March 30, 1999

To:Board of Health

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

Subject:Community Health Profiles and Strategic Planning Update

Purpose:

The purpose of this report is to update the Board of Health regarding Toronto Public Health's strategic and program planning and to share newly developed community health profiles.

Financial Implications:

None.

Recommendation:

It is recommended that the Board of Health receive this report for information.

Background:

At the February 22, 1999 meeting of the Board of Health a report was tabled outlining the 1999 strategic and program planning being undertaken by Toronto Public Health.

Comments:

The strategic and program planning is proceeding on schedule. A steering committee and sub-groups have been struck. Preliminary visioning exercises have been undertaken with the Divisional Management Team and middle managers. The Board of Health is represented by Gail Lindsay, Lee Zaslofsky, Jan Campbell and Brian MacKay.

At the urging of York Community Council, Public Health has prepared fact sheets on Health Risks and Public Health Service Needs for each of the community council areas in the City (see Appendix 1). Public Health staff extracted significant indicators for Family Health/Healthy Lifestyles, Communicable Disease Control, and Healthy Environments. The fact sheets will be used in the strategic planning process, placed on Public Health's site within the City's website, and circulated to community groups.

Conclusion:

Toronto Public Health's strategic planning process is underway. Community health fact sheets (attached) are a preliminary tool in this process.

Contacts:

Connie Clement

Director, Public Health Planning & Policy

Toronto Public Health

Tel:392-7463

Fax:392-0713

Dr. Sheela V. Basrur

Medical Officer of Health

Attach.

Appendix A

PUBLIC HEALTH HIGHLIGHTS: EAST YORK COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 107,822
• 28,360 persons (27%) and 34.1% of children in low income households
• 4% require services in a language other than English; additional 6% face literacy barriers
• 13,140 recent immigrants; shifting immigration patterns and changing health needs
• 16,590 seniors: 5070 seniors (33%) live alone
• 1633 births in 1997: 116 babies (7.1%) born underweight: Over 400 newborns and their families require public health assessment, referral, breastfeeding or parenting services (750 infant/child health referrals received; 1,000 calls to information line)
• 147 hospitalizations of children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families
• 25% of teens smoke, up from 19% in 1991: teen drug use is twice the rate of 1993
• estimated incidence of cancer is >300 new cancer diagnoses yearly
• 403 hospitalizations of seniors for falls and 446 for heart disease
• local programs provide nutritious meals/snacks to 1250 children on school days (1998)
• clinics/weekly programs in 8 sites; (e.g. breastfeeding clinics, prenatal nutrition, 54 parenting sessions, dental clinics >1900 clinical preventive services to children)
• programs and partnerships in schools, workplaces, community: (e.g. car seat safety clinics, injury prevention training, physical activity in schools, ESL classes, 230 teachers and teens trained in sexual health promotion)

COMMUNICABLE DISEASE CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 5 institutions, 43 day cares, 32 group homes, clinics, etc.
• respond to 12-15 outbreaks of disease
• track immunization records of 16,600 students in 32 schools
• 1043 grade 7 students immunized against Hepatitis B (1996/97)
• 20 new TB cases: over 200 close contacts and 95 immigrant referrals need follow-up
• case management for 163 cases of STDs; 697 sexual health clinic visits
• estimated 600 injection drug users and no needle exchange services for HIV prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION

• ensure food safety by inspection of 576 food premises; respond to 527 community identified potential food hazards; and promote safe food handling in the community
• enforce the Tobacco Control Act (197 vendors) to prevent tobacco sales to minors
• inspect 53 pools, spas, wading pools and monitor water quality at public beaches
• respond to animal calls & complaints, investigated >200 animal bites; animal shelter & adoption services; licensed 1700 cats & dogs
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 157 complaints and requests; 8 development applications; 4 identified landfill sites

Source: Demographic variables and low income incidence (1996 Census); all health and service indicators are for 1997 (Public Health Division data bases and Provincial Health Planning Data Base) except as identified

(22 March 1999)

PUBLIC HEALTH HIGHLIGHTS: SCARBOROUGH COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 558,960
• 151,395 persons (27.5%) including 37.6% of children in low income households
• 5.7% require services in a language other than English; additional 6% face literacy barriers
• 88,710 recent immigrants; shifting immigration patterns and changing health needs
• 69,955 seniors; 13,000 seniors live alone; 10,000 seniors are frail
• 7640 births in 1997: 521 babies (6.8%) born underweight. Over 1900 newborns and their families require public health assessment, referral, breastfeeding or parenting services: e.g. 567 PHN home visiting referrals, 100 teens in parenting groups, 3650 calls to Kidsline
• 904 hospitalizations of children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families
• 25% of teens smoke, up from 19% in 1991: teen drug use in 1997 is twice the rate in 1993
• 1078 hospitalizations of seniors for falls and 1634 for heart disease
• estimated incidence of cancer is >1550 new cancer diagnoses annually
• local programs provide nutritious meals/snacks to >6300 children on school days (1998)
• clinics/weekly programs in 21 sites: e.g: prenatal programs, dental services to >2220 children
• partnership programs in schools, workplaces, community: eg. Caring Alliance (homeless families) Teen Driving Challenge, Heart Health Network, Care Watch (seniors) in 10 sites, Coalition for a Tobacco Free Scarborough, Scarborough Hunger Coalition.

COMMUNICABLE DISEASES CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 34 institutions, 158 day cares, 377 group homes, clinics etc.
• respond to 50 - 60 outbreaks of disease
• track immunization records of 102,000 students in 240 schools: 6525 grade 7 students immunized against Hepatitis B in 1996/97
• 90 new TB cases: over 900 close contacts and 623 immigrant referrals need follow-up
• case management for 1377 cases of STDs: 6208 sexual health clinic visits
• estimated 3,400 injection drug users and no needle exchange services for HIV prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION

• ensure food safety by inspection of 2842 food premises; responding to 1270 community identified potential food hazards and promote safe food handling in the community
• enforce the Tobacco Control Act (850 vendors) to prevent tobacco sales to minors
• inspect 306 pools, spas, wading pools and monitor water quality at 2 public beaches
• respond to animal service calls & complaints, investigated >800 animal bites; provide shelter services; 2900 animal adoptions; license/identify 20,500 cats & dogs.
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 1248 complaints and requests; 59 development applications; 49 PCB sites and 29 identified landfill sites

Source: Demographic variables and low income incidence (1996 Census); all health and service indicators are for 1997 (Public Health Division data bases and Provincial Health Planning data Bases) except as identified.

(22 March 1999)

PUBLIC HEALTH HIGHLIGHTS: YORK COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 146,534
• 46,345 persons (32%) including 40.3% of children are in low income households
• 7.2% require services in a language other than English; additional 9% face literacy barriers
• 19,410 recent immigrants: shifting immigration patterns and changing health needs
• 19,455 seniors: 6135 seniors (33%) live alone
• 2236 births in 1997: 152 babies (6.8%) born underweight. Over 560 newborns and their families require public health assessment, referral, breastfeeding or parenting services:

e.g. 300 home visits provided; 95 breastfeeding contacts; 1500 calls on Health Line

• 176 hospitalizations among children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families
• 25% of teens smoke, up from 19% in 1991; teen drug use is twice the rate of 1993; 48% of York teens are sexually active
• estimated cancer incidence is >400 new cases diagnosed annually
• 398 hospitalizations of seniors for falls and 446 for heart disease
• local programs provide nutritious meals/snacks to 480 children on school days (1998)
• clinics/programs in 15 sites; e.g.: weekly prenatal sessions, dental clinics > 1460 children
• community/partnership programs in schools, community sites; e.g. food skills training, school sexual health curriculum development, after school neighbourhood teen groups

COMMUNICABLE DISEASES CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 5 institutions, 35 day cares, 179 group homes, clinics, etc
• respond to 7 - 10 disease outbreaks
• track immunization records of 22,000 students in 58 schools: 1300 grade 7 students immunized against Hepatitis B in 1996/97
• 30 new TB cases; over 300 close contacts and 89 immigrant referrals need follow-up
• case management for 560 cases of STDs; 2004 sexual health clinic visits
• estimated 900 injection drug users; 3831 needles distributed for HIV prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION

• ensure food safety by inspection of 728 food premises; responding to 356 community- identified potential food hazards and promote safe food handling in the community
• enforce the Tobacco Control Act (300 vendors) to prevent tobacco sales to minors
• inspect 41 pools, spas, wading pools and monitor water quality at public beaches
• respond to animal service calls & complaints, investigated >180 animal bites; provide shelter & adoption services; licensed/identified 5900 cats & dogs
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 1324 complaints and requests; 14 PCB sites and 26 identified landfill sites

Source: Demographic variables and low income incidence (1996 Census); all health and service indicators are for 1997 (Public Health Division data bases and Provincial Health Planning Data Base) except as identified

(22 March 1999)

