Working together to promote wellness, prevent and protect against disease and injury, and advocate for healthier communities.
Working together to promote wellness, prevent and protect against disease and injury, and advocate for healthier communities.
Welcome to our 2015 annual report. As you can see, the Eastern Ontario Health Unit (EOHU) plans and delivers many programs and activities aiming to protect and promote community health. One of the hallmarks of public health is to work and collaborate with multiple partners using a population-based health perspective. This collective and collaborative approach informs us about our community’s specific public health needs. Importantly, this perspective reflects the fact that “health” goes beyond the traditional healthcare system. From a holistic view, most of one’s health and wellness is determined by factors outside of the formal medical field. For example, health is affected, positively or negatively, by experiences during our early years, where we live, our income level and level of education. These factors, referred to as the “Social Determinants of Health,” contribute to more than 70% of one’s health status. This is why we are very happy that this year, we were able to formally assign two of our public health nurses to the Social Determinants of Health program.
By definition, when one addresses these determinants, it implies working across many sectors and with many partners and stakeholders with one common goal: the health and wellness of the population that we collectively serve. This is a unique aspect of public health activities that many people are not aware of. Combining this approach with many of our other programs, some of which deal with individuals, like vaccination clinics, dental screenings and young adult clinics, results in a deliberate blend of programs, services and activities designed to optimally promote the wellbeing of all EOHU region residents.
Dr. Paul Roumeliotis
Medical Officer of Health
Chief Executive Officer
The EOHU’s prenatal classes are designed to answer all the questions that a growing family may have related to their pregnancy and birth.
In 2015, 1763 participants took part in prenatal classes, whether they were offered as group sessions or online. The number is comparable to 2014, when a total of 1806 individuals participated in the EOHU’s prenatal classes. Individual prenatal education was also offered to 30 high-risk clients under the age of 20 years old.
The Baby’s Best Start (BBS) program provides nutritional assessments, healthy lifestyle education, breastfeeding education and referrals to other community services to pregnant clients who qualify for the program. Eligible clients may also receive prenatal vitamins and food coupons.
This program was successful once again in 2015. Demand for nutritional assessments remained strong, with 325 assessments planned and 229 initial assessments completed, compared to 250 in 2014. Keeping in line with numbers from past years, the program provided food vouchers to 123 clients, compared to 133 in 2014.
In terms of low-birth weight babies, progress is being made throughout the EOHU’s jurisdiction. In 2015, six babies whose mothers received BBS services had a birth weight lower than 2500 g, compared to 12 in 2014. These statistics are in line with a trend of decreasing numbers of low-birth weight babies since 2009, demonstrating that Baby’s Best Start is really making a difference in the community.
The Healthy Babies, Healthy Children (HBHC) program aims to help the youngest members of our community achieve their full potential by offering early detection and intervention for child developmental problems. This program is for pregnant clients and families with children up to the age of 6.
Starting in 2015, EOHU staff working within the HBHC program began to work more closely with hospital nursing staff to improve breastfeeding support. An HBHC agreement was revised with the Winchester District Memorial Hospital and signed with the Hawkesbury General Hospital. Agreements were also drafted with Valoris and the Children’s Aid Society of SDG.
A key feature of the HBHC program is to assist in early detection and intervention for child developmental problems. The Nipissing District Developmental Screen (NDDS) is an important screening tool that can help assess a child’s growth and development and determine if the child is developing normally.
In 2015, the program screened 434 clients, an increase from the 276 in 2014. The program’s screenings also introduced the NCAST scale in 2015, which is a tool used to assess parent-child interactions. Over 40 public health nurses were trained to deliver the NCAST scale and a core group of 21 of them were responsible for completing the NCAST scale with clients.
Corporate and program policies and procedures were also reviewed in anticipation of the EOHU’s Baby Friendly Initiative (BFI) pre-assessment visit in December 2015.
At the EOHU’s Watch Me Grow centres, health unit nurses are available to immunize and weigh children, answer parents’ questions and offer information on parenting, safety issues, breastfeeding, child development and more.
In 2015, 6428 clients were seen at the EOHU’s Watch Me Grow sites. Nearly 1200 of these were new clients, while 5232 were returning clients. These numbers are comparable to 2014, when 6444 clients were seen at the Watch Me Grow centres.
