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Welcome to HC Link's blog! Our blog will provide you with useful information on healthy community topics, news, and resources, as well as information on HC Link’s events, activities, and resources. Our bloggers include HC Link staff and consultants, as well as our partnering organizations, clients, and experts in the health promotion field.

Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

We look forward to engaging in thought-provoking conversation with you!

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Improve the Built Environment in Your Community: Questions, Responses and Helpful Links from our online discussion

onlinediscussionfeb13If you are working to improve the built environment in your community, there’s a good chance you participated in our online discussion with consultant on tap, Paul Young, this past Monday. With a steady flow of well-thought out questions from participants, informative responses, and lots of peer sharing among the 100 attendees – it was a great learning opportunity!

To further that learning and to allow those who couldn’t join an opportunity to gain insights and connect to helpful information and resources, we are sharing the questions that were asked, responses from Paul and participants, as well as helpful links and resources shared for each question with you all! Feel free to scroll to questions that appeal to you, and don’t forget to check out additional resource links at the bottom of the blog! If you have any remaining questions, or want clarification on the information provided, you can email Kyley atThis email address is being protected from spambots. You need JavaScript enabled to view it..

1)During the Healthy Communities Partnership Project we worked with some of the municipalities to strengthen wording or add wording for Active Transportation and Built Environment in MOPs – now they have been done and it will be another 5 years until they start reviewing them again. What do we do in the meantime? Do we keep reviewing MOPs and see how they can be strengthened, what if the municipality doesn’t want to see us for a while? Are there other municipal documents that public health can have input into?

  •            A lot of interest from public health units in getting involved in planning

  •          The Official Plan was a big hit – enabled a high level approach to including things related to the built environment that affect health

  •         Official Plan updates are typically every 5 years, but there are other mechanisms to provide input on planning matters, such as:

    - Working on Recreation policy - access, Rec master plans, coordinating with the transportation plan (trails, for example, cross over between recreation and transportation).

    - Secondary plans (for high growth areas) – you can look at how well this plan supports walkability. Can look at age friendliness, cycling supports, food access, density, mixed use, complete streets, etc.

    - Working with schools - access to recreation, healthy food, active travel

    - Other built environment projects, like Environmental Assessments – that can shape road design

    - Can get involved in Transportation Policy (master plans) – such as paved shoulders, etc.

  • Public Health and Land Use Planning document by OPHA – has as a spectrum of great ideas that other public health units are doing on built environment: http://www.opha.on.ca/OPHA/media/Resources/Resource%20Documents/CAP_PHLUP-Report-Apr2011_1.pdf?ext=.pdf

2)What are some of the best strategies to engage Councillors or Mayors in AT planning/development - especially those Councillors/Mayors that have been huge barriers to AT.

  • It can be difficult to start with people who are not on board...try to engage a Champion amongst council and have that person serve as spokesperson

  • Fairly common way to engage a councillor would be on an active transportation committee – they can lead and be spokesperson OR have councillors sign a Walking or Active Transportation Charter, which is a public declaration of support

  • Experience in Thunderbay – Public Health organized a bus tour of dangerous intersections with councillors, municipal staff and community. We also went to places that were very supportive of active transportation, so they could see the difference – easy opportunity for a councillor to be involved

  • Health is usually an issue that council will respond to – preventing crashes and fatalities

  • Economic development is another- municipalities interested in attracting and retaining populations (i.e. age friendly communities with retirement)

  • quality of life as well – usually councils will have a strategic plan, and quality of life is usually a part of this

  • active transportation is a great way to frame and address all three of these

3) How do you sell Built Environment ideas (new trail, park, etc.) to councillors who are budget conscious? Do you have a good evidence-based resource?

  • Municipalities often conduct Recreation Needs Assessments e.g., surveys to find out what residents prefer – walking comes up usually as #1 – one reason to invest in trails

  • Walking is the easiest and least costly physical activity and so trails (walking and biking) can be a great way to support the needs of a councillors constituents

  • Economic development - having trails and access to recreation is a great way to attract and retain populations in their community

  • World Health Organization has age-friendly guidelines: Walkable communities are featured prominently http://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf?ua=1

 

4) Is there a business case document that shows the return on investment for built environment (reduction of health care costs due to injury/increase in physical activity)?

