Blog

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!

To view past blogs, please click on the home icon below left.

Online Learning for All

With school now fully in session, I can't help but envy those bright minds sitting in lecture halls. Although I don't envy the essays and exams - or student loans - that punctuate all institutionalized educational endeavours. Free online courses are now offered by some of the world's most esteemed universities. Most classes can be completed on your own schedule, at your own pace. However, courses cannot be counted as class credits, and no certification is offered.

PhotobyPaulGoyette

 

Individual Course Offerings:

Learning Modules

Guest Lectures

  • Want a five (or twenty-five) minute cerebral boost? Try a TED talk!

What's your experience with learning online – have any recommendations? Did I miss a class? Leave a comment and share with us!

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Community Engagement Webinar Series

CEWSHC Link is hosting a series of four webinars on community engagement. The webinars are organized around the following themes:

Part 1: From Informing to Empowering: An Introduction to Community Engagement (October 18, 2012)

Part 2: Engaging Rural Communities (November 13, 2012)

Part 3: Engaging Communities in Policy Change (January 10, 2013)

Part 4: Engaging Marginalized Communities (February 27, 2013)

Each webinar will feature two or more presenters with a wide range of hands-on community engagement experience, and will cover a mix of theory, best practices, strategies, tools and success stories from across Ontario.

The webinars may be taken individually or as a series. Individuals who participate in three or more webinars and who submit their evaluation forms will receive a Certificate of Completion from HC Link. Certificate information will be released following the first webinar.

Registration is now open for all webinars.

 

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HIA Part 3: What's in a name?



This is the third and final in a series of blog posts recapping the 12th International Health Impact Assessment Conference, which I attended in Quebec City in August. Part 1 was an introduction to Health Impact Assessment (HIA), Part 2 discussed the benefits to conducting HIA, and in Part 3 I'll talk about the myriad of different types of assessment - and what is (and isn't) in a name.


EIS2There are many, many types of impact assessments. A 2004 literature review identified 142 different types: environmental, health, health equity, collective... and the list goes on (and on). As I talked about in Part 2, one reason to conduct an HIA is that it provides a framework to access the impacts on non-health policies or programs on health - which means that you can 'sneak' health onto the agenda even if there is little political will around health issues.


But is HIA the only – or best- way to go? In some cases, the decision about which types of assessment to conduct may come down to expertise or personal preference. The decision could also be determined by legislation or policy, or a level of government could make a conscious decision about which type of assessment to promote. For example, in Ontario, the Ministry of Health and Long Term Care (MOHLTC) has developed a Health Equity Impact Assessment (HEIA) tool. HEIA is a way to identify unintended impacts, support equity-based improvements, embed equity and raise awareness of the importance of health equity. As April McInness from the MOHLTC said in her presentation, health equity matters because poor living is a result of poor environments which are a result of poor policies. For example, in the City of Hamilton, Ontario, there is a 20 year variation in life expectancy between neighbourhoods. HEIA provides a way to identify potential harms and ensure that the proposed program or policy will be effective.


It is a confusing world of impact assessment out there - but as Isabelle Goupil-Sermany said in her presentation, "If you hear of any (type of) assessment happening, this is your opportunity to get health in. (These assessments) are the same language with different words".


In desperately trying to sum up HIA in general, and the incredible conference in particular, I find I'm still struggling, nearly two weeks later, to process everything. A few things are clear to me and so here are my final (for now?) thoughts on HIA:

 

  • HIA has the potential to bring collaborators together, to engage the community, and get health on the agenda of non-health folks. In this way, HIA may be a different "basket" or package of skills and techniques many of us in health promotion/public health already use: the aforementioned collaboration and community engagement, also research, analysis, contingency planning and advocacy.
  • There are a myriad of types of impact assessments out there. Be clear about why you want to conduct an impact assessment: that may help you to choose which type and framework to use.
  • If you're thinking about conducting an HIA or HEIA (or any other type of assessment) – stop thinking and get out there and do it! Look for others to experiment with you, track everything that you do, and learn as you go. There are lots of fantastic resources and experts out there (I have found a LinkedIn group for HIA) that you can tap in to.

Thanks for going on this 3 part HIA journey with me. I'd love to hear your comments, thoughts, experiences and ideas on HIA or other types of impact assessments. Let's learn together!

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HIA Part 2: Why should I do HIA? What’s in it for health?

This blog post is part of a series on the 12th International Health Impact Assessment conference which I attended in August in Quebec City. In Part 1 I gave an overview on HIA in case you – like me - are new to HIA (Health Impact Assessment). In this post, I'll try to answer the question "What's in it for me?" (with the 'it' being conducting an HIA) by exploring the themes that emerged over the course of the 7 plenary sessions/ keynote presentations and 6 concurrent sessions that I attended. These three themes, which really speak to the outcomes and benefits of conducting an HIA, are:
• Collaboration and expanded social networks
• Community engagement/participation
• Address health through non-health policies/programs


HIA provides opportunities for collaboration with sectors/organizations/people that may not have worked together previously. The process of conducting an HIA can build mutually respectful relationship and establish common language. While many of us work with partners in various sectors, HIA can take intersectoral collaboration to concrete action. HIA can be a way to build social networks by establishing new relationship and collaborations amongst people whose work addresses similar issues, but have not worked together (or even spoken to each before). For example, Rajiv Bhatia from the San Francisco Department of Public Health shared that in his city, the planning and education sectors did not have a working relationship until an HIA was conducted. The HIA brought the two sectors together and through the project, they established a relationship that carried on after the HIA was completed into future projects and planning.


HIA provides opportunities for community engagement and participation and gives communities a voice in matters that deeply affect them. In Thailand, conducting an HIA on "potentially harmful projects" is required by the Constitution and the National Health Act guarantees the right of citizens to participate in the process. In this way, HIA is a tool that gives people power- and a voice- in policy making. In Oakland California, the Change Lab conducted an HIA received a community participation grant to conduct an HIA regarding the placement of a transit.


