Addressing Income Security and other Social Determinants of Health Through Local Public Health Action Christine Post, Health Promoter Prevent More to Treat Less, June, 2014
Ontario Public Health Standards • Need: “The determinants of health will often inform what interventions are needed most.” • Impact: “Public Health strives to influence broader societal changes that reduce health disparities and inequities.” • Partnership and Collaboration: “Public health shall involve extensive partnerships within the health care sector, as well as other sectors (e.g. education, social services, housing etc…).”
Ontario Public Health Standards • Foundational Standard: – Health assessment includes measuring, monitoring and reporting on determinants of health and health inequities – Identification of priority populations – Tailoring programs and services to meet the needs of priority populations
Ontario’s Public Health Sector Strategic Plan • Mission Statement of the plan calls for effective partnerships and a focus on health equity. • “Health is bigger than health care, so the public health sector’s efforts to promote health must be bigger than the health sector”. Particularly recognized that “factors that contribute to poor health are outside the control of the health sector”. • “Public Health is uniquely positioned to create the bridge between the health sector and all other sectors that influence health”.
Public Health Paradigm Other Sectors Transportation Environment Education Public Municipal Affairs/Housing Health Social Services Finance Etc
Dr. Arlene King, CMOH February 9, 2012
Health Sector LHINS Hospitals Primary Care Long-Term Care Professional Associations NGOs Universities and Colleges Etc
Poverty in Peterborough • Declining manufacturing sector and increasing precarious employment • Shortage of affordable housing (1,500 people on wait-list). Least affordable place to rent in Canada • Almost 8,000 people using food banks every month
Local Public Health Action on Social Determinants of Health • • • •
Data collection, analysis and reporting Public education and engagement Strengthening community partnerships Advocating for healthy public policies
Data Collection, Analysis and Reporting
Public Education • Media campaigns • “Let’s Start a Conversation” video • Digital Story-telling project
Nutritious Food Basket Survey Monthly Income
Single Man
Single Man
Family of Four
Family of Four
(After tax)/Costs
(Ontario Works)
(Ontario Disability Support Program)
(Minimum Wage Earner)
(Median Income)
Monthly Income, including benefits and credits
$688
$1,167
$2,711
$6,852
Estimated Shelter Cost
$626
$779
$1,087
$1,413
Cost of a Nutritious Diet
$276
$276
$820
$820
What’s Left?
- $214
$112
$804
$4,619
From “what’s left” people still need to pay for phone, internet, transportation, cleaning supplies, clothing, gifts, entertainment, school essentials, medical and dental costs (in some cases), and possibly utilities.
Community Engagement • Community Consultations • ‘Stand Up for Poverty’ events • All-Candidates meetings on poverty
Strengthening Community Partnerships Steering Committee Planning Committee Ad Hoc Work Groups Neighbours in Action
Income Security
Food Security
Communications
Housing
Basic Needs
Employment and Training
Municipal Advocacy for Healthy Public Policies • Discretionary and emergency housing benefits • Local Housing Strategy • Municipal food programs • Emergency dental treatment • Work and Health initiatives
Strategies for Change Letter-writing, reports and media messages as an agency and as a collective Council meetings and Board of Health presentations Individual meetings with Councillors and City staff
Provincial Healthy Public Policy • Provincial Poverty Reduction Strategy • Social Assistance Reform • Minimum Wage review •“Put Food in the Budget” Campaign •Annual Provincial Budgets
alPHa-OPHA Health Equity Work Group Objectives: • Promote health equity within the mandate of public health units in Ontario • Advocate for policies to reduce health inequities at all levels of government • Support knowledge exchange, sharing of tools and resources related to health equity
Successes • Increased community profile of poverty and inequities • Successful influence of the local policy agenda and municipal budgets for social determinants of health • Increased collaboration for program and service delivery • Successful mobilization of coordinated responses to provincial policy proposals and directions
Collaboration with Primary Health Care • Data collection and reporting • Understanding of community needs, trends and issues • Connections to priority populations • Public education • Joint advocacy for healthy public policy
For any questions or follow-up please contact: Christine Post Poverty and Health Program cpost@pcchu.ca (705)743-1000 Ext. 293