2010 Annual Report
Message from Medical Officer of Health, Dr. Miriam Klassen
For the Perth District Health Unit, 2010 was a year for both looking back and moving forward. Lessons learned during the response to pandemic H1N1 of 2009 were processed and shared via debriefs and meetings with staff as well as community partners and the Ministry of Health and Long-Term Care. Meanwhile, programs and services that had been stalled due to the pandemic response
In addition, the Health Unit moved in several new directions. Internal renewal included a Technology Visioning session, which lay the groundwork for smarter use of information systems and technology as well as first steps into the use of social media to promote and deliver programs and services. Staff also achieved significant progress in the new Small Drinking Water Systems inspection program, initiated a Cancer Cluster Investigation in response to community concerns, developed the Healthy Communities plan, launched the Healthy Smiles Ontario program, and increased our Youth Engagement work.
In December, Dr. Arlene King, Ontario’s Chief Medical Officer of Health, released her 2009 Annual Report, Public Health, Everyone’s Business. In it she describes how, “we simply cannot afford not to” respond to current public health challenges such as healthy child development, health inequities, obesity and physical activity, and tobacco-related illness. The Health Unit is proud to be an active partner in addressing these issues, as well as the determinants of health, creating conditions in which our community can enjoy the best health possible.
I would like to thank our staff for their continued diligence and excellent service to our community in 2010, and our Board members for their ongoing support.
Dr. Miriam Klassen
Health Protection Happenings:
Cancer Cluster Investigation Undertaken
IN 2010, A RESIDENT contacted PDHU to draw our attention to a seemingly high number of young people with lymphoma. Further examination demonstrated a cluster of Hodgkin Lymphoma (HL) in Perth County youth aged 15 to 19 years old.
Investigating a cancer cluster requires a significant investment of resources and expertise, and a cause is rarely found. Cancer clusters can occur randomly without any underlying cause. However, when there is an elevated rate of cancer or any other disease in a community, an investigation can be valuable to better understand the situation, share the findings and address public concerns.
Therefore, the Health Unit decided to investigate this cancer cluster to:
- clearly characterize the cluster of HL
- seek potential known or unknown risk factors that may require more investigation;
- respond to public concerns; and
- recommend next steps if necessary.
From October 2010 to June 2011, the Health Unit conducted a cancer cluster investigation, which involved interviewing families affected by this illness. Data collected during these meetings was then analyzed and presented in a final report.
Key findings included:
- The rates of HL in Perth County youth aged 15 to 19 years old have been higher than the Ontario rates since 1986. Since this is an uncommon illness, the actual number of cases remains small (approximately two every three years in Perth County), which makes it difficult to form valid conclusions.
- The cluster appears to be centred around the city of Stratford. This geographic grouping is a result similar to previously investigated clusters of HL, in which it has been suggested that a social factor, such as an unknown infectious agent, may be involved.
- Some other factors were common to all cases: exposure to pesticides, time spent on farms, and chickenpox. However, these exposures are common to many Ontario youth and do not stand out as probable contributing factors to this cluster.
- As with other cancer cluster investigations, no single cause was suggested by our study.
In the final report, the Health Unit outlined the following as its next steps in this investigation:
- Continue to closely monitor the incidence of HL in Perth County youth in coordination with Cancer Care Ontario
- Assist with any further research into HL conducted by other agencies
- Consider presenting the report at conferences and events and publishing the report
- Promote the Ontario Health Study (www.ontariohealthstudy.ca), which is a long-term research study designed to create a large database of people to better understand complex chronic diseases such as cancer, and develop strategies for their prevention and
The Health Unit was very grateful for the cooperation of the families, Cancer Care Ontario and Public Health Ontario. To read the Report, you can download it at www.pdhu.on.ca – under PDHU Reports.
Safe to drink, swim or play!
As a part of its safe water program, the Health Unit encourages private well water owners to test their water for harmful bacteria three times a year. This is a free service. Of the 1,802 samples submitted in 2010, one in three came back as unsatisfactory. The
Health Unit continues to encourage private well owners to test their water regularly.
Public Health Inspectors also conducted routine inspections of swimming pools, wading pools, spas and splash pads. Five beaches were monitored for bacteriological safety with a total of 272 samples being collected.
Public Health Inspectors issued 67 directives to Small Drinking Water System (SDWS) operators outlining requirements that must be followed to bring their systems inline with the new regulations. Inspectors are continuing to do risk assessments of small drinking water systems in Perth County, as there are still about 100 systems to be inspected by end of 2011.
Influenza Season: from H1N1 & back again
In the spring of 2010, Dr. Miriam Klassen presented to municipalities and other stakeholders on the lessons learned in Perth County from the H1N1 influenza pandemic that was declared in 2009. Dr. Klassen also participated in debriefs with the Ministry of Health and Long-Term Care and contributed to research activities with other health sector organizations focusing on the response
of the health system. The presentations and research activities drew attention to many key issues and will help plan next steps in our ongoing pandemic response preparations.
