A8 Addressing Social Determinants of Health_Christine Post

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