  • There are resources around the economic impact of building trails from a tourism standpoint. The Waterfront Trail has resources on this: Contact Marlaine Koehler at the Waterfront Regeneration Trust. See also Ontario By Bike

  • Rails to Trails Conservancy – search in their library : http://www.railstotrails.org/

  • Economic investment in trails is pretty clear

  • Challenge - Health care costs aren’t born by municipality but most active transportation infrastructure work is undertaken by municipalities (so municipality spends and province saves) – although we are starting to connect those dots more

Participants shared:

  • Niagara developed an economic value of AT fact sheets that include one about health care. Halton replicated it:

  • City of Toronto's road safety plan targets areas with high collision and injury incidence. Used mapping to help identify areas.

  • See also Parachute Canada’s Cost of Injuries (including transport injuries)

 

5) Do you know of any community (rural or urban) that is using injury statistics as part of their infrastructure planning for roads/cycle lanes/sidewalks?

  • Thunder Bay - GIS maps of injuries/fatalities to ID problem areas (they then took councillors and stakeholders on a tour of these locations) – raise awareness among decision makers to make those places safer

  • Hamilton Walking Strategy - looks at crash data as well

  • Port Hope - looked at problem street crossings

  • Most Transportation Dep'ts are aware of where crashes are occurring and could contact them for info or ask if this data is being collected

Participant shared:

  • The Saskatoon Health Region did a report on unintentional injuries and looked at emergency room and discharge data. Transportation injuries were included and we have shared this with the municipality (they were interested as it accessed data sources that they normally do not refer to/have access to). We use the data and the recommendations from the Chief Medical Health Officer to guide our advocacy and work with the community. This is the link to the infographics and one-page summaries: http://www.communityview.ca/infographic_shr_injury.html

 

6) Do you know of any really great strategies/policies to encourage walking in small rural communities?

  • HKPR health unit - Communities in Action Haliburton (www.communitiesinaction.ca) – you can see the great work they have been doing for some examples.

  • Getting councillors to sign a Charter – so you know there is political support

  • Lots of interest in walking in rural areas but distances are quite long… not as likely to be utilitarian walking as recreational walking.

  • Great opportunities for trails on abandoned rail lines or adjacent to active rail lines, hydro corridors, river corridors, waterfronts.

  • Trails are a great strategy to connect settlement areas.

  • When there are no trails, then rural solutions along road ways like paved shoulders

  • Encourage purposeful trails that connect to practical destinations – Georgian Trail near Collingwood connects to everyday destinations like shopping – trail connects to backside of parking lot of Meaford grocery store. Makes it more part of active transportation network.

 Participant shared:

  • In Northern Ontario (Kapuskasing, Cochrane, Iroquois Falls) all have a walking map highlighting sidewalk routes which are distributed to various locations.

7) In rural communities transportation is often split between two tiers of government (Upper and Lower Tiers), with sidewalks and trails falling to the Lower government (at least this is the way it is in Peterborough County). Do you know of any upper tier ATMPs that include supportive policies/strategies for walkability?

  • Then you get down to details of how to separate the cyclists from pedestrians, which are usually covered in the master plan as well.

  • A lot of work going on in schools – unfolding at regional and municipal level

Participants shared:


8) Can anyone recommend any tools/checklists that planners can integrate into their planning process/application reviews in order to support health outcomes in approvals?

  • Peel Region - Healthy Development Index: http://www.peelregion.ca/health/urban/pdf/HDI-report.pdf

  • Checklists can be challenging to incorporate into the intricacies/nuances of planner's work

    • We can say we have a facility for cycling for example (and check the box), but it needs to be matched to the context – so if it’s a busy road way, you need a separated cycling facility and not just a bike lane.

  • City of Toronto has developed some tools as well. Example the Active City Reports

  • Most municipalities have a sustainable development or urban design checklist that incorporates sustainability – looking for things like bicycle parking, street trees, open space… (all tailored towards individual municipality)

  • This site provides a number of checklists: http://wcel.org/checklists

Particpants shared:

 

9) With respect to public spaces, aside from the requirements in the PPS, is there any research that shows how much park/green space you need in a built area (i.e., subdivision) so that this space contributes to increased physical activity and health?


