1. Making the Shift to the Determinants of Health The Experiences of the Peterborough County-City Health Unit

2. Community Profile County and City Population: 133,080 City Population: 74,898 1.5 hrs northeast of Toronto Employment: retail, manufacturing, health, food services, education Few visible minorities (2.7%) Median age higher than Ontario (44 yrs)

3. Poverty in our Community Median household income $9,000 below Ontario level 13% of all households, 37% of single adults below the poverty line Child poverty: 1 in 5 children Affordable housing waiting list: 1,469 people Social assistance: 9,039 people 52% of tenant households spending more than 30% of income on housing

4. Local Strategies Targeted services to high needs groups Board and staff education and support Community media campaigns and resources Advocacy for social policy change Active partnerships with community groups and agencies

5. 1) Targeted Services Areas of parenting support, teen pre-natal classes, school for young moms, dental treatment for adults and children, food security, street nursing. Address client needs and barriers Build partnerships Learning opportunities

6. 2) Board and Staff Education and awareness-raising Social Determinants of Health Committee Training series on social determinants Poverty and Health program staff New Ontario Public Health Standards opportunities

7. 3) Community Campaigns and Resources Child poverty television ad and booklet Local high school poverty ads

8. Social Policy Campaign Television ads Displays Web site 2007 Campaign “Income, housing and access to food affect health”

10. Social Policy Campaign - 2008 Peterborough County-City Health Unit web site expansion Poster Newspaper insert

11. Resource Development “Peterborough Health Services Directory” Free or low cost health and mental health services

12. 4) Advocacy for Policy Change Meetings with MP, MPP, election candidates Provincial All-Candidates positions on poverty

13. 5) Community Partnerships Strengthened community partnerships (Mayor’s Action Committee on Poverty Reduction, Peterborough Coalition for Social Justice, Poverty Action Network, Peterborough Health Coalition, Food Action Network)

14. The Mayor’s Action Committee Community Consultations and Report Committee and Workgroups Short Term Action Short Term Action Root Causes of Poverty Root Causes of Poverty Advocacy Advocacy Communication Communication

15. Lessons Learned Involve all levels of staff in the health unit, include the Board and MOH wherever possible. Involve all programs – start where staff are at. Build on their existing community relationships. Partner with the social justice sector – open your doors and listen, go out and visit. Don’t be overwhelmed. Small local actions can build.

16. On-going Challenges Meeting immediate needs for services while addressing long term policy issues (especially in structured programs like HBHC, inspection, sexual health). Integrating social determinants with other planning frameworks. Constant change, need for communication and feedback over a long period. Defining a clear health unit role and setting limits when needs appear unlimited.

17. Contact: Christine Post Health Promoter, Poverty and Health Program Peterborough County-City Health Unit cpost@pcchu.ca

18. Positioning for the Future – Principles of the New Ontario Public Health Standards Impact: “Public Health…strives to influence broader societal changes that reduce health disparities and inequities. …Boards of health shall not only examine the accessibility of programs and services to address barriers…but also assess, plan, deliver, manage and evaluate programs to reduce inequities in health, while at the same time maximizing the health gain for the whole population.” (Draft April, 2008)

19. 1) Targeted Services Healthy Babies/Healthy Children Nobody’s Perfect Parenting Program School for Young Moms Teen Pre-natal Supper Club Dental Treatment Assistance Fund Children in Need of Treatment Dental Program Food Security Health Promotion Project Collective Kitchens and YWCA food partnerships Food for Kids School Nutrition Program Street Nurse Project