Owen Sound Roundtable Report

April 17th 2004

In Owen Sound the Minister of State met approximately 20 local public health stakeholders.

1. Regarding a Mandate for a Public Health Agency of Canada:

Broad Scope

• The mandate should respect the determinants of health and include national health information and communication, emergency response, chronic and infectious disease prevention, injury prevention, health promotion, and mental health.
• Apply a "health lens" to the development of all new legislation in Canada. The federal government should also consider a Canadian Public Health Act that promises citizens access to services that will optimize their health potential.
• The Agency may struggle between its mandate to focus on infectious diseases, for instance SARS, and its mandate to provide health promotion, typically the former takes priority. However, in this region lifestyle problems and health determinants pose a greater risk to population health than infectious diseases.

Accountability

• The Agency should be governed by public health experts, not politicians.

2. Regarding Operational Strategies of a Public Health Agency of Canada:

Collaboration and Communications

• The Agency presents an opportunity for improved collaboration and for setting shared federal - provincial public health objectives. The proposed network should foster research, innovation and collaboration.
• Pharmacists are the most accessible health professional, they can play enhanced roles in underserviced communities and should be considered a key partner in public health. They are ideally positioned to provide health information to the public, and to make referrals to appropriate services.
• The Agency's activities must build upon strengths and support local public health efforts. Community Action Program for Children and the Canada Prenatal Nutrition Program represent good examples of federal programs that support and work collaboratively with local public health providers.
• The responsibility for communications should be removed from politics, development of a trans-Canadian public health information and communication system would provide a common resource for local providers, while not crossing jurisdictional lines.

Agency Activities

• The Agency can provide information that public health units need to plan and evaluate programs, connect community providers, etc. Develop standards for public health education and a virtual school of public health.
• The Agency should be a catalyst for action but not the direct service provider. It should support initiatives that are relevant and meaningful to people in their every day lives.
• Establish national public health goals based on the determinants of health and national standards to promote consistent access and practice nation-wide.
• Establish a national strategy for palliative care.
• Make better use of the good research available which shows the effectiveness of health promotion, for example, Dr. Gina Browne's work showing the effectiveness of recreation and child care for single mothers, etc. Disseminate research.
• Apply a "rural lens" to all Agency activities to ensure initiatives are sensitive to the unique needs of rural Canada. Or, support targeted rural initiatives.

Role of Nursing

• Public health nurses are the "glue" of the system. Apply efforts to address the nursing shortage and improve workplace conditions to public health settings. Establish wage parity for public health nurses.
• Create a Chief Nursing Officer for the Agency to support public health nursing practice and represent the workforce at senior decision making tables.

3. Investments:

• Reallocate resources to meet public health objectives.
• Ensure public health investments reach front line communities by targeting them to local levels, as well as to specific objectives, for example, cardiovascular initiatives, transportation, research etc.
• Fund a national daycare program to promote healthy pre-school development and improve readiness for school. Such investment would result in upstream savings across sectors, such as health care, justice system, etc. This requires long term investment and political courage.
• Fund a national mental health promotion initiative; include a special focus on children and youth.
• Invest in an electronic health record.
• Provide funding to support the visually impaired, especially for alternate format books.
• The current system of provincial - municipal cost sharing for public health diminishes accountability and results in inconsistent service levels across the province.

4. Public Health Issues:

• Public health needs of an ageing population, since the region has a high seniors population.
• Depressive illnesses will soon be the leading disease burden in Canada.
• This region has high youth suicide rates.
• Transportation is a key determinant of health, 85% of our population lacks access to affordable transit.
• Rural area fare most poorly with respect to the determinants of health. Poor access to primary health care, recreational programs, has significant impact on rural residents.
• Public health crises in recent years have served to increase public awareness of the issues. At the same time, public expectations are increasing.
• Small rural communities and the voluntary sector are experienced with innovation and stretching dollars, tap into that expertise.
• First Nations communities face unique health challenges requiring specific attention and financial resources.