As I talked about in my first blog post, HIA provides a framework to address health though non-health policies/programs. This gives the health sector an opportunity to influence strategies, policies and programs that affect health but are directed by other sectors. A note of caution here: that there is often seen to be a push-pull relationship between health and other sectors whereby health "pulls" other sectors into "our" territory and "pushes" those sectors to do work which they may see as the work of the health sectors. This can often evolve into a tug-of-war between health and other sectors. Danny Broderick, from South Australia, advised us to "drop the rope" and instead of attempting to pull sectors into our territory, move into the territory of the other sectors. This theme was echoed and referred to throughout the conference.


A final reason to conduct an HIA is this: it works. In New Zealand, nearly 50 HIAs have been conducted on a variety of strategies and policies. 17 were evaluated and 24 were included in a meta-analysis which showed that HIA does work. The majority of the recommendations made in the HIAs were accepted by the local council/government: this is the dream of those of us who work in policy development! When asked "What does HIA achieve?" Robert Quigley, who has worked in HIA in New Zealand, the UK and Australia, answered that HIA:
• informs and changes the proposal
• alters the proposal development process
• informs and changes the work of other sectors
• develops knowledge and skills of HIA and the social determinants of health
• develops technical, methodological, consultative, partnership development and community engagement skills of those conducting and involved in the HIA


As Francois Benoit, from the National Collaborating Centre for Healthy Public Policy noted, HIA is a WIN WIN WIN: a win for public health, for policy makers and for the community.


I'll wrap up this blog post by quote Robert Quigley again: you don't have to be an expert at HIA at the start. You'll build capacity along the way. Just get out and do one!


Stay tuned for the last blog post in this series: HIA Part 3: What's in a name?

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HIA Part 1: What is Health Impact Assessment?

 

Last week, I attended the 12th International Conference on Health Impact Assessment in Quebec City. The conference's theme was "How Health Impact Assessment matters in Health in all Policies" and it attracted 365 participants from 42 countries!


It's impossible to condense learning from a two and a half day conference into one blog post - so I'll be writing a three part series for the HC Link Blog. In this first post, I'll talk a little bit about what Health Impact Assessment (HIA) is. The second post will attempt to summarize some of the conference themes, how HIA can be applied in health promotion and what the benefits to conducting an HIA are. In the third and final blog post, I'll talk about Ontario's approach to HIA.

EIS

 

I am quite new to HIA. In fact, my pre-conference reading and then the conference itself were my first exposure to it. I think a good way to explain what HIA and what it's used for is to compare it to a more well-known type of assessment- environmental impact assessment. These are conducted for proposed projects – such as the Northern Gateway Pipeline project in Alberta, to determine what the effects of the project on the environment would be. In a similar fashion, Health Impact Assessments aim to predict the potential positive and negative effects of policies and programs on health, wellbeing and health inequalities.


HIA recognizes that the health of individuals and communities is largely determined by decisions made in other sectors; for example an oil/gas pipeline project may – or may not- have effects on health, but the health sector may not be involved in the decision-making process. HIA provides a framework to assess non-health policies or programs on health and helps decision-makers make choices about alternatives and improvements to prevent disease/injury and to actively promote health.


The World Health Organization's HIA is a four step framework. The screening phase determines whether or not the HIA should be conducted. In order to determine this, question if the policy will affect/address any of the 12 social determinants of health as well as any particular priority groups (such as Aboriginals, new Canadians, the homeless etc). In the scoping phase, decisions are made about how to conduct the HIA and who will do it. It's very important here to define the parameters for the HIA, as generally speaking, resources and time are limited! In the appraisal phase, health hazards are identified and impact evidence is considered. HIAs can incorporate a wide variety of data sources, from statistics and health data to findings from the literature to focus groups, community meetings and individual interviews with groups who will be impacted by the policy or program. In the final reporting phase, recommendations to reduce hazards and/or improve health are made. The Centers for Diseases Control and Prevention add two additional steps for reporting to decision-makers, and monitoring and evaluating the effect of HIA on the decision.


HIA, whether for a policy (such as land-use planning in a municipality) or a program (such as a Good Food Box program), is best done early in the development stages. In the policy development process, HIA can be a part of steps 1 to 3 in the Roadmap for Policy Development. In program planning, conducting as HIA can be done as part of step 2 (situational assessment). HIA can also be a powerful tool for community participation and engagement (more on this in part 2).


Please stay tuned for HIA Part 2: Why should I do HIA? What's in it for health?


Resources/References

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Ontario's Youth Action Plan: Considering mental health promotion in violence prevention

Last week, the Ministry of Children and Youth Services in partnership with the Ministry of Community, Safety and Correctional Services, released Ontario's Youth Action Plan. This Action Plan is the result of the Government of Ontario's 30-day consultation with youth, their families, elected officials, community leaders, and other relevant stakeholders to identify strategies to address youth violence.

The Youth Action Plan puts forth 14 immediate actions and 6 longer term goals to invest in youth. Many of the recommendations within the Action Plan were first identified in the 2008 Review of the Roots of Youth Violence. In this earlier report, specific determinants, including poverty, racism, community design, family issues, a lack of a youth voice, a lack of economic opportunity for youth, and issues in the education and justice systems, were named as some sources of youth violence.

As the Action Plan notes, since the time of the Roots of Youth Violence report, there are still significant improvements to be made in order to address poverty, child and youth mental health, youth engagement, and youth employment as factors affecting youth violence. In response, the report lists several recommendations for providing opportunities to youth. These recommendations align with a mental health promotion approach as they address the three key social and economic determinants of mental health: access to economic resources, freedom from violence and discrimination and social inclusion1. Furthermore, several seek to enhance protective factors, reduce risk factors and build resiliency among youth. Risk factors, such as biological or psychosocial variables, can increase the likelihood of poor mental health or the development of mental health disorders from exposure to extreme adversity or stress. In contrast, protective factors, such as personality and coping skills, promote optimal mental health and can even decrease the likelihood of mental ill-health2. Balancing risk and protective factors is a way to increase resilience which the ability of an individual, community or group to cope with "significant adversity or stress"3.

Highlights of the recommendations within the Action Plan that aim to build resiliency among young people are summarized below and include:

• Early intervention efforts to expand early years support for parents and children by adding an additional 17 sites to the Province's Parenting and Family Literacy centres.
• Greater opportunities for youth through positive alternatives and jobs by expanding after-school and summer employment opportunities.
• Supportive, safer communities by launching a youth fund to support community-based initiatives and increasing the number of outreach workers in communities.
• Youth and community engagement efforts, such as an Action Committee on Youth Opportunities to engage those who work with youth and youth themselves.

In addition to identifying the recommendations above, the Youth Action Plan also makes a case for the implementation of strategies that have evidence of being successful. Recently, the CAMH Resource Centre conducted a scan of such effective and promising practices across Canada and Ontario to learn more about the common elements of successful youth mental health promotion programming. If you have an interest in learning about the results of this scan, please stay tuned to the HC Link as we will be sharing the findings via a webinar this Fall. Ultimately, as efforts continue to build resiliency among young people in Ontario it will be important to maintain a focus on identifying and sharing effective and promising practices in youth mental health promotion so as to achieve the strongest positive impact.

 

 [1] Keleher, H & Armstrong, R. 2005. Evidence-based metnal health promotion resource, Report for the Department of Human Services and VicHealth, Melbourne.

[2] Centre for Addiction and Mental Health. Best practice guidelines for mental health promotion programs: Children and youth. Theory, definitions, and context for mental health promotion. Accessed on Aug. 29 2012 from http://knowledgex.camh.net/policy_health/mhpromotion/mhp_childyouth/Pages/default.aspx

[3] Health Canada, 2000. Risk, vulnerability, resilience: Health system implication. Ottawa: Supply and Services Canada, cited in Centre for Addiction and Mental Health.  Best practice guidelines for mental health promotion programs: Children and Youth Available from: http://knowledgex.camh.net/policy_health/mhpromotion/mhp_childyouth/Pages/references.aspxAccessed on: August 30, 2012.

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New Resource from HC Link: Are We Ready to Address Policy? Assessing and building readiness for policy work


Many of us working in health promotion and healthy communities are working to build healthy policies. The focus of this resource is on assessing the readiness of your community for the policy work that you're embarking on. Building on her popular workshop at last fall's HC Link Conference, Nancy Dubois has written this inDepth article to explore step 2 of THCU's (now housed at Public Health Ontario) Roadmap for Policy Development.

Stages


According to the Roadmap, the first step in the policy development process is to clearly define the problem or issue that your policy will address as well as to explore possible policy options. In step two, it's time to examine the readiness of your organization, your partners, and your community for the policy that you're proposing. In this resource, Nancy explores The Community Readiness Model as a way to identify to level of readiness of your community.

Once you to have a sense of the level of readiness of your community, you will be able to determine what your next steps will be in order to successfully move the policy forward. For example, if you determine that your community isn't ready to take action on the problem/issue, appropriate next steps may be to conduct an awareness or education campaign or to work with the media or social media to inform your community and begin to shift attitudes and beliefs.

This new resource is full of helpful information about how to move forward with this stage of policy development, as well as numerous resources. Nancy will also be giving a webinar on this topic on Tuesday September 18th in the afternoon. Hope to see you there!

 

Download the resource in English or French.

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Announcing HC Link’s 12/13 Webinar Series

We have a very exciting line up of webinars planned for this year on a wide range of topics, from social media to community engagement to youth substance use. We're pleased to be working with several partners, such as the Centre for Addiction and Mental Health (CAMH) and the Physical Activity Resource Centre (PARC) and Parks and Recreation Ontario (PRO).

This year we have two new things to announce: we are offering series of webinars in several topic areas – community engagement; youth substance use and related issues*; and social media and health promotion** (in French and English). Participants are encouraged to attend as many webinars in the series as they can as the content and material will build throughout the series. Participants who attend all of the webinars in the community engagement series will receive a certificate of completion.

We will also be offering several Peer Sharing Sessions this year. This is a format that we developed a couple of years ago for the Healthy Communities Partnerships and we're pleased to be able to offer this format to a broader audience. The purpose of a peer sharing session (as you may gather from the title) is to give participants a chance to learn from one another, as well as to ask questions or even ask for trouble-shooting advice. Peer sharing sessions will be offered via Adobe Connect (the same platform we use for webinars).

Here are the webinars that will be coming up in September and October:

  • September 18th: Assessing Community Readiness for Policy Development, with Nancy Dubois
  • October 9th: Session de Partage – Les médias sociaux et la francophonie (Peer sharing session- social media and Francophones), Melissa Potvin et Ronald Dieleman (**Series)
  • October 16th: Emerging Issues in Youth Substance Use - Distinguishing Evidence and Hype, with Patricia Scott and Diane Bhuler (*Series)

Stay tuned for more news about our webinar series for October and November!

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New Resource: Tools for supporting local action to reduce alcohol-related harms – Policy options and a resource inventory to support alcohol policy in Ontario

Submitted by Tamar Meyer, CAMH Resource Centre and Ben Rempel, Public Health Ontario

Screen Shot 2012-08-01 at 4.48.51 PM

Research evidence indicates that alcohol policies are effective measures in minimizing harms related to alcohol and can occur on both a large-scale (e.g. national/provincial policy) and a small-scale (e.g. municipal/community-based policy1) . Alcohol-related harms can often be seen at the local level - disorderly behaviour, public drunkenness, under-aged drinking, violence, addiction, criminal activity, and injuries. These harms directly affect our communities as they involve our neighbourhoods and roads, our sense of safety and wellbeing, our children, families and friends. Local problems are addressed by developing specific solutions to local alcohol issues and are best done in alignment with provincial and national alcohol policy initiatives.

Public Health Ontario and the Centre for Addiction and Mental Health (CAMH) Resource Centre have partnered on the development of a resource aimed at increasing awareness of and access to evidence-informed tools and resources regarding local/regional alcohol policy in Ontario. This resource also aligns with recommendations stemming from the Alcohol No Ordinary Commodity forum, specifically that: "Work can be done locally to build momentum towards an alcohol strategy: Initiatives include developing regional alcohol management strategies, creating and/or updating municipal alcohol policies, pressing for strong regulatory controls on alcohol, actively supporting alcohol-related health resolutions, and implementing proven interventions ..."2

Tools for supporting local action to reduce alcohol-related harms: Policy options and a resource inventory to support alcohol policy in Ontario consists of two tools which are intended to assist Healthy Communities Partnerships and public health stakeholders in the prevention of alcohol-related harms in their communities through increasing awareness of and the development of healthy public alcohol policies.

