CONSULTATIONS ON PUBLIC HEALTH GOALS FOR CANADA

Expert Roundtable on Methodologies and Tools

Meeting Summary

Federal Minister of State (Public Health) Carolyn Bennett was host of a roundtable discussion in Toronto as part of an ongoing initiative to develop public health goals for Canada. Participants formulated and discussed the tools and methodologies that should be considered to meet those goals.

WELCOME AND OVERVIEW (MINISTER BENNETT)

The Honourable Minister of State, Carolyn Bennett (Public Health) welcomed all of the participants and thanked them for agreeing to participate in these discussions. She noted that the broad aspirational goals arrived at through these sessions would be presented to the first ministers at meetings later this fall and would contribute to the establishment of public health goals for Canada.

She invited the participants to examine the themes through the lens of new tools to determine new ways of deploying human resources. She noted that they would be watching a DVD later and that it represented a tool, and that tools can be anything today—even video games.

She urged a deputization of other departments beyond those that are health-related, including the private sector, to draw them in saying they can’t address workplace health without the involvement of business which has a better understanding of productivity, retention and absenteeism. She cited Minister Theresa Oswald’s involvement as chair on the Cabinet committee on children where she involves cabinet ministers with children who have a vested interested in young people.

These policies must extend beyond economic goals and focus on social goals, similar to the policies being followed in Sweden. A similar plan has worked in Quebec where they followed health goals. We must work very hard to understand the barriers and factors to enable us to understand what they are doing, why this hasn’t worked here and find out what does. We use comparatives to describe what we want—greener pastures, healthier Canadians—so we better figure out how to measure it, then fund the things that work and stop funding things that don’t work.

Minister Bennett acknowledged the contribution of co-chair Minister Oswald, who chairs the cabinet committee on children and is a previous school vice-principal. She described her ministry as one dedicated entirely to the prevention and promotion of an integrated approach to early childhood development and healthy living. Together they demonstrate that the health departments require involvement from all sides of the community and the country. The purpose of these meetings is to benefit from the insights of leaders from the public health and public policy communities.

Phil Jackson, the interim lead, NCC for Public Health Methodologies and Tools, was introduced. He presented a brief overview of the NCC, its priorities and vision. He outlined its goals as having a clear mandate aligned with public health priorities as well as NCC efforts. He said links are established with work already underway so it can serve as an effective advisory structure, and because it avoids duplication it is a centre that can complement and co-exist with other efforts while retaining an identity.

OBJECTIVES

Session #1

• Discuss each theme and determine the tools, methods and approaches needed to achieve the theme area.
• Review, consider and discuss sub-theme areas
• Recommend goal statements for theme areas.
• Develop indicators

Session #2

• Discuss each theme area and offer the top goals to implement in a public health system identifying methodologies and tools that may aid the implementation, and indicators that will measure their results or success. (The groups were given a hypothetical budget of $115 million to spend on these goals.)

THEMES

Discussions took place in an open forum and then in small groups around the proposed theme areas and the sub-themes as they appear in the consultation workbook. Each table was asked to discuss one theme area, and develop goals, methodologies and tools to support each area, and address any values or principles they felt should be included. Other comments were also noted. Each theme as it appears in the consultation workbook and the suggestions (or sub-themes) around how they can be addressed appear in the text boxes and are followed by a summary of each of the small group discussions as reported back in plenary. Each theme has a section called Values, Principles, and Practices which illustrates the universality of many themes, the practical examples cited and the other considerations that led to their results.

Tools and Methods

• Forum for rapid response is essential.
• Think in a systems way to review the impact.
• Pay attention to natural experiments that work, especially in a community context.
• Collaborate across all systems and sectors.
• Focus on an infrastructure to link data and provide timely reporting.
• Evaluation is key. Collect data and information for specific, stated reasons; disseminate, integrate and interpret data consistently; use that information to do program planning, evaluation and needs assessment, and link them while protecting privacy.
• Must contextualize data and systems to local conditions. Need a way to understand context and why things work (or don’t). Include all factors i.e.: tools, behaviours, local champion.

Values, Principles and Practices

• Tailor feedback to sources of the data to help them act/change as necessary.
• The Internet has proven to be very useful in terms of timely access to data.
• Core measures are used everywhere but should incorporate specific local questions to obtain local relevant data. The pulse of the community needs to be measured with tool surveillance systems –so outcomes can be measured and data and results compared.
• Attend to concurrent issues. Integrate planning, safety and activity. i.e.: promote physical activity but ensure safety.
• There are no systems to consistently evaluate programs for early childhood; data is also lacking.
• Evaluation of programs throughout life phases is inadequate to assess impact.
• The Canadian Community Health Survey gets done every two years. Perhaps it should be changed to every year to monitor incremental changes.
• Follow up on what do we need to do to deal with the information from the health survey regarding skills, training, etc.
• Interactive hands-on activities and resources that address health lifestyles/behaviour and relevant issues (i.e.: infectious disease). Should be measurable in the classroom (at the tactical level-front lines). Should tie into existing provincial and pan-Canadian education frameworks.
• To illustrate the importance of rapid response, a survey was described that was conducted in high schools about students and smoking. Data collection was done within a one-year turnaround so principals could keep abreast of their progress and could adapt policies and approaches.
• Proper food handling, controlled eating, exercise—all should begin at home. Get the message into the home. Follow the practices like the tool kit sent out by the Canadian Museum in Ottawa that created attention to their project. “Put it on the fridge” – a campaign that kids and parents could follow every day to monitor themselves.
• An example of what not to do took place in Hamilton. A fall prevention program for seniors had been implemented as an intervention, while at the same time the timing at traffic lights was shortened allowing less time to cross the street. The system didn’t accommodate the intervention illustrating that both behaviour and environment modification are needed.

• Goal Statements
• Create tools to engage members of all facets of the community.
• Determine community priorities. Use community awareness vehicles: schools, workplace, public health and outreach (i.e.: to the homeless).
• Support a learning culture.
• Share knowledge, wisdom and information. Collect it for a reason and use info to do program planning, evaluation and needs assessment.
• Provide free access to good data.
• Disseminate, integrate and interpret data and systems consistently.
• Promote media training and how we communicate information to the media. Communicate data in a straightforward manner to citizens.

Tools and Methods

• Communities need to define their own goals for a healthy community. Requires education of citizens to understand what is needed.
• Communities need to feel empowered to take ownership of those goals as well as the responsibility for achieving them. Methods may be untraditional but should be adaptable community to community.
• Methods and tools need to be universal, yet diverse and flexible to be adapted for use in the local community.
• Assist communities in establishing their networks although the processes may vary.
  • mentorship
  • tool kits – where to go for information
  • framework
  • funding templates
  • how to target diverse community groups within themselves
• Remove barriers.
  • government funding needs to be broad and flexible to adapt to community priorities
  • infrastructure—define the local social infrastructure and ensure networks are in place
• Follow Aboriginal perspectives /methods that can be applied to other communities.
  • community ownership and control
  • framework for target groups – elders, youth, adults, children
  • Aboriginal stream illustrates diversity between Aboriginals and Métis which could be relevant within other communities

Values, Principles and Practices

• Indicators need to be developed that are appropriate to each community to make the approaches/systems more specific.
• Indicators should be understood by citizens.
• A social index should include education, income, housing as well as GNP and an economic index.
• There was discussion of front-page headlines that describe a man’s death while waiting for bypass surgery, yet the back page story described a single mother of three who lost her children in house fire because she couldn’t afford a babysitter. Both stories describe people in crisis—the man because of health circumstances; the woman because of her economics and inability to afford a safe environment. How do we communicate that to the media?
• Community resources need to be in place to support their goals.

