2011 Community Health Check-Up

Message from the Commissioner & Medical Officer of Health

2011 was a very busy and productive year for us. In the pages that follow, you will read the "top 11" highlights of our broad array of programs and services. For more information, I invite you to also check out our 2011 Performance Report, our 2011 Annual Health Statistics, and our 2012 Health Plan. You can also follow us on Facebook and Twitter and see how we "lead the way to a healthier Durham!"

Dr. Robert Kyle

In this issue...

Health Department shines spotlight on cervical cancer

In December 2011, the Health Department released a new report entitled “Snapshot on…Cervical Cancer”. In this report it was noted that in the past 21 years, almost 500 Durham Region women were diagnosed with cervical cancer. The report also found that while overall rates of cervical cancer in Durham Region were similar to provincial rates, young women 20 to 34-years old in Durham Region had consistently higher rates than their counterparts across Ontario.

The main cause of cervical cancer is persistent infection with certain types of human papillomavirus (HPV), but the presence of the virus is not sufficient by itself to cause HPV. Research has shown that cervical cancer can be prevented by HPV vaccination and regular Pap test screening. Pap test screening is important as the test can detect abnormal cell changes before cancer develops.

Understanding and awareness about HPV has seen an increase over the past few years through the implementation of an HPV vaccination campaign launched by the Health Department. As in other jurisdictions, Durham Region Health Department has offered HPV vaccination in three doses to female students in grade 8 since the 2007-08 school year. While Durham Region has experienced higher HPV vaccination rates compared to other Ontario jurisdictions, only six out of 10 eligible grade 8 girls in Durham completed all three doses in the four years that the vaccination has been available. Click here to read more from the Snapshot on…Cervical Cancer.

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New web-based resource introduced for final phase of DineSafe Durham

The Health Department celebrated the final launch of its DineSafe Durham food safety inspection disclosure program with the implementation of a new website. The new site is designed to provide greater access to information about Health Department food inspection results online.

The first phase of the DineSafe Durham program was launched in March 2009, which includes the posting of green, yellow or red summary inspection signs at the entrances of all area food establishments, as well as allowing members of the public to view a copy of the most recent food safety inspection report on-site at the establishment.

The second and final phase of the project was the creation the DineSafe Durham website, which also provides a current overview of legal activity for each food establishment in Durham Region. Inspection information on the website is updated frequently and results will be as close to real time as possible, with information likely to be as current as two working days. Click here to view information on DineSafe Durham.

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Addressing the issue of bed bugs in Durham Region

Following the announcement of provincial funding to help address concerns related to bed bugs, the Health Department established the Bed Bug Working Group, a region-wide group of stakeholders that have an interest in this growing social issue. Along with the Health Department, the group is comprised of representatives from various agencies such as Durham Region Social Services Department, health care facilities, long-term care homes, shelters, school boards, municipal by-law enforcement, landlords and tenants, the hospitality industry and the pest management industry.

This group has been tasked with the development of the major components of a Durham Region Bed Bug Action Plan which will include increasing awareness regarding preventing and controlling bed bug infestations for the general public and priority populations, clarifying the roles and responsibilities of various agencies regarding response to bed bug concerns, the development and provision of an agency referral list, enforcement options, and increased surveillance and data sharing amongst stakeholders.

To date, the group has undertaken a number of activities including the formation of two sub-groups, each focused on one of the two major components of the action plan: education and outreach, and supports for priority populations. In addition, a number of education sessions and presentations have occurred throughout the Region including presentations to various tenant and housing groups, Durham District School Board school administrators and the Ontario Association of School Business Officials board members. Public displays have also occurred at the four Lakeridge Health hospital sites, libraries and municipal offices.

To help develop a better understanding of both the scope of the issue and the general public’s level of knowledge, the Health Department partnered with other public health units to develop a survey module on bed bugs in the Rapid Risk Factor Surveillance System (RRFSS). RRFSS is an ongoing telephone survey of Durham Region adults 18 and older that asks questions about their awareness of various health issues and health behaviours.