This resource contains a Policy options table based on the seven policy approaches identified by Babor et al.3, and is broken down into two levels. The first level identifies the evidence-informed local policy strategies that have been adapted primarily from the Centre for Addictions Research of British Columbia resource, Helping Municipal Governments Reduce Alcohol-Related Harms4 and Alcohol: No Ordinary Commodity – Research and public policy, second edition5.

The second level identifies evidence-informed local actions that municipalities, communities and local stakeholders can take to reduce harms related to alcohol in their communities.

The second part of this resource is the Resource inventory which was developed as a companion to support the implementation of identified strategies and actions. Organized according to level of government involved in policy development, the inventory includes a summary of evidence-informed tools as well as examples of existing drug strategies, pertinent publications and other resources to help inform local stakeholders with the development and implementation of local alcohol policy.

We want to hear from you!

This first phase of the inventory is being launched as a working document and will continue to evolve over time. With your feedback, we will be able to ultimately offer a robust, evidence-informed compilation of tools and resources to support the development and implementation of local alcohol policies. In order to ensure that this resource is relevant at a local level, we welcome and invite your feedback regarding usability, gaps, success stories in developing and implementing local alcohol policy, along with additional tools and resources you are aware of. Specifically, we are interested in:

What other Ontario-specific policy-related tools or resources do you know of or have developed that can help communities/municipalities prevent or reduce harms related to alcohol?

What kinds of local alcohol policy activities and/or initiatives have you, your Public Health Unit, Healthy Communities Partnership, municipality/community been involved with?

To suggest a new tool or resource or for any questions or comments, please contact Tamar Meyer at This email address is being protected from spambots. You need JavaScript enabled to view it. or Ben Rempel at This email address is being protected from spambots. You need JavaScript enabled to view it..

 

___

1Centre for Addiction and Mental Health. (2004). "Alcohol Policy Framework for Reducing Alcohol-Related Problems" Centre for Addiction and Mental Health, Toronto.

2Rempel, B. July 20, 2012. Alcohol Policy in Ontario: The importance of on-going dialogue and discussions. Ontario Health Promotion E-Bulletin. 

3Babor, T., Caetano, R., Casswell, S., Edwards, G., Giesbrecht, N., Graham, K., et al. (2010). Alcohol: No Ordinary Commodity - Research and Public Policy. 2nd ed. Oxford: Oxford University Press.

4Centre for Addictions Research of BC (2010). Helping Municipal Governments Reduce Alcohol-Related Harms. Accessed March 16, 2012.

5Babor, T., Caetano, R., Casswell, S., Edwards, G., Giesbrecht, N., Graham, K., et al. (2010). Alcohol: No Ordinary Commodity - Research and Public Policy. 2nd ed. Oxford: Oxford University Press.

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Designing Cities for Health and Happiness

I recently attended Designing Cities for Health and Happiness, a public lecture hosted by 8-80 Cities in partnership with the John H. Daniels Faculty of Architecture, Landscape, and Design at the Design Exchange. The lecture provided an enlightening overview of the role urban planning plays in creating vibrant cities and healthy communities.

PhotoByMatthewBlakcettSpacingMagazine

Opening remarks by Gil Penalosa, Executive Director of 8-80 Cities, concluded that a great city must be good for everyone. The keynote presentation delivered by Helle Søholt, a founding partner of Gehl Architects, focused on the life between buildings. Much of urban planning does not account for the needs of daily life and that real people live, work and play in these spaces. But people will only do what is optional when space is inviting. People require stimulation and will only spend time in places that are social, cultural, recreational, healthy and fun. Ghel Architects have a history of changing behaviour through design. Søholt used examples from four quite different cities to illustrate this point:

Copenhagen, which shares many of the same geographic features of Toronto, was once a car-reliant society. Only a couple of decades later and two thirds of the population now use bicycles or public transport as the main mode of transport (with 70% of cyclists continuing to cycle in winter!)

Melbourne has considered the large population of students and residents with flexible lifestyles who use the city at all hours of the day. The introduction of steel furniture allows passersby to enjoy areas for longer periods of time. Abandoned alley and laneways were transformed to create new network of pathways and outdoor contemporary art galleries (complete with a few designated graffiti zones).

New York City, powered by Mayor Bloomberg's commitment to public health, has transformed Broadway and Times Square into pedestrian friendly boulevards.  Sidebar: the fifth annual Summer Streets occurs next month, opening up seven miles of city streets. Toronto's Celebrate Yonge is a similar, albeit much more minor initiative kicking off next month too.

Mexico City has introduced a bicycling strategy as an overwhelming 95% of all trips within the city are cyclable. Public spaces must be transformed to prioritize quality of life and inclusive accessible environments.

The lecture was followed by short presentations from a panel of local urban visionaries.  Monica Campbell (Director of Healthy Public Policy for Toronto Public Health) reiterated three points from the keynote: the need for evidence, the problem of inequity - citing many of the same issues favoured by Sir Michael Marmot - and how Toronto has led the example of the WHO's holistic Healthy City model. Associate Professor Robert Wright (Director of the Master of Landscape Architecture program at the University of Toronto's Daniels Faculty) gave an entertaining overview of the City of Toronto as a patient, with ailments approximating some of Toronto's biggest issues (including $200 billion deferred maintenance costs and impending loss of tree coverage). Shawn Micallef (writer for Spacing and Toronto Star) questioned "what about the suburbs?" and encouraged thinking about Toronto as a whole, whereas City Councillor Kristyn Wong-Tam (Ward 27) zeroed in on the history of Yonge Steet. Wong-Tam highlighed examples of retailers emphasizing heritage buildings amidst the bright lights and big billboards of Yonge and Dundas Square. Wong-Tam, who concieved Celebrate Yonge, closed the lecture by echoing the need for fair distribution of public space.