10) Please share information on community health promotion initiatives that incorporate elements of Built Environment into their programming, e.g. walking groups, ‘yoga in the park’, etc., and incorporate advocacy for healthier Built Environments as part of their community development efforts.

  • Advocacy: many health units are promoting multi-stakeholder engagement processes and focusing on relationship-building and collaboration between sectors/dep'ts and in the community (health, planning, etc.) (E.g. planning, transportation, economic development, health).

  • Most departments are looking for improvements on the built environment – this is consistent with health objectives – less car dependence, compete streets, etc.

  • Niagara Region Health Unit is promoting/supporting AT committees in each municipality

  • Ultimate objective – form a Committee of council – made up of local representatives (counsellor, technical advisory people on staff, volunteers from community) – will advocate for AT-supportive planning and design

  • Policy work on a broader level – OPHA has done great work there

 

11)I am on an Accommodation Review Committee, that is going to make recommendations to the school board regarding the transition from an elementary school and high school and combining the two schools. I would very much look to gain input an insight in to some of the ways that the built environment, inside and out can help to improve health for the school and the community. One of the daycares in my community has recently done a lot of work to take out play equipment, and go with more natural setting with wood and trees. I look forward to any suggestions that you might have in to providing input in to creating a new school play yard and indoor school space.

  • Dufferin Grove - was slated to come up with a new play equipment but they looked at adding more natural alternatives (sand pit, water hoses, gardens, etc)

  • If amalgamation of schools – one thing to consider is there might be a loss of green space

  • In terms of school siting, there are advantages to siting it where most people live (rather than outskirts of town) and enabling shorter walking distances and limiting bussing needs

  • Hamilton has done some work on school siting to support AT

  • Regarding inside the school – healthy food, standing up desks, etc.

  • Naturalizing playgrounds are popular – Look at Evergreen Canada - Learning Grounds Program– they have funding and resources available on school yard greening: https://www.evergreen.ca/

  • Richard Louv's book “Last Child in the Woods” – talks about nature deficit disorder and importance of access to nature and play

 12) Have you or any others done work regarding improving health equity in/through the built environment? If so, any lessons to share?

  • People with low income rely more on active transportation and transit – ensuring these are located in close proximity to where people need it

  • Recreation fees

  • Access to food

  • Proximity to noise, unsafe areas, pollution, etc. – where you live affects your health. Some people are living with more health stressors because that is where affordable housing is – these are some things to consider.

 

Additional Resources

Paul Young’s resource listing to promote active transportation: http://www.hclinkontario.ca/images/2017/Resources_for_promoting_active_transportation_Paul_Young_2017.pdf

HC Link resource page on the Built Environment: http://www.hclinkontario.ca/resources/resources/built-environment.html

HC Link’s Digest PLUS on Community Transportation: http://www.hclinkontario.ca/images/2017/HCLinkNewsDigestPLUS1FEB2017_CommunityTransportation.pdf

 

 

 

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Tried and True Tools for Collaborative Work

By Pam Kinzie, HC Link Consultant

Those of us who have worked in partnerships, coalitions and other forms of community collaboratives, have seen many frameworks for collaborative work come and go over the years. Sometimes, I believe that the baby does truly get “thrown out with the bathwater” when excellent tools are abandoned for the next new thing. I suggest that we examine ways in which well-founded, widely used, evidence-based tools can be integrated into collaborative work. I’d like to make a case for one such tool - Results-based Accountability (RBA). No doubt many of you have other tools that have components for planning and implementation that you still find useful after many years.

hands 565602 1280Currently there is widespread use of the Collective Impact framework in Ontario amongst community groups. Developed by John Kania and Mark Kramer in 2011, it requires the commitment of a group of important actors from different sectors to a common agenda for solving a specific complex social problem. Issues suited to collective impact are those that are not easy to resolve, have persisted over time, and cannot be solved in isolation.

The Ontario Trillium Foundation offers grants to support collective impact through strategy and transformative action to achieve a lasting change. It funds projects in three phases in order to assist collaboratives in defining, organizing and delivering impact initiatives.

The idea of working together to produce community “impact” is at the heart of both RBA and Collective Impact. Collective Impact literature sets out conditions for the success of community change efforts, and RBA provides specific methods to help partners meet those conditions. RBA is being used widely in North America, including by some groups in Ontario, and in more than a dozen countries around the world to create measurable change in people’s lives, communities and organizations. For complete information about RBA and how to use it I encourage you to read the book Trying Hard is Not Good Enough by Mark Friedman.

In her 2011 paper Achieving “Collective Impact” with Results-based Accountability Deitre Epps examines how application of the core RBA components enables community groups to operationalize each of the five collective impact conditions. She examines the seven population accountability questions in RBA that guide community partnerships and coalitions in their work to improve the quality of life conditions for children and families and draws parallels with how they can be used as practical tools to create common agendas, shared measurement systems, mutually reinforcing activities and continuous communication amongst partners. Mark Friedman the creator of RBA also demonstrates how RBA and Collective Impact fit together in his online article from 2014.

The strength of RBA is that it starts with ends and works backward, towards means. The “end”, “result” or difference you are trying to make looks slightly different if you are working on a broad community level or are focusing on your specific program or organization, but the two perspectives are always aligned. RBA makes the critical distinction between population and performance-level initiatives. It is what separates RBA from all other frameworks. It is a significant distinction because it determines who is responsible for what. Population accountability organizes work with co-equal partners to promote community well-being. In contrast, Performance Accountability organizes work to have the greatest impact on the customers of specific agencies – those whose lives are touched in the delivery of programs and services. What is done for customers is the contribution to the larger community impact.

Dan Duncan describes how RBA and a number of additional tools are important components of collective impact in his 2016 article The Effective Components of Collective Impact . He also describes the importance of community engagement and relationship-building, stressing that “organizations do not collaborate; people collaborate, based on common purpose and trust”. This article reinforced how many tools there are that can be employed to enhance collective impact work.

HC Link can support you to use RBA and other tools for collaborative work through workshops, webinars and customized consultations. Materials from previous workshops and webinars can be found in the “Resources” section of our website. For more information about how we can assist you in your collaborative initiatives please go to www.hclinkontario.ca or give us a call at 1-855-847-1575.

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Changing our Destiny: A Regional Gathering in Timiskaming

Every two years (alternating with our provincial conference), HC Link partners with local communities to design and deliver Regional Gatherings. This year, my colleague Stephanie Massot and I were lucky to work with a dynamic team in Timiskaming to hold a regional gathering there on January 11. The event was a partnership between HC Link, the District of Timiskaming Social Services Administration Board and the City of Temiskaming Shores.

We formed a planning committee in the spring/summer of 2016, and over several months our event took shape. Planning Committee members included Dani Grenier-Ducharme, Tiffany Stowe and Melissa Boivin (District of Timiskaming Social Services Administration Board) Dan Lavigne (Timiskaming First Nation), Tina Sartoretto (Town of Cobalt), Sylvain Guilbeault (Timiskaming Child Care), Stephanie Masson and I (HC Link). We selected the title “Changing our Destiny: Building a vision for all our communities” to represent the desire to make decisions that affect Timiskaming in Timiskaming. It is a vibrant region, with industry, tourism, a great deal of natural beauty, and--in January--a great deal of snow!

The focus of the event was to create a space for conversation about working together collaboratively to form community hubs in Timiskaming. Despite Mother Nature’s best efforts to dissuade attendance with a snowstorm, 78 people (including planning committee members) attended the gathering! Unfortunately due to cancellation of school buses, the youth that committee members had worked so hard to engage were not able to attend. We had representation from a wide variety of sectors, with a total of 15 different sectors represented. It would be impossible for me to pick just one highlight of the day, as each part of the day was a highlight for me! Instead, I’ll summarize the day for those of you who weren’t able to be there.

art

High school art work from the Indigenous art class, graciously lent to us for the day

We began the day with a traditional smudge and pipe ceremony, drumming and song. Elder Philip Snr Gliddy  told us that these ceremonies show respect and help us start our gathering in a Good Way. Mayors Tina Sarteretto (one of our planning committee members) and Carman Kidd gave opening remarks and Dani Grenier-Ducharme, Children's Services Manager with the District of Timiskaming Social Services Administration Board, was our fearless Master of Ceremonies for the day.

