January 15, 1999

To:Board of Health

From:Dr. Sheela V. Basrur, Medical Officer of Health

Subject:Status Report: Review of the recommendations of the Report of the Task Force on Health and Work for the City of Toronto

Purpose:

To report on the preliminary review of the recommendations of the Report of the Task Force on Health and Work.

Recommendations:

It is recommended that:

(1)The Board of Health recognize the critical link between employment and population health by supporting in principle the Report of the Task Force on Health and Work and its recommendations;

(2)The Board of Health request City Council to receive the report and undertake a full review of and report on how the City of Toronto can implement key recommendations, in particular recommendation 17;

(3)The Board of Health request City Council to ensure that these recommendations be considered in human resources policies as well as planning processes under development in the City of Toronto;

(4)The Board of Health request that, in investigating the feasibility of a four-day work week, the City of Toronto begin by monitoring overtime currently worked in the City; and

(5)The Board of Health and City Council advocate to Human Resources Development Canada for the initiation and development of a voluntary collective benefits insurance fund for all Canadians in the non-standard and contingent workforce.

Background:

The impact of conditions of employment on the overall health of the population has been documented for some time by a range of agencies and investigators. As conditions of work began to change rapidly in the 1990s, due to global economic trends affecting our domestic labour market, health impacts began to accelerate noticeably on individuals, families and communities. This impact on the health of Toronto residents was brought to the attention of the former Toronto Board of Health and was investigated by a Task Force formed specifically to make recommendations on the issue. The Report of the Task Force on Health and Work was adopted by the former City of Toronto Board of Health on September 9, 1997 and by the former City of Toronto Council on September 22 and 23, 1997 (see Appendix A for chronology).

The report was subsequently considered by the current Board of Health on April 21, 1998. The Board of Health deferred consideration of the report until the Medical Officer of Health could report on the outcome of a review by the Chief Administrative Officer and the Executive Director of Human Resources of the report's recommendations (see Appendix B for the recommendations of the Task Force on Health and Work). The following report is the result of that review. The Chief Administrative Officer and the Executive Director of Human Resources have participated in the development of this report and concur with its recommendations.

Comments:

In Canada, as in other parts of the world, lack of sustaining work remains a central determinant of the health of the population. In 1997, the National Forum on Health stated that "the most important yet the most difficult issue for the health of Canadians is the availability of jobs." One year later, the problem became acute in Ontario where, according to Statistics Canada, 14,000 jobs were lost in the month of June alone. In that month, Ontario experienced 40 per cent of the total job losses in Canada, more than any other province. Many of these job losses have been sustained in the City of Toronto.

The Task Force on Health and Work highlighted work-related stress as a key factor affecting the health of Toronto residents and uncovered the following causes:

(1)Many Toronto residents have no income-generating work;

(2)Other Toronto residents are employed at intermittent part-time or contract work at low wages and with no benefits;

(3)The Toronto residents that have full time employment are often working long hours under difficult conditions;

(4)Streamlining, downsizing and other changes in the workplace have resulted in job loss for some workers and a constant level of insecurity for others;

(5)Decreases in wages and benefits have occurred for many workers as a result of global competition and restructuring;

(6)Deregulation and de-skilling of the labour market has meant less access to safe, fair and sustaining conditions of employment for many workers;

(7)Changes in the labour market are having a particularly negative impact on women and youth;

(8)Self employment, while providing some benefits to workers, can also result in low wages and no employment benefits, and

(9)Changes in technology have eliminated many jobs and resulted in increased demands on workers to match the accelerated pace of business.

While the Task Force recognized that the findings of its investigation are in part due to changes taking place globally, its recommendations provide actions that the City of Toronto could take to improve work conditions for its own employees. These actions would build on a tradition of positive municipal employee relations within the former municipalities and of providing quality services to enhance health and employment in the larger community. These actions also offer an opportunity for the City of Toronto to set an example for other employment sectors by assuming a leadership role in healthy employment policies. Moreover, in the current climate of increasingly high employee stress levels, protecting the health of its own workforce is highly desirable if the City is to realize maximum employee productivity and retention. Key actions that could be taken by the City of Toronto (recommendation 17 of the Report of the Task Force on Health and Work) and the preliminary response of the City to these recommendations follow: