The health of Ontarians is improving, but not everyone is moving forward equally, according to a recent report by Ontario’s chief medical officer of health.
Dr. David C. Williams released his 52-page annual report for 2016, “Improving the Odds: Championing Health Equity in Ontario,” last month.
The report shows that “while the mean is getting better, there are sectors that are behind or even worse,” said Williams. In fact, the health of people in some areas is deteriorating.
If those differences were being noted in the area of infectious diseases, said Williams, public health could afford to monitor the situation for another year.
But because the inequities can be deadly, “we need to do something now.”
His document lays out what public health, and communities at large, “can and must be doing right now,” Williams said in a telephone interview from Toronto.
It offers suggestions for “what we can do, what we might do and what we could be doing now,” said the public health official.
The report contains what Williams calls “shout-outs”, examples of programs that are addressing the health needs of under-serviced populations.
“It is also a callout to say we need to be doing more,” he said.
Public Health Sudbury & Districts chose a program for inclusion in the report that highlights health equity and community development. The health unit offers judgment-free services for gay men, a sector of the population whose health needs are often not met. That is sometimes because they are reluctant to disclose their sexual orientation to their family physicians or other primary-care providers.
The program offers several confidential services including sexual health counselling, testing for HIV and other sexually transmitted infections, free treatment for chlamydia, gonorrhea and syphilis, and referrals.
The health unit delivers these services at the men’s clinic at Réseau ACCESS Network and with other organizations that serve gay men. It also has a presence on Grindr, a social media app for gay, bi, trans and queer people.
In the year after the program was initiated, the rate of men who have sex with men, seeking point-of-care HIV testing, increased by 133 per cent.
Williams pointed to other programs highlighted in his report such as one in Peterborough that addresses food insecurity and one to improve the health of children offered by the Thunder Bay District Health Unit.
“It’s really them telling their story of a story they want to tell,” said Williams.
The data in his report is five to 10 years old, he points out. A recommendation in this and previous reports of his is called “mapping wellness.” If the data collected is not timely and local, “you can’t have a good dialogue with the community.”
Penny Sutcliffe, medical officer of health for Public Health Sudbury & Districts, was a member of the advisory committee for Williams’ report, something she sees as recognition for the good work the health unit has done in the last 20 years.
The gay men project Public Health chose to highlight in the report shows how relatively minor “tweaks” can have a big impact on levelling access to services.
Williams’ report again highlights the inequity in the premature mortality rates in Northern Ontario when compared with the rest of Ontario. Cities such as Sudbury, however, do better in this area than some others.
According to mortality rate information contained in Health Quality Ontario’s Northern Health Equity Report, the life expectancy of residents of northern areas is 2.5 to 3.5 years” less than in southern Ontario, something Sutcliffe calls “quite startling.” Read the report here.
Sutcliffe describes community development as working together to understand communities’ needs, the strengths they have and the challenges as well. “It really is as simple as that.”
It’s not just talking about the health care or public health systems, but making sure they are working together.
“It’s not rocket science. It’s not complex. It really is kind of low tech,” said Sutcliffe.
Opportunities for health go up with people’s income grade – and everyone is adversely affected by the gap between the rich and the poor, said Sutcliffe.
No single action is going to save the world, and issues such as health inequity and unequal distribution of income can seem overwhelming, said the medical officer of health.
People may think they can’t do anything because “it’s too much,” said Sutcliffe.
Williams’ report points out “if we all take action, then it’s going to amount to something,” said Sutcliffe.
That message resonates with Public Health Sudbury & Districts “You Can Create Change” campaign. It urges people to be aware of how their neighbours are doing or that the child in the locker next to your child might not have lunch.
It’s also being aware of the platforms of candidates running in the June 7 provincial election “and speaking up,” said Sutcliffe.
She agrees having better and more current data will demonstrate how some people are being left behind when it comes to health care.
Williams’ report was presented to the Ontario Legislature, but it is also meant for Ontarians and is what he calls “public friendly.”
He recommends other ministries besides Health use it for discussion and dialogue.
Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists.