Transcript Enhancing Capacity for Surveillance of Healthy Living and

Enhancing Capacity for
Surveillance of
Healthy Living & Chronic Disease
in Canada
Paula Stewart MD, FRCPC
Public Health Agency of Canada
APHEO, September 26. 2005
PHAC Mission and Vision
Mission
 To promote and protect the health of
Canadians through leadership,
partnership, innovation and action in
public health
Vision
 Healthy Canadians and communities in
a healthier world.
PHAC Mandate (1)
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Anticipate, prepare for, respond to and
recover from threats to public health;
Carry-out surveillance, monitor,
research, investigate and report on
diseases, injuries, other preventable
health risks and their determinants, and
the general state of public health in
Canada and internationally;
PHAC Mandate (2)
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Use the best available evidence and tools to
advise and support public health stakeholders
nationally and internationally as they work to
enhance the health of their communities
Provide public health information, advice and
leadership to Canadians and stakeholders
Build and sustain a public health network with
stakeholders.
PHAC: Organization
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Chief Public Health Officer of Canada – Dr David Butler-Jones
Centre for Health Promotion (CHP)
Centre for Chronic Disease Prevention and Control (CCDPC)
Centre for Infectious Disease Prevention and Control (CIDPC)
Centre for Emergency Preparedness and Response (CEPR)
Office of Public Health Practice
Laboratory for Foodborne Zoonoses (LFZ)
National Microbiology Laboratory (NML)
Regions
Health Surveillance
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The tracking and forecasting of any health event
or health determinant
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through the continuous collection of high-quality
data,
the integration, analysis and interpretation of those
data into surveillance products (such as reports,
advisories, warnings)
and the dissemination of those surveillance products
to those who need to know.
Surveillance products are produced for a specific
public health purpose or policy objective.
Public Health Agency Context
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Risk factor, chronic diseases – a priority
Health goal with objectives and targets.
Reporting on the health of Canadians.
Reporting on Pan-Canadian initiatives
such as Healthy Living and Diabetes
Public health units need help – “Public
health renewal”
Work in partnership “facilitator”
Vision: Surveillance
Canadians have reduced burden of
chronic disease as a result of changes
in policy, programs and services based
on timely surveillance.
IDEAL SURVEILLANCE SYSTEM
Improve health of the population
Action Based
on Information
Policies
Programs Services
Need Population Information
Indicator
Framework
Data
Collection/
Collation
Data Analysis/
Interpretation
Management
Coordination/Collaboration
Legislation & Regulation
Surveillance
Products and
Dissemination
Scenario A : Unaware, lack of culture, lack of
resources
Improve health of the population
Policies
Indicator
Framework
Data
Collection/
Collation
Programs Services
Data Analysis/
Interpretation
Management
Coordination/Collaboration
Legislation & Regulation
Surveillance
Products and
Dissemination
Scenario B: Data not there
Improve health of the population
Policies
Programs Services
Need Population Information
Indicator
Framework
Data
Collection/
Collation
Data Analysis/
Interpretation
Management
Coordination/Collaboration
Legislation & Regulation
Surveillance
Products and
Dissemination
Scenario C: Can’t access
Improve health of the population
Policies
Programs Services
Need Population Information
Indicator
Framework
Data
Collection/
Collation
Data Analysis/
Interpretation
Management
Coordination/Collaboration
Legislation & Regulation
Surveillance
Products and
Dissemination
Scenario D: can’t interpret, culture lacking
Improve health of the population
Policies
Programs Services
Need Population Information
Indicator
Framework
Data
Collection/
Collation
Data Analysis/
Interpretation
Management
Coordination/Collaboration
Legislation & Regulation
Surveillance
Products and
Dissemination
Goal
To improve capacity in Canada for
surveillance of chronic disease, its risk
factors and determinants.
Outcomes
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Public health organizations conduct
surveillance using data from existing
population databases, and use the
information in decision-making.
Public health organizations have access to
surveillance data collection systems that are
timely, rapid and flexible to meet their
information needs, and use this information in
decision-making.
Administrative and clinical databases are used
effectively for surveillance purposes.
Outcomes (continued)
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Data users and data owners from health and
other related sectors, such as recreation,
education, transportation and social services,
work collaboratively to increase data
availability and its use for chronic disease risk
factor and determinants surveillance.
The public health environment encourages
the use of surveillance information in
decision-making.
Coordination of surveillance supports public
health organizations surveillance activity.
Action Areas
#1 Enhance Federal, P/T and local/regional
capacity to analyse, interpret and use
surveillance data.
#2 Expand data sources to fill gaps in
knowledge.
#3 Enhance collaboration, planning and
evaluation among all stakeholders.
#4 Build capacity across jurisdictions for
congruent public health legislation
supportive of chronic disease surveillance.
#1 Enhance Federal, P/T and
local/regional capacity to analyse,
interpret and use surveillance data.
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Central coordinating function for resources
(questionnaires, guidelines, validation, analyses)
Access to existing surveys and databases (public
health portal – tailored tables, maps, figures)
E-learning, conferences, and workshops
Facilitate surveillance support systems at regional level
Public health human resource strategy
Healthy Living and Chronic Disease Surveillance
Potential Data Sources
Administrative Databases
- recreation, municipalities,
housing, transportation, police,
justice
Sentinel
Centres
Surveillance
Community
environment
On-going Surveys
-Central (CCHS,
PAM, CTUMS,
CLSCY)
-Regional/local
(RRFSS, RHS –
First Nations)
Individual and
Family
Electronic
Health Record
Databases
Health
Services
P/T Health Admin
- physician billing,
hospital, lab, drugs
School,
workplace, other
Insurance
Databases
EAP, school,
prison databases
Mortality
Databases
#2 Expand data sources to fill gaps in
data.
Local/Regionally Directed
 Facilitate the development and sustainability of
local/regionally coordinated on-going flexible data
collection systems. (ala Ontario RRFSS)
Provincially/territorially Directed
 Health administrative databases – build on NDSS, add
regional analyses, add conditions
Nationally Directed
 CCHS including Physical Measures Survey
 PAM – add more community environmental assessments
 Sentinel Centres - Primary health care networks
#3 Enhance collaboration, planning and
evaluation among all the stakeholders.
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Pan-Canadian Public Health Network
Issue Group - Surveillance of Healthy Living
and Chronic Disease
Coordinating function – PHAC
#4 Support the public health mandate for
surveillance through legislation.
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Develop model public health legislation
Facilitate jurisdictions to consider the model
legislation when reviewing and revising their
health legislation.
Creation of a centre of expertise in public health
law within the Public Health Agency of Canada,
and a national interest group in public health law
linked to the Public Health.
Next Steps
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Waiting for final approval and budget
amounts
Gradual ramp-up
Immediate plans
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Expand NDSS to other conditions
Regional Risk Factor Surveillance