Goal Statements

• Healthier school environments
  • decrease burden on schools
  • increase ability to inform/promote policy
  • increase ability to identify best practices
  • obtain school-based community level data collection
  • ongoing data surveillance
  • provide comprehensive health education i.e.: smoking, eating, recreation
  • links between individual data, school programs/policy and public health

Tools and Methods

• Goals should encompass consumer protection, environmental climate change, good management, and sound urban design and planning.
• Any goals emerging will be successful through goodwill supplemented by good data and performance maintenance systems and these means:
  • good technical data
  • follow best practices models – i.e.: New York City guidelines
  • effective public communication and information – fact sheets
  • multiple stakeholders/disciplines
    • advocates
    • consumers
    • researchers, etc.
  • mirror successes on the environment side through effective health and environmental impact assessments i.e.: intersectional planning in urban design and development
  • goodwill - tell compelling stories that appeal to core values, fairness and not cutting corners
  • cultivate champions/leaders: CMOH, municipalities, schools, etc.
  • discover performance lessons
  • learn lessons from healthy cities/community movements
  • learn lessons from tobacco control movement i.e.: local leadership

Indicators

• Legislation/policy/local bylaws.
• Air quality index, smog advisories, building codes.
• Need a reporting mechanism to handle data received from police, public and other agencies.

Values, Principles and Practices

• Consider different types of evaluations and assessments. When considering patient care, in addition to determining the effectiveness of the medical care, conduct a “happy people” evaluation to present a different side.
• Sound leadership and planning will examine high-rise vs. urban sprawl, etc., to develop healthy communities and cities.

Goal Statements

• Creation of national interactive clearinghouse of best practices for all disciplines to access (western Moss have done so). It should be expanded beyond medical officers and beyond public health and within an infrastructure. Perhaps this is a role for the NCC.
• Establish a network of teaching health units across Canada for applied public/population health research and planning capacity.
  • to provide a standardized set of data analysis/outputs
  • a venue for students to access practice and placements
  • provide continuing education for public health staff
  • take leadership internally as a specific area of practice/topic
  • link to both university and local health regions as a resource to influence the public health system as a whole.
  • create a support network among other disciplines so they can come together as a user group for conferences or workshops, to share interventional evidence or techniques developed in other disciplines.
  • provide population health data for the entire health system and other observatories. i.e.: share teen pregnancy reports
  • invest in development of new methodologies for public health analysis
    • geo-spatial methods/tools for use in public health
    • user groups for specific methods/tools
    • interventional evidence
  • will need IT infrastructure, human resources, and geographic analysis and local understanding of the country’s sub-regions
• Education of the community.
  • Educate community members on how to use research and participate in research.
  • Educate health professionals in community-based research.
  • Make efforts to recruit Aboriginals and Immigrants into public health work.

Tools and Methods

• Establish tools for citizen engagement. When dealing with populations in transition, we need a voice to get them involved with designing research, interpretation and interventions. Those in need are often more affected by the results of data.
• Data needs to be stratified by age, culture, sex and time because of the transitional nature, and linked so a true analysis can be done for health outcomes, risk factors and health determinates.
• Establish a health card ID for aboriginal community so use of services can be tracked, data gathered and indicators noted.
• Assessment on how and why research dollars are allocated.
• Identify where lack of ongoing funds is being felt and what it affects.
• Longitudinal data doesn’t exist due to cost and other factors and the analytical capacity to mine that data set. We need to invest in a prioritized set of questions but the challenge is getting locally relevant longitudinal data to make local policies.
• Identify the missing pieces in the research on vulnerable populations whether it’s evidence on a local or national level to make the changes. The missing data may determine the intervention. Need to identify:
  • missing local evidence
  • missing data sources
  • missing information on interventions
  • missing analyst capacity
  • funding required to fill in the gaps
• Remove barriers to data.
  • need free access
  • need capacity to analyze
  • need human resources as not all groups have equal ability to analyze the data, and the ability to make locally relevant policy changes.
• Need tools and methods at the local level. Design them to deal with what the community defines as its population in transition so that it’s not defined at a federal or provincial level. Must get the balance right.
• Need tool for “future planning” to analyze tables, rates and prevalence that will project future impact of certain disease based on population characteristics (age, risk, ethnicity, gender, etc); and a sensitivity analysis of preventable death and disease with different types of investment (primary prevention costs vs. surgical interventions)
• Public health units need to be able to implement tools. Rural health units need to increase capacity.
• Need more social relevance. Take the focus away from data and place it on what would be useful to the public where vulnerable populations are present.
• Support a summary index to make inequities real to Canadians and how to monitor progress.
• Need public health equivalents to “unit time” or average length of stay vs. admission rates.
• Need a co-ordinated approach to evaluate and disseminate best-practice and program reviews.
• Monitor progress. Are we making progress on these goals nationally and locally?
• Need real time access tool for MOH’s information needed such as ontime alerts. As many are rarely at workstations, it should have wireless capability. (i.e.: Saskatoon health region)
• Need a GIS-based data access/analysis/monitoring tool for intersectional data.

Values, Principles and Practices

• There was difficulty accepting the term of “vulnerable population”. Some alternate suggestions were: Health Inequities – referring to the difference in distribution of health, power and determinates; Populations in Transition – a period in time that they are vulnerable.
• With the issue of vulnerable populations, it’s not just public health, there should be an overall system planning with these populations represented at the planning tables – whether health-related or other areas.
• Vulnerability is transient and we don’t have good surveillance systems that look at the life course. We should be looking at reducing that time period of those in vulnerable situations. As well, there is a possible role for a collaborative system for providing expertise to assist in these areas.
• The privacy issue was discussed. Who is going to be the data steward for mental illness – the data gatekeeper? Who will they release data to and for what purpose? It was noted various checks and balances are already in place for privacy.
• A lot of thought must be given to what is measured and how frequently, with policy decisions taking place in the intervening time period. As an example, we should be looking beyond tobacco/smoking statistics and at admissions to hospital to see if there is an impact.
• There are important indicators for smoking already in place so it can be drawn upon immediately to relate to new goals/strategies.
• Sharing of information. When one part of the health system doesn’t share with another and creates duplication of tests and research, it was suggested that the public be advised. Incensing the public should provide incentive for the system to share information within itself.
• Minister Bennett suggested a form of “one-stop shopping” that goes beyond the medical model because if it’s not a medical need “it’s not our job”. In the evolution of electronic health record, are we capturing everything we can —individual, family, community? An electronic record would have alerts and reminders for patients tough to access for needs beyond health care.
• It was pointed out that about 90% of individuals would visit a primary health care provider who can often detect an environmental or stress-related problem that can be addressed differently than referring them on to a specialist. It may reflect increased use of primary health care, but translates into reduced referrals to specialists.
• A quantitative index is what counts to describe a universe of stories, not the atoms. Minister Bennett said she has difficulty accepting averaged indices. You can’t throw data together without understanding what it means. As an example, she said Canada is one of the highest ranking countries when it comes to keeping preemies alive, and yet those stats bring the average birth weight down affecting our indicators in a negative manner.
• On the subject of indicators, Minister Bennett asked why we need to make up indicators when there are some already in place. Ironically, she said there are requests for indicators to determine the effectiveness of handwashing, and yet some say there is no need to measure hospital-related infections which can obviously be related directly to handwashing procedures.
• Minister Bennett discussed the guaranteed income supplement—an opportunity being offered without meaningful outreach. We need data to show we’re closing that gap. How do we make this data automatic so we know who’s entitled, who’s getting welfare, who should be getting GIS? This is related data and the keepers of the data should know which things should be linked. This is also a delivery issue and the primary health care system is not set up to deal with this. Run of the mill local citizens don’t have the ability to access and utilize what is available so we need to enable them to access resources in a tangible way.
• Collecting of data is old-fashioned and it’s everywhere. There is some information we need to know every day, once a month, once a year and it should be there. Nobody collects my bank balance – it’s just there. Minister Bennett said we should have that same availability to the data we need.

Goal Statements

• Strengthen all aspects of the planning structure.
• Create evaluation tools to determine ways to evaluate and amend programming.
• Create tools to measure the breadth of health promotion strategies.
• Establish a clearing house of public health interventions that offers:
  • best practices information
  • advice on preferred methods
  • assistance to communities in choosing the right intervention for them
• Engage the community as stakeholders in healthy public policy. Sell the value of public health so it’s a public good.
• Get to root causes of high-risk behaviour (through social determinants). Establish intersectoral collaboration to determine how to work together to change high-risk behaviour.
• Establish access to data and linkage to healthy outcomes.
• Provide incentives and practise accountability and create the tools that provide a link to public health.

Tools and Methods

• Integration of knowledge generation and knowledge use.
• Use indicators to link to programs and interventions.
• Strengthen all aspects of the public health infrastructure, especially at the local levels, including:
  • Public Health Act
  • cross-sectional coordinating mechanisms and support at local levels
• Infrastructure at local, provincial and federal levels to facilitate the collection, analysis, comparison, dissemination and communication about healthy behaviour, attitude and services.
• Improved data collection and feedback at local levels
  • Ontario Rapid Risks Surveillance System
  • as a means to generate community response
  • for improved analytical capabilities at local level
  • for improved availability of linked data (surveys and administrative data)
  • to guide planning that targets high risk settings
  • to evaluate impact
  • to learn from natural experiments about what works, in what context
• Focus on areas where a difference can be made
  • what’s working and what’s not
  • learn as we go
• Increased support at local and provincial levels to enable public health and citizens to identify problems through
  • data sources
  • indicators
  • dissemination
  • knowledge exchange/integration/programs/strategies with central support (provincially and federally)
  • ongoing surveillance
  • collection analysis, comparison and dissemination
    • i.e.: Rapid Risk Surveillance System, school health survey
  • implementing best practices approach
  • ongoing planning implementation
• Develop tools to estimate the impact of preventable illness, disabilities and premature deaths in order to identify priorities for interventions.
• Develop tools to establish priorities for interventions and local policy development, and the impact on the population.

Values, Principles and Practices

• How do we get communities moving to establish their own best practices model?
• We need the ability to collect data at the local settings to target the population and evaluate the impact to see what’s working and what’s not. What worked 10 years ago elsewhere, might not work here now.
• Are there examples of interministerial organizations that have addressed specific problems? Finland has made an impact on improving health of the population. Are there lessons we might learn?
• We must support of personal choices from a variety of strategies. Offering environmental supports and opportunities for skills development complements the services of health agencies so we can go beyond education and literature.
• Knowledge is key to helping to make informed decisions. The Atkins Diet created a groundswell of attention, and a problem for potato farmers. Balanced information is still needed to make decisions but the fact remains that this campaign has visibility. We must find a means of reaching people in the same manner.
• There is no performance criterion for leadership or bureaucrats. There are a number of places where people get bonuses for getting bad results. Can become more personal if they were held accountable for performance as they are in private sector. A case was cited in Mexico where the three ministers of education, health and social services have to negotiate hard targets with the president and report quarterly on how they’re doing. If a child stays in school and attends health checkups, a bonus is included in a core cheque. The three ministers have sorted out how to achieve this to meet their goals. Need to figure out cross-departmental ways to work together and be accountable here.
• Kitchener-Waterloo became the gold standard across the country when it was the first community to ban smoking in pubs. It became a consultant to the entire country. Unfortunately, there was no infrastructure in place to handle this massive increase in correspondence and communication increasing the workload which still had to be fulfilled.

Goal Statements

• Need annual, ongoing sustainable funding.
• People - human resources. Increase public health staff in every unit. Power to the people.
• Databases – new, existing and standardized – to measure things that count in public health framework
  • performance vs. health interface
  • human resources
  • programs and services
  • NPHS expanded
  • RRFFS
  • non-health data
  • data-sharing agreements
  • indicators
  • specific data collection i.e.: drugs, smoking, child health
  • longitudinal data
• Networking
  • virtual communication through public health sectors and government
  • e-learning
  • library
  • secondment
• Knowledge integration and training to avoid repetition
  • gather/share success stories
  • public health legislation
  • central coordinator
  • predictive tools to model public health impact
  • training on information and health policy
  • present a business case for public funding of public health
• Increase profile and communications
  • create public health awards
  • use Wanless Report as a guide
  • instead of the NASDAQ, implement CBC Health Report
  • change the culture to evidence-based practice
• Evaluation
  • longitudinal studies
  • dedicated funding
  • learn and expand from demo projects

Sub-Themes

• Develop model public health legislation to address high priority public health issues.
• Define public health programs in a consistent manner across the country.
• Conduct annual surveys on tobacco/drug/alcohol use and attitudes with analysis to a community level.
• Place PHAC staff into every local health unit/regional authority.

