecurity and lessen associated developmental consequences. The dietitian will also mobilize community partners to improve emergency access to infant formula and breastfeeding services, while continuing to advocate for more sustainable solutions.

Positive Parenting

Collaborating with community partners to provide evidence-based parenting programs that build positive parental mental health, parenting skills and improve child development outcomes.
Collaborating with key community stakeholders that serve high-risk parents (e.g., those experiencing substance use, incarceration, homelessness, or risk of homelessness) to implement an evidence-based program that focuses on building secure attachment relationships between children and caregivers.

Healthy Pregnancy and Preparation for Parenting

Offering healthy pregnancy and preparation for parenting focused classes in WEC, including Building Blocks for Better Babies in partnership with the University of Windsor.
Dispensing prenatal multivitamins and mineral supplements throughout prenatal and postnatal program.
Engaging with local health professionals and community partners to provide evidence-based resources, healthy families’ prenatal programs and appropriate referrals to community agencies.

Immunization (General and School Health)

The goal of the Immunization and School Health Immunization standards is to eliminate the burden of vaccine preventable diseases through immunization. Examples of local data that influence program implementation include:

The Canadian national immunization coverage goal is 95% for vaccines for 7-year-olds for seven vaccine preventable diseases: diphtheria, tetanus, pertussis, polio, measles, mumps, and rubella, while the goal for vaccine coverage of 17-year-olds is 90% for the following adolescent vaccines: meningococcal, hepatitis B, and HPV.
In 2023, 7-year-olds exceeded the national target for Rubella and Meningococcal Disease vaccines but fell below for all other ISPA diseases.
In 2023, 12-year-olds in Windsor-Essex fell below the national target for all adolescent vaccines.
As of October 25, 2023, 87.9% of the total population has been vaccinated with at least one COVID-19 dose, 85.1% has been vaccinated with two doses, 47.3% has been vaccinated with at least three doses.
As of October 25, 2023, there have been 55,302 local cases of COVID-19 and 775 deaths recorded.
There are 365 vaccine refrigerators operating in Windsor-Essex County, which require annual inspection to ensure they meet cold chain inspection compliance.
Outbreaks of influenza and chicken pox have been common over the past few years; from January 2019 to present, there have been 19 influenza outbreaks in the general community and 3 chicken pox outbreaks.
There have been 76 outbreaks caused by non-VPD pathogens since 2022, with the most common being enteric/gastroenteritis infection unspecified (32), rhinovirus (15), parainfluenza (11), and human metapneumovirus (6).

A number of activities under the Immunization and School Health Immunization standards are mandated under the OPHS including inventory management for provincially funded vaccines, timely outbreak management, and access to provincially funded immunization programs and services through community and school-based clinics. In addition, the ISPA requires boards of health to assess the immunization records of students in schools to determine coverage rates and enforce the requirements of the ISPA. Below is a list of each program under the standards, along with examples of work included under each.

ISPA Implementation in Schools and Licensed Childcare Settings

Assessing the immunization records of students in schools to determine coverage rates and enforce the requirements of the Immunization of School Pupils Act (ISPA).
Collaborating with licensed childcare settings, prioritizing those in high-risk FSAs, to ensure the immunization records of children attending the centres are up-to-date and available to the health unit.

Vaccine Administration

Providing school-based immunization clinics to eligible grade 7 students.
Providing immunizations to highest risk groups, as mandated by the Ministry of Health, of publicly funded vaccines.

COVID-19 Vaccine

Offering COVID-19 vaccines based on Ministry of Health guidance for high risk and vulnerable populations.
Managing supply and distribution of COVID-19 vaccines to local health care providers.
Inventory management for all WEC providers administering COVID-19 vaccine in accordance with reconciliation requirements from the ministry.
Providing COVaxON data entry and support for local vaccine administrators.

Community Based Immunization Outreach

Seasonal vaccination campaigns, focused on highest risk groups, for influenza and COVID-19 to increase the uptake of vaccines during peak transmission times.
Partnering with local Health Care Providers (HCPs) and pharmacies to support effective vaccine administration by providing education and resources.

