Public Health Annual Report

City of Hamilton Public Health Services is required to produce an annual performance and financial report to the communities they serve as part of the Ontario Public Health Standards: Requirements for Programs, Services, and Accountability,

This report provides a look at both ongoing programs and services and highlights any new public health issues that are emerging in our communities.

Message from Mayor Fred Eisenberger

On behalf of the Board of Health, I am pleased to share Public Health Services’ 2019 Annual Report which outlines key achievements in addressing important health issues in our community. Through increased access to dental services for those most in need, supporting student mental health and well-being, addressing the opioid crisis and harms related to substance use, and continued action on climate change, Public Health Services continues to advance the City’s vision to be the best place to raise a child and age successfully.

Message from Paul Johnson

General Manager, Healthy and Safe Communities
Hamilton Public Health Services is vital to supporting the City of Hamilton’s Strategic Plan priority to ensure Hamilton is a safe and supportive community where people are active, healthy and have a high quality of life. Public Health Services plays an invaluable role in working together with partners within the City and the community to address health inequities across neighbourhoods and populations throughout Hamilton. I commend our Public Health Services team for its significant contributions to many important City-wide initiatives, particularly for its excellent support in moving the Hamilton Health Team forward as part of Ontario’s new model of organizing and delivering care to better connect patients and providers to local health and social services. The accomplishments outlined in this report demonstrate the collective action required to ensure Hamilton is a healthy safe community for all residents.

Message from Dr. Elizabeth Richardson

Medical Officer of Health
Protecting and promoting the health of our community is our top priority. To this end, I am pleased to present the 2019 Annual Report which highlights key impacts of our work across three priority areas, including Health Equity, Healthy Weights, and Mental Health and Addictions. I am proud of our passionate team who works tirelessly every day to make a positive difference in the lives of all Hamiltonians, working with our many partners across health, education and social services. We look forward to continuing to work together with our partners, including the Ontario Ministry of Health as it works to modernize public health services to meet the evolving needs of communities throughout the province. As we continue moving forward, we remain focused on supporting the health and well-being of our community.

Priority Health Issues

Hamilton Public Health Services (PHS) has identified three priority areas based on population health assessment data and knowledge of the community, including:

  • Health Equity
  • Healthy Weights
  • Mental Health and Addictions

Health Equity

Health equity is created when individuals have the fair opportunity to reach their full health potential. Achieving health equity involves reducing unnecessary and avoidable differences that are unfair and unjust such as those related to income, social status, race, gender, education, and the physical environment.

Public Health Services implements specific initiatives to reach priority populations who are most at risk for negative health outcomes and more likely to benefit from health interventions. The goal is for all residents of Hamilton to attain full health potential without disadvantage due to the social determinants of health.

Young girl smilingThe mobile dental clinic pilot project was launched in 2018 to help children and youth access preventive dental care within the elementary school setting. In 2019, the project was expanded and five mobile clinics offered dental cleanings, pit and fissure sealants and fluoride applications to students in elementary schools identified as having the greatest needs for preventive dental services.

Learn about Dental Clinics & Programs


Oral health is linked to overall health and is an important issue for seniors. In April 2019, the provincial government announced a new dental health program for low-income seniors aged 65 and over, with the goals of reducing unnecessary emergency department visits, preventing chronic disease, and improving quality of life for seniors. This program will address important community health needs given many Hamilton seniors who need dental care do not have dental insurance coverage and cannot afford to pay out-of-pocket costs. PHS worked with community partners to plan and implement the new Ontario Seniors Dental Care Program, which officially launched in November 2019.  

Learn about Dental Clinics & Programs

Home breastfeeding consultant visitIn 2019, access to support services became easier for 41 single-parent families involved with the Healthy Babies, Healthy Children home visiting program and Ontario Works, with the launch of the Coordinated Supports for Families pilot. Through the pilot, families received joint home visits with their Public Health nurse and Ontario Works worker, and streamlined access to the child care subsidy, recreation assistance program, employment services and housing support services.

Learn more about the Healthy Babies, Healthy Children Home Visiting Program 

Offering a food skills and employability program, particularly for vulnerable individuals, is a priority action outlined in Hamilton’s Food Strategy. PHS and Ontario Works staff partnered with Indwell, a local charity creating affordable housing communities; Compass Canada, and Hamilton Health Sciences to offer The Gather Culinary Academy at Indwell’s Parkdale Landing residence. Led by Indwell, The Gather Culinary Academy provided comprehensive culinary job training at no cost for 13 people receiving social assistance and seeking employment in the culinary arts. Participants received uniforms, non-slip shoes, knife kits, and transportation to the training location. Over the 11-week program from September to December 2019, participants prepared and served 130 healthy meals for residents of Parkdale Landing. Twelve of the program participants successfully completed the training and at least half had received job offers upon graduation.

Learn more about Hamilton Food Strategy

Healthy Weights

Public Health Services promotes healthy weights through interventions that change the context of our environment, making healthy eating and physical activity a part of where we live, learn, work, and play. This approach supports optimal health of the whole population by making healthier choices easier and unhealthy choices more difficult. Healthy eating and physical activity are essential to the healthy growth and development of children and play an important role in the prevention of disease in later life.  The goal is for Hamilton residents achieve and maintain a healthy weight throughout their lives.

Young girl eatingGood nutrition in young children helps them grow, develop, learn, and get ready for school. Nutrition screening identifies issues early and refers children at risk for further assessment. NutriSTEP® for toddlers ages 18-35 months and preschoolers ages 3-5 years is a set of valid and reliable Canadian nutrition risk screening questionnaires. NutriSTEP® is a fast and simple way to find out if children are healthy eaters. In 2019, PHS focused on NutriSTEP® as a continuous quality improvement initiative to increase nutrition screening rates among young children. NutriSTEP® tools are completed in various settings, including through PHS program home visits and in EarlyON Child and Family Centres, with Registered Dietitians and Public Health nurses. PHS is also measuring awareness among health care providers and developing a plan with community partners to increase awareness of NutriSTEP®. Parents and caregivers can access the tools through PHS and online at

Virtual visit breastfeeding familiesBreastfeeding is recognized as the ideal nutrition for infants and young children. It can help build healthy eating habits early, leading to a healthy weight in adulthood. To help support breastfeeding families, PHS has implemented virtual visits through the Ontario Telemedicine Network (OTN). Families are able to connect with a Public Health nurse via smartphone, tablet or computer to receive a breastfeeding assessment and advice. Virtual visiting provides face-to-face breastfeeding support in real time and is being offered in addition to the breastfeeding services PHS already provides. Offering this as an option will help PHS to understand whether families want this type of service, the length of time for which they breastfeed, and whether it will help to increase the number of Hamilton families providing only breastmilk.

Learn more about Breastfeeding Services & Supports

Breastfeeding Friendly Places symbolThe Hamilton Breastfeeding Coalition encourages and promotes supportive environments that normalize breastfeeding in public and in the workplace. As a member of the Coalition, PHS is helping recruit local businesses to become breastfeeding friendly places. To date, over 100 local businesses have become breastfeeding friendly places, with recreation centres and EarlyON Child and Family Centres on track for 2020.

Learn more about Breastfeeding Friendly Places

School travel planning is a community-based approach that aims to increase the number of students and adults choosing active and sustainable travel, such as walking or wheeling, to get to and from school. Active and sustainable school travel helps to improve air quality and mitigate climate change; increase physical activity and reduce sedentary time; and improve safety and prevent injury.

Group of parents and children riding bikesKey community stakeholders worked together to identify and address their school travel needs. As a result, 28 more Hamilton schools have created school travel action plans and 25 more schools have implemented their action plans and are monitoring and making improvements as needed. A parent engagement strategy and toolkit were developed with support from parents and is available at The goal is to engage parents and caregivers in active and sustainable school travel and to build champions, which may lead to more children walking and wheeling to school. The project has been piloted in nine local elementary schools for future roll-out to all Hamilton schools. An early outcome includes the creation of permanent positions within all pilot school councils to address active school travel.

Mental Health and Addictions

Public Health Services promotes positive mental health and well-being across the lifespan so all Hamilton residents live, learn, and grow in a supportive and connected environment to build healthy relationships, develop resiliency, and improve coping. Public Health Services also implements initiatives to reduce the health and social harms related to substance use and focuses on reducing the spread of communicable diseases, preventing overdose deaths, and increasing access to safe supplies. The goals are that all residents of Hamilton, live, learn, and grow in a supportive and connected environment to develop resiliency, healthy relationships, and coping and are free of harm due to substance use and are able to enjoy the best quality of life.

Learn more about Alcohol, Drug and Gambling Services, Alcohol and Other Drugs and Mental Health Services

Group of teensPHS works collaboratively with local school board leadership to prioritize, plan, implement and evaluate programs and services to support the creation and maintenance of healthy school communities. The top three shared health priorities are mental health and addictions, healthy eating, and physical activity. In addition to this, 50 high priority schools have been identified collaboratively to receive intensive support in addressing these identified health priorities. Throughout the 2018-2019 school year, school program Public Health nurses completed nearly 300 actions and activities to support student mental health and well-being within these identified schools. 

Bullying and violence prevention is one of the ways that PHS supports mental health and well-being. In the fall of 2019, PHS partnered with educators at the Hamilton Wentworth District School Board (HWDSB) to create bullying prevention lesson plans that were delivered to all students from kindergarten through grade 12 within the board during Bullying Awareness and Prevention Week. PHS continues to partner with our local school boards and schools to further develop healthy school communities.

Learn more about Mental Health Services Child and Adolescent Services

Holding handsTo address longer than usual wait times for child and youth mental health services, a walk-in mental health services pilot was implemented in 2019 through a partnership between Hamilton Public Health Services Child and Adolescent Services program and Contact Hamilton.

To date, the pilot has provided mental health services to approximately 105 youth and their families, has helped to mitigate wait times for these vital services, and has resulted in improved mental health and school functioning for some of the most vulnerable children and youth in the community.

No one chooses addictionStigma impacts people who use substances, their families, and the community. Many people who use substances face barriers in getting the support and services they need and in sustaining recovery because of the stigma that surrounds addiction. In November 2019, PHS partnered with the Hamilton Drug Strategy – a community collaboration of 125 key stakeholders and community members to address substance use-related stigma through the campaign entitled, “See the Person. Stop Stigma.”
The campaign included a series of eight videos featuring stories from community members who have been affected by substance use-related stigma and a webpage providing information about stigma and the steps people can take to stop stigma at The campaign webpage received more than 4,000 visits, and the videos received more than 3,500 views.

One third of Grade 9-12 students in Hamilton reported vaping in the past year. Despite the fact that the long-term effects of vaping are not clear, there is evidence to show that non-smoking youth who vape are up to five times more likely to initiate cigarette smoking. In response to the growing prevalence of vaping in youth and non-smokers an action plan was developed by the Tobacco Control Program. The goals include:

  • Reduce vaping initiation amongst youth and young adults
  • Educate and increase knowledge about risks associated with vaping
  • Increase compliance with laws that govern smoking and vaping
  • Increase access to cessation services for priority populations

Learn more about Tobacco and E-cigarettes

Other Initiatives

Cover for Corporate Climate Change Task Force reportThe City of Hamilton is moving forward towards a prosperous low carbon and sustainable future. In March 2019, Hamilton City Council declared a climate change emergency to acknowledge the scale of the climate crisis and the need for accelerated action. Through this declaration, Council directed staff to create a multi-departmental Corporate Climate Change Task Force, which is Chaired by Hamilton Public Health Services (PHS). In December 2019, the Task Force released a report outlining corporate goals and areas of focus for climate change mitigation and adaptation. In addition, PHS provided key project management support in the creation and ongoing support of the Bay Area Climate Change Office and the Bay Area Climate Change Council (BACCC). The BACCC is a collaboration between 13 regional organizations across the cities of Hamilton and Burlington and is supported by both municipalities and Mohawk College’s Centre for Climate Change Management. The mandate of this regional collaboration is to provide guidance, strategic leadership and support for community mobilization that drives local climate change action.

Radon bannerIn September 2019, Hamilton Public Health Services launched the second phase of a radon awareness project to better understand the number of homes with high radon levels in Hamilton. Through the Hamilton Radon Prevalence Study, over 400 homeowners enrolled and received a free radon monitor to identify the level of radon in their home, help them learn about any associated risks to their health, and learn what they can do to reduce risks. The year 2020 marks the third and final year of the study.

Hamilton Public Health Services successfully planned and hosted the 2019 Canadian Institute of Public Health Inspectors (CIPHI) Ontario Branch Annual Education Conference in October 2019. Hamilton hosted over 180 Public Health Inspectors from across Ontario for the three-day conference, which focused on the theme, “Building Bridges in Public Health: A commitment to innovation and collaboration.”

Public Health Measurements

Measure 2018 2019 % Change
Total inspections completed 11,374 11,599 2% ▲
Tobacco inspections 1,714 1,869 9% ▲
Food inspections 6,536 6,762 3% ▲
Water inspections 797 772 -3% ▼
Residential care facility inspections 550 419 -24% ▼
Personal service setting inspections 967 1,002 4% ▲
Day care inspections 528 515 -2% ▼
Infectious disease cases investigated 4,827 4,966 3% ▲
Rabies exposures investigated within 1 day 96% (1,550) 99.2% (1,618) 3% ▲
Health hazard investigations initiated within 24 hours 97%

96.7% (456/472)

Health connection calls from families 6,302 7,005 11% ▲
Clients seen at dental clinics 4,464 4,420 -1% ▼
Client seen at dental bus 1,418 1,925 36% ▲
Home visits to families during pregnancy, infancy & early childhood 8,716 7,754 -11% ▼
Immunizations given 31,869 25,985 -18% ▼
Student immunization records reviewed and addressed +70,000 ~ 70,000 0%
Naloxone doses distributed 6,412 17,705 176% ▲
People reported as being revived by Public Health’s naloxone kits 568 2,214 290% ▲

Hamilton Public Health Services Funding

2019 Approved Budget: $51,623,220

Historical Reports

2018 Public Health Services Annual Report (PDF,  344 MB)
2017 Public Health Services Annual Report (PDF, 2.5 MB)