 

Additional Resurces:

HC Link Resources on the Built Environment

Active Design Guidelines: Promoting Physical Activity and Health in Design

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CAMH’s OSDUHS Mental Health and Well-Being Report released today!


2011

 

The CAMH Resource Centre is pleased to announce that the mental health and well-being findings of the 2011 OSDUHS have been released today! While the Ontario Student Drug Use and Health Survey (OSDUHS) originally started as a drug use survey, it is now a broader study of adolescent health and well-being and reveals important trends in mental and physical health and risk behaviours among Ontario students in grades 7-12. The Mental Health and Well Being Report is an important resource to inform planning, programming and policy development for public health and health promotion professionals in Ontario.  For more information on the OSDUHS, please visit the OSDUHS webpage on www.camh.ca.

Topics new to the 2011 OSDUHS Mental Health and Well-Being Report include asthma prevalence, seatbelt use, and cyber-bullying victimization but cover a wide range of mental health and well-being indicators including health care utilization, body image, bullying and cyber-bullying, internalizing indicators (emotional health problems such as symptoms of anxiety or depression), externalizing indicators (overt risk behaviours such as aggression, theft, gambling, drug use), bullying and anti-social behaviour, screen time, physical health and gambling.

Some key findings are outlined below:

 

Bullying remains a big concern, particularly for girls:

-  29% of students reported being bullied at school since September with the most prevalent form of bullying victimization being verbal

-  22% of students (approximately 217,500 students) reported being bullied over the internet over the past 12 months with females being twice as likely to be bullied than males (28% vs. 15%) 

Psychological distress and suicidal ideation:

-  34% of students indicated elevated psychological distress (symptoms of depression, anxiety or social dysfunction) with females (43%) reporting higher rates than males (24%)-  In regards to elevated psychological distress, the total sample (males and females) has remained stable since 1999.  However, females show a significant increase from 36% in 1999 to 43% in 2011

-  The most common distress symptoms experienced by students are the feeling of being constantly under stress (41%); losing sleep because of worrying (30%); feeling unhappy and depressed (27%)

-  6% of students report symptoms of anxiety or depression in the past few weeks with females (9%) reporting higher than males (3%)

-  1 in 10 students had serious thoughts of suicide in the past 12 months; 3% reported a suicide attempt in the past 12 months; with females more likely than males (14% vs. 7%) to contemplate suicide and attempt suicide (4% vs. 2%)

Too much sedentary time, not enough physical activity:

-  23% of students overall (37% of males) report playing video games daily and 12% of students show possible indicators of video gaming problems (symptoms of preoccupation, loss of control, withdrawal, and disruption to family and school)

-  1 in 10 students spend at least 7 hours per day in front of a television/computer

-  26% of Ontario students are classified as obese or overweight with males more likely to be overweight obese than females (30% vs. 21%)

-  Only 1 in 5 (21%) of all students met the recommended daily physical activity guideline (60 minutes of moderate to vigorous activity per day) during the last 7 days

Regional variations:

Toronto

-  Compared to the provincial average, students in Toronto are more likely to be worried about being threatened or harmed at school; to engage in no physical activity; and to report a high level of “screen time.”

-  Compared to the provincial average, students in Toronto are less likely to report being cyber-bullied or bullied while at school, and less likely to report an injury requiring medical care.

Northern Region

-  Compared to the provincial average, students in Northern Ontario are more likely to report an injury requiring medical care.

-  Compared to the provincial average, students in Northern Ontario are less likely to be physically inactive.

Eastern Region

-  Compared to the provincial average, students in Eastern Ontario are less likely to be physically inactive, to report a high level of screen time or to rate their physical health as poor.

Western Region

-  Compared to the provincial average, students in Western Ontario are more likely to report being cyber-bullied.

 

To access the full Mental Health and Well-Being report, please click here.

For more information on the 2011 OSDUHS drug use results, including how to access the report, please click here.

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Reflecting on Madiba

Today is Mandela Day, and Nelson Mandela's 94th birthday. With South Africa six hours ahead of Ontario, I woke up to a flood of emails, social media alerts and articles celebrating the life of Madiba, as he is affectionately known. But as the day wore on, I noticed international tributes circulating as well. As a South African, his effect on me is profound. But I often forget that his legacy is admired around the globe, as he is arguably one of the most influential people in the world. Amongst the wishes and reflections, one quote was shared more than the rest:

nelson-mandela-quotes

As a bibliophile and a quote fanatic, one of my most cherished gifts is Nelson Mandela By Himself: The Authorised Book of Quotations, bestowed upon me by my brother. Organized by theme, the entry on poverty is four pages long. It is not surprising that Mandela became Amnesty International's Ambassador of Conscience. In his acceptance speech, he says:

"Overcoming poverty is not a gesture of charity. It is an act of justice. It is the protection of fundamental human rights. Everyone everywhere has the right to live with dignity, free from fear and oppression, free from hunger and thirst, and free to express themselves and associate at will.
 
Yet in this new century millions of people remain imprisoned, enslaved and in chains. Massive poverty and inequality are terrible scourges of our times - times in which the world also boasts breathtaking advances in science, technology, industry and wealth accumulation. While poverty persists, there is no true freedom...
 
People living in poverty have the least access to power to shape policies - to shape their future. But they have the right to a voice. They must not be made to sit in silence as "development" happens around them, at their expense. True development is impossible without the participation of those concerned."
 

Today we reflect upon, and celebrate, a man who dedicated his life to equality. He made a difference in a once divided land. He left the prison gates as a friend of the prison wardens; he ventured into the new South Africa with no bitterness, as he said he had to leave that behind to be truly free. For a time, he made everyone know what it is to be united as one, to share a common destiny. He chose to focus on the future rather than the past, on reconciliation rather than retribution. There was a euphoric sense of community – South Africa celebrated as one! We need to be reminded of this as the South Africa, and the world, prepares for a time without Nelson Mandela. With so few giants of his stature bestriding the world stage, it is imperative that his values live on, even as his physical presence will inevitably fade away.

To learn more about the life of Madiba, visit the Centre of Memory.

