March 2023 Board of Health Meeting

Meeting held via video: https://youtube.com/live/m9IJV3aMESs

Board of Health
Windsor-Essex County Health Unit
c/o Lee Anne Damphouse
ldamphouse@wechu.org

December 20, 2022

Dear Members of the WECHU Board of Health,

I am writing to you as a Windsor resident and a parent of two children. I know I am not alone in wanting to be confident that up to date peer-reviewed science is used to inform local public health policy.

Almost a year has passed since Windsor reintroduced fluoride to the municipal water supply. The page relating to fluoride on the WECHU website¹ states that the optimal concentration of fluoride in drinking water to support good dental health is 0.7 mg/L and that Health Canada considers 1.5 ml/L to be the maximum acceptable concentration. It refers the reader to Health Canada for further information. Health Canada states:²

Since the 1940’s, researchers have been testing the safety and benefits of fluoride. Apart from dental fluorosis and skeletal fluorosis, there are no other health effects related to fluoride.

During pregnancy and breastfeeding: Fluoride is not harmful to a fetus or through breastfeeding.

When it comes to bottle-fed babies, the following advice appears lower down on the page:

If you live in an area with naturally occurring high levels of fluoride (higher than the guideline of 1.5 mg/L- the maximum acceptable concentration), we suggest you mix the formula with drinking water with a lower fluoride concentration level. (emphasis added)

I am concerned about the stated maximum acceptable threshold of 1.5 ml/L in this advice from WECHU and Health Canada.

The underlying reason for my concern is that the authors of the January 2020 study Fluoride exposure from infant formula and child IQ in a Canadian birth cohort³ found statistically significant reductions in IQ in formula fed infants, even when using “optimally fluoridated water” at a concentration of 0.7 mg/L:

Using optimally fluoridated water (0.7 mg/L) to reconstitute infant formula may diminish the development of intellectual abilities in young children, particularly for non-verbal abilities. The findings also suggest that both prenatal and postnatal fluoride exposure affect the development of non-verbal intelligence to a greater extent than verbal intelligence.

This level is less than half the concentration below which Health Canada deems fluoride to be safe.

In its strategic plan, the WECHU Board has committed that it will “make decisions based on quality evidence and apply best practice program planning and policy development frameworks.”⁴

For this reason, I am writing to ask that WECHU:

• add a link on the fluoride page of its website to inform pregnant women and families who choose to formula-feed their babies about the findings from this now 3-year old peer-reviewed study;
• start advising pregnant women and new parents to use non-fluoridated water to protect the developing brains of their babies.

These common-sense measures will enable parents to be better informed regarding the current science relating to municipal water fluoridation, enabling them to protect the health of their children during the most vulnerable phase of their lives.

I look forward to the Board’s response to my concerns.

Yours sincerely,
Philippa von Ziegenweidt
 

• ¹Fluoride | The Windsor-Essex County Health Unit - (wechu.org)
• ²Fluoride and Oral Health - Canada.ca
• ³Fluoride exposure from infant formula and child IQ in a Canadian birth cohort - ScienceDirect
• ⁴Evidence-Based Public Health Practice | The Windsor-Essex County Health Unit - (wechu.org)

PREPARED BY:

Planning and Strategic Initiatives Department

DATE:

March 2023

SUBJECT:

2022 Annual Statistical Reporting 

BACKGROUND

The WECHU is a “health information custodian (HIC)” in accordance with section 3 of the Personal Health Information Protection Act (PHIPA), and an “institution” in accordance with section 2 of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Under this legislation the WECHU has obligations to ensure the rights of individuals with respect to privacy, access, and correction of records of personal information (PI) and personal health information (PHI), and access to general records that pertain to the WECHU operations and governance.

All institutions under MFIPPA, and HICs under PHIPA, are required to provide statistical reports to the Information and Privacy Commissioner of Ontario (IPC) on an annual basis with respect to:

• Confirmed privacy breaches under PHIPA
• Access and correction requests under PHIPA
• Access and correction requests under MFIPPA

The WECHU submitted statistical reports for each category by the required deadline of March 1st for PHIPA reports and March 31st for MFIPPA.

DISCUSSION

Privacy breaches

In 2022, the WECHU had eight confirmed breaches, the same as in 2021. Privacy breaches in 2022 predominantly included incidents where Personal Information (PI) and/or Personal Health Information (PHI) was disclosed without authority and emailed or faxed to the wrong person and/or organization.

The WECHU is looking at various ways to prevent breaches of this manner through training and investigating additional electronic information management systems.

MFIPPA Access and correction to information requests

In 2022, the WECHU received twenty-one formal MFIPPA access requests, compared to thirty-eight in 2021, and one correction request during the reporting year. All requests were completed within the reporting year.

Of the twenty-one access requests completed in 2022, the majority of requests came from an “individual /public” (43%) and “individual by agent” or lawyer (43%). This was followed by “media” (9%), and “government” (5% each).

PHIPA Access and correction to information requests

In 2022, the WECHU received 1540 formal PHIPA access requests and 169 formal correction requests during the reporting year. This was a significant increase from 2021 due to the WECHU’s involvement in supporting the proof of COVID-19 vaccination certificate program, as well as in the implementation of a COVax client access and correction process.

CONCLUSION

In summary, 95% of all MFIPPA requests and 99.9% of all PHIPA requests were completed within the statutory time limits, despite the operational impacts of the pandemic. Priorities for the coming year will include continued dedication of resources for the access to information and privacy program, including additional training, and updated workflows to improve request handling processes. These actions will improve records and information management (RIM) within the program, and allow the WECHU to respond with increased efficiency to information requests.

PREPARED BY:

Communications Department

DATE:

March 2023

SUBJECT:

January 15, 2023 – February 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

Website Overview Graph

Social Media Overview Graph

DISCUSSION

The Communications Department launched Phase One of the Corporate Marketing Campaign on January 31.

This phase, which is focused on the historical aspect of public health, as well as introducing the seven main programs at the WECHU, will run until the end of March.

To date, organic (unpaid) social posts have been issued once per week, a boosted social post has run for seven days, emails have gone to our general subscribers, and our owned communication pieces (e.g., website banner, on-hold phone message) point to the new webpage.

The boosted post which ran from February 3 – 10, 2023 had a reach of 11,749 accounts, and resulted in 92 link clicks (visits to the wechu.org/history webpage). The post was targeted to adults living in Essex, Leamington, and Windsor (geographic tags available through Facebook’s ad centre, Meta), with the goal of boosting website visits.

PREPARED BY:

Planning and Strategic Initiatives Department

DATE:

March 2023

SUBJECT:

2023 Board of Health Competency Self-Evaluation

BACKGROUND

The Ontario Public Health Standards (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”. 

In order to meet this requirement, the WECHU developed a competency-based self-evaluation survey for Board of Health (BOH) members. The survey includes twelve competency areas used to identify the strengths of the BOH, as well as opportunities to provide additional training and support for the BOH.

CURRENT INITIATIVES

The survey was sent to current BOH members in January 2023. Analysis of the results from the 2023 BOH survey demonstrated that the top strengths of the BOH were Leadership and Governance, Political Acumen, and Communication and Marketing. Identified areas of opportunity were Knowledge of Public Health Programs and Services, Health Equity, and Legal Requirements. Future training opportunities will be provided to the BOH to support their efforts; as well, quarterly feedback opportunities will be provided to support effective BOH operations and decision-making.

Introduction

In January 2023, a competency based self-assessment survey was distributed to WECHU Board of Health (BOH) members. This survey was structured around twelve competency areas and was developed based on the Ontario Public Health Standards (OPHS) (2021), the WECHU BOH By-laws, and the Association of Local Public Health Agencies Board of Health Governance Toolkit. The purpose of this approach was to identify the strengths of the BOH, while also identifying opportunities to provide additional training and support. The OPHS (2021), under the Good Governance and Management Practices Domain, states: “the board of health shall have a self-evaluation process of its governance practices and outcomes that is completed at least every other year. Completion includes an analysis of the results, board of health discussion, and implementation of feasible recommendations for improvement, if any”. 

The same survey was implemented in 2017, 2018, 2020, 2022 and again in 2023, allowing for a comparison of the data across years. Current BOH membership includes 10 members, of which 10 completed the 2023 self-evaluation competency survey.

Results

Competency Scores

There were 2 to 4 questions asked for each of the 12 competency areas. Average scores for each competency range from 0 to 4. The BOH average scores for each statement can be found in Appendix A. The overall BOH average score for each competency, along with the difference from the satisfactory and optimal range, can be found in Table 1.

The satisfactory response range (BOH average scores greater than 2, but below 3) reflects a score indicating that BOH members, on average, have the necessary competencies to successfully complete tasks related to that topic, but might require assistance from an expert at times.

The optimal response range (BOH average scores greater than or equal to 3) represents areas where BOH members on average are able to function most effectively, and are able to perform actions related to these topic areas without expert assistance.

The overall average for 2023 was 2.47, which was slightly higher than the 2022 average of 2.42.

As shown in Table 1, average scores in 2023 were higher than those in 2022 for all but five competencies (Health Equity, Leadership and Governance, Performance Management and Quality Improvement, Political Acumen, and Strategic and Operational Planning).  

Figures 1 and 2 are visual representations of the BOH average score on each competency compared to the satisfactory and optimal range. Scores for all but two competencies (Health Equity and Knowledge and Delivery of Public Health Programs/Services) fell into the satisfactory range, while no scores fell into the optimal range.

Figure 1. Average scores compared to the satisfactory and optimal range

Figure 2. Average scores compared to the satisfactory and optimal range (con’t).

Additional Comments and Suggestions

Lastly, members were asked if they had any further comments or suggestions. The themes of the comments included the request for more information regarding the future of the modernization of Health Units in Ontario, opportunities to make WECHU stand out amongst other Health Units, and more information on WECHU programs and services, namely Consumption and Treatment Services Sites (CTS) and the related regulations. 

Overall Recommendations

• Provide training education sessions and e-learning modules to board members, beginning with those areas with the lowest scores (i.e., Health Equity, Knowledge and Delivery of Public Health Programs and Services).
• Provide quarterly opportunities to Board of Health members to provide feedback and recommendations in regards to Board of Health operations and decision-making to ensure continuous quality improvement.

Appendices

Letters in support and regading provincial funding of CTS operations.

An accessible version of these documents will be posted when available.

Letter of Support for CTS - Andrew Dowie - MPP (PDF)

Letter of Support for CTS - Lisa Gretzky - MPP (PDF)

Letter re: Provincial Funding for CTS - Sudbury and Districts Public Health (PDF)