Report to/Rapport au :
Ottawa
Board of Health
Conseil de santé d’Ottawa
Monday May 7,
2012/le lundi 7 mai, 2012
Submitted by/Soumis par :
Dr./Dr Isra Levy,
Medical Officer of Health/Médecin chef en santé publique
Contact
Person/Personne-ressource :
Sherry Nigro, Manager/Gestionnaire
Health Promotion
and Disease Prevention/Promotion de la santé et prévention des maladies
Ottawa Public Health/Santé
publique Ottawa
613-580-2424,
ext./poste 28971 or sherry.nigro@ottawa.ca
|
ACS2012-OPH-HPDP -0005 |
|
SUBJECT: |
|
OBJET : |
RAPPORT D’ÉTAPE SUR LE FARDEAU
DES BLESSURES À OTTAWA, 2010 |
That the Board of
Health for the City of Ottawa Health Unit receive this report for
information.
Que le Conseil de
santé de la circonscription sanitaire de la ville d’Ottawa prenne connaissance
du présent rapport à titre d’information.
Background
On May 16, 2011, the Board of Health directed that staff
report back by the first quarter of 2012 on program developments that address
findings presented in The Burden of Injury report 2010 (ACS2011-OPH-IQS-0001)
The key findings
from the Burden of Injury 2010 report were as follows:
1.
Falls are the leading
cause of hospitalization and emergency room (ER) visits among Ottawa residents.
They account for approximately 50 deaths and 21,000 ER visits a year on
average.
2.
Motor vehicle traffic
collisions are also one of the city’s leading causes of injuries, accounting
for an average of about 30 deaths and about 4,000 ER visits annually.
3.
Unintentional poisoning
and substance misuse lead to an average of about 20 deaths and close to 850 ER visits every year.
4.
Sport and recreation
injuries account for an average of six deaths and over 6700 ER visits every
year.
5.
There was an average of about
50 suicides a year in Ottawa. The rate
of emergency room visits for self-harm had been significantly higher in Ottawa
than in Ontario. Girls aged 15-19 years
have the highest rate of ER visits for self- harm.
DISCUSSION
CURRENT PROGRAM DEVELOPMENTS
Falls Prevention Programming
Local
data from the Burden of Injury Report (2010) indicates that one in four people
over the age of 65 will fall at least once each year, a rate that increases to
one in two people over the age of 80. Seniors remain one of the groups most adversely
affected by falls. The Ministry of Health and Long Term Care has recognized
this more formally by including an indicator on falls in the Ottawa Board of
Health’s Accountability Agreement.
The performance indicator target is to decrease fall-related emergency
visits in older adults aged 65+ (rate per 100,000 per year) from 5,340 in 2009
to 5,233 in 2013.
OPH
has undertaken the following activities to reduce the number of falls in
seniors and deliver on the Accountability Agreement:
1)
Raise Awareness: The following four core messages have been
developed focusing on protective behaviours that not only promote healthy aging
but also prevent injury due to falls.
These core behaviours have been identified from the literature to inform
programming, targeted strategies and activities. The messages encourage seniors to undertake:
·
An
annual
o
review
of medications with physician or pharmacist;
o
medical
check-up with physician
o
vision
test with optometrist
·
150
minutes of physical activity per week with a focus on balance and strength
training
·
Eating
3 servings of foods high in Calcium daily and a vitamin D supplement of 400 IU
daily
·
Identification
and modification of home hazards
2)
Surveillance: A baseline
survey will be implemented in the next quarter, to determine how well Ottawa’s
senior population utilizes the above core behaviours for falls prevention.
3)
Education and
skill building:
In 2011, medication clean out activities have been carried out in Aging in
Place buildings where over 530 seniors were reached and over 1150 medications were
collected for disposal. Falls prevention
education activities were delivered to over 1650 seniors. Efforts in the first quarter of 2012 focused
on Ottawa Community Housing (OCH) buildings and have already reached 1200
seniors on medication awareness.
4)
Policy: OPH is
currently working with OCH low-income seniors apartment buildings, to conduct
fall risk environment scans and to identify remediation strategies where issues
have been identified.
Also,
OPH is currently adapting its education and skill building content, into
screening and referral interventions that will provide Personal Health Plans
for seniors. The assessments will be
conducted during brief interventions with seniors at various venues and through
assistance from our numerous community partners. Falls prevention behaviours
are a primary feature of this first prototype.
A full
report of the Seniors’ Healthy Aging strategy initiatives will be brought
forward to the Board later this year.
Road Safety Programming
There are several elements to
OPH road safety programming that aim to reduce the burden of injuries from
motor vehicle collisions. This
programming includes elements for pedestrian and cyclist safety; child
passenger restraints and safer roads for all activities. Details of each initiative are found
below.
Advocacy: OPH submitted letters to two Coroners’
Inquests on pedestrian and cyclist death that were conducted in 2011 (Document
1). OPH suggested several recommendations
for inclusion in the Coroners’ final reports.
Once the final reports are released, OPH will align our programming and
messaging with the reports recommendations.
Head Injury Prevention - Helmet Safety: Pedalists were recognized as a sub population at risk
of injury in the 2010 report. The Head Injury Prevention Strategy update
report (ASC2012-HPDP-0004), provides details of OPH interventions to reduce
brain injuries.
Young Drivers: Driver distraction has been
identified as an modifiable behaviour that can prevent injury from motor vehicle
traffic collisions. OPH has engaged
Young Drivers of Canada, Ontario Students Against Impaired Driving and the
Ottawa Hospital Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.)
program to develop and disseminate a youth focused intervention targetting
distracted driving.
Child Passenger Restraints: Awareness and
proper use of child car seats and booster seats were raised as a potential
collision prevention intervention. OPH
conducted 3 car seat road side checks in partnership with the Ottawa Police
Service in the month of November 2011. A total of 119 car seats were inspected
in three different neighbourhoods in the city (East, West and Central Ottawa).
In summary, at least 66 % of front facing and rear facing seats, 43% of booster
seats and 60% of seat belts were not properly used for children 6 months to 14
years.
OPH successfully secured one-
time funding from the Ministry of Health and Long Term Care ($164,500.00) to support
car seat safety program expansions. With this funding, OPH has partnered
with S.E.A.T.S (Safety, Education,
Advocacy, Training, Support) for Kids Canada, a local non-profit organization dedicated to increasing the appropriate and
correct use of child restraint systems of children in our community.
Together OPH and S.E.A.T.S aim to increase
training for volunteer technicians to double the number of car seat installation clinics in the community and increase
the availability of car seat safety materials in multiple languages.
OPH is also leading the launch of a social marketing campaign, called the “A1
Secure”, aimed at enhancing child passenger safety. Local Ottawa hospital
obstetric units, the Ministry of
Transportation, Ottawa Police Service,
Transport Canada, S.E.A.T.S. for Kids Canada and child care providers have
partnered in this campaign. The A1Secure
campaign includes multilingual educational materials, a new website A1secure.ca, traditional and new media
marketing tactics, educational videos and strategic partnerships.
Results
from these efforts include twice as many car seat installation clinics offered
to the public since December 2011. All
of the Ottawa hospitals obstetrical units have booked multiple in-service
education sessions for their nursing staff throughout April and May 2012.
Road safety for all users: The OPH Healthy Eating Active Living (HEAL) strategy contains an active transportation and
walking component. Pedestrian safety
initiatives are integrated into the Active Transportation component of the HEAL
report. As part of this strategy OPH
will:
·
Complete 15 neighbourhood profiles in
2012, which will include the completion of a walk-ability assessment of these
neighbourhoods.
·
Continue to support the School Travel
Planning initiative lead by Green Communities Canada as well as the Active and
Safe Routes to School program to increase access to safe routes to school for
school aged children.
·
Initiate peer-led and sustained walking
groups in neighbourhoods, workplaces and seniors residences as well as education
on pedestrian safety.
OPH is also part of the
larger municipal Safer Roads Ottawa program, led by the City of Ottawa Public
Works Department. The activities
described also align with the Safer Roads Ottawa priorities and serve as OPH’s
contributions to Safer Roads Ottawa. OPH will increasingly advocate for the
implementation of appropriate traffic calming measures through our
participation in this program.
