York Region Public Health 2018 Annual Report

Supporting healthy child development for parents and families

The Child and Family Health division supports healthy child development from preconception to school transition. The division offers prenatal classes, breastfeeding clinics and support, parenting education and resilience building and home visits through the Healthy Babies Healthy Children program.

Registered nurses call all mothers in the first few days after being home with a new baby to answer questions and provide support. In addition, the division provides dental screening for preventive or urgent treatment for children and youth including assistance to find a dentist and apply for help with the cost of children’s dental care.

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Child and Family Health Community Needs Assessment

The Community Needs Assessment (CNA) Project was launched in January 2018, in response to our Division’s growing need to learn more about the parenting experiences of parents and caregivers of children 0-17. We also needed to better understand the many partner agencies that support York Region families to explore future collaborative opportunities

The CNA engagement uncovered an array of joyful stories and parenting challenges experienced by York Region residents. Our team heard from 806 residents, including mothers, fathers, individuals planning to have a baby, and grandparents through an online survey offered in six languages. We hosted 21 community conversations with over 72 residents and connected with 33 community partners, completing in person interviews with 16 of them.

The CNA project offered an incredible opportunity to get to know more about resident and community partners’ experiences in York Region raising and supporting families. The information collected, has been and continues to be, instrumental in the planning of York Region Public Health programs and services and is essential to supporting our current and future relationships. 

2018 Highlights

7,497 home visits to families

8,454 Healthy Babies Healthy Children (HBHC) screenings completed to help identify families and children who might be at risk for compromised child development or parenting

2,727 breastfeeding clinic appointments completed for 1,333 clinic program participants

51,232 children and youth received dental screenings

38,937 children and youth identified as needing dental care

2,026 children and youth received preventative dental treatment in public health dental clinics

44 parenting program sessions with 637 attendees

1,844 expectant parents registered for prenatal education

354 mental health promotion sessions with 1,994 attendees

6,106 telephone contacts with clients within the prenatal period to parenting children up to age 6 years stage supported by registered nurses

Inspecting and monitoring places where we work, live and play

The Health Protection division delivers programs and services to reduce the incidence and spread of infectious diseases, food and water-borne illnesses and other environmental health hazards. Key strategies include education, monitoring, inspection, enforcement and policy development.

Programs include food safety, rabies control, safe water, vector-borne diseases, infection prevention and control, health hazard prevention and management and tobacco/electronic cigarette education and control.

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Infection control complaints are publicly reported when an IPAC lapse is confirmed

Since October 2015, York Region Public Health has been investigating reports of possible infectious disease transmission as a result of improper Infection Prevention and Control (IPAC) practices in the community, known as an “IPAC Lapse”. Investigations are conducted in the following settings:

• Personal services settings such as nail salons and spas
• Settings not routinely inspected such as clinical offices, medical clinics and dentist offices
• Settings where a regulated health professional is involved such as physician, nurse or dentist

Investigations will often involve the IPAC practices of a regulated health professional. In these cases, concerns will also be shared with the appropriate regulatory college of the health professional, if applicable, as they operate in the interest of the public.

Public Health Units are required to publicly disclose IPAC lapse investigation reports on their website which outlines the details of each investigation. The number of posted lapses per year is as follows:

Year	IPAC Complaint Investigations	IPAC Lapse Reports Posted
2016	53	17
2017	83	19
2018	130	12

For IPAC lapse postings in York Region, please visit our webpage Infection Prevention and Control Lapses

2018 Highlights

63 investigations of indoor air quality

4,870 people certified though YorkSafe Food Handler Certification

12,812 food premise inspections

2,890 tobacco and electronic cigarette vendor inspection

1,299 inspections of pools, splash pads, receiving basins, wading pools and spas

1,658 personal services setting inspections

219 rabies vaccine dispense

1,284 animal exposure and rabies investigations

630 infection prevention and control (IPAC) inspections in long-term care homes and child care centres

71 infection prevention and control (IPAC) inspections in group living residences

106,054 street and environmentally sensitive catch basins treated with larvicide to prevent the spread of mosquitoes which carry West Nile disease

35 locations for active tick surveillance

25 inspections of tanning salons for compliance with the Skin Cancer Prevention Act

130 IPAC Lapse Investigations and 12 requiring posting

195 inspections of small drinking water systems
796 adverse drinking water quality incidents investigated

240 inspections of migrant farm worker accommodations

Promoting and supporting health and wellness for children, youth, families and seniors

The Healthy Living Division is made up of 16 distinct Public Health programs. These programs include those focused on health promotion and disease prevention, program surveillance and evaluation, health emergency planning, sexual health promotion, and sexually transmitted and blood borne infection follow-up.

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Sexual Health Clinic Outreach Framework

The sexual health clinics program developed an outreach initiative framework to provide access to sexual health promotion and clinical services for at risk priority populations. Components of the framework included partnering with community agencies to provide individual risk assessments, health teaching and testing for sexually transmitted and blood-borne infections and pregnancy; agency staff training to promote sexual health; on call support for agency staff and workshops and presentations for clients of community agencies that provide services to at risk priority populations. In 2018, clinical sexual health services were provided at 6 agencies with a total of 40 individuals tested for sexually transmitted and blood-borne infections, 80 individuals attended outreach events and 50 individuals were provided with risk assessment, health teaching and/or referral.

Development and Implementation of the Naloxone Program

York Region Public Health’s naloxone program was launched in February 2018, acting as a naloxone distribution hub for eligible clients, community agencies, and emergency services in York Region. Using a harm reduction approach, Public Health staff built capacity and provided individual and group training in the community to distribute naloxone to those at risk of an opioid overdose or someone who can help them. For more information on naloxone and York Region’s Opioid Action Plan, visit york.ca/opioids

2018 Highlights

72 fall prevention consultations provided to senior-serving organizations

68.7% of schools operated a student nutrition program

72.7% of elementary schools and 72% of secondary schools implemented comprehensive Healthy Schools Program initiatives

212 student leaders trained to deliver peer-to-peer substance misuse prevention messaging in schools

77% of the participants who attended tobacco cessation workshops made a quit attempt

9,743 investigations related to sexual and blood-borne infections

6,439 visits to sexual health clinics

21 sexual health workshops for community groups

4,274 students attended injury prevention education sessions

6 senior serving organizations collaborated with to host and recruit older adult clients for a mixed methods study of focus groups, individual interviews and survey questions to gain a fuller understanding the current status of fall prevention services in the Central LHIN

1,358 naloxone kits provided to clients, community agencies for distribution, and emergency services, of which 1175 naloxone kits reached 867 residents

11 naloxone agreements signed with 4 community agencies, 6 fire services and St. John Ambulance

Reducing the impact of infectious diseases

The Infectious Diseases Control division delivers programs and services to reduce the burden of infectious diseases and build capacity for disease prevention through health protection and promotion initiatives. The division investigates cases and outbreaks of reportable infectious diseases (not including sexually transmitted and blood-borne infections), conducts ongoing disease surveillance, manages the supply and distribution of publicly funded vaccines to community health care providers, provides school and community based immunization clinics and enforces the Immunization of School Pupils Act.

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Protecting York Region’s private school students through immunization

The 2017/18 school year was the first time York Region Public Health (YRPH) ensured compliance with the Immunization of School Pupils Act (ISPA) in private schools for the 9,029 students aged 7 to 17 years old.

The ISPA is an Ontario law that requires all students <18 years attending schools in Ontario to have their immunization up to date or have a valid exemption for nine vaccine preventable diseases (VPDs). The ISPA aims to prevent outbreaks in schools and keep schools healthy through protection against VPDs.

In fall 2017, YRPH used an inclusive and collaborative approach to ensure private school administrators and students’ parents/guardians had information about ISPA requirements. 

Ensuring compliance with the ISPA requirements in the public school student population from aged 7 to 17 years occurred during April and May 2018 and resulted in the suspension of only 111 students (1.22%), who weren’t in compliance with ISPA. The majority of these students were back in class within one to two days!

2018 Highlights

608,382 vaccine doses distributed to community health care providers and public health clinics (valued at over $29 million)

722 immunization clinics held by public health and 50,235 vaccine doses administered by public health staff

45 confirmed tuberculosis cases, total 312 tuberculosis investigations and 344 contact of confirmed pulmonary tuberculosis investigations

2,760 cases of public health significance investigated
2,345 (85%) cases of diseases of public health significance that met disease-specific case definition

798 vaccine storage fridges inspected of which 556 (70%) were in compliance. Note: Re-inspections of all fridges with a fail or conditional rating were carried out to ensure all violations were corrected

67,018 requests for updated immunization information