Through the bed bugs survey module in RRFSS, the Health Department found that while there has been an increase in complaints about bed bugs to public health units in the GTA, including Durham Region, the survey showed a very low level of prevalence of bed bugs in Durham Region households. However, most area residents have heard about bed bugs and about one-half were very or somewhat concerned about bed bugs getting into their home, while about one-third of those surveyed didn't know how to prevent bed bugs from getting into their home. The survey also found that the majority of residents thought that bed bugs have an effect on human health with bites and skin problems, and the spread of disease being the most common effects reported. Read more about the control and prevention of bed bugs.

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Ensuring the protection of clients’ confidential information

The protection of confidential information of clients is an ongoing, important issue for all Health Department staff. In 2010, the Health Department formalized its privacy initiatives with the implementation of its Privacy and Information Security program, designed to streamline all activities related to the protection of confidential information under one central area.

Working with all Health Department programs and services, staff in the Privacy and Information Security area are responsible for policy development, monitoring all incidents of breach or potential breach of confidential information, training of all Health Department staff in the areas of privacy and information security, and assurance services.

Through the delivery of these services, the Privacy and Information Security program ensures that the Health Department is focussed on:

For 2011, the Health Department continued to streamline its Privacy and Information Security program through the revision of all privacy policies to ensure both awareness and compliance of these policies by staff. Also, staff continued to monitor potential incidents and found that the Health Department had 23 low-risk privacy incidents, but no privacy breaches had occurred.

In addition, training and awareness continues to be a high priority with training provided and completed for over 600 Health Department staff, students and contract nursing agency staff. Click here to view the Health Department’s Information Practice Statement.

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Healthy Smiles Ontario gives Durham Region residents something to smile about

In October 2011, the Ontario Ministry of Health and Long-Term Care launched the Health Smiles Ontario (HSO) program, a program which provides access to routine dental care for children up to 17-years old, when their family has a net adjusted income of $20,000 or less per year.

As part of the HSO program, the province provided boards of health with funding to expand current infrastructure and to help with upgrades to existing oral health clinics in health units. Throughout the winter of 2010 and spring of 2011, the Health Department renovated its preventive dental clinic, with an expansion from two portable dental clinic rooms to four fully equipped permanent dental clinic rooms. The clinic officially started seeing clients on May 1, 2011. To date, the Health Department has enrolled over 613 children in HSO, providing $98,000 worth of treatment for Durham area children. Learn more about HSO by clicking here.

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Helping infants and young children at risk for delay

Infant and Child Development Services is a home-based, family centred early intervention service available to infants and young children with, or at risk for, developmental delay and their families living in Durham Region. Throughout the year, in addition to regular home visits to families, staff provide a number of clinics and information sessions for parents and caregivers of premature babies. Through these clinics, discussions centre on topics such as motor development and concerns about feeding, sleeping and communication, and other areas of development.

Staff has also been called on to share their experiences and expertise in this unique area of care. In May 2011, Health Department staff, along with colleagues from Halton and Peel, attended the Third Conference of the International Society on Early Intervention in New York City. While there, staff provided four poster presentations entitled:

All presentations were very well received and provided delegates of the conference with a front-line perspective of the services provided. To learn more about the Health Department’s Infant and Child Development Services click here.

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Helping health care providers address healthy weights with clients

The Health Department has a healthy eating initiative that provides information and resources to help people understand how to introduce and maintain healthy eating habits into everyday living.

For 2011, the staff of the healthy eating initiative reached out to health care providers through the promotion of a healthy eating resource, specific to health care providers, pertaining to healthy weights in conjunction with physical activity.

Research has shown that health care providers are a key group to help address the topic of healthy weights with clients. Clients consider information from their health care providers to be reliable and are more likely to adopt the health behaviour if recommended by a health care provider. As a result, the Health Department developed a healthy weights resource, designed to assist health care providers in supporting clients to achieve and maintain a healthy weight. The resource provides practical and easy tips related to healthy eating and physical activity that can be used by clients.

In November 2011, an information package was sent to over 550 area health care providers to introduce the new healthy weights resource and a number of other new resources that support the key messages related to healthy weights. As a result of this initiative, over 3,300 resources were ordered and provided to health care providers to share with clients. Learn more about the Health Department’s Healthy Eating initiative by clicking here.

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Working with teen parents and young parents in Durham Region

Throughout 2011, Health Department staff in the Reproductive and Child Health program provided support to the Canadian Pre and Post Natal Nutrition Program (CPNP), a drop-in program for pregnant women and new mothers 26-years old and under, funded by the Public Health Agency of Canada. This program is a comprehensive, community-based service that supports vulnerable, pregnant women who face conditions of risk that threaten their health and the development of their babies. Through a community development approach, this CPNP program aims to reduce the incidence of unhealthy birth rates, improve the health of both mother and infant, and encourage breastfeeding.

Food 4 Thought as the program is known in Durham Region, aims to reduce disparities in health by improving accessibility of services through flexible nutrition/health focussed support geared towards women who are isolated, have limited social support, limited education and/or low income. The program provides food, nutritional guidance, breastfeeding support and information about other resources for young women at nine locations throughout Durham Region. The program is collaboratively delivered by health and social service agencies in Durham Region.

In 2011, Health Department staff provided approximately 1,500 hours of community facilitation across the nine sites. Participant satisfaction surveys completed indicated that 91 per cent of participants found that almost all or most of their needs were met through the supports of the program.

The Supporting Mother and Infant Learning Experience (SMILE) program is a free prenatal, labour and delivery program offered to expectant parents under 23-years old. The purpose of the program is to enhance the knowledge and confidence of young parents through education so they can have the healthiest pregnancy, labour and early parenting experience possible. Classes are informal with activities designed to encourage relationship building between participants, Offered in a series of classes, SMILE sessions are highly interactive and cover topics such as preterm labour, stages of labour and comfort measures, the role of the coach, newborn appearance and care, breastfeeding and supports available to young parents. The number of sessions in a series may vary from location to location, with the average series consisting of six two-hour sessions.

In 2011, 20 series were completed. A total of 224 client registrations were received with 165 clients attending all the sessions in a series. A method to track registration, attendance and demographic information was developed to support the future planning of the SMILE program. Click here for more information on community supports available for young parents.

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Young Parents Community Coalition

In 2005, the Health Department in partnership with nine community agencies, created the Young Parents Community Coalition (YPCC), in order to co-ordinate resources available to young parents, identify gaps in service and develop solutions.  The coalition included the Health Department, Rose of Durham, Family Community Action Program, Oshawa Community Health Centre, The Youth Centre, Durham Alternative Schools, Durham Region Social Services, Girls Inc. of Durham, and the Ontario Early Years Centre.

The purpose of the YPCC is to work in partnership to ensure that expectant and young parents in Durham Region receive information and services to help support and encourage them to be the best parents possible. The group meets at least four times a year and has seen membership expand to include the Durham Children’s Aid Society, Teen Education and Mothering Clarington, Lakeridge Health Oshawa, Pinewood, Pregnancy Help Centre and Sunrise Support for Young Moms. There are currently 15 agencies involved in the YPCC.

The YPCC has had a number of accomplishments over the years. In 2007 and 2008, the coalition advocated on behalf of young parents with Durham Region Transit regarding the use of strollers on buses. Issues were brought to the attention of Durham Region Transit, resulting in several positive outcomes including clarification of the policies regarding stroller use on buses for both drivers and riders, and the implementation of a customer service survey that was distributed to all transit users, including YPCC clients.

In 2008, the coalition began working on a resource for both clients and service provides to help clarify the process of registering the birth of a baby, applying for a birth certificate and child tax benefits. Many clients had indicated that they found this process to be long and confusing, resulting in many failing to complete the necessary forms, which ultimately led to a lack of access to various benefits for parents and their babies. In 2011, the coalition’s work on this project resulted in the production of two resource guides, one for clients and one for service providers. These guides provide user-friendly information on the provincial government’s four in one birth registration process that allows clients to complete a birth registration, apply for a birth certificate, social insurance number and the Canada Child Tax Benefit. These resources have been widely distributed through Durham Region. Click here for more information on community supports available for young parents.