Tools and Methods

• Data standards
  • collection, analyzing, interpreting, communicating, policy implications
  • infrastructure for integration for data collection
  • population-based not individually focused
• Tools to adapt success stories across inter-disciplinary groups and across provinces
  • should look at business success stories – no tools to translate knowledge into health system
• Tools to examine what works and what doesn’t and why it does or doesn’t. Need to understand incentives and disincentives and policies, behaviours and beliefs.
  • case study tools
  • quasi-experimental policy and behavioural models
  • simulation tools – will show what can be saved or spent
• Simulation tools to measure the benefits and risks of public health investment planning models. In the Wanless Report, a former banker demonstrated that public health was like an investment. Simulations showed the result of investment in health will make the health care system more successful overall while creating a demand for integrated services.
• Build in incentives for researchers to collaborate at the university or national level and work with users, policy-makers and the community to translate the research into practice/policy.

Values, Principles and Practices

• Data could be translated into quality of life measures on a personal or family level for greater understanding of how it relates to the individual.
• The better public health is at reducing the burden on the system, the less burden is shouldered by the community so small investments so an investment in services like immunization offer that return.

GENERAL DISCUSSION

Following is a summary of general discussion items raised in plenary before and after the small group discussions around the themes.

Emergency Preparedness & Infectious Disease

There is a Cree saying they use when referring to government representatives: “She had really nice teeth” meaning nothing meaningful or productive was said in discussions with them. The Aboriginal people have been treated like invisible people and are given programs that make no sense causing them to be doubt government plans and policies.

This comment was submitted following the discussion: It is assumed that public health is an integral part of the health system. Canada’s health system should be a “learning organization”. eg: So many interventions/programs/policies have not yet been evaluated; new ideas and technologies are coming up all the time. Therefore, to be an effective learning (and adaptable and effective) system, Canada’s health system should have: a mathematical projection modeling capacity to assess which policies would offer the largest bang for the buck; and the underlying human resources (researchers, local analysts) to make this all work.

ADJOURNMENT

The session ended with the airing of a DVD called Dreaded Red, Sixty Minutes to Save the World. It was a pilot project developed in Manitoba featuring high school students in the roles of emergency care workers, scientists, media, politicians and victims during an outbreak. It was created to promote careers in infectious disease in Manitoba. Actual representatives from the public health system, national microbiology lab, world health organization, and a health inspector, Canadian chief public officer of health, an epidemiologist and others, coached the students on their roles/jobs in the emergency situation that was being created. It is expected to be in Manitoba classrooms this fall.

Minister Bennett, commended the project and said she could almost believe it would be possible to track student interest in science from this. “You know it works when you see kids that engaged in a project.”

Minister Bennett concluded the session by thanking everyone for their time and expertise. She described this session as a prescription for excellence in doing homework for the First Ministers conference. She encouraged them to remain actively involved in the process by filling out the workbooks and visiting the website (www.healthycanadians.ca). She asked that participants stay in touch through the website, read the various reports posted, and provide feedback.

She proposed establishing an awards program for health—like the Oscars—as was suggested during the discussion. “How can we generate some excitement and give them out?” She encouraged participants to e-mail their suggestions and awards categories to get the ball rolling. “It would be fun to think of something the equivalent of the best practices award—Best NGO, citizen, health practitioner….”

Keeping as many people healthy for as long as possible is our overriding goal, she said.

