Kamloops Roundtable Report

In Kamloops, the Minister of State met approximately 18 public health stakeholders from the interior of British Columbia.

They advised the Minister to consider the following factors in building a Public Health Agency of Canada.

1. Regarding a Mandate for a Public Health Agency

• The Agency should take a holistic approach to public health encompassing the physical, emotional, spiritual, and social dimensions of health;
• Public Health Agency of Canada must be more comprehensive than the U.S. Centers for Disease Control and Prevention:
  • Needs to also strengthen public health system at local levels while maintaining connections between local, provincial and national infrastructures; and,
• Needs to bridge professionals and the public.
• Opportunity now to expand or rebuild a range of public health programs that have been recently neglected including:
  • Primary health care;
  • Chronic disease prevention;
  • Early childhood development;
  • Injury prevention; and
  • School youth health.
• Agency should secure a federal role in the training of public health professionals for Canada.

2. Regarding Operational Strategies for a Public Health Agency

An Agency should consider:

• Developing a comprehensive School Health Education Policy:
  • Promoting lifelong learning towards healthy lifestyle choices including nutrition and parenting education.
• Committing to the Action for Healthy Communities Initiative, a local school and city initiative in Kamloops area to support physical activity and good nutrition for youth;
• Seeking a national approach managing infectious disease like West Nile, SARS, etc.;
• Ensuring that the close links between mental health and addiction are recognized in the development of broader public health programs:
  • Communities like Kamloops would like to adopt the Vancouver Four Pillar Approach to address drug use problems; and,
• Addiction treatment workers are generally isolated from other public health colleagues and should be linked more closely.
• Ensuring that national public health strategies are linked closely to primary health care strategies on a national basis:
  • Finland and Denmark have built systems that exemplify the link.
• Building on national standards for Public Health Nursing, including strengthening Community Health Nursing with Aboriginal communities;
• In First Nations communities, the Agency should consider operating strategies that:
  • Do more to involve teams of community members;
  • Pay close attention to the policy advice of people who have experienced the effects of diseases and public health issues, like fetal alcohol spectrum disorders;
  • Develop a consistent approach to Aboriginal health, that define federal, provincial and local roles clearly; and,
  • Embrace the holistic perspective that First Nations take to health issues - encompassing the physical, emotional, spiritual and social spheres.

3. Investments

Participants urged an Agency to focus on the following priority investments:

• Seek dedicated federal funding to target improvements in public health outcomes, supported by strong provincial and national infrastructure and standards, so that public health funds cannot be easily diverted to acute care;
• Re-examine the effectiveness of public spending on advertising lifestyle changes;
• Improve the recruitment and retention of public health professionals, especially in remote or rural communities;
• Place public health nurses in schools;
• Equalize provinces' access to certain public health services like immunization;
• Create a national public-health literature database on the Agency's Web site, to improve citizen access to the Public Health literature;
• Improve data surveillance, and ensure that it works well at the community level - and is not simply imposed according to national standards;
• Development of electronic health records that can be used to manage and study public health issues;
• Invest in volunteer run programs, because they offer a great deal of leverage for relatively few federal dollars;
• Filling other gaps in public health services:
  • Mental health;
  • Addiction treatment; and,
  • Transitional Housing (where people can heal from addictions).
• Attendees also suggested the following kinds of investments in First Nations Health:
  • Addressing the serious shortage of Aboriginal doctors and nurses, including strategies to get youth interested in health professions;
  • Ensuring Non-Insured Health Benefits (e.g. patient transportation); and,
  • Mental Health programs and funding are significantly lacking.

4. Public Health Issues

Participants also raised concerns about specific public health issues:

• Drug and Alcohol Education in Schools:
  • Federal funding should enable school districts to institute a formal program in schools to improve awareness and understanding of the drivers and consequences of drug and alcohol use.
• Food security for the poor and disenfranchised:
  • Healthy Eating Initiatives can provide quality food to these groups;
  • An example of a local Best Practice is the Garden Gate Training Centre. It provides food support with a social connection and has resulted in a 30% drop in food bank usage; and,
  • Such programs have been more effective in improving food security than providing clients with direct cash subsidies.
• Food security breaks down into three kinds of issues:
  • Short-term, manifested by hunger;
  • Mid-term issues, manifested by homelessness; and,
  • Long-term issues, manifested by bad public policy.
• Celiac disease should be targeted for chronic disease prevention under public health. Such a strategy should:
  • Seek earlier diagnosis, through physician education; and,
  • Offer better disease management through proper nutritional awareness.
• First Nations Communities in The West Kootenays are facing significant water dangers, because:
  • Band lacks proper infrastructure;
  • Band has to purchase bottled water; and,
  • Band needs new infrastructure for water.