Public Health Services Annual Report

We prioritized the health and well-being of Hamilton’s children, families, and seniors. These populations require special attention and support to achieve optimal population health outcomes. Supporting children is important for ensuring a strong foundation in life in terms of educational attainment, economic productivity, and lifelong health and well-being. Families play a vital role in community well-being, and supporting their health contributes to a healthier, more resilient Hamilton. Lastly, seniors, especially those with limited resources, often face unique challenges in accessing public health services. 

Key achievements completed under this priority include catching up on routine immunizations for students, catching up on dental screenings, supporting the mental health and well-being of school-aged children, expanding initiatives and supports for mental health screening in infants and young children, developing and implementing a health equity strategy that incorporates and builds on lessons learned throughout the COVID-19 pandemic, and sustaining support for transition and recovery initiatives.
 

In 2022, Public Health Services’ Vaccine Program organized catch-up vaccine clinics across Hamilton to address the backlog of school-aged children who had not received their routine immunizations during the pandemic, including Hepatitis B, Human Papillomavirus, and Meningococcal vaccines. Starting in March 2022, Public Health Services held catch-up clinics for students in grades 7 to 12 at multiple locations, including Lime Ridge Mall (now closed), East End, and Mountain public health clinics. In September 2022, Public Health Services staff returned to schools to restart regular school-based vaccinations for grade 7 students and began catching up with the grade cohorts missed during the pandemic. Grade 8 students were prioritized because they would soon age out of regular school-based vaccine clinics. Additional catch-up clinics will run throughout 2023 to ensure school-aged students receive any missed vaccines and stay up-to-date with their immunizations.

Public Health Services’ Dental Program, through the Healthy Smiles Ontario program, ensures that children and youth from low-income households have access to free preventive, routine, and emergency dental services. The COVID-19 pandemic presented its own set of challenges for dental care, temporarily disrupting school screenings and Healthy Smiles Ontario services, which resulted in a backlog of students awaiting screenings and a waitlist for preventive Healthy Smiles Ontario services.

In August 2022, we successfully restarted the Healthy Smiles Ontario dental clinics, and by the end of the year, we efficiently cleared the waitlist of 278 clients. Additionally, routine dental screenings in schools resumed in October 2022. We are committed to providing comprehensive oral health assessments to all students throughout the 2022-2023 school year, especially those who missed screenings during the pandemic. Our goal is to ensure that every student receives the care they need for a healthy smile.

At Public Health Services, we are dedicated to ensuring equitable access to high-quality dental care for low-income seniors in the community as well. To bridge the gap in dental care among seniors, we launched the Seniors Dental Health Bus, as part of the provincial Ontario Seniors Dental Care Program. The Seniors Dental Health Bus increases the Dental Program’s capacity to offer free preventive and restorative dental services for eligible seniors aged 65 and older. Initially operating on a limited schedule, the Seniors Dental Health Bus expanded to four days per week by November to meet the growing demand and ensure seniors receive the care they deserve.

“Many thanks for your dedication, service, and care working in Hamilton's much-needed Public Health Dental Program. My parents have been so kindly treated over the past year and a half. I always appreciate the professionalism and high level of care that they receive. My parents are very grateful to all!"

- Daughter of Dental Clinic Clients

Public Health Services recognizes that mental health is crucial to students' well-being, academic success, and overall development. This resulted in action to improve mental health support in schools. In the 2022-2023 school year, the School Program resumed full operations with the continuation of funding for an additional 23 public health nurses through the Ontario Ministry of Health’s School-Focused Nurses Initiative. While the initiative was initially launched during the 2020-2021 school year to assist with COVID-19 management in schools, the funding also enabled our nurses to address broader health needs outlined in the School Health Program Standard and related guidelines and protocols. The funding extension until June 2023 allowed us to scale up mental health promotion support and provide direct services in 103 priority schools in Hamilton, which is double the usual number of schools we serve. Public health nurses worked closely with these schools, collaborating with students, teachers, parents and caregivers, and community partners to create comprehensive plans that support students' mental health and well-being.

To promote good mental health, we organized activities, provided social-emotional support sessions, and worked to create safe and welcoming school environments for all students. We are proud to announce that 63 out of the 103 priority schools were certified as “Healthy Schools” by the national healthy schools certification program. This certification ensures schools have the appropriate tools to promote and enhance the health and well-being of students, school staff, and the broader school community.

“[Healthy Schools Certification] is a testament to the hard work and commitment that each school has shown as well as the collaboration of many partnerships. Most notable is the strong partnership that the HWCDSB [Hamilton-Wentworth Catholic District School Board] has with Public Health and the amazing group of public health nurses that work at our schools.”
– HWCDSB

The Healthy Growth and Development Program played a crucial role in supporting families during pregnancy, postpartum, and the early years, particularly during the challenging times of the pandemic. Throughout this period, essential services such as Healthy Babies Healthy Children Home Visiting Programs, Health Connections, breastfeeding support, and virtual groups for the Canadian Prenatal Nutrition Program were offered, as well as engagement through social media. In 2022, our Healthy Growth and Development Program fully resumed its operations, ensuring that families continued to receive the support they needed.

The Healthy Growth and Development Program recognizes the unique impact of the pandemic on toddlers and young children, who faced limited opportunities for social interaction and emotional development. To address this, interventions were prioritized that focused on education, early identification of developmental and social-emotional issues, confidence and skill building, and connecting families to community supports. The aim is to support children aged 0 to 6 years old who are at risk of poor social and emotional development, providing them with the necessary tools for healthy growth.

Another important aspect of our Healthy Growth and Development Program was optimizing health during the perinatal period, which encompasses pregnancy to 12 months after birth. We offered prenatal education, identified individuals at risk for poor mental health during pregnancy and postpartum, provided breastfeeding support, and connected families with community resources. We transitioned from virtual and phone-based interventions to in-person sessions for programs such as the Canadian Prenatal Nutrition Program and parenting education groups, allowing for more direct and personal support. By focusing on this critical period, we aimed to ensure the well-being of both parents and their babies.

The impacts of the COVID-19 pandemic were addressed through collaboration with community coalitions, planning tables, and key partnerships. This involved identifying the effects of the pandemic, establishing priorities, and expanding screening, assessment, and intervention during pregnancy, infancy, and the early years. We used geospatial mapping to identify neighbourhoods with high needs to ensure that our resources were allocated where most necessary.

Another noteworthy program implemented by Public Health Services, fully funded by the Ministry of Health, is the low-barrier, quick-access mental health clinic established through a sustained partnership with the Good Shepherd Centre and the Hamilton Family Health Team. This collaborative effort has played a crucial role in providing on-site support for families experiencing homelessness, ensuring they receive comprehensive care during challenging times. One significant outcome of this partnership is the introduction of Theraplay group programming for caregivers and their young children.

“Theraplay, a play-based therapy approach, has fostered stronger bonds between caregivers and children during this trying period. The benefits of this partnership are evident, as it contributes to greater social stability and lasting support for those in need.”
- Grace Baldwin, Director of the Good Shepherd Family Centre.

For more information on HPHS’ Healthy Growth and Development Program, please visit Pregnancy & Prenatal Health and Parenting Supports.

The COVID-19 pandemic exacerbated existing health and social issues, disproportionately affecting marginalized populations. To address some of these challenges, Public Health Services established the Vaccine Readiness Network in December 2020. The Vaccine Readiness Network consisted of community organizations and representatives in Hamilton, working together to improve COVID-19 vaccine planning, distribution, and access for priority populations.

In June 2022, the Vaccine Readiness Network published a report titled “Community Impact on Equitable Vaccine Delivery in Hamilton: Stories and Lessons Learned from the Vaccine Readiness Network”. This report highlighted the valuable lessons learned from various health, education, social service, and community organizations across Hamilton to strengthen community engagement and equitable vaccine rollout during the COVID-19 pandemic. The Vaccine Readiness Network demonstrated that community outcomes are improved when community and institutional partners work together to plan policies and programs to address health inequities at the local level. 

Building upon the lessons learned from the Vaccine Readiness Network, in 2022, Public Health Services’ Health Equity Program developed a comprehensive plan across various program areas to enhance public health capacity for health equity and anti-racism action. The plan, with four components - Competency Development, Data for Health Equity, Community Collaboration and Awareness, and Communication - aims to equip Public Health Services to meet health equity outcomes outlined in the Ontario Public Health Standards.

The plan will be implemented in stages over several years, with a focus on achieving tangible progress. It includes comprehensive training and competency development for Public Health Services staff to deepen their understanding of health equity principles and empower them with effective tools to address health disparities. The plan also involves establishing health equity key performance indicators for each program within Public Health Services, allowing for monitoring progress toward health equity goals by the end of 2024. Data collection on the social determinants of health will be enhanced to inform evidence-based decision-making, and a co-design approach will be employed, working closely with community organizations, to gather insights and shape strategies that effectively address social determinants of health.

Through these collective efforts, Public Health Services aims to foster a healthier and more inclusive community in Hamilton, ensuring that everyone, regardless of their background or circumstances, can thrive.
 

In addition to the other programs and services mentioned, Public Health Services took specific actions to prioritize various public health needs in the Hamilton community. Here are some more key initiatives achieved in 2022:

• Safeguarding Food and Water
  In 2022, our dedicated team conducted thorough inspections of 3,007 food inspections and 198 water sources, including various recreational water facilities, in Hamilton. These inspections allowed us to proactively identify and address potential risks that could lead to foodborne illnesses, compromised water quality, or safety concerns in recreational water areas. Our commitment is to protect the community by enforcing food safety regulations, monitoring water quality, and promoting safe recreational water activities. We strive to create a healthy and enjoyable environment for everyone in Hamilton, where they can have confidence in the safety of their food, water, and recreational experiences.
• Restoring Essential Programs
  In response to the pandemic's impact, we resumed essential programs at Public Health Services, such as the Chronic Disease Prevention Program and the Tobacco Control Program. These programs play a crucial role in promoting healthier lifestyles, preventing chronic diseases, and reducing the harmful effects of tobacco use, directly benefiting the residents of the community.
• Addressing Climate Change
  Recognizing the interplay between human health and climate change, our Health Hazards and Vector Borne Disease Program provided leadership to the City of Hamilton’s Climate Change Impact Adaptation Plan, which is now being implemented corporately. This collaborative effort involves multiple stakeholders across the community, working together to address the specific climate change impacts affecting Hamilton and to develop strategies for adaptation and resilience-building.
• Workforce Development for Local Expertise
  We are committed to nurturing a skilled workforce within the community. Training opportunities for individuals aspiring to become certified public health inspectors continued to be provided. This investment in local expertise ensures that our public health services are delivered by qualified professionals who deeply understand the specific needs and challenges faced by the Hamilton community.

Through these initiatives, Public Health Services demonstrated its firm dedication to protecting and promoting the health and well-being of the community. By focusing on local food and water safety, restoring essential programs, addressing climate change, and investing in our local workforce, we strive to create a healthier and more resilient future for the residents of Hamilton.