Public Health Services Annual Report

• Staff Received Equity Training - 296
• Staff Received Indigenous Cultural Safety Training - 70
• Programs Received Equity-Specific Data Reports - 6
• Pregnant Individuals Received a Healthy Babies Healthy Children Screening - 900
• Students Received Dental Health Screening - 22K+
• Students Immunization Records Reviewed - 41K+
• Vaccines Administered to Students - 46K+
• Schools Received Public Health Nurse Support - 100
• National Certified Healthy Schools - 53%
• Needle Exchange Van Responses - 3K+
• Sites Distributed Naloxone Kits - 57

Building our staff’s knowledge, skills, and attitudes is critical for effectively addressing health inequities in the community. When our staff understand the complex health and social issues impacting our community and their underlying causes, they are better equipped to address them. This means they engage in meaningful ways to co-create services and interventions that address the unique needs of populations impacted by health inequities.

In 2023, Hamilton Public Health Services prioritized enhancing staff competency to create a more equitable and inclusive community for all:

• 296 staff members received health equity and anti-racism training, empowering them with tools to apply these principles effectively towards program planning and decision-making.
• 70 staff members underwent Indigenous Cultural Safety Training, deepening their understanding of the historical context underlying health inequities among Indigenous populations in our communities. It also enabled our staff to provide comprehensive and culturally responsive services and continue on the journey of developing meaningful relationships with Indigenous communities.
• 25 staff members and 23 community partners bolstered their skills around the equitable and ethical use of data. This training equipped participants with the skills to use data to drive health equity work in the community, ensure the data reflects the community's needs, and ensure staff have the knowledge and skills to effectively implement Hamilton Public Health Services’ forthcoming Health Equity and Anti-Racism Plan.

Data is an essential component of advancing health equity issues in the community. Population health data identifies existing health inequities and is used to inform decisions about co-design, programming, and service delivery. Data is also used to determine if our efforts are having the intended impact and outcomes in the community.

In 2023, Hamilton Public Health Services developed equity-specific population health assessments for six programs and equity-related key performance indicators for three programs to guide our efforts to ensure our programs work towards reducing health inequities in the community. Looking ahead, Hamilton Public Health Services is committed to expanding these efforts across all our programs. Additionally, significant work went into planning and analyzing content for the Community Health Status Report that will be released in 2024. This report will provide a comprehensive snapshot of the community's health and guide planning and service delivery.

Community engagement is essential for addressing health equity issues in the community. By working together with community members, we foster collaboration, inclusivity, empowerment, and a deeper understanding of local needs. When community members are involved and co-design efforts, we ensure our programs and services are equitable, responsive, culturally safe, and tailored to the diverse needs of our community. Community engagement builds trust and strengthens relationships between our organization, community members, and partners.

In 2023, Hamilton Public Health Services undertook various community engagement initiatives to ensure our work reflects the voices and experiences of our community:

• A comprehensive consultation process was undertaken with the City of Hamilton’s Advisory Committees, community partners, health professionals, and the public to modify the Board of Health governance structure. This process gathered valuable insights to help make sure our governance reflects and leverages the diversity within our community.
• Working closely with Indigenous leaders and community members, we developed the Indigenous Health Strategy to reflect direction and feedback from the Indigenous community. This strategy identifies opportunities for Hamilton Public Health Services to better support the specific health needs of our Indigenous community. It also emphasizes the importance of self-determination and cultural safety in all our services.
• Through the continuation of the Vaccine Ambassador program, developed in partnership with the Hamilton Black Health Community Leaders Forum and the Vaccine Readiness Network, we shared culturally appropriate information about vaccines and other public health and community services among Black, Indigenous, and racialized communities. This initiative increased vaccination rates among these populations and built trust and strengthened relationships with these communities.

Raising awareness and inviting dialogue about health inequities is vital for addressing disparities in our community. By sharing information and facilitating dialogue through effective communication strategies, we can collectively work to implement targeted interventions to tackle these challenges.

In 2023, Hamilton Public Health Services developed the Community Health Status Report to provide comprehensive information about the community’s overall health status. Routine updates were shared with over 50 community stakeholders to inform them about the report’s progress, milestones achieved, and upcoming work. Various strategies were also planned to communicate and initiate community conversations about the report’s findings upon its release in 2024. Additionally, Hamilton Public Health Services explored new communication channels, launching our own Instagram account to reach and engage with the population we serve.