Consultations on Public Health Goals for Canada
Expert Roundtable on Methodologies and Tools

List of Participants

Carolyn Bennett, Minister of State, Public Health
Dr. Fraser Mustard, Founding President and Institute Fellow, The Founders Network of Canadian Institute for Advanced Research
Dr. Michael Rachlis, Consultant in health policy analysis
Dr. Cory Neudorf, Chief Medical Health Officer and Vice President Research
Janet Hatcher-Roberts, Executive Director, CSIH
Dr. Brian Emerson, Medical Consultant, Population Health and Wellness Division, Ministry of Health Services
Scott Leatherdale, Scientist, Cancer Care Ontario
Dr. Loraine Marrett, Senior Scientist & Director, Surveillance Unit, Division of Preventive Oncology, Cancer Care Ontario
Larry Svenson, Team Lead, Epidemiologic Surveillance, Alberta Health and Wellness
Steve Manske, Scientist, Centre for Behavioral Research and Program Evaluation, University of Waterloo
Dr. Peggy (Margaret) Millson, Associate Professor, University of Toronto
Jean-Marie Berthelot, Gestionnaire et Chercheur principal, Groupe d’analyse et de mesure de la santé
Dr. Mark Tremblay, Senior Scientific Advisor on Health Measurement, Statistics Canada
Dr. Patricia Martens, Director, Manitoba Centre for Health Policy, University of Manitoba
Dr. Roy Cameron, Executive Director, Centre for Behavioral Research and Program Evaluation, University of Waterloo
Dr. Parminder Raina, Associate Professor, McMaster University
Ron de Burger, President-elect, Canadian Public Health Association
Kathryn MacDonald, Project Manager, Health Council of Canada
Dr. Michael Wolfson, Assistant Chief Statistician Analysis and Development, Stats Canada
Trevor Hodge, Senior Vice President, Investment Strategy and Alliances
Dr. Fran Scott, Director, Planning and Policy and AMOH, City of Toronto Public Health
Connie Uetrecht, Interim Executive Director, Ontario Public Health Association
Cindy Scythes, Vice President, Ontario Public Health Association
Monique Stewart, Director, PHRED Program Ottawa Public Health
Dr. Harvey Skinner, Professor and Chair, Department of Public Health Sciences, Faculty of Medicine
Ruth Sanderson, Health Unit Epidemiologist, Middlesex-London Health Unit
Dr. Vic Sahai, Lead, Health System Intelligence Project, Ministry of Health and
Long-Term Care, Health Result Team Information Management
Dr. Robert Kyle, Commissioner & Medical Officer of Health , Durham Region Health Department
Dr. Jeanette Ward, Director, Institute for Population Health, University of Ottawa
Liz Rykert, President, Meta Strategies
Brian Szklarczuk, Manager, Research Promotion and Outreach, National Microbiology Laboratory, Public Health Agency of Canada, Canadian Science Centre for Human and Animal Health
Jeff Reading, Scientific Director, Institute on Aboriginal Peoples Health Canadian Institute on Health Research
Lorraine Dacombe Dewar, Director of Manitoba Health Regionalization Support Unit
Jennifer Zelmer, Vice President, Research and Analysis, Canadian Institute of Health Information
Bernice Downey, Chief Executive Officer, National Aboriginal Health Organization
Michelle Westin, Public Programs and Services Coordinator, Canadian Diabetes Association
Paulina Salamo, Senior Policy Analyst, Strategic Planning and Implementation Branch, Public Health Division, Ministry of Health and Long-Term Care
Alex Jadad, Director, Centre for Global eHealth Innovation, U of T
Dr. Ed Brown, Executive Director, North Network, Sunnybrook & Women’s College Health Sciences Centre
Bruce Barry, Health Director, Metis National Council
Phil Jackson, Interim Lead, NCC For Public Health Methodologies and Tools
Dr. David Mowat, Director General, Public Health Agency of Canada
Sinead Tuite, Senior Policy Advisor, Minister of State’s Office
Candace Smith, Senior Policy Analyst, Public Health Goals Policy Team, Public Health Agency of Canada

Natasha Manji, Communications
Public Health Goals Secretariat
Public Health Agency of Canada