PUBLIC HEALTH HIGHLIGHTS: TORONTO COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 653,734
• 184,430 persons (29%) including 35.7% of children live in low income households
• 7.4% require services in a language other than English; additional 7% face literacy barriers
• 68,435 recent immigrants: shifting immigration patterns and changing health needs
• 78,325 seniors: 35% live alone; 59% are at nutritional risk
• 8200 births in 1997: 443 babies (5.4%) born underweight. >2050 newborns and their families require public health assessment, referral, breastfeeding or parenting services

(2860 prenatal, 3500 postpartum and 4128 Parents Helping Parents home visits provided)

• 767 hospitalizations of children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families, also high are ESL youth 21%; street youth 41%; institutionalized seniors 55%
• 1765 hospitalizations of seniors for falls and 1946 for heart disease
• estimated cancer incidence is >1700 new cancers diagnosed annually
• 25% of teens smoke, up from 19% in 1991; teen drug use is twice the rate in 1993
• local programs provide nutritious meals/snacks to >17000 children on school days (1998)
• clinics/weekly programs in 100 sites (parenting groups, dental clinics >100,000 procedures)
• community programs/partnerships in schools, workplaces, agencies: e.g. mental health services in hostels, oral health in 34 seniors centres, child care workers trained in nutrition and physical activity promotion, 62 communities receive grants for drug abuse prevention

COMMUNICABLE DISEASES CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 72 institutions, 247 day cares, 1300 groups homes, clinics, etc.
• respond to 80 - 90 outbreaks of disease
• assess immunization status of 93,000 students in 270 schools: 4800 grade 7 students immunized against Hepatitis B in 1996/97
• 132 new TB cases: over 1320 close contacts and 560 immigrant referrals need follow-up
• case management for 2008 cases of STDs: 27,472 sexual health clinic visits
• estimated 6165 injection drug users: >200,000 needles distributed for HIV prevention;
• 43 grants/contracts for AIDS prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION

• ensure food safety by inspection of 8041 food premises; responding to 4817 community identified potential food hazards and promote safe food handling in the community and at events (e.g. Caribana, CNE, Gay Pride) which draw millions
• enforce the Tobacco Control Act (2083 vendors) to prevent tobacco sales to minors
• inspect 98 pools, spas, wading pools and monitor water quality at 12 public beaches
• respond to animal service calls & complaints, investigated >800 animal bites; provide shelter & adoption services and licensed 1100 dogs.
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 3350 complaints and requests; 432 Development applications; 163 PCB sites and 22,000 potential landfill sites)

Source: Demographic variables from 1996 Census; low income threshold is set by Statistics Canada based on family size; all health and service indicators are for 1997 (Public Health Division data bases) except as identified

(22 March 1999)

PUBLIC HEALTH HIGHLIGHTS: NORTH YORK COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 589,653
• 163,595 persons (28%) including 39.6% of live in low income households
• 6% require services in a language other than English: additional 7% face literacy barriers
• 90,120 recent immigrants: shifting immigration patterns and changing health needs
• 88,375 seniors: 20,250 seniors (24.3%) live alone
• 7812 births in 1997: 552 babies (7%) born underweight. Over 1950 newborns and their families require public health assessment, referral, breastfeeding or parenting services.

(6000 home visits provided, 2500 referral/counselling contacts with children <10 and their families; 1200 calls to Caring for Kids Line)

• 683 hospitalizations among children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families
• 25% of teens smoke, up from 19% in 1991: teen drug use is twice the rate in 1993
• estimated cancer incidence is >1500 new cases diagnosed annually
• 1551 hospitalizations of seniors for falls and 2374 for heart disease
• local programs provide nutritious meals/snacks to >4000 children on school days (1998)
• clinics/weekly programs in 30 sites (breastfeeding clinics, dental services >5750 children)
• partnership programs in local schools, workplaces, agencies (e.g. North York Prenatal Coalition, Heart Health partnerships, Caregiver Coalition, parenting programs, trained 350 ESL leaders in disease prevention, peer-led high school substance abuse/injury prevention programs, workplace health promotion, Seniors Falls Prevention Network)

COMMUNICABLE DISEASES CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 32 institutions, 161 day cares, 320 group homes, clinics, etc.
• respond to 25 - 40 outbreaks of disease
• assess immunization status of 100,000 students in 236 schools; 5780 grade 7 students immunized against Hepatitis B in 1996/97
• 116 new TB cases; over 1160 close contacts and 793 immigrant referrals need follow-up
• case management for 1220 cases of STDs; 5284 sexual health clinic visits; estimated 1800 injection drug users without local needle exchange service for HIV prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION

• ensure food safety by inspection of 3086 food premises; responding to 1434 community identified potential food hazards and promote safe food handling in the community
• enforce the Tobacco Control Act (845 vendors) to prevent tobacco sales to minors
• inspect 310 pools, spas, wading pools and monitor water quality at public beaches
• respond to animal service calls & complaints, investigated >400 animal bites; provide shelter, 600 adoptions and licensed 12,700 cats & dogs
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 3319 complaints and requests; 112 Development applications; 78 PCB sites and 51 identified hazardous sites

Source: Demographic variables and low income incidence (1996 Census); all health and service indicators are for 1997 (Public Health Division data bases and Provincial Health Planning Data Base) except as identified.

(22 March 1999)

PUBLIC HEALTH HIGHLIGHTS: ETOBICOKE COMMUNITY COUNCIL AREA

Health Risks and Public Health Service Needs

FAMILY HEALTH/HEALTHY LIFESTYLES

• PROMOTE OPTIMUM HEALTH AND BEHAVIOURS THAT REDUCE DISEASE, DISABILITY AND PREMATURE DEATH IN THE POPULATION, IN HIGH RISK GROUPS AND IN THE COMMUNITY

• Population: 328,718
• 23.2% (75,380 persons) including 34.3% of children live in low income households
• 4% require services in a language other than English; additional 6% face literacy barriers
• 35,645 recent immigrants: shifting immigration patterns and changing health needs
• 50,130 seniors: 11,470 seniors (24%) live alone
• 4503 births in 1997: 295 babies (6.6%) born underweight. Over 1125 newborns and their families require public health assessment, referral, breastfeeding or parenting services

(e.g. 1950 calls to breastfeeding information line, 374 attend breastfeeding sessions)

• 385 hospitalizations among children for traffic, cycling or other injuries
• 50% of children experience dental decay: highest in immigrant and low income families
• 25% of teens smoke, up from 19% in 1991: teen drug use is twice the rates in 1993
• 754 hospitalizations of seniors for falls and 1292 for heart disease
• estimated cancer incidence is >850 new cancers diagnosed annually
• local programs provide nutritious meals/snacks to 5700 children on school days (1998)
• clinics/weekly programs in 12 sites; e.g.: prenatal drop-ins, dental clinics > 1100 children
• community & partnership programs in schools, workplaces, events (e.g. car seat safety demonstrations, 697 heart health sessions in elementary schools, health teaching in ESL classes, Heart Health Network, train caregivers working with isolated/frail seniors)

COMMUNICABLE DISEASES CONTROL

• PREVENT, REDUCE OR ELIMINATE OVER 65 REPORTABLE DISEASES

• ensure infection control in 13 institutions, 80 day cares, 259 group homes, clinics, etc.
• respond to 20 - 25 outbreaks of disease
• assess immunization status of 54,000 students in 119 schools: 3300 grade 7 students immunized against Hepatitis B in 1996/97
• 60 new TB cases; over 600 close contacts and 215 immigrant referrals need follow-up
• case management for 500 cases of STDs: 1250 sexual health clinic visits; estimated 2100 injection drug users; distributed 6,860 needles for HIV prevention

HEALTHY ENVIRONMENTS

• MINIMIZE EXPOSURE TO HEALTH HAZARDS AND ENFORCE BY-LAWS/LEGISLATION
• ensure food safety by inspection of 2325 food premises; respond to 159 community identified potential food hazards, and promote safe food handling in the community
• enforce the Tobacco Control Act (193 vendors) to prevent tobacco sales to minors
• inspect 220 pools, spas, wading pools and monitor water quality at 6 public beaches
• respond to animal service calls & complaints, investigated >200 animal bites (55 people received rabies vaccine); 1000 animal adoptions and 9000 cats & dogs licensed
• maintain 24 hour availability for emergencies; and, identify and respond to health hazards: (e.g. 852 complaints and requests; 75 PCB sites and 7 identified landfill sites

Source: Demographic variables and low income incidence (1996 Census) all health and service indicators are for 1997 (Public Health Division data bases and Provincial Health Planning Data Base) except as identified.

(22 March 1999)

PUBLIC HEALTH SERVICE NEEDS FACTS SHEETS

BY COMMUNITY COUNCIL AREA

PURPOSE

TO INFORM COMMUNITY/COMMUNITY COUNCILS ON PUBLIC HEALTH NEEDS BY:

• using numbers and examples that people can identify with;

• reflect the broad range of public health services;

• draw upon data compiled by the division for its own service planning to deliver programs that respond to local needs;

• be concise (one page) while as comprehensive as possible;

• be mindful of the interest in specific areas at this time;

• not to make comparisons between community council areas or identify share of needs or services, service efficiency;

• to also have general use for staff, orient students, etc.; and

• uses most up-to date data available (1997); update and revise as new and better data is available.