Public Health Services is on Instagram

We are excited to have launched our own Instagram account this year, providing a new channel to connect with community members and partners.

This platform will play an important role in ongoing efforts to heighten awareness of health equity issues and spotlight the initiatives undertaken to address them.

Instagram Post - Introduction of HPHS channels to engage more Hamiltonians

“When working with clients with syphilis who may have transient living situations and limited means of communication, it can be challenging to reach them to provide important public health guidance. Communication through multiple channels including phone and text messages, as well as collaboration with community support workers and with healthcare partners make a huge impact to connect people to the right care and facilitating appropriate treatment. These experiences underscore the importance of proactive outreach and collaboration in addressing the needs of vulnerable individuals within our community.” – Infectious Diseases Program Public Health Nurse

The perinatal period, spanning from pregnancy to 12 months postpartum, is a critical timeframe for infants and parents; it establishes the foundation for long-term well-being. Adequate support during pregnancy contributes to healthier pregnancies, reduces the risk of complications, and promotes positive birth outcomes. In the postpartum period, appropriate support can help establish a nurturing environment for optimal development. Additionally, targeted strategies can address health inequities among children and youth during this critical period.

In 2023, Hamilton Public Health Services increased access to perinatal support:

• Educated health professionals and organizations on the importance of prenatal screening for early identification of pregnant individuals at risk for poor mental health. This outreach and education resulted in the completion of 900 prenatal Healthy Babies Healthy Children screens.
• Introduced virtual breastfeeding sessions to reach those who experience challenges accessing in-person services. Delivering the services in this client-centred way allowed us to reach families who would not be able to access support otherwise and reduce barriers to perinatal support.

Mental health among children and youth shapes their cognitive, emotional, and social development. Early experiences profoundly influence long-term mental health outcomes, making it crucial to provide support during their early years. Expanding access to infant and early-year mental health supports builds the foundation for resilient and emotionally healthy individuals, fostering positive outcomes that extend into adolescence and adulthood.

In 2023, Hamilton Public Health Services has implemented various strategies to enhance mental health support for young children:

• Strengthened early identification of social-emotional developmental concerns and created tailored support plans for children aged 0 to 6.
• Streamlined access to appropriate supports and services for children aged 0 to 3.8 years, resulting in increased screening rates and increased referrals to vital mental health and developmental services.
• Introduced innovative approaches, such as play-based therapy sessions, to nurture the social and emotional development of children aged 0 to 6.

“The Coordinated Supports for Families (CSF) program is geared towards single parents receiving Ontario Works subsidy and was created to support the most vulnerable families within the Healthy Babies Healthy Children program. This program improves health equity by reducing barriers to accessing community resources through streamlined referrals to Child Care Subsidy, Recreation Assistance Program, and a free Presto card. It also includes regular joint meetings with the assigned public health nurse and Ontario Works case manager, creating opportunities for client advocacy, relationship building and reduced burden on families. This program has significantly impacted the families involved as we have seen families achieve timely access to daycare, increased involvement in community programming, and parents succeeding in returning to work or school. Access to these resources improves child and family health and well-being, health literacy, and client autonomy, thus contributing to community health. It is a privilege to support the families involved with the CSF program.” - Home Visiting Program Public Health Nurse

Creating a supportive school environment is crucial for students’ overall well-being, impacting their physical, mental, and emotional health both in and out of the classroom. Public health efforts in schools play a crucial role in promoting the long-term health and well-being of students and the broader community.

In 2023, Hamilton Public Health Services focused on enhancing school-based health services surrounding dental screenings and immunization clinics to address deficits of care resulting from the pandemic. Additionally, Hamilton Public Health Services focused on continually improving partnerships and collaboration with local schools and school boards. Key achievements during the 2022-23 school year included:

• Completed dental screenings for 22,295 students to identify potential dental issues and urgent dental needs. Regular assessment of oral health issues contributes to the prevention and early intervention of dental problems, promoting overall oral health among students.
• Reviewed and updated immunization records for 41,611 students, ensuring compliance with the Immunization of School Pupils Act.
• Administered 46,668 vaccine doses to grade 7-12 students to catch up on missing immunizations, which are crucial for preventing vaccine-preventable diseases.
• Provided direct public health nurse services to over 100 “high priority” schools. This work focused on supporting student mental health and contributing to pandemic recovery efforts.
• Facilitated National Healthy Schools Certification for 53% of the identified “high priority” schools, promoting and enhancing students’ health and well-being and bolstering relationships with schools and school boards.