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Helping pregnant teens and young mothers to complete high school

The Teen Education and Mothering Program (TEAM) addresses a number of barriers that can prevent pregnant teens and young mothers from attending regular school, including challenges such as:

To help address these challenges, the Health Department, working in partnership with the Kawartha Pine Ridge District School Board, John Howard Society, Rose of Durham, the YWCA Early Years Centre, Durham Region Social Services Department, Port Hope Community Health Centre and Rehoboth Christian Reformed Church, applied for and received funding from the Ontario Trillium Fund to implement a model for a new alternative education program, which resulted in the creation of TEAM.

Launched in February 2011, the program works by allowing students to work on individual credit accumulation in the mornings, while participating in life skills programming in the afternoons. Child care is provided on site, with a component of the program allowing for mothers to interact with their children, while classes are in session, with support from child development staff. The program initially started with five students enrolled and saw student numbers increasing throughout the balance of the year.

The benefits of this collaborative program include support for young women to increase their opportunity for academic success and graduation, as well as increasing their parenting skills and use of community resources. Click here for more information on community supports available for young parents.

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EMS works to preserve the environment and provide aid to Haitian earthquake victims

Durham Region Emergency Medical Services (EMS) continues to explore initiatives to help reduce greenhouse gas (GHG) emissions and the service’s carbon footprint, while continuing to ensure the availability of a reliable ambulance and emergency vehicle fleet.

In 2010, the service began the transition to ambulances equipped with gasoline engines instead of diesel, in an effort to:

In 2011, it was determined that ambulances equipped with gasoline engines did meet most of these objectives, but also demonstrated increased fuel consumption when compared to diesel powered ambulances. Working with Demers Ambulances, Durham Region EMS continued to investigate other ways to reduce fuel consumption to help further reduce GHG emissions. As a result, the eight new gasoline-engine ambulances received in 2011 were purchased with new the ECOsmart idle-reduction technology system.

The ECOsmart system continuously monitors the ambulance conversion battery charge levels, as well as the internal vehicle temperatures. The system automatically turns the engine on and off to help maintain battery charge and internal temperatures, using pre-established threshold tolerance ranges.

It is anticipated that the ECOsmart technology will help to reduce engine idle time and also help to reduce associated gasoline costs, engine hours and associated preventative maintenance costs, while having no negative impacts on the operation of emergency warning systems or performance of the ambulance.

Durham Region EMS will continue to evaluate the overall performance of the new ECOsmart system throughout 2012. In addition, all ambulances purchased from Demers Ambulances for 2012 will be equipped with the ECOsmart idle reduction system; therefore, by the end of 2012, Durham Region EMS will have 70 per cent of its front line ambulance fleet equipped with ECOsmart technology.

From Jan. 25 to Feb. 1, 2011, two Durham Region EMS staff visited Haiti following the devastating earthquake that destroyed most of the Caribbean island. Shift manager Troy Cheseboro and advanced care paramedic Jeff Jordison volunteered their time to be part of a five-person team that travelled to Haiti with the Ontario Volunteer Emergency Response Team (OVERT).

While there, Mr. Cheseboro and Mr. Jordison focussed their efforts on patient care, helping with the cholera outbreak and spending most of their time volunteering as part of a multi-disciplinary medical team at medical clinics in the Saint Marc area, about two hours north of the Haitian capital of Port-au-Prince. Working with OVERT, they also provided assistance with the installation of water filtration units and other equipment to help provide clean water for local residents.

Mr. Cheseboro and Mr. Jordison also volunteered at an orphanage, operated by a local Haitian-born physician who is Canadian-trained, helping to provide medical care for the many children who had been displaced. Click here to learn more about the activities of Durham Region EMS.

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2011 Financial Information

 Expenditures  Revenues
Chronic Diseases & Injuries   7,797,000 Region of Durham   29,997,860
Emergency Medical Services   35,581,000 Province of Ontario   47,748,140
Environmental Health and Emergency Preparedness   5,090,000 User/Program Fees   829,000
Family Health   12,335,000  
Infectious Diseases   8,356,000  
Professional & Administration Services   9,416,000  
  $78,575,000   $78,575,000

2011 Community Health Check-Up