Triple P is an evidence-based parenting program that promotes and supports the mental, emotional, and physical development of children, youth and families. The program encourages parents to develop simple and practical strategies to confidently manage the behaviour of their children through the developmental stages of their lives by helping to create a setting that is loving, supportive and consistent. Depending on individual needs, the program offers one-on-one support, group sessions, seminars and a variety of other resources including an information line for telephone support.
In 2015, Regional Triple P training was offered to 60 practitioners. In addition, 40 daycare providers and supervisors attended Brief Primary Care training in early November.
Overall, 88 live courses were presented to 720 registered participants, of which 358 completed the training. The program continued to spark parents’ interest, as 314 calls were received on the toll-free information line and 47 emails were received at firstname.lastname@example.org.
Words in Bloom is a speech and language development program for children up to the age of 5. Following a screening at 18 months of age, speech and language pathologists work with children who may be at risk for not achieving their speech and language milestones. Early detection of a speech or language development problem is often the key to successful treatment.
NutriSTEP is a nutritional screening questionnaire for parents of toddlers and preschoolers that was implemented in 2015. It helps to assess a child’s eating habits and identify nutritional needs. The NutriSTEP team at the EOHU is composed of a public health nutritionist and two dietitians from both SD&G and P-R.
Before its launch, the team working on the NutriSTEP program worked with priority partners to collect baseline information and develop a customized implementation plan. They also made presentations to the EOHU’s Board of Health and provided training to public health nurses. A letter of introduction was sent to registered dietitians, external agencies, healthcare providers and family health teams as well.
The NutriSTEP team then identified and prioritized the EOHU’s programs and services as well as those of external agencies. They developed a work plan and established a process to manage and monitor the distribution of questionnaires and resources. An EOHU data management procedure was also developed.
In 2015, 14 educators and parent resource coordinators were trained to administer the screening. The individuals were provided with 885 NutriSTEP questionnaires for toddlers and 850 questionnaires for preschoolers.
The Immunization of School Pupils Act (ISPA) requires that all students registering in Ontario schools be immunized according to the immunization schedules for Ontario. Parents are responsible of notifying the heath unit when their child’s immunization record has to be updated.
Activities associated with the implementation of the Panorama inventory module were the main priority for 2015. This created significant changes to the health unit’s work processes, impacting all levels of staff. The inventory module will allow the health unit to better monitor vaccine usage and wastage.
The fall of 2015 was the first time the health unit used Panorama for school surveillance activities. A staffing plan will be developed and presented in 2016 to identify the health unit’s needs to maintain ongoing assessment and surveillance work for all students and children every year.
Good oral health is important to kids’ overall health. That’s why the EOHU is mandated by the Ministry of Health and Long-Term Care to provide a number of oral health programs for children and youth.
Healthy Smiles Ontario is a program for kids 17 and under. The program provides eligible kids with regular dental services at no cost to their parents. The Healthy Smiles Ontario program covers regular visits to a licensed dental care provider, such as a dentist or dental hygienist, to establish and maintain good oral health. It covers a full range of preventive and early treatment dental services including check-ups, cleanings, fillings, x-rays, scaling and more. Healthy Smiles Ontario enrolled 206 new clients in 2015.
The Young Adult Centre (YAC) is a school-based drop-in centre available in 37 schools throughout the EOHU’s jurisdiction. Teenagers can talk to a public health nurse (PHN) about any health-related matter. Students are consulting the school PHNs mainly to obtain information on contraception, STIs, sexuality, life skills, stress, mental health and relationships.
In 2015, PHNs at the YAC drop-in centres counseled 1361 students, an increase of over 200 students compared to the previous year.
In 2015, EOHU staff gave 108 presentations on puberty, contraception, STIs and healthy relationships to 2797 students from grades 5 to 12 within three different school boards (CEPEO, CSDCEO and UCDSB).
The tobacco prevention education campaign Love my Life Tobacco Free / J’m ma vie sans fumée was presented in several schools in the EOHU’s jurisdiction, and ten talented young artists got to present their performances and works of art to the public. The project encourages participants to explore “life’s breath” by sharing their passions through various artistic disciplines such as song, dance and visual arts.
The local youth project was such a success that a documentary about it was featured at the 6th Global Forum on Health Promotion held in Charlottetown, PEI. The documentary about the Cornwall-based project was one of 10 selected and presented at the international event for its innovative and collaborative health promotion practices.
The Love My Life tobacco denormalization workshop was also given to around 1000 students over the course of 30 presentations.