National Healthy Schools Week

In honour of National Healthy Schools Week, we highlighted the work being done to support, empower and engage school communities as they work toward becoming healthy school environments for all.

The series of posts highlighted the work of our School, Dental and Vision Screening and Vaccine programs in local schools.

Instagram Post - National Healthy Schools Week 

A trauma- and violence-informed approach acknowledges the profound and lasting impact of trauma on the well-being of individuals and the community. Implementing a trauma- and violence-informed approach prioritizes safety, trust, and empowerment that will allow Hamilton Public Health Services to better meet the unique needs of those who have experienced trauma, promoting healing and resilience.

In 2023, Hamilton Public Health Services initiated work to develop a plan to integrate trauma- and violence-informed care practices. This initiative will be implemented in the coming year.

Promoting the mental well-being of children and youth shapes their cognitive, emotional, and social development and influences their life-long well-being. To build the foundation for resilient and emotionally healthy individuals, it is essential to focus on prevention and early intervention for this age group and ensure access to the appropriate support and services in the community. The pandemic has heightened the need for mental health services among children and youth, emphasizing the importance of increasing collaboration across the community.

In 2023, Hamilton Public Health Services partnered with the City of Hamilton’s Healthy and Safe Communities Department to align efforts in promoting mental well-being and preventing substance use among youth and children. This collaboration aimed to create a more integrated and comprehensive approach to address these issues. This work will be continued in the coming year, seeking additional opportunities to further collaborate with community partners to enhance the effectiveness of mental health promotion and substance use prevention efforts.

Addressing substance use challenges in our community requires a comprehensive, multi-faceted approach. By advancing healthy public policies grounded in health promotion, we can effectively address substance use issues within the community. Evidence-based policies not only bolster public health initiatives but also work systematically to reduce the impact of substance use on communities.

In 2023, Hamilton Public Health Services made significant progress in this regard. A City-wide, cross-departmental working group was established to revise the Municipal Alcohol Policy to reflect current legislation, evidence, and local needs. The policy revision process is ongoing, and the updated policy is expected to be brought forward to City Council for approval and implementation in early 2024.

Adopting a harm reduction approach recognizes the challenges of substance use and prioritizes community well-being. By implementing harm reduction strategies, Hamilton Public Health Services aims to promote safer practices, prevent overdose-related deaths, and reduce the spread of communicable diseases. This approach builds trust between our team at Hamilton Public Health Services and community members, meeting individuals where they are in their substance use journey. Ultimately, embracing a harm reduction approach improves population health outcomes by addressing the immediate needs of individuals, improving community safety, and fostering a more inclusive and compassionate approach to well-being.

In 2023, Hamilton Public Health advanced several harm reduction efforts:

• Developed the Hamilton Opioid Action Plan, a comprehensive strategy to respond to the toxic drug supply and reduce opioid-related harms and deaths in the community, through collaboration with community partners.
• Collaborated with Housing Services to make a call for applications to launch a supervised consumption site within a men’s shelter to support safer substance use among men who are experiencing homelessness. While no applicants emerged, we collaborated with local shelter providers to propose embedding harm reduction workers into the shelter system. This alternate proposal will be presented to City Council in 2024.
• Provided guidance to community organizations seeking municipal endorsement for Consumption and Treatment Services applications, expanding access to consumption services in the community.
• Created a 12-month pilot program for drug checking strips to support safer substance use, with roll-out scheduled for early 2024.

Core principles of a harm reduction approach

The Van Needle Syringe Program is a great example of how we are honouring the core principles of a harm reduction approach and meeting clients where they are at, in both a literal and figurative sense.

The post takes our community behind the scenes of the van to better understand how we provide harm reduction education, supplies, needle disposal and referrals to other community partners.

