(website posting Dec28,05)
The Five public health Vows
During the past year we were reminded about how fortunate we are to live in a country which is free from war and disaster. The events of this past year remind us of the uncertain nature of life on our planet. Witnessing these events gives us pause to review our own circumstances, which we often take for granted. Living in Ontario each person has the opportunity to explore in freedom the possibilities for a satisfying and rewarding life. Having good family and individual health whilst living in a safe community helps each of us to achieve this goal.
There are many impediments to establishing this fundamental goal. Families and individuals and communities may be affected by illness and health hazard. The great crippling diseases remain with us. They include acute infections and injury and the common chronic diseases. These can and do prematurely disable and kill us.
As a community of course we do not sit back and idly accept this. The largest proportion of our tax money goes to health care. Much of this goes to treatment of disease and patient care. However this is extremely expensive. The cost of operating hospitals and the health care delivery system to say nothing of the price of drugs is very high. A small proportion of the health budget goes to disease prevention. This is what we do in public health, otherwise known as community health. We try to prevent disease. It is a very exciting prospect. We have had some huge successes, most notably in the prevention of infectious diseases which are still out there but which are so seldom seen now in this country that we sometimes become complacent and inclined to take their absence for granted.
Public health programs are mandated under provincial law. As a community we have decided that participation in public health is not an option or choice.
In Hastings Prince Edward Counties the Health Unit serves 150,000 residents. We have 130 employees which is somewhat less than the one per thousand residents suggested by the province. The Board of Health can therefore be pleased to say that you are running a very lean operation. We have five offices in the region and five departments to deliver our product to our residents. We spend $9 million per year of public money, half of which comes from local taxes and half from provincial funds. Each resident therefore pays about $25 per person through local taxation for the services of the health unit. Considering the services that we deliver I suggest to you that this is a good investment.
Our goal then in public health is "family and individual health, in a safe community". How do we accomplish this? We do it through five programs. These are: promotion of family and dental health; prevention of acute illness including infection and injury; prevention of chronic illness, especially heart and lung disease, stroke and cancer; investigation of health hazards; and finally, disaster planning . (I call these our "vows" of public health, which we can remember by the "vowels" of public health, a-e-i-o-u.)
First of all, our family and dental Health program is a very exciting and rewarding one. As young people in our community approach adulthood and embark on relationships many of them come in to see us, in this place, to get friendly nonjudgmental advice on how to avoid problems as they organize their lives. Later as they go on to start their families these young people return for more help with their pregnancies and with their young children. In the matter of dental care we prevent dental disease in young families by screening students in the schools and by subsidizing treatment when it is needed for those children who cannot afford it.
What a privilege it is to help the young people of our community in these important, personal ways. What could be more important for the future of our community as these young people are its very foundation.
Prevention of acute illness is our second program. First of all, prevention of infection. It is worthwhile simply to utter the names of some of the dread diseases which now are preventable by means of a vaccine administration: diphtheria, whooping cough, lockjaw, polio, meningitis, measles, hepatitis , tuberculosis, rabies, pneumonia, influenza. Each of these can be devastating and/or killing diseases.
These infections routinely descended like the plague on the population of our own region in the last century. Now, with the exception of the unsolved problem of influenza, these diseases are generally no longer encountered as a result of the stunning advances in vaccine technology which we have the privilege to deliver to the community. We take this all for granted but we should not. Furthermore it is only through careful and diligent attention to detail by our Health Unit staff that 99% of our young people here in Hastings and Prince Edward receive complete vaccination. This is the highest in the country, equal or better than any other jurisdiction in Ontario or Canada and far ahead of the United States.
Furthermore in the prevention of acute infectious illness it is our responsibility to ensure food safety, and safe drinking water. What could be more basic or more important than this? Neither of these are guaranteed without oversight on our part. As well we prevent and control sexually transmitted diseases. And a very important program which is generally below the radar screen of community awareness is our monitoring of outbreaks of infectious diseases in our hospitals and long-term care facilities. This is a continuous process particularly in the wintertime when respiratory and enteric infections occur, sometimes with deadly results especially in the elderly and thus vulnerable residents of these facilities. Our role in controlling these outbreaks is organized, effective and essential.
The other component of acute illness prevention is injury prevention. Motor vehicle collisions are the number-one cause of death in the age range one to 41 in Canada and also the one least discussed. In the province of Ontario about 900 people are killed in motor vehicle accidents every year. Prevention of Bicycle accidents, drowning, and falls in the elderly are also within our mandate. All these are difficult problems to solve but here at the health unit we take up the challenge. Alcohol and drug abuse prevention is one way that we approach the goal of injury reduction.
Next, the prevention of chronic diseases.
As our population ages the chronic diseases including heart disease, lung disease, stroke, cancer, diabetes and osteoporosis are the common diseases which cripple and kill people prematurely. Again it is challenging to prevent these diseases but it is much more expensive and less satisfactory to treat them once they have developed. We tackle them through our anti-smoking, nutrition, and physical activity life style programs as well as through cancer screening. There are many profitable corporations out there who make money through promotion of unhealthy lifestyles. It is our privilege to provide alternatives to our citizens so that they can make the choice between good health and bad. There is no question that these diseases can be prevented. I see this in practice on a daily basis.
Finally, Hazards, whether biological, chemical or physical, can threaten the community and Disaster can strike. It is the responsibility of the health unit to have the capability in place to investigate health hazards which very commonly present themselves. Full scale disasters on the other hand may only rarely occur but an organized and practiced approach which coordinates the resources of municipal agencies within the community is required if an effective response is to be mounted when needed. I am pleased to say that as a result of provincial legislation disaster planning is now receiving the attention it deserves.
Members of the board of health, you have an excellent product here. It should be an easy one to sell to the community. The principle of shared funding between the province and the local community is a very sensible one. It helps us to achieve the same provincial standards of public health as everyone else in Ontario, while at the same time allowing us to have some influence and control over the local public health agenda.
However in the four months that I have been at the health unit I have discovered an interesting problem. As I talk to my colleagues and to members of the general public I have found that there is little comprehensive understanding out there in the community about what exactly we do here at the Health Unit .
This is a problem in two ways. First of all people cannot take full advantage of our services if they do not know what we offer. Secondly when we ask for funding our product is needlessly difficult to sell.
What we do here is not complicated. The goal of p~U~blic Health, again, is "family and individual health in a safe community". To do this we pr~O~mote family and dental health, we pr~E~vent acute and chronic illness, we ~I~nvestigate health hazards, and we pl~A~n for disasters. These are what I referred to as the vows - and the vowels - of public-health - A-E-I-O-U. That is a message that we need to get out there.
Apparently we have not been entirely effective in communicating our role. This needs to change. You have an excellent and very exciting and important product here, members of the Board of Health. Your effect in reducing misery and mortality in the community is huge. As a general physician in this community I see on a daily basis how effective public health measures can be in preventing acute infection and chronic illness. I also all too frequently see the disastrous results of not so doing. As a coroner in the community I have too often witnessed the end result of failure to prevent injury as well as acute and chronic illness.
I hope as the New Year of 2005 gets under way that you will be excited about your work on the Board of Health and that you in turn will convey your enthusiasm to your patrons and to your constituents.
All the best for 2005.
***********************
Speech, January 2005 Board of Health Meeting
Mr. C, Members etc
Today, a New Year begins...... for the Board of Health of H PE Counties
This is a good opportunity .....for me to
Re state the purpose and goals ...of our work here at the Health Unit
During the past year.... we were reminded again
about our good fortune .......in living in a country
where good health....and public safety....is a priority.
This in fact is the goal .......of Public Health:
Healthy families .......and healthy individuals.......... Living in a safe community
But ...there are many roadblocks......... to good public health.
The great crippling diseases....... remain with us.
And....health Hazards and disasters ......may occur.
Much of our health care budget ....goes to patient care and treatment
But in public health... we approach the problem from the other end of the pipe
We try to prevent disease.........From occurring in the first place
It is a very exciting prospect.
Prevention......... is known to be of such fundamental importance
That in Ontario.... Public health programs are mandated under provincial law.
In Hastings Prince Edward Counties
the Health Unit serves.....about 150,000 residents.
To do this.....We have 130 employees
There are 5 offices in the region......... and five departments at the Health Unit
to deliver our product........ to our residents.
We spend $9 million per year........ of public money,
¼ of which comes from local taxes........ and ¾ from provincial funds.
Each resident therefore pays........ about $15 per person in local taxes
for the services......... of the health unit.
So what do you get............ for your $15?
Well what we in public health....would like you to have (for your $15)
Is "family and individual health.... in a safe community".
How do we accomplish this?
We do it through 5 programs.
I call these the 5 vows ....or the 5 Promises.....of public Health
1. PrOmote..... of family and dental health;
2. PrEvention .......of acute illness......... including... infection and injury;
3 and of ...chronic illness...including heart and lung disease, stroke and cancer;
4. Investigate ......... health hazards;
5. and finally plAn for Disasters.
Let us review....each of these in turn.
1. First of all, our family , and dental, Health program
This is a very exciting and rewarding one.
As young people.... in our community
approach adulthood.... and embark on relationships
many of them come to see us..... to get friendly, nonjudgmental advice
about how to avoid Health problems .........as they organize their lives.
Later as they go on .....to start their families
these young people often return.... for more help
with their pregnancies.......... and with their young children.
In the particular matter .....of dental care
we prevent dental disease....... Again, in young families
by screening students........ in the schools
and by arranging treatment ..........when it is needed
for those children ........who cannot afford treatment
What a privilege it is........ to help these young people
Indeed, what could be more important......... for the future of our community
2. Our second Vow...it to prevent acute illness
There are two kinds of Acute illness .......... Infection and Injury
First of all ..........prevention of Infection.
It is instructive.......... simply to utter the names
of some of the dread diseases ............which now are preventable
by means of ....... vaccination
Each of these names....should bring to mind
the image of a patient .....suffering from....
diphtheria, whooping cough, lockjaw, polio,
meningitis, measles, hepatitis, rabies,
tuberculosis, influenza.
Each of these...10 diseases......... can be devastating
These infections routinely....... Used to Occur in epidemics
In our own region........ as recently as the last century.
Now, with the exception ......of the unsolved problem of Influenza,
these diseases generally.... no longer occur
This is because of the stunning advances.... in vaccine technology
which we have the privilege........ to deliver to the community.
We tend to take this all for granted........... but we should not.
These contagious diseases....are still out there
It is only ......through careful attention to detail
by our Health Unit staff ....that 96% of our young people (corrected)
here in Hastings and Prince Edward .........
receive protection.............by complete vaccination
This is amongst the highest rates.... in the country, and in North America
Another way....... that we prevent infectious disease
Is By ensuring.......... Food safety.... and the safety of drinking water.
What could be more basic.... or more important than this?
However, Food safety, and safe drinking water .....in our community
is not ensured ......... without our oversight
We also work to prevent and control..........sexually transmitted diseases .
And we monitor............. Outbreaks of infectious diseases
When they occur......... as they frequently do,
in our hospitals........ and long-term care facilities.
This Outbreak Control program is continuous.......
It is especially important..... in the wintertime ...
when respiratory ........and gastrointestinal infections occur
These are usually caused by viruses.....and they can be deadly
especially in the elderly.......... who are vulnerable to these infections.
Our role in controlling these outbreaks........ is organized ....and effective ..and essential.
*********************
The 2nd component of acute illness prevention......... is the prevention of Injury
Motor vehicle collisions......... are the number-one cause of death
in the age range one to 41 ......in Canada....... .
The OPP have just announced.... the 2004 so called "statistics" for Eastern Ontario
88 people...... lost.... as a result of MVC's last year
Bicycle accidents, drowning, and falls in the elderly
Are also difficult problems.... to prevent
One specific way ....that we try to reduce Injuries
Is through......Alcohol and drug abuse prevention
3. Our third Vow......... is to prevent chronic diseases.
As our population ages ....it is the chronic diseases
Namely...heart and lung disease, stroke, cancer, diabetes and osteoporosis
which sicken adults prematurely.
We tackle these chronic diseases ............
through our........... life style programs
specifically.....Don't smoke... good nutrition..... physical activity
as well as through cancer screening.
There are many profitable corporations out there
who make money.......... through promotion of unhealthy lifestyles.
It is our privilege in Public Health... to provide alternatives to our citizens
so that they can make the choice....between good health or bad.
4.5. Finally..... the 4th and 5th Vows of public health:
Health hazards......whether biological, chemical, or physical
commonly threaten... or apparently threaten..... the community
It is the responsibility of the health unit ........to investigate these.
We saw a number of examples.....during the past year.
This our 4th program......HHI
Full scale disasters on the other hand.......... rarely occur
Our 5th program.... Disaster Planning....produces an organized and practiced approach
Which coordinates the resources............ of municipal agencies
so that an effective response............. can to be mounted when it is needed.
Members of the board of health.... you have an excellent product here.
It should be an easy one.......... to sell to the community.
Funding of Public Health............is shared........
¾ from the province..... and ¼ from the local community
This is a very sensible approach. ......on the one hand
It helps us in H/PE ........to achieve the same provincial standards
of public health....... as everyone else in Ontario
On the other hand......it allows us to retain
some control........ over the local public health agenda.
Now in the four months........ that I have been at the health unit
I have discovered ...an interesting problem.
As I talk to my colleagues.......... and to members of the general public
I find.......... that there is little general understanding
out there in the community
about what exactly we do here......at the health unit .
This is a problem.......... in two ways.
First of all........ people cannot take full advantage of our services
if they do not know ...........what we offer.
And Secondly.......... when we go to the Municipalities for funding
our product...... is more difficult to sell than it should be
To summarize......the 5 Vows of Public Health
(conveniently remembered.....by the 5 vowels)
The goal of p~U~blic Health, again, is
"family and individual health............ in a safe community".
To do this..... we pr~O~mote............. family and dental health,
we pr~E~vent .........................acute and chronic illness,
we ~I~nvestigate ......................health hazards,
and we pl~A~n .........................for disasters.
That is a message............ that we need to get out to the community.
Apparently we have not been entirely effective .....in communicating our role.
This needs to change.
Mr. Chairman......and Members of the Board of Health.
You have a very exciting..... and very important.... product here
Your effect... in reducing misery and mortality in the community.... is huge.
As a general physician in this community I see on a daily basis
how effective........ public health measures are
in preventing......... both acute and chronic illness.
I hope as the New Year of 2005 ..........gets under way
that you will be excited.......... about your work on the Board of Health
and that you in turn ........will convey your enthusiasm
to your patrons......... and to your constituents.
I look forward .....to working with you again this year
I wish you all good Health.......... for 2005
....Mr. Chairman