Vaccine Management

Managing supply and distribution of Publicly Funded Vaccines to local health care providers.
Promoting, monitoring, and enforcing effective vaccine inventory management while minimizing vaccine waste and promoting vaccine safety.
Conducting annual vaccine refrigerator inspections for all health care providers who store publicly funded vaccines to ensure adherence to cold chain requirements.

Immunization Monitoring and Surveillance

Conducting annual reviews of contingency plans to deploy health unit staff in the event of an outbreak, surge in cases, or the emergence of new infectious diseases.
Monitoring and reporting immunization coverage rates for all provincially funded vaccines.
Monitoring, investigating, and documenting all reported adverse events following immunization (AEFIs) reported by health professionals per provincial guidelines.

Infectious and Communicable Diseases

Under the Infectious and Communicable Diseases Prevention and Control standard, boards of health are required to work toward reducing the burden of communicable diseases and other infectious diseases of public health significance. Local data that influences program implementation includes:

As of October 25, 2023, there have been 55,383 local cases of COVID-19 and 776 deaths recorded. In 2023 there have been 100 COVID-19 outbreaks (as of Sept 22) investigated.
Excluding COVID-19 cases, the largest disease burden was due to sexually transmitted and blood-borne infections (STBBIs). Respiratory diseases were the second most common type of disease, followed by enteric, foodborne, and waterborne diseases.
The syphilis crude rate rose 29% locally to 17.37 cases/100,000 population in 2022 and has increased further in 2023. In 2022 and 2023, there were 4 cases of congenital syphilis, the first cases since at least 2013.
Between 2022 and 2023, cases of HIV have increased substantially.
Chlamydial infections in WEC stood at 180 cases/100,000 population in 2022.
There were 8 cases of active tuberculosis in WEC at a rate of 1.9 cases/100,000 population in 2022 with 264 cases of latent tuberculosis at a rate of 61.2/100,000 in that same year. For 2023 the case count of active cases has significantly increased to 14, year to date.
In 2022, WECHU Public Health Inspectors identified 48 critical infractions (potential for immediate public health risk and/or infection) in personal service settings during inspections.
As of September 2023, WECHU had 580 personal service setting (PSS) facilities, 110 group homes, 19 long term care homes, 181 childcare centres, 21 funeral homes and 23 retirement homes. In 2021 there were 8185 inspections conducted at facilities across the region.
Cases of vector-borne disease continue to occur in WEC and 12 mosquito pools tested positive for West Nile Virus (WNV) with 3 human cases in 2022.
Twenty-one blacklegged ticks and one Lone Star tick (cause of “red meat allergies”) were identified through active surveillance in WEC in 2022.
In 2022, a total of 858 rabies cases were investigated in WEC.

Requirements under this standard include responding to all reports of infectious diseases, working with community partners to provide infection prevention and control (IPAC) education, responding to outbreaks, providing outbreak prevention, management, and control, and managing all zoonotic and vector-borne diseases (ZVBD) of public health significance. Below is a list of each program under this standard, along with examples of work included under each.

Communicable Diseases

Preventing and reducing the spread of infectious and communicable diseases recognised as Diseases of Public Health Significance (DOPHS), including COVID-19.
Conducting case and contact investigations upon receiving reports from primary health care providers, labs, schools, childcare settings, and congregate living settings.
Reporting on and reviewing surveillance data to identify trends, outbreaks, and clusters to inform response decisions.
Recognising emergent infections, including COVID-19 variants-of-concern.
Providing enhanced management of case, contact and outbreak principles to members of high-risk groups such as Emergency Service Workers (ESW).
Managing applications and inquiries for Mandatory Blood Testing Act.

Sexually Transmitted and Blood-Borne Infections

Investigating and managing all reported cases of STBBIs to minimize the spread of infection through case and contact management.
Engaging key community partners through outreach, such as Street Health and the Windsor Police, to promote community STBBI clinical services to clients who have street involvement and/or unstable living conditions.
Supporting priority and high-risk populations to promote healthy sexual practices and increase access to sexual health services.
Dispensing publicly funded medications and vaccines and filling orders for HPV vaccine and birth control, at no to minimal cost.
Engaging with health care providers to build capacity and ensure that appropriate and needed services related to STBBI's are available in the community.

Infection Prevention and Control

Implementing the requirements outlined in all applicable IPAC Protocols and enforcing Ontario Regulation 136/18 (Personal Services Settings) for the purpose of reducing incidents of illness and death related to infectious diseases including the Diseases of Public Health Significance and responding to all requests for IPAC support.
Conducting routine inspections of all long-term care homes, retirement and rest homes, correctional facilities, licensed childcare centres, and personal service settings every 12 months for adherence to IPAC practices.
Working with local congregate living facilities (Long Term Care, Retirement Homes and other high-risk facilities), licensed childcare centres, local correctional facilities, and Emergency Service Workers to increase awareness of best practices for infection prevention and control (IPAC) and providing targeted education as the Windsor and Essex County IPAC Hub lead.
Facilitating an online course for personal service setting operators and staff to assist in meeting their legislated training requirements.
Providing public disclosure of all confirmed IPAC lapse investigations for personal service settings, childcare settings, regulated health care facilities, unlicensed childcare settings, community centres, recreational facilities, schools, and temporary dwellings for seasonal workers.

Institution/Facility Outbreak Management

Responding to and managing all reports of suspected or confirmed infectious disease outbreaks and clusters and declaring outbreaks (including COVID-19).
Conducting site visits, monitoring facility compliance, and ensuring the implementation of IPAC and outbreak control measures.
Collaborating with public health inspectors who conduct site visits, validating internal facility policies, and ensuring the implementation of IPAC measures.

Tuberculosis

Investigating and managing TB medical surveillance referrals, suspected or confirmed active TB disease, contacts of TB disease, and individuals with latent TB infection.
Dispensing preventive treatment to clients and community partners at no cost.
Implementing community outreach initiatives to reduce stigma and increase awareness of mental health issues associated with TB.

Zoonotic and Vector-Borne Diseases

Supporting seasonal surveillance of ticks and mosquitoes, as well as ongoing prevention of human cases of rabies, Lyme disease, West Nile Virus, Eastern Equine Encephalitis (EEE), and Zika in our region.
Following up within 24 hours all confirmed cases of avian chlamydiosis, avian influenza, novel influenza, and echinococcus multiocularis in mammals or other emerging Vector-Born Diseases (VBDs) to evaluate potential disease transmission to contacts and human exposures.

Healthy Environments

Activities under the Healthy Environments standard aim to reduce exposure to health hazards and mitigate existing and emerging health hazard risks, including climate change. Examples of data used to identify local priorities and influence program implementation include:

In 2022, the WECHU received and actioned 178 health hazards related complaints.
The WECHU has approximately 1200 seasonal housing accommodations that require inspections every 8 months, as required by Services Canada. There were roughly 1431 seasonal housing inspections and re-inspections conducted in 2022.
In 2021 and 2022, WEC experienced 55 and 46 days above 30°C (compared to 24 and 30 days in 2017 and 2018).
From 2010 to 2019 alone, the mean annual rainfall was recorded at 995mm, representing an 18% increase from 1941-1969 (City of Windsor, 2020).
The prevalence of “10-year storms” and “100-year storms” is expected to increase over the coming years, by 25% and 40%, respectively (City of Windsor, 2020).
Windsor was the worst city in the province for smog-causing ozone and recorded the highest one-hour carbon dioxide concentration (MOECC, 2016).
In 2021, an Air Quality Health Index (AQHI) category of moderate or higher was recorded on 67 days throughout the year in downtown Windsor, and 54 days in Windsor West (Air Quality Ontario).

Boards of health are required to inspect facilities where there is an elevated risk of health hazards, investigate potential health hazard exposures, and respond to reports of health hazards. Below is a list of each program under this standard, along with examples of work included under each.

Healthy Environments and Climate Change

Communicating provincial and federal updates to the local community on extreme weather notices or emerging health hazards, such as rising temperatures, food and waterborne illness, forest fires, and air pollution.

Health Hazards

Providing direction on the investigation, assessment, and management of mitigation strategies for all emerging hazards.
Inspecting and providing education to all recreational camps, ice rinks/arenas, seasonal farm worker housing and special care homes for potential health hazards.
Inspecting schools, licensed childcare centres, shelters, and other facilities that may serve priority populations when there is an identified health hazard.

Environmental Exposures

Providing timely response and information to potential and confirmed hazardous environmental exposures, including biologic agents and other emerging environmental exposures.

Safe Water

Activities under the Safe Water standard aim to prevent and/or reduce exposure and transmission of water-borne illnesses. Examples of local data that influence program implementation include:

There are over 150 recreational facilities (swimming pools, wading pools, splash pads, public spas) which require inspections.
In 2022, there were 38 small drinking water systems (SDWS) in WEC (primarily located on Pelee Island).
There are eight public beaches in the region that are monitored weekly for E. coli levels and blue-green algae. In 2022, there were 13 beach closures.
In 2022, there were 85 confirmed cases of campylobacter Enteritis and 35 confirmed cases of Salmonellosis in WEC.

The OPHS and the HPPA dictate minimum requirements for inspection, enforcement, surveillance, and reporting under the Safe Drinking Water Act; and for monitoring, reporting, and responding to suspected and confirmed water-borne illnesses or outbreaks. Below is a list of each program under this standard, along with examples of work included under each.

Small Drinking Water Systems

Conducting risk assessments/inspections of SDWS and issuing site-specific directives to owners and operators, which include requirements for sampling and testing frequency, treatment, and equipment.
Providing information and educational materials to owners/operators of Small Drinking Water Systems (SDWS).

Recreational Water

Conducting surveillance and inspection of all recreational water premises within its jurisdiction and discloses results of routine and complaint-based inspections.
Inspecting local public beaches to ensure they meet Ontario’s water quality objectives, which includes the presence of E.coli and/or Blue-Green Algae.

Drinking Water

Monitoring water testing results and recommending corrective action when notified of any adverse water quality incidents, including those from local school boards and municipalities.
Ensuring 24/7 availability to receive and respond to reports of suspected water borne illnesses, adverse water results, and water quality reports from municipal drinking water sources where fluoride is added.

School Health

The goal of the School Health standard is to achieve optimal health of school-aged children and youth through partnership and collaboration with schools and school boards. Some examples of data related to the local priorities include:

Self-harm related ED visits for those aged 10-19 continue to be high, with rates in 2021 and 2022 higher than in any year since at least 2012.
69% of 2SLGBTQINA+ youth in Canadian schools report experiencing verbal harassment due to their sexual orientation; 57% experience harassment due to their gender expression.
24% of WEC students in grades 9 to 12 felt depressed most days in the last week and 39% felt nervous, anxious, or on edge on most days in the last 2 weeks in 2022/2023 (2022-2023 COMPASS survey).
Less than 50% of students from grades 7 to 12 were able to calm themselves down when stressed and 54% of students in grades 9 to 12 reported worrying always or most of the time (GECDSB, 2019).
There was a significant increase in cannabis use from Grade 7 to Grade 12 (from 2% to almost 40%). Similarly, the use of e-cigarettes (vapes) increases from Grade 9 to Grade 12 (from 9% to nearly 20%) (OSDUHS, 2017).
Only 2% of Windsor-Essex students in grades 9-12 are meeting the National guidelines of 2 hours or less or recreational screen time per day (2022-2023 COMPASS Survey).
Less than half (45%) of Windsor-Essex students in grades 9-12 are meeting the National guideline of 8 to 10 hours of sleep per night (2022-2023 COMPASS Survey).
Only 24.6% of youth (12 to 24 years of age) in WEC reported eating vegetables and fruits five or more times per day (CCHS, 2020).
Overweight and obesity affects 35.6% of WEC youth (12 to 17 years of age) compared to 31.4% of Ontario youths (CHCSY, 2019).

The OPHS requires boards of health to consider a range of topics based on local need. In WEC, priorities include mental health, sexual health, substance use and harm reduction, food literacy and healthy eating, and increasing physical activity amongst school-aged youth. Below is a list of each program under this standard, along with examples of work included under each.

Comprehensive School Health

Providing schools identified as highest need and in high priority postal codes with dedicated program resources that will support them to address their priority health topics.
Providing support for diseases of public health significance including surveillance, absenteeism reporting, responding to emerging health concerns and outbreaks, and developing and implementing health and safety plans.

Mental Health Promotion (School Aged)

Developing, implementing, and disseminating evidence-based resources to educators to support curriculum and build awareness of positive mental health, social emotional skills, and supportive school environments.
Reviewing existing Health and Physical Education curriculum and resources (e.g., School Mental Health Ontario, Strong Mind Strong Kids-Psychology Canada) to develop enhanced supports that address local school community needs.
Evaluating and expanding existing mental health interventions implemented in local schools (e.g., Mental Wellness Series, Resiliency Rocks) using emerging evidence.

Healthy Sexuality and Healthy Relationships (School Aged)

Supporting schools to fulfill the requirements of Human Development and Sexual Health curriculum and to navigate more complex or sensitive concepts where educators feel they need more understanding and capacity.
Supporting educators in addressing violence and bullying, including cyberbullying which has been identified as a large issue in our school communities.
Engaging and empowering youth by supporting peer-developed messaging to increase knowledge and awareness of youth sexual violence, refusal skills, and help-seeking behaviour.

Substance Use and Harm Reduction (School Aged)

Developing, implementing, and disseminating evidence-based resources to support curriculum and build awareness of substances and their risk of use.
Developing and implementing a strategy to educate, provide cessation information/support, enhance policy development, and enforce vaping related legislation in local elementary and secondary schools.
Supporting school boards in ensuring that their substance use polices are evidence-based and include new and emerging substances.

Physical Activity, Sedentary Behaviour, and Sleep (School Aged)

Promoting curriculum-based resources that provide a range of supports for educators to incorporate physical activity, limit sedentary behaviour, and increase awareness of healthy sleep behaviours in their classrooms.
Promoting opportunities for children and youth who are members of an identified priority population to participate in physical activity outside of school hours (e.g., Pathway to Potential funding).
Working with local school boards and educators to improve the school environment through the implementation of policies, practices, and programs, that help increase opportunities for students and families to meet the Canada’s 24- hour Movement Guidelines (physical activity, sedentary behaviour/screen time, and sleep).

Food Literacy and Healthy Eating Behaviours (School Aged)

Providing support for increased access to food for children, youth and their families through partnerships, program referrals or other resource provision.
Developing and piloting of a Nutrition Toolkit for Educators and Schools to increase the capacity of educators to incorporate positive body image and relationships with food into the classroom.
Supporting food literacy through experiential learning and cross-curricular activities (e.g., promoting and training support for the You're the Chef program)

Oral Health

The OPHS specifies that boards of health shall provide the Healthy Smiles Ontario (HSO) program and the Ontario Senior’s Dental Care Program (OSDCP) in accordance with the Oral Health Protocol (2021). In addition, the OPHS states that boards of health shall collect local oral health data and promote oral health based on locally identified needs. Local priorities include improving oral health in children and older adults, especially from lower socioeconomic status households. Some examples of data related to the local priorities include:

WEC has seen a worsening trend of oral health related indicators for children in the community. In 2022/2023, data showed that 14% of children screened in schools required urgent dental care, compared to 12.4% in 2018/2019.
Children from schools associated with lower socioeconomic status had the worst oral health outcomes locally (e.g., prevalence of caries). In Windsor, 14.5% of all children (0-17 years old) in WEC live in low-income households compared to 11.5% for all of Ontario.
There are approximately 22,327 low-income seniors living in WEC who may be eligible for the OSDCP. As of April 31st, 2023, a total of 2,251 OSDCP cards have been issued to seniors in WEC.

Below is a list of each program under this standard, along with examples of work included under each.

Healthy Smiles Ontario

Operating two fixed dental clinics that offer direct clinical services to Healthy Smiles Ontario (HSO) clients including preventative and emergency services.
Connecting clients to community dental offices and covering the fees for service for those eligible.
Supporting families with children and youth 17 years of age and under to improve their oral health knowledge and awareness of oral health services through targeted outreach to priority populations.

Oral Health Assessment and Surveillance

Providing oral health screenings of Grade 2 students in all elementary schools annually by registered dental hygienists to identify children in need of dental care.
Notifying parents of all children who are screened and identified in need of preventive or emergency and/or essential oral health services, enrolling eligible children in the Healthy Smiles Ontario program, and helping parents/guardians that may face language barriers.

Ontario Seniors Dental Care Program (OSDCP)

Operating two fixed dental clinics that offer clinical service delivery to OSDCP clients including preventative and emergency services.
Connecting clients to community dental offices and covering the fees for service for those eligible.
Assisting eligible seniors 65 years old and older to enroll in the OSDCP, including support to complete and submit the required documentation and consents.

Substance Use and Injury Prevention

The OPHS requires boards of health use local data on substance use and injuries to inform public health interventions. Local priorities related to substance use focus on opioid use, alcohol, cannabis, and methamphetamine consumption. Local priorities related to injuries include life promotion and suicide risk and prevention. The OPHS also requires the enforcement of the Smoke-Free Ontario Act and the Electronic Cigarettes Act, based on both the Tobacco Protocol (2018) and the Electronic Cigarettes Protocol (2018), and addressing local priorities related to smoking cessation and enforcement. Some examples of data related to the local priorities include:

Opioid-related ED visits are steadily increasing in WEC. The annual standardized rate in 2012 was 159.84/100,000 population and in 2021 was 370.52/100,000 population.
There were 112 opioid-related deaths in WEC in 2022 and the number in WEC is higher compared to Ontario in all years, beginning in 2005, except for 2014 and 2017.
In 2021, the rate of methamphetamine-related ED visits in WEC remained above the provincial rate (16.4/100000 vs 12.7/100,000).
Alcohol use is the most common cause of substance-use related ED visits in Windsor-Essex. In 2021, there were 1,746 ED visits and 943 hospitalizations attributable to alcohol. The rate of alcohol-related hospitalizations (230.83/100,000) was higher amongst WEC residents compared to the rest of the province (195.71/100,000).
Since the legalization of cannabis, the annual standardized rate (per 100,00 population) of cannabis-related ED visits in WEC has seen a steady increase from 76.3 in 2018 to 101.5 in 2021. Cannabis-related hospitalizations have also increased from a rate of 18.6/100,000 in 2018 to 24.5/100,000 in 2021.
In 2021, there were 487 ED visits for intentional self-harm in WEC, which was an increase of 28% compared to the previous year. Also in 2021, hospitalization related to self-harm in WEC rose 23% compared to the previous year. In 2021, the rate/100,000 of hospitalizations related to self-harm in WEC was 11% higher than the province.

Below is a summary of planed work to address program requirements and local needs:

Harm Reduction Program Enhancement

Operating the Ontario Naloxone Program (ONP) includes managing and onboarding ONP partners, processing orders, usage reporting, promoting access to naloxone, and inventory management.
Serving as the structural backbone organization and implementing recommendations from the Windsor-Essex Community Opioid and Substance Strategy (WECOSS).
Operating the Opioid and Substance Use Notification System (OSUNS) which uses local surveillance data to rapidly identify statistical spikes and patterns in substance use-related events and issue community alerts to notify affected stakeholders.

Other Drugs

Coordinating and implementing the communication recommendations from the Windsor-Essex Community Opioid and Substance Strategy (WECOSS).
Advocate for provincial funding for SafePoint, the region’s first safer consumption site and support through a transfer payment agreement with the operating lead agency once obtained.
Increasing access to drug checking services, which includes advanced drug checking equipment and/or simpler methods such as take-home drug test strips to aid in harm reduction and enhance the opioid alert system.
Working with the Windsor-Essex Community Primary Care Partnership on a pilot project to increase screening, brief intervention, and referral to treatment services related to substance use (including alcohol and cannabis use).
In collaboration with community partners, creating and delivering community-wide education campaigns and providing educational sessions and workshops to priority populations related to substance use.

Needle Syringe Program

Reducing the transmission of blood-borne infections such as Hepatitis C and HIV in partnership with Positive Pathways Community Services through the implementation of the Needle Syringe Program. This program reduces potential harms related to the re-use of and unsafe disposal of used needles.

Injury Prevention

Completion of a needs assessment related to injury prevention services and gaps in our community.
Determine the burden of injury in our community and the impact injury has on priority populations.

Smoke Free Ontario

Offering up to 16 weeks of free Nicotine Replacement Therapy (NRT) patches and one-on-one counselling from a TEACH trained (Training Enhancement and Applied Cessation Counselling and Health) staff member.
Engaging with social/co-op housing providers and private rental landlords to assist in the voluntary adoption of smoke-free policies within multi-unit dwellings (MUDs).
Completing all mandated inspections under the Smoke-Free Ontario Act and investigating 100% of smoke-related complaints.