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Brazil’s National School-based Drug Education Program

At the July 5 meeting of the Prevention Working Group of the Toronto Drug Strategy, Dr. Ines Gandolfo Concepcion, from the University of Brasilia, presented Curso de Prevenção do uso de Drogas, a national school-based drug education program.

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The program was created by the National Anti-Drug Secretariat, in conjunction with the Ministry of Education and the University of Brasilia, in line with Brazil's National Policy on Drugs and "Crack Can be Conquered!" campaign. Brazil is currently experiencing a crack cocaine epidemic, likened to that of the United States in the late 1980s and early 1990s. The policy includes the following under general guidelines for prevention:

"Preventive action must be planned and geared toward human development; education for healthy living; access to cultural assets, including sports, cultural, and leisure activities; dissemination of knowledge about drugs validated by scientific information; encouragement of youth leadership; and the role of family, school and community in replicating such activities."

The accredited distance-based learning course trains public school teachers on the prevention of drug use in public schools using a non-judgmental curriculum. The extensive training hopes to shift the negative attitudes and biases of public school teachers who traditionally use shock tactics when dealing with drug use. Rather than presenting basic drug information (as in the past), the text and video-based curriculum encourages students to become actively engaged in the learning process. The program insludes a final project which requires each school to implement a prevention-focused initiative in their community.Teachers have access to a virtual learning platform and tutors who provide guidance on all aspects of the program.

The program piloted in 2004, with an enrollment of 5000 teachers. Now in its fifth cycle, the program is steadily growing with an enrollment of 70 000 teachers in 2012. The program also recognizes and rewards those teachers and school with the best prevention initiatives. The program aims to educate 210 000 public school teachers (and 3 300 military police instructors) by 2014.

However, almost 20% of Brazilian youth either don't enroll in highschool or drop out before graduating. The program is currently investigating ways of reaching youth outside formal education.

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Webinar Recap: Introduction to promoting positive mental health

On June 28th, in collaboration with HC Link, the CAMH Resource Centre held the third iteration of the ever popular webinar "Introduction to Promoting Positive Mental Health". Marianne Kobus-Matthews and Tamar Meyer, both Health Promotion Consultants in the Provincial System Support Program at CAMH facilitated the webinar.

The first half of the webinar provided an overview of mental health promotion concepts and why it is a mainstream activity; or in other words, the "what" and "why" of mental health promotion. Tamar spent some time delineating between "mental health" and "mental illness" and referred to what Corey Keyes calls a mental health continuum and a mental illness continuum. Keyes argues that "mental illness and mental health are highly correlated but belong to separate continua, and therefore the prevention and treatment of mental illnesses will not necessarily result in more mentally healthy individuals." To see a visual explanation of this mental health/mental illness continuum including a story that may help illustrate it, view the recording starting at the 12:00 minute mark.

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In the second half of the webinar, Marianne covered the "how" of mental health promotion. That is, she reviewed strategies, best practices, resources and exemplary programs to promote positive mental health and explored how our work in mental health promotion may intersect with other risk factors and priority areas. In addition to highlighting the series of best practice guidelines for mental health promotion programs (Children (7-12) and Youth (13-19); Older Adults 55+; Immigrants and Refugees) identified by Marianne, a webinar participant from Sick Kids shared information on Infant Mental Health Promotion, including a set of best practice guidelines. For more information and resources on infant mental health promotion, please email: This email address is being protected from spambots. You need JavaScript enabled to view it.. Thanks to all the webinar participants who shared their innovative programs, best practices and resources!

Marianne also highlighted a newly released resource called YouThrive – a bilingual web-based resource for leaders in communities and schools that uses a health promotion approach to support positive mental health and prevent risk-taking behaviour among young people. Developed in a partnership involving CAMH, the Canadian Mental Health Association (Ontario), the Ontario Lung Association and Ophea, it is for leaders in communities and schools across Ontario who work with youth aged 12 to 19. While technical issues prevented us from showing the YouThrive video during the webinar, we encourage you to take a look at the 4-minute video and visit the YouThrive website.

 

Over 60 people participated in the webinar and included a broad array of sectors with the majority (43%) of participants working in a Public Health setting, followed by community services (18%). Other participants included Ministry staff, those working in school health, workplace health/human resources, and First Nations health, as well as community engagement. Thank you for your continued interest in promoting positive mental health!

Slides, webinar recording and a list of web links and resources identified during the webinar are available via HC Link.

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Green Space, Parks and Healthy Communities

Submitted by Parks and Recreation Ontario (PRO)

June was Parks and Recreation and Parks month, and to reflect, Parks and Recreation Ontario (PRO) has profiled some important new research into the effects of green space and parks on the health of our communities, and those who live in them.

 

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Parks and Mental Health

Dr. Marc Berman of Baycrest's Rotman Research Institute published a study on the positive effects of walking in nature for people who suffer from depression. His research is part of a cognitive science field known as Attention Restoration Theory (ART) which suggests that people concentrate better after spending time in nature or looking at scenes of nature.  

This theory is supported by an overwhelming amount of research. Dr. Frances Ming Kuo of the University of Illinois published a monograph in 2010 to summarize this research. Its an essential read for anyone who is making a case for more parks and natural spaces. Find Dr. Kuo's paper (along with four other great reference documents about recreation, parks and physical activity) here.

Parks and Physical Activity

In another study, published in the American Journal of Public Health, researchers studied neighbourhood park size, proximity and features and their effect on physical activity levels. The study, conducted by faculty at the University of South Carolina, the University of Waterloo and the University of Washington, found that the more features a park had - such as playgrounds, ponds and trails, the more it was used. It turns out that proximity and size of the park had less of an impact on use. The researchers conclude that a system of attractive, natural parks interconnected by trails may be more effective for promoting physical activity. 

Parks and Healthy Communities

The healthy cities movement has been around for almost 30 years - and it had its genesis right here in Ontario with the work of Dr. Trevor Hancock. We know a great deal about what the components of a healthy city should be, but less is known about how to deliver the potential health benefits and how to ensure that all citizens reap those benefits. A new study in the medical journal The Lancet focuses on the complex issues of health and environment. One size won't fit all communities, especially in under-resourced areas. The article looks at different aspects of the built urban environment from wastewater to active transportation and physical activity. The authors promote a collaborative approach between planners and health professional and the involvement of many stakeholders. 