In the fall of 2010, the pandemic had been declared over by the World Health Organization and the Health Unit geared up for what would be a more “typical” flu season. Although the number of people in Perth County who received the seasonal flu shot dropped
slightly in 2010/2011, this trend was seen across the province. Over the flu season, Health Unit staff provided 4,000 flu shots through community clinics and distributed 23,840 additional doses of flu vaccine to Perth County health care providers. During 2010, a total of two outbreaks in longterm care homes were attributed to seasonal influenza A.
Community Health Updates:
Giving Families Something to Smile About
In November 2010, Healthy Smiles Ontario was launched across Ontario. Healthy Smiles is a new dental program for children 17 and under who do not have access to any dental coverage and who meet the program’s eligibility requirements. Eligible children receive regular dental care, including preventive and early treatment, at no cost.
Kids 17 and under may be eligible if:
- They are residents of Ontario;
- They are members of a household with an Adjusted Family Net Income of $20,000 per year or below; and,
- They do not have access to any form of dental coverage (including other government-funded programs, like Ontario Works).
As of December 2011, 232 clients have registered for the Healthy Smiles program in Perth County. A new dental clinic in Milverton is helping to service these new patients.
Changes in Child Health 0 to 6 Programs
The Health Unit is a founding member of the Kids First Huron Perth children’s service system. Approximately 65 community
agencies are committed to integrating services for young families in Perth and Huron counties. In 2010, Health Unit staff participated on a range of working groups to collaborate in the planning and provision of services which support healthy child development. Kids First launched the first Best Start Child and Family Centre at Holy Name Catholic School in St. Marys. Leadership was also provided to collaborate with other health units and coordinate services for priority families in the southwest region.
The Healthy Babies Healthy Children program began changing the way it delivers its programs and services in 2010 to address
community trends and budget constraints. As a result, universal home visits by public health nurses to all new parents were scaled
back, and the percentage of parents in Perth who received a postpartum visit fell from 40% in 2009 to 34% in 2010. To address community trends, the Health Unit began work on a new, online version of the Let’s Grow program called Giddy-up Let’s Grow. The goal of the e-based newsletter is to reach parents where they are – online – and deliver age-paced child health and development
information into their inbox. The program launched in mid-2011.
Sexual Health Clinic Visits Keep Rising
FOR THE SIXTH year in a row, the number of people who sought services at the Sexual Health Clinic increased to a total of 3,687 visits in 2010 (see below).
The number of reported cases of Chlamydia reached a five year high in Perth with 152 cases, an upward trend that has been noted across both Canada and Ontario. Increased access to testing and improved testing partially explains this increase, and further attention to education and prevention will continue.
Healthy Eating Support Continues
In 2010, local schools continued their journey in becoming Healthy Schools, receiving various forms of support from the Health Unit. Training on the new provincial School Food and Beverage Policy was also held with school principals, Boards of Education, and Huron Perth Eat and Learn program volunteers.
The Health Unit staff provided support to enhance the capacity within the Perth County Food Security Coalition. A highlight for the coalition was the successful partnership with STOP Toronto to develop the local Community Food Centre.
Finances for 2010
2010 Board of Health
Joan Facey, Provincial Representative
Teresa Barresi, Provincial Representative
Don Chapman, Councillor, City of Stratford
Bonnie Henderson, Councillor, City of Stratford
Ed Hollinger, Councillor, Municipality of North Perth
Ron McKay, Councillor, Township of Perth South
Bruce Symons, Councillor, Town of St. Marys
John Van Bakel, Councillor, Municipality of West Perth
BOARD OF HEALTH SECRETARY
Randy Brown, Business Administrator
Board of Health meetings are open to the public. Meetings are held every 3rd Wednesday of the month at 9:30 am. To view the agenda and minutes from meetings, go to www.pdhu.on.ca and click on “About Us.”
The Year in Numbers
- 159 people received training at Food Safety Courses
- 135 health hazard complaints addressed on issues such as mould, foodborne illness and bed bugs
- 30 communicable disease outbreaks investigated
- 604 children from Perth County received developmental screening as part of the Calling All Three Year Olds kindergarten registration events
- 1,266 home visits made to families by the Healthy Babies Healthy Children team
- 2,557 immunizations given at travel and immunization clinics and at clinics for the Anabaptist community
- 1,420 travel health consults provided
- 13,486 school records and 533 day nursery records assessed for immunization compliance
- 4,915 contacts made with the public health nurses on Health Line
- 1,382 volunteer hours contributed
- 804 prenatal health packages given to pregnant moms
- 1,790 appointments with the Nurse Practitioner by Anabaptist clients
- 3,887 students received dental screening at schools; 458 children required urgent follow-up care
- 115 girls participated in Teen Esteem and 29 boys participated in Elements schoolbased programs
- 140 parents checked the safety of their car seats at clinics
- 230 (100%) elementary school students observed to be wearing their bike helmets as part of the annual Operation Melon
- 778 postcards signed by youth to advocate for stricter tanning bed regulations
- 2,000 quit smoking kits provided to hospitals to distribute to patients
- 23 elementary schools in the AMDSB and HPCDSB and 5 secondary schools received service from school-based public health nurses