Instagram Post - VAN Needle Syringe Program

“The Tobacco Cessation team re-opened our Quit Clinic in May of 2023. The clinic helps meet the needs of Hamilton residents who are trying to quit smoking or vaping, particularly those without a family physician. Clients are offered free nicotine replacement therapy in addition to one-on-one counselling with a public health nurse. Many clients are facing multiple challenges that make it more difficult to both quit and access support. In addition to the clinic, a cessation care pathway is used by health care providers in Hamilton to refer clients to the appropriate service for their cessation needs, including referral to the public health Quit Clinic or other services for Indigenous, youth, those with mental health concerns, and pregnant people, and others. The partnerships with community organizations provide access to free nicotine replacement therapy in our community, which allows residents to receive reducing pressures on those trying to quit.” - Tobacco Control Program Public Health Nurse

The impact of extreme heat, which has worsened with a changing climate, poses significant threats to the community’s health. Rising temperatures increase the risk of heat-related illnesses and deaths, especially among vulnerable populations. As climate change continues to amplify the frequency and intensity of extreme heat events, proactive measures are essential to safeguarding public health and mitigating the adverse health outcomes associated with extreme heat. Hamilton Public Health Services plays a vital role in raising awareness about the health risks associated with extreme heat and implementing initiatives to mitigate its impacts. This includes targeted education efforts to inform communities about heat-related illnesses and promote preventive measures to enhance community preparedness and resilience.

In 2023, Hamilton Public Health Services completed several initiatives to minimize the adverse health impacts of extreme heat:

• Developed a Heat Response Strategy to prevent heat-related illnesses and deaths and protect vulnerable residents.
• Launched the “Be A Heat-Wave Hero” campaign to educate landlords about extreme heat risks in high-risk areas.
• Developed “CoolKit” toolkits to educate public and private subsidized housing providers about the risks, impacts, and prevention of heat-related illness.

Changes in our climate significantly influence the prevalence and distribution of vector-borne diseases. As temperatures rise and weather patterns change, the geographic range of disease-carrying vectors, such as mosquitoes and ticks, can move into new areas, putting more people at risk. Addressing the impact of climate change on vector-borne diseases requires a comprehensive approach that incorporates surveillance, prevention, and responsive public health measures to protect the growing health threats posed by these environmental changes. Hamilton Public Health Services plays a role in this area by making sure people know how to protect themselves from these diseases and promoting actions that reduce the vector-borne disease transmission.

In 2023, Hamilton Public Health Services:

• Installed more signs about Lyme disease on local trails to help residents understand how to protect themselves adequately from it.
• Developed educational materials about Lyme disease and infection information in multiple languages to reach culturally and linguistically diverse groups. This work was achieved through collaboration with our Vaccine Ambassadors to engage and educate diverse community members.
• Developed plans to increase surveillance, public awareness, and detection of climate-sensitive vector-borne diseases, which will be implemented in the coming year.

Surveillance of Vector-Borne Diseases

Part of our education on vector-borne diseases involves showcasing what is being done to prevent, assess, and respond to vector-borne disease concerns.

The post demonstrates the annual spring surveillance conducted by our Health Hazards and Vector-Borne Diseases program to assess the local risk of human tick-borne infections by monitoring the presence of ticks in the area.

Instagram Post - Annual Spring Tick Dragging & Surveillance

Understanding climate change and its impact on health relies heavily on data collection. By gathering data, we can identify health risks related to climate change and prepare for emerging challenges. This helps us better plan and allocate resources where they are needed most to protect our community.

In 2023, Hamilton Public Health Services aimed to develop a plan for a monitoring system to track weather-related health events with more real-time communication. This involved initiating the development of a plan to enhance data surveillance for monitoring heat-related illnesses in hospitals. These data will be shared with the Public Health Committee in mid-2024 to inform future climate response initiatives.

It is essential to raise awareness about how climate change affects our health, especially those most vulnerable in our community. Understanding these connections can help us prepare for increased risks of heat-related illnesses and deaths, vector-borne diseases, and other health issues due to environmental changes.

In 2023, Hamilton Public Health Services focused on supporting the Corporate Office for Climate Change Initiatives and others across the City of Hamilton. Our efforts included developing climate and health promotional material, conducting research for awareness, and identifying communication channels for priority and at-risk populations. Hamilton Public Health Services will build on this work in collaboration with the Office for Climate Change Initiatives to align priorities and identify ongoing initiatives for 2024.