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Summer Long Weekends

By Patricia Scott-Jeoffroy, Parent Action on Drugs

As the July long weekend approaches, our thoughts turn to an extra day off work, fun with family and friends, and celebrating Canada. Another common association with summer long weekends is the use of alcohol. It is hard to watch TV without seeing the joy of the "beer commercial lifestyle" where revellers are depicted having a great time, courtesy of a cooler full of beer. The message is clear: part of having the great cottage, the newest boat, and a houseful of friends is also having an abundance of alcohol. I am concerned that our culture seems to have embedded the use of alcohol with the celebrations of our summer long weekends. 

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Police will typically increase their surveillance of the highways and increase RIDE checks during a long weekend, and hospitals tend to increase staffing for emergency rooms. It appears that those who deal with the consequences of excessive drinking know the other side of long weekend drinking. 

As adults we may have an understanding of the role that drugs and alcohol are playing in our lives, but do our actions send conflicting messages to youth? The baseball tournament where you over-indulge after the game and wake with a pounding headache, family gatherings where your uncle falls in the pool but manages to keep this drink above water, the T.G.I.F parties after work soaking up some sunshine with co-workers, the association of the May 'two-four' weekend... what culture are we creating?

Over the next several months, Parent Action on Drugs and HC Link will be hosting a series of webinars focused on youth and substance use.  For additional information and programming options on youth and substance use please access our website.

 

Related resources from the Canadian Centre of Substance Abuse:

Reducing Alcohol-Related Harm in Canada: Towards a Culture of Moderation

- National Alcohol Strategy: Reducing Alcohol-Related Harm in Canada

Alcohol and Health in Canada: A Summary of Evidence and Guidelines for Low-Risk Drinking

 

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Helpful Resources on Health Equity

Submitted by Health Nexus and the CAMH Resource Centre

Health Promotion in Ethnocultural Communities

 

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Culture Counts: A Roadmap to Health Promotion 

If you are thinking about starting a health promotion initiative in mental health and substance use for particular ethnocultural communities, Culture Counts: A Roadmap to Health Promotion can help. Culture Counts is a guide developed to help organizations and agencies break down the barriers between ethnocultural communities and effective health promotion in mental health and substance use. The guide is the outcome of the Best Practices in Community Education in Mental Health and Addiction with Ethnoracial/Ethnoculutral Communities Project, a provincial partnership between the Centre for Addiction and Mental Health and seven community organizations. The Culture Counts guide, available in online and PDF versions, has been rereleased with updated links to online resources.

This guide outlines the basic steps and background to culturally competent health promotion in mental health and substance use but can be applied to almost any type of health promotion initiative aimed at ethnocultural communities. These basic steps include: breaking down barriers; working with community partners; gathering and analyzing information; planning the initiative, translating and cultural adaptation; putting the plan to work; and follow-up.

Cultural competence refers to the "capacity of an organization or individual to appreciate diversity, and to adapt to and work with people of different cultures, while ensuring everyone is treated equally.i" Improving health outcomes and reducing disparities in mental health and substance use health promotion initiatives and services for ethnocultural communities is of particular importance since increased rates of illnesses, poorer access to care and care outcomes and poorer satisfaction with services have been reported amongst immigrant, refugee, ethnocultural and racialized groups in Canadaii.

*To help support Healthy Communities audiences develop health promotion initiatives in mental health and substance use with ethnocultural communities, the CAMH Resource Centre is offering a complimentary hard copy of Culture Counts: A Roadmap to Health Promotion. Please see below for detailsiii.

 

Reduce Racialized Health Inequities

Health Nexus has developed two resources focused on building capacity to reduce health inequities among communities that experience racism in Ontario:

LitReview

 

Health Equity and Racialized Groups: A Literature Review

The Literature Review presents a framework for understanding and action on racialized health disparities that will be welcomed by those who are working to reduce health inequities.

It provides an overview of the topic, a synthesis of our knowledge to date on it, a brief history of how it has been addressed in Ontario, and examples of what is meant by taking an anti-racist approach to health promotion.

 

 

 

 

ResourceGuide

 

Addressing Health Inequalities for Racialized Communities: Resource Guide

This Resource Guide is a tool to support the capacity and effectiveness of those who are engaged in health promotion to reduce racialized health inequities.

Physical activity, mental health promotion, healthy eating/food security are examples of entry points to address racialized health inequities, and direct attention to the broader, underlying causes that need to be addressed.

 

 

 

 


iKobus-Matthews, M, Agic, B, Tate, M. (2012). Culture Counts: A Roadmap to Health Promotion.  A Guide to Best Practices for Developing Health Promotion Initiatives in Mental health and Substance Use with Ethnocultural Communities. Toronto: Centre for Addiction and Mental Health.

iiHansson E, Tuck A, Lurie S and McKenzie K, for the Task Group of the Services Systems Advisory Committee, Mental Health Commission of Canada. (2010). Improving mental health services for immigrant, refugee, ethno-cultural and racialized groups: Issues and options for service improvement

iiiTo receive a complimentary hard copy of Culture Counts, please send an email to resources[at]ohcc-ccso[dot ca] with the subject line: "Culture Counts". Please note that this offer is only available to those working in Ontario. Due to limited quantities, this offer is available on a first-come-first-serve basis with a limit of one complimentary hard copy per organization. Please include the following information in the body of your email: 1. Name; 2. Organization; 3. Work address, phone number and email address.

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Celebrating Our Collective Successes: Release of HC Link's Inaugural Report

HC Link is thrilled to release our Inaugural Report! HC Link has had an incredible year of learning and growth, and we are proud to share some of our accomplishments with you.

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By working together with organizations across Ontario we have helped create healthy, vibrant communities that are engaged and passionate about the factors that contribute to their wellbeing. Our report contains a sampling of stories from some of the community organizations and partnerships with whom we've had the pleasure to work with this last year. Community story highlights include:

- Supporting the creation of an active transportation plan for the communities of Port Severn, Honey Harbour, and MacTier;

- Engaging Francophone community leaders in the creation and implementation of an action plan to support elderly-friendly villages in West Nipissing and Sudbury East;

- Providing a workshop to introduce a comprehensive approach to mental health and substance abuse providers in Sioux Lookout; and

- Guiding the design of a community-based planning process to connect community members from a wide range of sectors in Lanark, Leeds and Grenville.

