Durham Region Health Department Health Check-Up 2014

Registered dental hygienist Faith Lowman demonstrates proper dental hygiene for a client in the Health Department’s Oral Health Clinic.
Psychometrist Rosanna McCarney from the Health Department’s Infant and Child Development program works with a young client.
Durham Region EMS paramedics Dan Gagnon and Melissa Humphries attend to a patient.

Message from the Commissioner & Medical Officer of Health

Welcome to Check-Up 2014! We continue to make a difference in the lives of Durham residents of all ages. For more detailed information check out our 2014 Performance Report and 2014 Annual Health Statistics. You can find our 2015 program priorities in our 2015 Health Plan. To assist and support you with healthy living, contact us, browse our website, ‘like’ us on Facebook and ‘follow’ us on Twitter. Once again, here’s to your good health and well-being!

Robert Kyle, BSc, MD, MHSc, CCFP, FRCPC, FACPM


In this issue...

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Health Neighbourhoods examines patterns of health in Durham Region communities

Durham Region Health Department has introduced a Health Neighbourhoods project, designed to examine information for 50 Health Neighbourhoods across the Region to better understand patterns of health in area communities. The ultimate goal of the information gathered is to support strong, safe and equitable neighbourhoods that help to improve the health and well-being of all Durham Region residents.

The information collected provides a picture of how health varies by where we live and includes indicators on population, income, education, births, breastfeeding, early child development, injury, smoking, physical activity, obesity, infectious disease, life expectancy and more. Each indicator is mapped and summarized, and each Neighbourhood is compared to Durham Region as a whole. Recently, 62 indicators were posted online on the Health Neighbourhoods webpage. This webpage features a variety of information including:

The Health Department uses information from this project to help improve Health Department programs and services for the residents of Durham Region. An example of this would be to target smoking cessation programs in areas of the Region with higher smoking rates. Maps of school readiness and well-baby visits have resulted in a pilot project that aims to improve early child development in areas with poorer measures. The information is also valuable to Health Department community partners including school boards, municipalities, health care providers, health and family service agencies, social planning councils and other Regional departments such as Social Services.

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Working to help prevent concussion among Durham Region youth

Since 2008, the rate of concussion-related emergency room visits in Durham Region has been on the rise. Statistics show that youth 14 to 19-years old account for the largest proportion of concussion-related emergency room visits and hospitalizations, with concussions occurring more often in males.

A concussion is a brain injury that is caused by a bump or blow to the head or body that causes the brain to move rapidly inside the skull. All concussions are serious.

Certain sports have been found to put individuals at higher risk for concussions. These sports include football, rugby, hockey, soccer and boxing.

Prevention is the key treatment for concussion-related injuries. To help reduce the risk of concussions, youth are:

Most people with a concussion are able to recover quickly and fully; however, for some people, symptoms can last for days, weeks or longer. Individuals who have had a concussion in the past are also at risk of having another and may also take longer to recover. Repeat concussions are serious and may require the individual to alter their level of participation in a sport or stop playing the sport altogether.

The Health Department has worked with school boards and grade nine students to develop a concussion prevention awareness campaign targeting youth 14 to 19-years old. Based on input from the students, four different concussion awareness messages and materials were developed.

Parent Resource: Heads Up on Concussions

Parent resource

These concussion awareness messages were promoted across Durham Region using media outlets, recreational centres, arenas, movie theatres, transit shelters, mall ads and libraries. Messages were also promoted on social media sites including Facebook and Twitter.

In addition to the concussion messages for youth, the Health Department also consulted with school boards on how to support the implementation of a concussion policy. Development of resources for parents was identified as a role for the Health Department. A parent resource was developed to assist parents in understanding how to prevent concussions, how to recognize concussions, what to do if they suspect a concussion and how to re-introduce their child to school and sports after a concussion.

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Young parents participate in epic parenting forum

On Sept. 27, 2014, the Young Parents’ Community Coalition (YPCC) hosted its third annual Epic Parenting Forum in Oshawa. Young parents often express many barriers to accessing parenting information; this forum provided them with an opportunity to attend various educational workshops and panel discussions. Topics covered at the forum included positive parenting, healthy relationships and infant/child CPR.

The forum also served as a celebratory event that highlighted the important role of young fathers. Young fathers frequently encounter a number of parenting challenges; they’re often unmarried, may not be romantically or practically involved in the life of their child’s mother and sometimes have few positive role models. Despite stereotypes, there is increasing evidence that young fathers want to be involved with their children and research also shows that involved fathers of all ages can have a positive effect on their child’s development, social adjustment, readiness to learn and cognitive/intellectual skills.

A total of 26 young parents attended the event, including 21 mothers and five fathers. After attending the event, evaluations indicated that 100 per cent of respondents were more aware of tools and information to make positive choices for themselves and their families and 89 per cent were more aware of the important role fathers can play in the lives of their children.

The YPCC was established in 2005 with the goal of working in partnership to ensure expectant and young parents in Durham Region receive information and services that support and encourage them to be the best parent possible. Membership of the YPCC is currently made up of 12 community agencies from across Durham Region.

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Outbreak Management

As part of the management of human rabies exposures, the Health Department held a Rabies Outbreak Tabletop Exercise on Nov. 24, 2014. This exercise was conducted by the Health Department’s Outbreak Management team which is responsible for planning and preparing for large-scale community outbreaks.

The objective of this exercise was to assess our ability to respond to a large rabies outbreak, to identify gaps and areas requiring additional training and education, to identify and clarify roles and responsibilities for members of the outbreak team and, to improve collaboration and communication internally between various Health Department staff, as well as with key external stakeholders including, the Ontario Ministry of Agriculture, Food and Rural Affairs.

This in-house exercise involved staff playing different roles in a mock scenario, which involved the investigation of a dog from northern Ontario that was available for adoption at a local pet store. Upon adoption by a local family, the dog bit a member of the family that adopted the dog and also attacked the family’s unvaccinated pet cat. The dog subsequently tested positive for rabies.

The exercise included a number of situations that required the participants to practice investigative and interviewing skills, as well as their ability to think quickly and make decisions based on the best available information at the time. A debrief and evaluation session was held immediately after the exercise. The results of the debrief will be documented in a summary report which will be used to help improve the Health Department’s ability to respond to a rabies outbreak and assist with the planning of the next outbreak exercise.

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Investigating infection prevention and control failures

The Health Department performs infection prevention and control (IPAC) inspections on various establishments including child care centres and personal services such as, tattoo shops and nail salons. However, on occasion, complaints are filed for other establishments that are not required to be inspected by public health units, such as private health clinics.

When complaints are filed, an investigation must be conducted and, if any lapses in IPAC procedures are found, the Health Department reviews the situation to assess for the risk of transmission of disease. Once a risk is identified, even if it’s only a potential risk, Health Department staff will request a client list from the business to begin follow-up with those potentially affected. If the facility cannot produce a complete client list, the Health Department must then notify the public in an attempt to capture all individuals who may have been exposed to the IPAC lapse. When a client is identified, Health Department staff will provide consultation for the client on the necessary follow-up procedures.

Some of the IPAC lapses that occurred in different establishments in 2014 included failure to practice hand hygiene at appropriate times, the use of unsterile items and, using improper cleaning and disinfection procedures. When these lapses are identified, usually an “Order of a Public Health Inspector” is issued immediately; this will require the establishment to correct the situation, while allowing the Health Department to monitor the business’ compliance with the order over a period of time. Usually, identification of the IPAC lapse is sufficient to help educate the business operator. However, on rare occasions during the monitoring stage, the IPAC lapses may be identified again and, at that stage, charges may be laid against the business.

Starting in 2015, the Ontario Ministry of Health and Long-Term Care will mandate all boards of health to publicly release all IPAC lapses due to complaints. As a result, the Health Department will begin posting the required initial and final reports on its website in the near future. This transparency will increase the public’s access to any potential IPAC lapse concerns in Durham Region and will give the public easier access to information that will help consumers to make informed choices.


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Concerns about fluoride in the community

Under the Child Health protocol of the Ontario Public Health Standards, one of the requirements is to monitor communal water fluoridation (CFW) in communities where fluoride is used and to communicate with the public if there are any concerns regarding the use of fluoride. Complaints and inquiries regarding CFW are forwarded to the Health Department’s Oral Health division for follow-up.

Since 2010, the Health Department has noted an increase in interest in CFW; while this interest has been negative in nature, it has been a challenge for several Ontario public health units and also other jurisdictions throughout North America.

A common tactic used by a group known as “anti-fluoridationists” is to initiate small claims court challenges seeking reimbursements for reverse osmosis filters that have been installed in homes to avoid perceived negative health effects of fluoride. In 2014, a case was filed in Durham Region by a local resident who was seeking $850 to cover the cost of a reverse osmosis filter. While the complainant didn’t claim a specific health problem that was related to fluoridation, the resident submitted numerous documents to the court for consideration. The Region vigorously defended this case, with staff participating in multiple meetings to review evidence and to prepare for this challenge.

Two court dates occurred in January and July 2014 with the complainant providing an expert witness from the U.S. The Region was represented by its own legal counsel and called on two of its experts in the field – Dr. Patricia Abbey, Director, Oral Health, Durham Region Health Department and John Presta, Director, Environmental Services, Durham Region Works Department – who both provided testimony regarding the safety and efficacy of communal water fluoridation.

The Region was successful in defending the case, as the judge found that the complainant had failed to show any harm caused by fluoride.

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Infant and Child Development – celebrating 35 years of service

On April 1, 2014, the Health Department’s Infant and Child Development program (ICD) marked 35 years of service to the community. Over the past 35 years, ICD has supported the development of the youngest, most vulnerable children and their families with services designed to address the unique needs of children who are at risk for development.

Although the ICD’s mandate has not changed significantly over the years, there has been a significant increase in the number of children requiring early intervention and prevention services, as well as an increase in the complexity of special needs that staff in the program is seeing.

To mark its 35 years of service to the Durham Region community, ICD hosted an Open House on Oct. 23, 2014, welcoming numerous community partners and ICD staff to help celebrate this milestone in the program’s history.

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New paramedic station for north Oshawa

On April 14, 2014, Durham Region Emergency Medical Services (EMS) opened a new Oshawa North Paramedic Response Station at 1260 Wilson Ave. N. This facility replaces the old station which was located at 400 Ritson Rd. N.

The construction of this new station will serve to enhance the delivery of emergency medical services for the City of Oshawa and surrounding area, while allowing EMS to continue providing the very best in out of hospital care from a facility designed to augment the outstanding work of the service’s paramedic team.M

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3-year certification awarded to Durham Region EMS

Durham Region EMS has received another three-year certification to operate the paramedic service for the Region and surrounding area. The Ontario Ministry of Health and Long-Term Care (MOHLTC) reviewed Durham Region EMS in December 2014; EMS received its three-year certification shortly after the review was completed.

MOHLTC indicated in its report that Durham Region EMS is to be commended for its efforts in the following areas:

Aside from a few minor omissions on ambulance call reports (ACR) and employee immunization records, EMS achieved a very good report, with all other areas reporting 100 per cent compliance. The issues related to immunization will be corrected by August 2015, in accordance with the new immunization standards issued by the MOHLTC. The omissions in the ACR will be addressed through EMS’ normal continuous education process in spring 2015.

In addition, the management lead for the MOHLTC review team indicated that this was the best review outcome that he had witnessed and that Durham Region should be extremely proud of its organization.

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2014 Financial Information

Expenditures

Revenues

Chronic Diseases & Injuries

$ 8,697,542

Region of Durham

$36,114,142

Emergency Medical Services

40,978,360

Province of Ontario

51,760,958

Environmental Health & Emergency Preparedness

5,747,149

User/Program Fees

614,000

Family Health

13,530,731

 

Infectious Diseases

9,333,210

 

Professional & Administration Services

10,202,108

 

 

$88,489,100

 

$88,489,100


2013 Community Health Check-Up