In late March 2015, the EOHU, along with its partners (Heart and Stroke Foundation, the City of Cornwall, and the Centre de santé communautaire de l’Estrie), organized a seminar titled Healthy Eating, Active Living. Over 50 people of different agencies participated.
An EOHU employee was also a guest speaker at the provincial Best Start workshop. Her subject was “Healthy Children on the Move.”
In addition, two representatives from the EOHU participated in a project from the Eastern Ontario Physical Activity Network (EOPAN) titled Rural Youth and Access to Active Recreation.
The EOHU was also represented by staff on the committee for the Active Transportation Challenge. The event was well covered by the media and there was a 29.5% increase in participation compared to the previous year. The challenge, which encourages participants to use public transit or active transportation to get around, saw increases in several categories:
As for the Alpha challenge, the EOHU had a 95% participation rate amongst its staff, making it the 7th health unit in the province in terms of participation.
The Green Food Box (GFB) is a non-profit program that brings neighbouring communities together to buy a variety of quality fresh fruits and vegetables at a wholesale price. Green Food Boxes are available monthly across the EOHU’s jurisdiction at a cost of $10 or $15 per box. In 2015, the program distributed 3730 boxes, an increase of almost 100 boxes compared to 2014.
The EOHU held a contest to celebrate Nutrition Month, which takes place every year during the month of March. Participants answered 10 questions about healthy eating in an online quiz and had a chance to win a grocery store gift certificate.
The nutrition team at the health unit was pleased to see a substantial increase in the public’s interest for its Nutrition Month campaign. 1248 participants took part in the contest in 2015, almost doubling the number from 2014, when 631 participants entered the contest.
In 2015, the EOHU continued to offer tobacco cessation services to the public. The health unit also developed policies to support tobacco-free properties and promoted smoke-free entrances to workplaces. 37 workplaces agreed to place the smoke-free entrance stickers, exceeding the goal of 20 workplaces.
In addition, the EOHU continued to collaborate with municipalities on the development of bylaws banning the use of tobacco products in public spaces and partnered with various community agencies to offer smoking cessation services, such as MyQuit. In 2015, 138 individuals from the EOHU’s jurisdiction participated in the MyQuit program, and 1540 vouchers for nicotine replacement therapy (NRT) products were distributed. Out of this number, 930 were redeemed.
At the end of 2015, the EOHU had approximately 1132 food premises facilities operating year round under its jurisdiction, broken down into 234 high risk facilities, 473 moderate risk facilities and 425 low risk facilities. There were also 171 seasonal facilities under the EOHU’s jurisdiction.
By the end of the year, approximately 1958 compliance inspections were conducted, along with 283 re-inspections. In addition, 81 food facility-related complaints were received and investigated with follow-ups by public health inspectors.
2015 also saw the implementation of a new program whereby food premises inspection results are posted at the entrance of the premises. The project was completed by the end of the year and although it wasn’t mandatory for food premises to display their inspection results to the public, most of them did.
On another front, the EOHU’s Food Handling Certification (FHC) program saw an important increase in demand compared to the previous year. 531 food handlers were certified over the 25 workshops held in 2015, an increase of 98 food handlers from 2014.
The EOHU protects the health of our community by issuing drinking water advisories for municipalities and public places when tests reveal the presence of harmful bacteria or chemical products in public drinking water systems. In 2015, 29 water advisories were issued while 30 were lifted.
The EOHU also offers free water testing to private households that draw their drinking water from a well. The program remained popular in 2015, with 8740 drinking water sampling bottles distributed to the public. Out of that number, 6167 bottles from all offices were sent to the public health laboratory for analysis. Compared to 2014, over 550 bottles more were distributed to the public.
The EOHU met its goal of inspecting all high-risk Small Drinking Water Systems (SDWS) that were due for inspection in 2015, and therefore achieved 100% of the Accountability Agreement. A total of 280 SDWS were inspected, of which 15 were high risk. 52 directives were issued throughout the year.
The EOHU’s beach water quality monitoring program includes weekly water samplings, postings and lifting of postings. In 2015, the EOHU monitored 17 beaches, reporting a total of 1265 samples. A total of 1440 samples were sent to the public health laboratory, including samples from a voluntarily monitored private beach.
In addition, 61 public pools (both indoor and outdoor) were inspected, as the health unit performed 100% of planned inspections.
