Transcript Ontario Health Protection and Promotion Act

3rd Year Public Health Session
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Current high profile: SARS; West Nile;
Walkerton; smoking bans; needle
exchange & harm reduction... What’s
next??
New emerging infections
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MCC exam objectives; recently revised
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SIM web site resources
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FRCP(C) residency training programs in
Community Medicine in Toronto, McMaster,
Kingston & (soon) Ottawa
Structure and Brief History
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Boards of Health established in 1833 in Upper
Canada “to guard against the introduction of
malignant, contagious and infectious disease.”
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Public Health Act passed in Ontario in 1873
First Medical Officer of Health (MOH) in Toronto in 1883
Health units established in 1945
In 1989, Mandatory Health Programs revised to take a
population approach to prevent disease and promote
health.
37 health units in Ontario, of which 27 are rural
area units. Grouped under 9 regions; Toronto
has its own health department
Coordinated at the municipal level
50:50 shared funding between province and
municipalities (to go to 75:25)
Medical Officers of Health in teaching health units
hold an FRCP(C) in Community Medicine
City of Ottawa Public Health
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Covering legislation contained in the 2008
Ontario Public Health Standards under the
Ontario Health Protection and Promotion
Act). These establish requirements for basic
public health services in the province.
Standards cover:
• Chronic diseases & injury programs
• Family health programs
• Infectious disease control
• Environmental health, and
• Emergency preparedness.
Essential Functions of Public Health
1: Health Protection
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Food safety—inspections; helping with recalls
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Safe water—follow-up on reports of problems
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Infection control in institutions, child care
facilities and personal service settings
Vaccine preventable diseases — supply
vaccine & advice to physicians, school
immunization program, flu shot clinics
Sexually transmitted infections — partner
notification
Essential Functions of Public Health
1. Health Protection (con’t)
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Tuberculosis—directly observed treatment for all
cases; contact testing
Rabies—supply vaccine and immune globulin;
work with Animal Control for pets and Min. of
Nat. Resources for raccoon rabies control
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Health hazard investigation
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Public swimming pool inspection
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Inspections of residential care facilities and
rooming houses for health hazards
Emergency preparedness—e.g., bioterrorism
Essential Functions of Public Health
2: Health Surveillance
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Reporting of notifiable diseases in
order to recognize outbreaks and
assess effectiveness of control
programs
Behavioural risk factor surveys
Local data available from public
health department
Essential Functions of Public Health
3: Population Health Assessment
CDC in Atlanta estimates that 2/3 of
premature mortality is preventable by
applying available knowledge
So, Health Dep’t seeks to develop better
services and policies, by asking:
• What is the health of the population?
• What factors underlie good health?
• What factors create health risks?
“Population Perspective”
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Tries to address needs rather than demands
Focus on Determinants of Health
Ottawa health department’s perspective:
“Public health means more to our city than the
prevention of infectious disease, illness and injury
- it is about creating healthier environments at home,
at work and in the community, promoting healthier
lifestyles and choices, adopting programs and initiatives
that lead to healthier children and families, and offering
protection to the health of all citizens.”
Cf. CANMEDS 2005 & Royal College’s
“Physician skills for the new millennium”
PHAC web site on Population Health
Essential Functions of Public Health
4. Disease and Injury Prevention
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Alcohol
Bicycle safety
Bullying prevention
Car seats
Cold alert
Dog bite
prevention
Driving safely
Drowning
prevention
Heat alert
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Needle exchange
program (SITE)
Smog alerts
Snowmobiling
Sun safety
Tattooing and body
piercing
Water safety—
backyard pools;
public pools
West Nile mosquito
monitoring
Essential Functions of Public Health
5. Health Promotion
City of Ottawa Healthy Living programs
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Alcohol, drugs and tobacco
Dental Health
Nutrition & body weight
Physical activity
Safety & injury prevention
Sexual health
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These mainly offer informational material & links to
other programs
Professionals (includes Physician’s Update)
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Essential Functions of Public Health
5. Health Promotion (cont’d)
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Most activities now
occurring as result of
community partnerships:
Partners in Healthy Living
They emphasize education
& skill building; advocacy;
partnerships.
Numerous examples of
programs