charles

Charles Cirtwell from the Northern Policy Institute gave a keynote address and spoke about how the North already does community hubs: people in the North have worked together in this way for hundreds of years.  Dr. Cirtwell advised us to have:

  • Flexible thinking: to not constrain the who, how and where of community hubs

  • Flexible funding: funding should promote collaboration, be used for transportation and technology, and as an incentive

  • Flexible doing: blend organizational objectives, knowledge and assets. The goal is for everyone to see that their mandate is being achieved, even if someone else is doing some or even all of the service delivery

Following Dr Cirtwell’s presentation, Stephanie Massot gave a short presentation on partnership and working collaboratively. Melissa Boivin, one of our planning committee members, then led the group in a “Merry-Go Round” exercise to give participants the chance to talk with each other about the ways they currently work together, the challenges and benefits they receive from their work.

I then led a panel discussion to find out how the community hub model is working in four different communities.

Carol McBride is the Director of Health and Social Services at Notre Dame du Nord, Temiskaming First Nation Health Centre. The centre has experienced significant growth from its beginnings in the 90s with 4 employees to its current staff complement of 35. Previously, the centre worked in silos, where people who accessed services did get help but not as much as they needed. When Carol learned about the community hub model, the centre transformed using the Medicine Wheel as its model, with the individual in the middle of the wheel and the Centre providing emotional, physical, mental and spiritual support.

Scirish Panipak is the Vice-President of the Friendship Centre in Parry Sound. That organization will be opening a “bricks and mortar” community hub, focused on community housing, in June. The organization was able to purchase a school to use for non-profit housing, and a priority for them was to keep the gymnasium to use for the community as well as clients and residents. They began to look for community partners to move into the space, and currently have more than they can hold!

Laura Urso from the Best Start Network in Sudbury shared her experiences in this long-standing network of service providers. The network began with agencies that provide like-services, and now they are programming and delivering services together. One of the keys to the success the network has experienced is the designation of a staff-person who is responsible for bringing--and keeping--stakeholders together.

Brent Cicchini is an officer with the Ontario Provincial Police (incidentally, the first time I’ve had a panelist who wore a bullet-proof vest) who has been working with a variety of community partners to address the needs of high-risk youth, with the aim of supporting them before they come into contact with the justice system. There is a good network of services and stakeholders, though meeting can be viewed as being redundant. Brent spoke about the idea of connecting with existing networks/tables, rather than constantly inventing new groups of the same people to talk about different things.

After lunch, Karen Pitre, Special Advisory to the Premier on Community Hubs, joined us via remote technology. Community hubs, explained Karen, are a service delivery model that brings together service providers to offer a range of services that respond to demonstrated community needs and priorities. As our four panelists demonstrated, there is no one formula for a community hub: they can be a bricks and mortar building, a “virtual” hub or a group of service providers working together. There could be as many variations of what a community hub as there are communities in Ontario. One of the key components of a community hub is that they are cross-sectoral, bringing together education and training, health care, children and youth, sport and recreation, social services and a variety of other community partners together.

communityhub

Following Karen’s presentation, participants formed small groups in a Conversation Café designed to help the group discuss how they can work together, in partnership, to support community wellbeing in Timiskaming. The group had a robust discussion, with a group who discussed Indigenous health committing to meet monthly after the gathering to continue their conversation!

It would take me at least another two pages to talk fully about the incredible experience that Stephanie and I had in Timiskaming and the wonderful things about the Regional Gathering itself. We had such a rich experience in working with our planning committee members, our event partners, and our event sponsors Northern College and Presidents Suites. Aside from the experience of being in the north and being at the event itself, another highlight was the excursion to Dani’s farm, where Stephanie rode a horse and I collected eggs. The beauty of the scenery, the warmth of the people, and their dedication to working together will be in my memory for a long time.

You can access the slide decks, videos from the presentations and panel, and more at http://www.hclinkontario.ca/events/regional-gatherings.html/#Timiskaming

chicken

andreasteph

stephhorse

 

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HC Link's 2016 Top Resource Round-up

top2016

Happy New Year! We are looking forward to another exciting year of working together to create healthy communities across Ontario. In case you missed them the first time around, here is a collection of a few of our most popular resources, webinar recordings and blog posts from 2016.

 
popularresources2016
 

Here are a few of our most popular resources of 2016:

 
popularwebinars2016


Here are a few of our most popular webinars of 2016:

 
popularblogs2016
 

Here are a few of our most popular blogs of 2016:

AND our most popular guest blog was by the Ontario Society of Nutrition Professionals in Public Health (OSNPPH):

continue

We look forward to another great year of working together and continuing to offer our customized consulting services, resources, webinars, workshops, and other learning events! Please contact us to learn more about how we can work with you and your community to meet your specific needs for building healthy communities!

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What does the Task Force’s recommended minimum age of purchasing cannabis at 18 mean for health promoters?

By Kyley Alderson, HC Link

cannabis2imageLast week, HC Link co-hosted a webinar with the Canadian Centre on Substance Abuse (CCSA) and Parent Action on Drugs (PAD) – Canadian Youth Perceptions on Cannabis: Implications for practice and policy. This webinar was part of a two-part webinar series that covered the methods, findings and implications of CCSA’s recent qualitative research study, Canadian Youth Perceptions on Cannabis. In this second webinar, presenters discussed implications of the research on prevention practice and policy, and featured a panel discussion of youth prevention practitioners – Patricia Scott-Jeoffroy, an Education Consultant with PAD and Cathy Maser, a Nurse Practitioner in the Division of Adolescent Medicine at Sick Kids.

frameworkimageHours before our webinar, the Task Force on Cannabis Legalization and Regulation released their highly anticipated report – A Framework for the Legalization and Regulation of Cannabis in Canada.

One participant asked the presenters what their thoughts were on the Task Force’s recommendation to set a national minimum age of purchase of cannabis at 18. With limited time to have even read the report, Cathy Maser provided an explanation from the report and opinion that many participants found very helpful. So, for those who have not had a chance to go into the detail of the report, but are curious about this recommendation that has gained a lot of attention – I thought I would share.

Here is a brief summary of what Cathy shared with our participants, and what is stated in the report:

While many health professionals and those in public health are concerned about how the brain is still developing until around age 25, most of those consulted felt that this age was too high to set as the minimum, as many of the issues that legalization is trying to address – such as the illicit market and criminalization, would still persist. Youth who are in the 18-24 age range are in fact the highest users of cannabis, so setting the minimum age at 25 might further criminalize youth. While age 21 was suggested by many, age 18 was decided on because it is the age of majority and provinces and territories can raise the minimum age to align it with the minimum age to purchase alcohol – which from a societal context, seems to make sense. As stressed by Cathy, a key point in this recommendation is the need to align this policy with education, prevention and treatment – with emphasis on robust preventative measures to discourage and delay cannabis use to mitigate the harms between the ages of 18-25, a critical period of brain development.

This is where many of us as health promoters can focus our attention. Given the results from CCSA’s report, and this recommendation from the Task Force, some considerations for minimizing harms to youth include:

• Providing youth with factual, accessible, and non-bias information – talking about potential benefits and real risks/harms (possibly even low-risk cannabis use guidelines)

• Focussing on tangible harms (and those they would experience in the short term versus long term) so that these harms resonate with youth

• Providing health professionals, peer mentors, parents, and others who youth believe are credible sources of information, with the right information/tools/resources to provide the information to youth

• Developing youth critical thinking/decision-making skills, so they are better equipped to make their own decisions

• Building youth resiliency through programs, support, and positive relationships so that they are more capable of avoiding/minimizing harms of cannabis use

• Clear, and consistent messaging across the board – including messaging and information around medical marijuana – as this causes youth to perceive cannabis as less harmful and also leads youth to self-diagnose and self-medicate.

While many of the ways that health promoters can help to minimize the harms to youth listed above are focused around education and skill building, we must not forget about the many other factors at play – the social determinants of health – that cause some youth to disproportionately experience more harms associated with drug use. Factors like poverty, education, social exclusion, etc., all come into play, as they do with almost any other health issue, and cannot be left out of the picture.

 

Link to the Task Force report: http://healthycanadians.gc.ca/task-force-marijuana-groupe-etude/index-eng.php

Link to the webinar recording and slides: http://www.hclinkontario.ca/events/webinars1.html/#YouthPerceptionsonCannabis2 

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