2019 Health Check-Up!

New surveillance systems present timely health data for public health action

Public health surveillance involves the ongoing collection, analysis and interpretation of health data that is used and shared to improve the health of communities. Health information can: serve as an early warning system for public health emergencies; track progress towards specific goals; monitor health problems; and identify priorities for decision-making and public health action.

The Health Analytics & Research Team created two different surveillance systems in 2019.

1) The Durham Region Opioid Information System (DROIS)

DROIS provides the latest opioid-related statistics by tracking and updating information on a weekly, monthly and annual basis, including:

• suspected opioid overdose calls to Region of Durham Paramedic Services;
• opioid overdose emergency department visits; and
• opioid-related deaths.

Durham Region Health Department (DRHD) and the Durham Region Opioid Task Force use DROIS to address the increasing number of opioid overdoses.

DROIS is available online by visiting durham.ca/opioidstats. To subscribe for email notifications when new information is posted, click the “Receive email updates” button at the bottom of the DROIS page.

2. The Rapid Risk Factor Surveillance System (RRFSS) Data Explorer

RRFSS is an ongoing phone survey of Durham Region adults that collects information on health behaviours, conditions and determinants of health. The Data Explorer tool takes a modern approach to public health surveillance by using a web-based application to view RRFSS results. The tool tracks information related to:

• alcohol, cannabis, tobacco and opioid use;
• general health;
• disease prevention; and
• health protection.

The RRFSS tool is also capable of exploring health data by five categories, including age, gender, income, municipality and time trends. RRFSS data is updated annually, and new indicators are added as they become available. The Data Explorer is available at rrfss.durham.ca or via DRHD health statistics page: durham.ca/healthstats.

Check&Go! disclosure program – easy access to health inspection results

Durham Region Health Department continues to make it easier for area residents to access health inspection results through the Check&GO! disclosure program. Check&GO! consists of on-site signage at establishments and online postings of health inspection results, confirmed infection prevention and control lapses, complaints and legal activities.

Check&Go! displays inspection results and legal activities for:

• Food establishments.
• Personal service settings.
• Child care settings.
• Recreational water facilities (public swimming pools, spas and splash pads).
• Small drinking water systems.
• Recreational camp facilities.
• Convictions for retailers under the Health Protection and Promotion Act and Smoke-Free Ontario Act, 2017.

Through cloud technology, Check&Go! posts inspection results in real-time, minutes after an inspection is completed. In 2019, Check&Go! received over 125,000-page views from over 6,600 users. To access Check&Go!, visit durham.ca/checkandgo.

The Check&GO! disclosure program meets and exceeds the Ontario Public Health Standards’ requirement for transparency.

Health Connection Line - Your access to Durham’s public health services

Durham Health Connection Line (DHCL) is a confidential help line available to people living, working and visiting Durham Region.

In 2019, Durham Region Health Department worked towards harmonizing call centers for three divisions: Population Health, Health Protection and Oral Health. Prior to harmonizing the call centers, each division promoted its own call centre and contact number. With the new harmonized line, all public health inquiries are directed to one phone number and brand. That means, clients only need to know one number to reach a public health nurse, public health inspector or an oral health team member. The DHCL team is available to assist clients with a variety of inquiries, including how to interpret well water test results, what immunizations a child needs or answer questions about the new Ontario Seniors Dental Care Program.

The new DHCL phone numbers are:

• Local: (905) 668-2020
• Toll Free: (800) 841-2729

The harmonized call centre was officially launched in January 2020. Existing Population Health, Health Protection and Oral Health phone numbers continue to operate during a transitional period to ensure that clients can access public health services without disruption.

Child and Youth, Prenatal and Newborn, and Healthy Babies Healthy Children

Goal: To achieve optimal preconception, pregnancy, newborn, child, youth, parental and family health.

Accomplishments:

• Facilitated 162 breastfeeding groups, visited 395 homes and provided 1,606 breastfeeding clinic consultations, resulting in over 90 per cent of participants reporting that they met their infant feeding goals, increased their knowledge with breastfeeding, and received timely access to services.
• Increased by 6 per cent public awareness of the adverse health effects of cannabis use during pregnancy and breastfeeding with the launch of 2 digital media communication campaigns.
• Facilitated 10 health education sessions at the YMCA: Eat, Play, Love Program. 93 per cent of participants reported implementing strategies to support healthy child growth and development at home.
• Collaborated with 7 urban Indigenous organizations, resulting in completing 7 community profiles to identify specialized public health priorities, and supported 4 Indigenous community events.
• Screened 4,957 prenatal and postpartum families using the Healthy Babies Healthy Children (HBHC) tool to identify any risks to child development.
• Delivered 7 training presentations to health care provider teams to increase referrals to the HBHC program.
• Completed 7,495 home visits to support at-risk families, which resulted in 85 per cent of family service plan goals achieved or partially achieved.
• Collaborated with 15 community partners to develop a regional approach to address early childhood vulnerabilities in Durham Region and hosted education sessions for social services and childcare providers on healthy growth and development and school readiness.

Vaping: an emerging and serious health trend

Vaping means inhaling and exhaling a vapour substance from an electronic device (e.g., e-cigarette or vape pen). A vape device can be open (i.e., refillable, typically with a liquid e-juice or cannabis product) or closed (i.e., not refillable).

Since vaping is a relatively new trend, the health effects are uncertain. However, evidence shows that long-term exposure to vapour products may be harmful to health in the following ways:

• Many vape products contain nicotine, which is addictive and can alter brain development and affect memory and concentration.
• Vaping e-juice (both with and without nicotine) increases exposure to harmful chemicals which has been linked to severe respiratory disease including coughing, wheezing and worsening of asthma, heart disease and eye irritation.
• E-cigarette use among youth and young adults increases the risk of ever smoking cigarettes.

Local health data show that vaping among youth in Durham Region is an emerging trend. In a 2016 to 2017 survey, five per cent of elementary students and 17 per cent of secondary students reported smoking e-cigarettes within the past year (OSDUHS, 2016-2017). Further, 13 per cent of elementary students and nine per cent of secondary students felt there is no risk of harming themselves physically (OSHUHS, 2016-2017).

In 2019, DRHD accomplished the following in response to the emerging vape trend and associated health concerns:

1. Staff collaborated with 87 school communities to raise awareness of the risks of vaping and promote prevention.
2. Staff strengthened smoking and vaping restrictions in local workplaces and public spaces by passing the Regional Smoke and Vape by-law (28-2019).

New Vision Screening Program - Visual health care for all SK students

Timely vision care for children is important to support proper visual development and/or prevent misdiagnosis of a learning and/or behavioural problem. In Canada, it is estimated that only 14 per cent of children under the age of six receive professional eye care.

In Ontario, statistics show that:

• Approximately one in four children experience learning difficulties related to vision.
• Three to five per cent of children lose the use of one eye from an untreated vision problem.

In 2018, the Ministry of Health and Long-Term Care mandated boards of health to ensure all senior kindergarten (SK) students receive vision screening in the school setting annually. Requirements for the new program are outlined in the Child Visual Health and Vision Screening Protocol, 2018.

In 2019, DRHD rolled out the new vision screening program to SK students with public health nurses (PHN). PHNs identify vision problems which may otherwise go unnoticed. Between January and June 2019, PHNs screened SK students at publicly funded schools and interested private schools.

Program activities included:

• Offering SK vision screening services at all 186 public elementary schools in Durham.
• Screening 6,820 SK students (i.e., 94 per cent of the entire SK population enrolled at Durham public schools)
  Please note: 416 or six per cent of students were not screened for one of the following reasons: absence (327) voluntary exclusion by parent/guardian (58); or inability to complete all three screening tools (32).
• Referring 2,296 students to an optometrist (i.e., 34 per cent of students screened).
• Referring 20 students to urgently seek visual health care by an optometrist (less than 1 per cent of students screened).

Regardless of test results, it is recommended that all children see their local optometrist for a comprehensive eye exam, which is free annually for all OHIP-covered children up to 19-years old.

PHNs continue to work with school communities to promote the health and well-being of children in Durham Region with the new SK vision screening program.

New program offers free dental care to low-income seniors

On April 11, 2019, the province announced the creation of the 100 per cent provincially-funded Ontario Seniors Dental Care Program (OSDCP). Through the OSDCP, low-income seniors can access free comprehensive dental care. Locally, the new program was rolled out at Durham Region Health Department’s (DRHD) Oral Health Clinic.

Services provided through the program include:

• Examinations/assessments.
• Preventive services.
• Restorative services to repair broken teeth and cavities.
• X-rays.
• Oral surgery services to remove teeth or abnormal tissue.
• Anaesthesia.
• Endodontic services to treat infection and pain.
• Periodontal services to treat gum conditions and diseases.
• Prosthodontic services, including dentures.

To enroll in the program, individuals can get an application form online or by contacting DRHD to receive a form through the mail. Applications must be approved by the Ministry of Health prior to booking an appointment.

Program eligibility is determined based on the below criteria:

• Age (i.e., 65 years or older).
• Annual income (i.e., $19,300 or less for singles and $32,000 or less for couples).
• Lack of access to another dental benefit (i.e., no private insurance plan or government program).

In late December 2019, the DRHD Oral Health Clinic opened its doors to its first OSDCP clients, and in that month, staff saw 9 clients and called 175 seniors on the waitlist to help them get application forms. With 4,000 clients expected to participate in the new seniors’ program, DRHD received approval from Regional Council to relocate and expand the Oral Health Clinic. It is anticipated that the new clinic will open its doors in late summer or early fall of 2021.

Smoke and Vape By-Law - Protecting residents from second-hand smoke exposure

Durham Region Health Department (DRHD) is making it easier for residents to avoid involuntary exposure to second-hand smoke in public spaces and workplaces. The Regional Smoke and Vape by-law (28-2019) was adopted on April 24, 2019, which expanded the number of places where smoking or vaping substances, including cannabis, is prohibited.

The new by-law prohibits smoking and vaping in the following locations:

• Within nine metres of all entrances/exits at workplaces and public places.
• Inside hookah/vape lounges, and specialty vape stores.
• On the property or grounds of a post-secondary institution or municipal building.
• In or within 20 metres of a public park.

These additional restrictions protect the health of Durham Region residents by reducing exposure to harmful second-hand smoke and vapour which are linked to chronic diseases and other adverse health conditions. Smoking and vaping cannabis was included in the by-law as cannabis smoke contains many of the same cancer-causing chemicals as tobacco.

DRHD posted signs in prohibited locations to inform the public of the new restrictions and will continue to work with municipalities and other community partners to provide education and awareness.