Substance misuse programming
OPH approaches substance
misuse through three areas of focus:
·
Building resiliency in
children and youth
·
Promoting a culture of
moderation
·
Increasing access and
referral to health and treatment services
The Ministry of Health and
Long Term Care Public Health Accountability Agreements include an accountability
measure to decrease the percentage of people who exceed the newly released Low Risk Drinking Guidelines
from 32.6% to 31.3%. The accountability agreement target will be met through
the implementation of the substance misuse departmental response initiatives,
as detailed below.
The Low Risk Drinking Guidelines, (document 2) developed by the National Alcohol Strategy Advisory Committee Expert Panel, outlines the standard size for an alcoholic beverage, the number of alcoholic beverages that should be consumed at one time and provides an outline for when an individual should not consume alcohol. The Guidelines are endorsed by several agencies including Association of Local Public Health Agencies, Centre for Addiction and Mental Health, Canadian Centre on Substance Abuse, Canadian Medical Association, Canadian Public Health Association, and Council of Chief Medical Officers of Health., , In 2012, OPH will meet the accountability agreement target through:
·
Promoting Check Your Drinking, a web based self assessment tool that
individuals can complete anonymously online for personalized feedback on their
alcohol consumption;
·
Expanding the existing public awareness
campaign “A Hangover is the Least of Your Worries” to the general public using
a traditional advertising targeting bus shelters and selected licensed
establishments, and implementing a social media component;
·
Collaborating with local post secondary
institutions to reach young adults to promote responsible drinking through
effective media channels; and
·
Continuing to increase outreach to
physicians by providing information on low risk drinking guidelines and a self
assessment tool for use with patients.
OPH will continue
participating in the Substance Abuse In School counselling program. As a funder, OPH contributes to in-school
prevention and early intervention support from trained addictions counsellors. There
has been positive results in the number
of students who had achieved abstinence from the drugs for which they were
seeking treatment, and the number of students previously at risk of dropping
out of school who stayed in school.
Sport and recreation programming
The 2010 Burden of Injury report outlined that sports and recreation programming account for an average of six deaths and 6,722 ER visits every year. In April 2010, a report to Ottawa’s City Council outlined a comprehensive strategy to raise awareness and promote helmet use among children and youth. This strategy is implemented in partnership with Parks, Recreation and Cultural Services and community stakeholders.
Since June 2010, residents of Ottawa have benefited from increased
helmet promotion interventions across public health and recreation programming,
enhanced community based partnerships to
address helmet accessibility issues and initiatives to engage youth about
helmets.
On January 1, 2012, Parks, Recreation and Cultural Services implemented a helmet use policy, that
requires all users aged 10 and under, as well as weak or non-skaters of any age,
to wear a certified multi-impact helmet during all public skating sessions at city
of Ottawa indoor arenas.
OPH and Parks, Recreation and Cultural Services promoted the new policy through rink board signage, posters at indoor arenas, signage at outdoor rinks and bus shelter advertising.
Mental health, suicide and self-harm, programming
The fifth issue raised in the Burden of Injury report 2010,
related to suicide and injuries due to self-harm. In response, OPH
has launched a number of activities to promote mental health and reduce suicide
and self harm. This includes dedicated funding to Youth Service Bureau to
expand their mental health walk-in clinic hours, and implementation of Healthy
Transitions program to students, teachers and parents to increase resilience
and coping skills in youth. It also includes free safeTalk training – an
evidence-based training for youth, parents and vulnerable groups to equip them to
intervene to prevent suicide and increased screening and early intervention
services for preschoolers in collaboration with Crossroads Childrens Centre and
Centre Psychosocial.
A full report detailing
progress of the OPH mental health strategy to promote child and youth mental
health will be brought to the Board of
Health in 2012.
LEGAL IMPLICATIONS
There are no legal impediments to receiving the
information in this report.
FINANCIAL IMPLICATIONS
There are no financial implications beyond regular program budget
allotments pertaining to this report.
However, OPH is actively seeking alternate, supplemental funding on
several of the initiatives.
TECHNICAL IMPLICATIONS
There are no technology implications associated with
this report.
Document 1- Letter to the Coroner
Document 2 - Low Risk
Drinking Guidelines (English)
Low Risk Drinking
Guidelines (French)
Ottawa Public Health will continue to engage community partners, policy-makers and Ottawa residents in developing and informing injury prevention programming that address key findings presented in The Burden of Injury report 2010.
.