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We are proud that our services are well-received and that the demand for our expertise is steadily growing. To read other client testimonials, and learn more about HC Link's work, please download the report.

For more information:

- browse HCLinkOntario.ca;

- email us at us at This email address is being protected from spambots. You need JavaScript enabled to view it.; or

- call us 416-847-1575 or 1-855-847-1575.

 

 

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Webinar Recap: How to Engage Francophones: when you don't speak French!

By Andrea Bodkin, HC Link Coordinator

Supporting our clients in engaging their Francophone communities is an area that HC Link has been working in for the past several years. We've delivered several webinars and produced many resources – in both languages – on the topic. But this week, Estelle Duchon and I delivered a webinar with a slightly different spin: how do you engage Francophones in your community work when you don't speak the language?

For many people working in the areas of community-based planning, health promotion and healthy communities, we want to fully engage and work with all of the people who live, work and play in our community. When it comes to working with the Francophone community many feel that this can only be done if we are fluent in French. In our 90 minute webinar, Estelle laid out three easy steps to engage Francophones regardless of your French capacity.

Step One: Examine Your Motives: be very clear about the purpose and objectives for your engagement strategy, and also have a plan in place for what you will do with the results. The Francophone community has, in many cases, been consulted often with sometimes invisible results. By properly identifying what you want to accomplish you'll be able to put the appropriate plans in place. You'll also be able to clearly communicate what you are doing, why, and what will happen as result of participation. In this way, you'll be able to manage expectations.

Step Two: Understand Francophone Contexts in Ontario, your community and your organization: Before beginning an engagement strategy with Francophone communities (or any community for that matter) it's critical to understand the history and contexts of that community. For instance one of our participants remarked that she didn't realize that many Francophones in Ontario are new Canadians from 29 of the world's countries that speak French. This can have huge implications regarding culture and beliefs. It's also important to investigate the history of your organization's past engagement strategies (if any) as these can colour (positively or negatively) future participant's expectations.

Step Three: Find people to work with: For many of us who don't have the capacity or comfort to work in French, this step is really key. Are there colleugues in your organization or networks that have the capacity to liaise with communities in French? Also investigate existing networks and initiatives that you could partner with. Take the time to establish a trust relationship with new partners as well as with the communities themselves.

We had terrific audience participation in this webinar thanks to HC Link's new webinar platform which includes a chat board. In fact, 78% of evaluation respondents rated opportunities for participation as excellent! Participants shared ideas for engaging Francophones and also shared what their organizations are doing to boost French capacity in the workforce. Unfortunately due to some technical challenges we weren't able to record the webinar, but the slides have been posted for you on our website.

 This blog post just gives you a smattering of the information that Estelle and I presented – there is lots more out there, including in these resources:

Working Together with Francophones: Understanding the Context and Promising Practices

Working Together with Francophones @ a Glance Part 1: Understanding the Context

Working Together with Francophones @ a Glance Part 2: Legislation and Institutional Support

Community Engagement @ a Glance

Have you experienced successes or challenges in engaging Francophone communities in your work? Please leave us a comment and tell us about it!

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Fairness in Policy

Last week I had the pleasure of attending the prestigious Hastings Lecture, named for Toronto's first Medical Officer of Health, Dr. Charles Hastings. The event was moderated by the current Medical Officer of Health, Dr. David McKeown, who introduced Sir Michael Marmot as a "health equity rockstar." The title is a fair for the man who is currently Director of the Institute of Health Equity and a Professor in Epidemiology at University College, London, UK. Sir Marmot is best known for his work on the Whitehall II study, as well as leading the World Health Organization's Commission on the Social Determinants of Health. Like the rest of the 350-person crowd I sat captivated, only breaking to laugh at Sir Marmot's well-delivered jokes – or at the panel's comments on local politics.

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Sir Marmot opened with the bold statement that "social injustice is killing on a grand scale." He asserted that a society's success can be judged by the health of its population. Governments, however, tend to focus on only lowest end of the gradient in society, even though health inequality affects all of us. A health system for the poor is a poor health system. Sir Marmot stressed that while inequality exists on a national level, it can also be seen within the same city. In Glasgow, the life expectancy differs by as much as 28 years in different neighbourhoods. In the small town of Lenzie, the average male life expectancy is 82. In the district of Calton, the male life expectancy is only 54 years of age.

To counter this imbalance, Sir Marmot suggested that all ministers operate as ministers of health - as is the practise in Norway, where health performs as a social accountant. Governments should focus on policies which increase the standard of living for all:

  1. Give every child the best start in life.
  2. Enable all children, young people and adults to maximise their capabilities and have control over their lives.
  3. Create fair employment and good work for all. (Marmot shared some disturbing statistics about unemployment and the damaging effects of health – and on economics)
  4. Ensure healthy standard of living for all.
  5. Create and develop healthy and sustainable places and communities.
  6. Strengthen the role and impact of ill health prevention.

Individuals can only be responsible (and be held responsible) when they have the conditions to do so. Fair policies create the necessary conditions. Fairness should sit at the very core of health policies. Ever the evidence-based optimist, Sir Marmot closed his lecture with words of encouragement, "Dream of a world where social justice is taken seriously. Then take the pragmatic steps necessary to achieve it."

Following the inspirational lecture, Sir Marmot was joined in discussion by Dr. Kwame McKenzie and Dr. Charles Pascal. Dr. McKenzie, the director of the Canada Institutes of Health Research Social Aetiology of Mental Illness Training Centre and a senior scientist of Social Equity and Health Research at the Centre for Addiction and Mental Health, used John David Hulchanski's theory of the three Torontos to draw local relevance to Marmots remarks. Dr. Pascal, a professor of Human Development and Applied Psychology at OISE/University of Toronto, bemoaned short term thinking about policy, and advocated for policies with "teeth."

 

Resources:

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