The EOHU also took part in activities to educate the public about water safety. During the Eastern Ontario Children’s Water Festival, safe water education was provided at 2 locations:
The EOHU began working on a new program titled the Social Determinants of Health (SDoH) in 2015. According to the World Health Organization, the SDoH are the circumstances in which people are born, grow up, live, work and age, and they have a greater impact on an individuals’ health than any healthcare they’ll receive throughout their life.
In 2015, the EOHU began collaborating with other agencies to address the SDoH affecting the population in the health unit’s jurisdiction and to increase access to services for the people who need them the most.
The EOHU assigned two public health nurses to the new program, and their task is to educate and raise awareness about SDoH issues amongst decision-makers within the healthcare system, other sectors of society, and the general public. Much effort was put into the creation of the “Let's Start a Conversation about Health” video, available in both English and French.
With 148 cases, there were 19 more occurrences of enteric diseases in 2015 than in 2014. Campylobacter remained the most common enteric illness reported locally as well as provincially. In 2015, there were 51 cases, an increase of 44 cases from 2014. Salmonella remained the second most predominant enteric disease reported, with 40 cases in 2015.
However, the number of cases of Giardiasis saw the biggest increase in 2015, nearly doubling that of the previous year, going from 16 in 2014 to 27 in 2015. It was the highest number reported in the past 10 years.
There was a decrease in the number of cases of sexually transmitted infections (STIs) in the health unit’s jurisdiction in 2015, with the number going down to 458 from the previous year’s 612. The overall decrease can be explained by a decrease in cases of Chlamydia, Hepatitis B, Hepatitis C, and Gonorrhea.
However, there was a dramatic increase in the number of Syphilis cases in 2015, increasing from 5 in 2014 to 16 in 2015.
2015 was a very active year for vector-borne diseases. Although there were no cases of Rabies reported in the EOHU’s jurisdiction in 2015, preventing the disease kept the team busy as the EOHU’s surrounding jurisdictions (New York and Akwesasne) reported cases of rabid raccoons. Given the geographic proximity of cases, the EOHU was invited to participate in the baiting process in August.
More pet owners got their pets immunized at the EOHU’s annual rabies vaccination clinics in 2015. 2626 pets were vaccinated at 24 clinics, a slight increase over the 2603 pets who were vaccinated at 23 clinics in 2014.
Based on tick surveillance, the EOHU’s jurisdiction is considered a high-risk region for Lyme disease, and it showed in the number of cases reported in humans. There were 20 confirmed human cases of Lyme disease and 4 probable cases in 2015, up from 3 confirmed cases and 4 probable cases in 2014.
As for West Nile virus, there were no human cases in 2015, but the virus was detected within a pool of mosquitoes. The mosquito surveillance program ran from mid-June to late September.
Despite the Ministry of Health and Long-Term Care’s general recommendation to discontinue testing for Eastern Equine Encephalitis Virus (EEEV), the EOHU continued to monitor the disease in 2015 due to the EEEV activity in its jurisdiction the previous year. However, no cases were detected.
The EOHU once again offered free Influenza immunization to the public in 2015. The year was marked by the implementation of the universal booking calendar, a centralized system that allows EOHU staff to book appointments for the public at any EOHU office and for any service, including Influenza immunization.
Presence at the EOHU’s influenza clinics continues to decline in numbers, most likely due to increasing access via other sources such as pharmacies, physicians, community health clinics, and workplace clinics. The health unit will therefore focus on providing its mass community clinics in areas where there is less access to the influenza vaccine.
The EOHU immunized 2906 individuals at its community clinics in the area, and another 113 by appointment at its offices, for a total of 3019 individuals. The number of individuals who got immunized against the flu at their local pharmacy grew dramatically, increasing from 6429 in 2014 to 11 103 in 2015.
The EOHU continued to take part in the Medi Drop program in collaboration with the Cornwall Community Police Service (CCPS) in 2015.
The EOHU continued its partnership with the Seaway Valley Community Health Centre to prevent fall-related injuries. In 2015, presentations were given to 828 participants in 48 groups.
Staff at the EOHU also set up their display on falls prevention at 7 seniors’ fairs, where they had the opportunity to present to 684 participants.
The EOHU also continued to offer car seat consultations to the community. In 2015, EOHU staff completed 92 car seat consultations at its offices in Cornwall, Rockland and Winchester. The EOHU’s three other offices didn’t have trained individuals to offer the service.
In 2015, staff at the EOHU developed a comprehensive suicide prevention plan and also made the required changes to Reachoutnow.ca, a website providing tips and advice to individuals who want to help a friend or loved one who may be thinking of committing suicide.
Additions were made to the website, including a section for older adults. In 2016, sections for men and members of the LGBTQ community will be added as well.
Healthline is a free and bilingual telephone service for residents of the five Eastern Counties. It provides information about healthy living, travel precautions, immunization, EOHU programs and services, and more.
The greatest increase of calls coming to Healthline in 2015 was for child health, including dental services, increasing from 7735 in 2014 to 9454 in 2015. Overall, there was a greater volume of both incoming and outgoing calls in 2015 than in 2014.
As of December 31, 2015 there were 159 active full time employees and 30 active hourly employees for a total of 189 active employees at the EOHU. During the year, 5 new (or replacement) employees were hired, including:
The EOHU and the communities we serve are fortunate to benefit from many selfless hours donated by volunteers that support our public health efforts. Whether it’s behind the scenes in our offices, at major events such as the immunization clinics, or providing rides to clients so that they can attend appointments, our volunteers are an essential part of the EOHU team. Their energy, dedication and thoughtfulness help make our Eastern Ontario community a healthier place to live. We cannot thank our volunteers enough for their generous spirit! In 2015, the EOHU’s 107 volunteers donated a total of 2684 hours.
The Communications department completed 488 projects in 2015, some of which were started in 2014. The year was marked by the successful launch and promotion of several programs, including the special events and restaurant inspection signage system.
2015 was also marked by the growth of the EOHU’s presence on several social media channels, with an increase of 122% in clicks on Twitter in English and 164% in French. On the other hand, views on the EOHU’s Youtube channel decreased 44% compared to 2014, down to 167 247 views.
As for the EOHU’s website, Facebook was the top referrer for both English and French sections. There was also a substantial increase in the number of employees using the EOHU’s intranet website, as can be seen by the number of downloads, which increased from 13 186 in 2014 to 19 187 in 2015.
The Communications department collaborated with community partners on several marketing projects in 2015, including Medi Drop with the Cornwall Community Police Service (CCPS), and the Reach Out Now website with the Suicide Prevention Coalition of Champlain East. The Communications team worked on a number of marketing campaigns that take place on an annual basis as well, including Nutrition Month, rabies immunization for pets, and influenza immunization.
The department also worked on a Healthy Aging web section and a new stand alone Green Food Box website, not to mention a variety of video productions.
An initiative of the Ministry of Health and Long-Term Care (MOHLTC), the Community of Practice Public Health en français encourages public health stakeholders to exchange resources and best practices in the field. They can access an inventory of French resources free of copyright, a bulletin board, an event calendar, webinars and discussion forums. Membership in the Community of Practice continued to grow in 2015 as the addition of 30 new members throughout the year increased the total to 110. The members represent 17 public health units and 13 health-related agencies.
In 2015, a partnership was also established with the Réseau des services de santé en français de l’Est de l’Ontario (RSSFEO).
The Continuous Quality Improvement (CQI) department strived to improve various processes at the EOHU in 2015. The department managed the process, review and completion of the Infection Prevention and Control Canada (IPAC) accreditation. It also managed the Managing Medications and Public Health accreditation self-assessment questionnaires.
Several efforts were also made in 2015 to incorporate the CQI philosophy and culture into everyday practice. The CQI section on the EOHU’s new Intranet was further developed as a repository for CQI tools and resources.
The organizational complaint/incident management system served as another venue for assessing internal processes in 2015. Quarterly complaints/incidents reports were submitted in 2015 showing frequencies and trends.
The health unit also held its fourth annual Privacy Awareness Week from December 1st to the 4th. The theme in 2015 was the role of public health staff as advocates when it comes to privacy and youth.
The IT department worked on several transformative projects in 2015. One of them was the implementation of the Panorama vaccine inventory module, which was launched in May 2015. Another initiative that was successfully implemented in 2015 was the “sound alike/look alike” program for vaccines. The EOHU’s hardware was also upgraded in 2015. Boardrooms and conference rooms now have better connectivity due to the installation of new TVs and HighFive cameras.
The HighFive program allows health unit staff in different offices to easily hold a teleconference. In addition, generators were installed in 5 out of 6 offices.
The Epidemiology, Surveillance and Research department is the main point of contact within our region for public health and disease risk factor data. Local survey results and reports are shared on an ongoing basis with EOHU employees and with the community through presentations and the Reports section of the EOHU website. The epidemiology and evaluation projects of 2015 include: