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Community health providers across Ontario continue to offer steadfast supports to marginalized people

le Mardi 5 Janvier 2021

All for Public Health campaign led by Seaway Valley CHC

[Using posters like this and sharing messages with partners in the Cornwall region, Seaway Valley CHC staff are supporting their Public Health Unit colleagues who've led the COVID-19 response in the region. Details are below.]

In the last several weeks, as Alliance members across the province have continued and stepped up their efforts to support marginalized people facing the impacts of the pandemic and the effects of measures to slow the spread of COVID-19, we've also seen a lot of centres join Black Creek CHC, Rexdale CHC, Somerset West CHC and other organizations who've led the way on community-led testing and response. We've also seen Alliance members across Ontario jumping in to support the messages and the efforts of their local public health units, and still others taking steps to support increased harm reduction and overdose prevention services to help address the sharp increase in overdose deaths. All over, Alliance members are still working hard every day to support isolated people, deliver food and supplies, as well as checking in people, especially isolated seniors. Here's a review of the some of the stories from different areas:

In the Greater Toronto Area, which has seen some of the fastest rising numbers of COVID-19 cases, Alliance members have stepped up their efforts, with South Riverdale CHC, Unison Health and Community Services joining early leaders on testing and direct COVID-19 outreach and supports at Rexdale CHC, Black Creek CHC, TAIBU CHC, Unison Health and Community Services, and Flemingdon and South Riverdale CHCs. Acting on the knowledge that 1 out of every 4 new COVID-19 cases in Toronto affects a Black family, TAIBU has also partnered with the Scarborough Health Network to launch a COVID-19 helpline to support Black community members with information, guidance and directions to support. In Bramalea, WellFort Community Health Services continues to offer free, community-based testing on site, three times per week in the month of December. All across the GTA, the Anishnawbe Health Toronto's Mobile Healing Team continues to offer accessible testing and other supports to urban Indigenous people in the region, several times per week in different areas. The team was also profiled recently in the Globe and Mail, in an essay by Anishinaabekwe physician Lisa Richardson.

And testing efforts driven by Alliance members and their community partners continue to grow across the province, while adapting to the shifts in the pandemic. In southwestern Ontario, where Windsor-Essex recently entered lockdown, North Lambton CHC continues to offer testing with its partners, including testing for secondary school students in the region. In the Ottawa region, Somerset West, Sandy Hill and Centretown CHCs have all been actively involved in COVID-19 testing, specfically to help reach people not being served by other assessment centres, such as people facing transportation barriers. South-East Ottawa CHC is the lead agency for the Ontario COVID-19 "Supporting High Priority Communities" strategy for Central Ottawa (see image below).

These efforts were highlighted in a big way in late December when the Ontario government released the earlier mentioneded strategy or plan for "Supporting Priority Communities." Alliance members, who in many areas led early efforts (since March) in testing and isolation supports, make up a large proportion of the leadership in these areas, on the chart below. All of these community health organizations have staff who are working directly with their local partners, including public health and hospitals, to ensure:

-Tailored community outreach and engagement, including translation/interpreation, transportion help, and addressing barriers related to health and social inequities-Increased access to testing, including through on-site testing in congregate living spaces, pop-up testing to reach people facing barriers, and mobile testing-Wraparound supports using a case management approach-Increased capacity/locations for isolation facilities, support for short-term case management on site, etc.

[Alliance members are among those organizations leading the efforts to "support priority communities" -- work they've led for decades, but that has taken on additional importance during the pandemic.]

In Kingston, staff at Kingston CHCs have also been busy helping people get tested for COVID-19 right at their centre, like so many Alliance members across the province, particularly in red and lockdown regions. The centre also pulled together a list of local supports in one spot on their website, to make it easier for people to find the support they need right now. Of course, in other areas of the province, community-based responses have played a key role since last spring, such as with migrant workers being supported by the Delhi Community Family Health Team.

Down the highway in Cornwall, Seaway Valley CHC worked with their community partners to lead a campaign in support of their local public health unit and their efforts to slow spread of COVID-19 and keep people safe. Centre staff felt the health unit deserved support and acknowledgment of their months of hard work so they launched a five-week #AllforPublicHealth campaign. Each Monday a new message goes out on Twitter and Facebook to all of Seaway Valley CHC's partners with a request that they spread the messaging. Here's an example of the campaign's posts, in English and French, passionate calls by Primary Care providers and their partners for us all to support public health, our hospitals, and to help protect marginalized people and those at higher risk due to COVID-19. The centre also helped to lead a flu vaccine campaign that saw some 400 shots per day delivered via a drive-through model, which was a model used in plenty of other places in Ontario, such as this drive led by Niagara Falls CHC.

Advocacy efforts in Toronto paid off as it was announced earlier this week that overdose prevention services would open within shelters, to help reduce the risk of a fatal overdose. Parkdale Queen West CHC's Angela Robertson and South Riverdale CHC's Jason Altenberg led the call, alongside their community partners, to have these services installed. Thanks to both of them and their colleagues for working to making this vital shift a reality that can help save lives this winter and beyond.

Elsewhere, Alliance members continued their ongoing efforts on food security, with examples at Georgian Bay CHC, where an emergency grant from Community Food Centres Canada will help the CHC to reach more people; in Etobicoke, LAMP CHC continues to see increased need, and has stepped up its food security efforts alongside community partners; Carea CHC in Oshawa has teamed with local businesses on a food and toy drive; Access Alliance continued its string of take-away meals for people in need of support; at Centretown CHC in Ottawa, a donation of warm clothing for children is helping out parents in the CHC's Early Years program; in Scarborough, the Scarborough Centre for Healthy Communities is helping to distribute a donation of homemade masks to help keep people safe.

There are literally hundreds of other stories like this, efforts by community health organizations to meet the evolving needs of the people they serve, and across their communities.

If you're reading this and you're from a centre and have a story to share, please email me directly, so I can include yours in my next update: jason.rehel@allianceon.org.

Déclaration du conseil d’administration de l’Alliance sur les mesures urgentes requises pour garantir l’accès à l’eau potable à toutes les communautés des Premières Nations et des Inuits

Les communautés autochtones doivent avoir accès à de l’eau potable MAINTENANT. Joignez-vous à l’appel urgent lancé au gouvernement fédéral pour qu’il tienne sa promesse de garantir l’accès à l’eau potable à toutes les communautés autochtones en 2021. Des vies en dépendent

Date:

le Vendredi 4 Décembre 2020

L’Alliance pour des communautés en santé est solidaire avec les peuples autochtones du Canada et exhorte le gouvernement fédéral à prendre des mesures urgentes pour assurer l’accès à de l’eau potable à toutes les communautés des Premières Nations et des Inuits. Elle demande les mesures suivantes :

Que le gouvernement fédéral fasse les investissements nécessaires et agisse rapidement afin de lever tous les avis d’ébullition d’eau au pays;
Que les dirigeants fédéraux établissent des politiques pour donner un plus grand contrôle concernant l’eau aux Premières Nations afin de promouvoir les droits des peuples autochtones à l’autonomie gouvernementale et à l’autodétermination et d’assurer un approvisionnement durable en eau potable dans leurs communautés.

Il doit donc s’en suivre un accès continu à de l’eau potable maintenant et à l’avenir pour toutes les communautés des Premières Nations et des Inuits.

Le mois dernier, la Première Nation de Neskantaga fut l’objet de nombreux reportages dans les médias lorsque tous les résidents de la communauté ont été obligés d’évacuer leur domicile à cause d’une contamination de leur réservoir d’eau. Ce récit est un des nombreux exemples des effets dévastateurs de la colonisation qui sont encore ressentis par les communautés autochtones au Canada. La situation d’urgence dans la Première Nation de Neskantaga ne date pas d’hier. Cette communauté du nord-ouest de l’Ontario est soumise à un avis d’ébullition de l’eau depuis 25 ans. Il s’agit d’une des nombreuses communautés autochtones de l’Île de la Tortue sans accès à un élément de première nécessité que de nombreuses personnes tiennent pour acquis. Selon le Conseil des Canadiens, en tout temps, plus de 100 avis d’ébullition touchent les Premières Nations au Canada.

En tant que réseau exhaustif de fournisseurs de soins de santé primaires, nous savons que l’eau potable est essentielle au maintien de la santé et du bien-être. Cela est d’autant plus vrai pendant la crise de la COVID-19 puisque l’eau potable et l’assainissement sont indispensables à la prévention de la propagation du virus. Le manque d’accès à l’eau potable dans les communautés des Premières Nations et des Inuits enfreint aux droits de la personne reconnus par les Nations Unies et aux droits des peuples autochtones. Il s’agit également d’une crise de santé publique. Le nombre de cas de COVID-19 est à la hausse et l’accès à de l’eau potable dans toutes les communautés des Premières Nations et des Inuits est primordial pour composer avec la pandémie et assurer un rétablissement dynamique dans chaque communauté.

En 2015, le premier ministre Trudeau, alors nouvellement élu, avait promis d’éliminer les avis à long terme d’ébullition de l’eau d’ici mars 2021. Selon le site Web du gouvernement du Canada, 97 avis ont été levés depuis 2015 et 59 avis demeurent en vigueur. Ce nombre n’inclut pas les avis à court et à moyen terme d’ébullition de l’eau.

L’énoncé économique de l’automne 2020 publié le 30 novembre comprend des investissements additionnels pour le financement de l’infrastructure pour l’eau et les eaux usées dans les communautés des Premières Nations. Ces investissements représentent un pas dans la bonne direction, mais ils ne sont pas suffisants, surtout après un autre engagement rompu. Nous sommes déçus par l’annonce du gouvernement fédéral qu’il ne pourra respecter son engagement et nous sommes préoccupés qu’aucun échéancier ne soit établi pour la levée de tous les avis concernant l’eau potable. Le manque d’empressement pour le respect d’un droit humain fondamental serait inacceptable dans les autres communautés du Canada et serait considéré comme un échec du leadership fédéral.

L’Alliance exhorte le gouvernement fédéral à respecter sa promesse aux peuples autochtones du Canada et à accélérer les travaux pour garantir un accès à de l’eau potable à toutes les communautés des Premières Nations et des Inuits. Il est impératif que le premier ministre et le gouvernement assument leurs responsabilités pour remplir cette promesse incontournable à la réconciliation, et que le gouvernement publie un plan et un échéancier définissant clairement les travaux qui seront mis en œuvre pour assurer que toutes les communautés des Premières Nations et des Inuits aient accès à un approvisionnement durable en eau potable en 2021. Il est tout simplement inacceptable de retarder ces travaux.

Le gouvernement fédéral et le premier ministre ont déclaré à maintes reprises que l’accès à l’eau potable est essentiel à la réconciliation et à la lutte contre les séquelles du colonialisme au Canada, ainsi qu’au respect de la Déclaration des Nations Unies sur les droits des peuples autochtones. C’est le moment de tenir parole. Des vies en dépendent.

Cette déclaration est publiée par le conseil d’administration de l’Alliance pour des communautés en santé, qui représente un réseau dynamique d’organismes de soins primaires régis par la communauté et qui comprend des centres d’accès aux services de santé pour les Autochtones, des centres autochtones de santé communautaire et des équipes interprofessionnelles de soins primaires pour les Autochtones régis par les Autochtones. Nous collaborons également avec le Conseil des services de santé de première ligne aux Autochtones afin d’établir une relation d’alliés et d’appuyer leur vision de la santé autochtone entre les mains des Autochtones.

Alliance Board Statement on Urgent Action Needed to Ensure Clean Water in all First Nations and Inuit Communities

Text graphic reads: Safe drinking water in Indigenous communities NOW Join the urgent call to the federal government to keep its promise for safe drinking water in all Indigenous communities in 2021. Lives depend on it.

Date:

le Vendredi 4 Décembre 2020

The Alliance for Healthier Communities stands in solidarity with Indigenous peoples across Canada and demands urgent action from the federal government to ensure access to clean drinking water in all First Nations and Inuit communities. Urgent action means:

The federal government makes all investments needed and takes swift action to lift all drinking water advisories across the country;
Canada’s federal leaders take policy steps that transfer greater control over water to First Nations to support Indigenous peoples’ rights to self-government and self-determination and to ensure long-term, sustainable safe water supply in their communities.

The end result must be that all First Nations and Inuit communities have sustained access to clean drinking water now and in the future.

Last month, Neskantaga First Nation was reported on widely in the news when the entire community was forced to evacuate their homes because of contamination to their water reservoir. This story is one of the many examples of ongoing devastating impacts of colonization on Indigenous communities in Canada. The emergency situation in Neskantaga First Nation is not new. This community in northwestern Ontario has been living under a boil water advisory for the past 25 years. It is one of many Indigenous communities across Turtle Island that lacks access to a basic commodity many people take for granted. According to the Council of Canadians, at any given time there are more than 100 water advisories in First Nations across Canada.

As a network of comprehensive primary health care providers, we know that safe, clean water is vital to maintaining good health and wellbeing. This has been especially true during the COVID-19 crisis when clean water and sanitation are essential to preventing the spread of the virus. Lack of access to clean drinking water in First Nations and Inuit communities is a violation of the United Nations recognized human rights and of Indigenous peoples’ rights. It is also a public health crisis. With COVID-19 cases on the rise, access to clean water in all First Nations and Inuit communities is essential to dealing with the pandemic, and it is crucial to a healthy recovery in every community.

In 2015, then newly-elected Prime Minister Justin Trudeau promised to eliminate all long-term drinking water advisories by March 2021. According to the Government of Canada website, 97 advisories have been lifted since 2015, with 59 water advisories still remaining in place. That number does not include short-term and medium-term water advisories.

The Fall Economic Statement released November 30 includes additional investments in water and wastewater infrastructure in First Nation communities. This is a step in the right direction, but not enough, especially after another broken commitment. We are disappointed by the federal government’s announcement that it will not meet its promise and concerned that there is no indication of when all water advisories will be lifted. This lack of urgency to ensure the upholding of a fundamental human right would be unacceptable in other communities in Canada, and considered a failure of federal leadership.

We urgently call on the federal government to keep its promise to Indigenous peoples in Canada and accelerate the work to bring clean drinking water to all First Nation and Inuit communities. It is imperative that the Prime Minister and the government hold itself accountable to this essential reconciliation promise, and that the government release a clear plan and timelines for how it will prioritize the work and ensure all First Nations and Inuit communities have access to long-term, sustainable, and safe water supplies in 2021. To delay this work longer is simply unacceptable.

As the federal government and the Prime Minister have themselves stated many times, ensuring clean water is an essential, foundational step toward reconciliation and addressing the impacts of Canada’s legacy of colonialism, as well as key to upholding the United Nations Declaration of the Rights of Indigenous Peoples. The time has come to keep your word. Lives depend on it.

This statement is issued by the Board of the Alliance for Healthier Communities, which represents a vibrant network of community-governed comprehensive primary health care organizations that includes Indigenous-governed Aboriginal Health Access Centres, Aboriginal Community Health Centres and Indigenous Interprofessional Primary Care teams. We also work with the Indigenous Primary Health Care Council to build ally relationships and support their vision of Indigenous Health in Indigenous Hands.

To effectively support marginalized people most impacted by COVID-19, Ontario needs a community response strategy

le Mardi 17 Novembre 2020

Late last week, like many other stakeholders in the province’s health system, we were encouraged to see the Ontario government modify its COVID-19 Response Framework to lower thresholds for putting public health restrictions in place in different regions.

The Alliance and its members remain very concerned, however, that not nearly enough is being done by the Ontario government to coordinate and resource local responses to support marginalized people during the pandemic. For those at higher COVID-19 risk -- including front-facing workers, racialized people, people living on low incomes and in crowded living conditions, people experiencing homelessness, and those dealing with addictions issues and the overdose crisis -- a robust community-based response strategy is needed from provincial leaders. One-size-fits-all public health messages and directives – such as telling people to work from home, physically distance from people outside your household, get your food/meals delivered, get tested if you have symptoms, isolate for 14 days – when many of these directives are near impossible for marginalized people to follow, is ineffective, inequitable and unjust. The result of the government’s continued inaction to support marginalized communities has been a direct and stark correlation between existing health inequities in Ontario and the worst impacts of COVID-19. Ontario’s marginalized communities, the least supported during the pandemic, are being forced to bear the brunt of the consequences of this continued inaction and lack of local supports.

People in higher risk groups face challenges such as housing and food insecurity, mental health concerns, increased stigma and distrust of the health system, often due to racism, and lower or loss of income due to the pandemic. Unfortunately, the current Ontario COVID-19 response framework and messaging from the Chief Medical Officer of Health continues to be focused on individual responsibility ahead of systemic strategy, interventions and supports. We’ve seen criticism in recent days of the focus on “individual responsibility” as ineffective given the lack of clarity and consistency in messaging from the province in the last two months. For people already at higher COVID-19 risk due to social and economic factors, the lack of a systemic response focused on health equity goes from ineffective to being (avoidably) tragic.

COVID-19 has made (and continues to make) health and economic disparities worse; this pattern will continue unless action is taken to support marginalized communities and the organizations responding to their needs. The need for an equity-focused COVID-19 response is the key thesis in the Chief Public Health Officer of Canada’s annual report From Risk to Resilience: An equity approach to COVID-19, released in October.

Just last week, community health leaders pointed again to trust and local support as the key missing elements of Ontario’s COVID-19 response plan. While Community Health Centres in Ontario hotspots such as northwest Toronto, Peel, Ottawa and across the province have worked diligently with partners to provide testing and other supports to marginalized populations where positive COVID-19 test rates are the highest, messaging, outreach and community level supports need be resourced, coordinated and more robust. Local lines of trust and support are critical now to infection prevention and control, and the same lines of community-built trust will be vital to the successful uptake and distribution of a COVID-19 vaccine.

A common and widely understood response framework is important in Ontario’s COVID-19 efforts, but it can only be one piece of a robust strategy. For marginalized people and communities, targeted and tailored approaches are needed to ensuring local needs are being met, unique barriers to staying healthy and safe are mitigated, and that people at higher risk of COVID-19 are not left behind. As experts in community health have pointed out again and again, including those at Black Creek and Rexdale Community Health Centres in Toronto, Thunder Bay, Ottawa, and elsewhere, the province needs to support an equitable and coordinated response – both during the pandemic to help people prevent and control infections, but also crucially during the vaccine and recovery phases. The health and wellbeing of everyone in Ontario depends on it.

Transformative Change Awards 2020

le Mardi 10 Novembre 2020

Graphic with illustration of birds flying with words: Transformative Change Awards Prix du changement transformateur

Congratulations to the 2020 Transformative Change Award recipients!

Here is the full list of honurees, plus videos featuring the three innovative programs chosen as this year's Transformative Change Award recipients by the Alliance Board.

Joe Leonard Award (description of this career recognition award)

Notisha Massaquoi, former executive director, Women's Health in Women's Hands CHC.

Health Equity Champions: "commitment to dismantling barriers to equitable health and championing policies and interventions that address discrimination and oppression" - Also, as a special tribute to the late Denise Brooks, the award will now be known annually as the "Denise Brooks Health Equity Champion Award" to honour Denise's legacy of health equity and anti-poverty leadership in Ontario.

Denise Brooks, Hamilton Urban Core CHC, for dedication and inspiring leadership in health equity, anti-racism and anti-poverty work in Hamilton, Ontario and across Canada.

Dr. Andrea Sereda. London Intercommunity Health Centre, for advocacy and support on harm reduction and the breakthrough of safer supply to help save lives during the overdose crisis.

Community Health Champions: "outstanding contributions to improving community health and advancing health equity"

Ontario Oral Health Alliance, for their contributions to advocacy for publicly-funded oral health and dental care, and for the achievement of the Low Income Seniors Dental Program in Ontario.

Adrianna Tetley Legacy Award (new): "an emerging leader who inspires contributions to primary health care transformation to improve the health and wellbeing of people and communities facing barriers"

Adrianna Tetley (inaugural year)

Transformative Change Awards (three): "work at the forefront of transformative change to achieve the best possible health and wellbeing for everyone living in Ontario"

CANDID ServicesNurse Practitioner-Led Clinic, Canadian Mental Health Association Durham:

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Équipe du site de Kirkland Lake (Rx: Communauté – La prescription sociale)Centre de santé communautaire du Témiskaming:

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Windsor Team Care Centre Windsor Family Health Team:

Budget de l’Ontario de 2020 : Déclaration et analyse de l’Alliance pour des communautés en santé

le Vendredi 6 Novembre 2020

Le 5 novembre 2020, le gouvernement provincial a publié son budget annuel, qui s’inscrit dans son Plan d’action pour la protection, le soutien et la relance dans le cadre de la COVID-19 et qui contient des prévisions pluriannuelles. En tout, les investissements sont de l’ordre de 45 milliards de dollars, dont plusieurs avaient été annoncés antérieurement.

Bien que ce budget ait pour principal objectif de répondre aux impacts immédiats de la pandémie de la COVID-19 par l’augmentation de la capacité des soins actifs et des soins de longue durée et du soutien aux entreprises, l’Alliance est préoccupée par le manque de clarté en ce qui concerne des mesures particulières pour les personnes et les communautés marginalisées. Les aînés isolés, les personnes à risque en raison de la crise des surdoses, les populations noires, les communautés autochtones, les personnes à faible revenu, et d’autres personnes qui ont été touchées de façon disproportionnée par la pandémie sont pour ainsi dire invisibles dans ce budget.

Nous sommes aussi préoccupés par le fait que bien que les soins de santé primaires en équipes aient joué un rôle de premier plan dans les réponses locales contre la COVID-19, par la collaboration avec des partenaires et des bureaux de santé publique pour appuyer le dépistage, le travail de proximité et d’autres mesures relatives à la COVID-19, il y a peu de mentions spécifiques ou de ressources affectées à ces efforts dans le budget. Dans l’ensemble, les objectifs du budget sont les bons, soit de soutenir et de protéger les individus pendant la pandémie et de faire en sorte qu’ils ont ce dont ils ont besoin pour se remettre sur pied lors du rétablissement. Cependant, afin d’assurer un rétablissement dynamique qui fonctionne pour tous, il faut en faire encore bien plus, particulièrement pour les personnes marginalisées plus susceptibles d’avoir de mauvais résultats en santé maintenant et lors du rétablissement.

Soins primaires

Les organisations de soins primaires, dont les membres de l’Alliance, ont joué, et jouent toujours, des rôles essentiels dans la vie des gens, ayant depuis des années établi des relations de confiance entre les fournisseurs et les communautés. La confiance est essentielle, surtout chez les communautés marginalisées, pour assurer des mesures équitables relatives à la COVID-19, et le sera d’autant plus au moment de distribuer les vaccins. Même si le gouvernement prend des mesures dans le budget pour couvrir certains des coûts liés à la pandémie, peu de détails sont offerts sur l’aide directe que recevront les fournisseurs de soins primaires pour leurs activités et la gestion des coûts additionnels associés à la pandémie. Des investissements provinciaux sont toujours requis pour des initiatives communautaires de travail de proximité, de dépistage, de vaccination contre la grippe, de services sociaux, et de visites pour assurer le bien-être, ainsi que pour des services de soins de santé et de promotion de la santé de base. La prestation par les membres de l’Alliance de soins de santé primaires complets est essentielle pour garder les personnes en santé et en sécurité pendant la pandémie, surtout si l’on considère les difficultés additionnelles auxquelles les gens font toujours face, et leur travail sera essentiel à des rétablissements communautaires dynamiques et durables.

Comme en fait état un article paru cette semaine dans la publication Healthy Debate, le plan de l’Ontario pour contrôler la deuxième vague doit inclure la participation des soins primaires. L’Alliance poursuit ses efforts de sensibilisation et de revendication avec ses membres et ses partenaires du secteur pour que le travail essentiel des soins de santé primaires complets soit reconnu et qu’il reçoive des ressources et du financement adéquats de ce gouvernement.

Crise des opioïdes et des surdoses

Nous sommes très préoccupés par l’absence de mention de la crise des intoxications aux opioïdes et des surdoses, d’un approvisionnement plus sécuritaire, de la réduction des méfaits et de mesures connexes pour soutenir les communautés. Sans reconnaissance ou financement, ce budget ne prévoit aucun plan d’action concernant cette crise qui s’aggrave et son impact sur les personnes et les communautés de la province. Les personnes meurent toujours, le taux de mortalité de surdoses en Ontario étant à son niveau le plus élevé depuis l’aggravation de la crise il y a quelques années. Les fournisseurs de soins de santé mentale et de réduction des méfaits ont besoin d’investissements pour lutter contre cette crise qui continue de s’aggraver. Dans le cadre de ses efforts de revendication, ce travail demeurera prioritaire pour l’Alliance dans toutes ses discussions avec le ministère de la Santé.

La santé des Noirs et le racisme envers les Noirs

Lors de son adresse à l’Assemblée législative le 5 novembre, le ministre des Finances de l’Ontario, Rod Phillips, a reconnu qu’il avait réfléchi aux conversations importantes qui ont lieu dans les communautés sur le racisme envers les Noirs. Il a aussi déclaré que l’Ontario est un endroit où toutes les personnes ont droit au respect et aux possibilités d’atteindre tout leur potentiel. Il a ajouté qu’il est inacceptable que le racisme systémique et d’autres formes de haine demeurent des obstacles, et que dans bien des cas, la COVID-19 a exacerbé des inégalités existantes. Il a conclu en disant que des efforts importants étaient déjà entrepris concernant ces enjeux.

Cependant, à l’exception du financement accru pour le Plan d’action pour les jeunes noirs, une nouvelle bien accueillie, aucun autre investissement n’a été annoncé pour des stratégies ou des programmes pour favoriser la santé des Noirs ou pour lutter contre le racisme envers les Noirs. Comme l’Alliance l’avait expliqué dans sa soumission prébudgétaire au gouvernement, la création et le financement d’une stratégie provinciale de promotion de la santé des Noirs sont essentiels pour engendrer des changements et pour lutter contre le racisme envers les Noirs dans les soins de santé et d’autres secteurs.

Conclusion

Nous entendons les gens parler de plus en plus du déficit imminent qui sera causé par la pandémie. Cette notion d’un manque de ressources va bien au-delà d’un déficit financier. Lorsque les communautés doivent faire des compressions et offrir plus de services sans un financement accru, ce sont généralement les personnes et les communautés marginalisées qui ne reçoivent pas de services et qui en subissent les conséquences sur leur santé. Dans ce budget, l’absence de solutions communautaires et le manque d’importance accordée aux soins primaires et aux équipes interprofessionnelles risquent d’entraîner l’Ontario dans un « déficit communautaire » causé par la COVID-19. De plus, le budget n’adopte aucune mesure substantielle concernant les priorités pour l’équité en santé, comme la lutte contre le racisme et les questions liées aux déterminants sociaux de la santé, dont la pauvreté, la sécurité alimentaire, l’emploi juste et stable, le logement abordable et des écoles plus sécuritaires. L’Alliance demeure préoccupée par le fait que l’absence de gestes concrets et de leadership du gouvernement provincial concernant l’équité en santé engendrera des déficits communautaires à l’avenir qui seront ressentis davantage par les personnes pouvant le moins porter le fardeau de cette pandémie. Nous poursuivrons nos efforts avec nos partenaires pour demander des mesures et des ressources visant à promouvoir l’équité en santé.

Ontario Budget 2020: Alliance for Healthier Communities' statement and analysis

le Vendredi 6 Novembre 2020

Graphic that reads: Ontario needs to make community a priority

On November 5, 2020, the provincial government released its annual budget, which further builds on its COVID-19 Action Plan to Protect, Support and Recover, and contains a multi-year forecast. Overall, there are $45 billion in investments, many of which were previously announced.

Although this budget focused heavily on addressing immediate impacts of the COVID-19 pandemic through increasing acute care and long-term care capacity and supporting businesses, the Alliance is concerned at the lack of clarity about specific supports for marginalized people and communities. Isolated seniors, people at risk due to the overdose crisis, Black populations, Indigenous communities, people living on low incomes, and others who've borne disproportionate impacts of the pandemic are largely invisible in this budget.

We're also concerned that, although team-based primary care has been foundational in local COVID-19 responses – working with partners and local public health units to support testing, outreach, and other supports related to COVID-19 – there are few specific mentions or dedicated resources in the budget to support this work. On the whole, the budget has the right goals in mind: to support and protect people throughout the pandemic and to ensure people have what they need to get back on their feet in recovery. But in order to ensure a healthy recovery that works for everyone, much more needs to be done, particularly for those marginalized people at much higher risk of poor health outcomes both now and in recovery.

Primary Care

Primary care organizations, Alliance members among them, have played and continue to play foundational roles in people’s lives, with years of trust built between providers and communities. Particularly among marginalized communities, trust is essential to ensuring equitable COVID-19 responses, and will be especially vital when it’s time to distribute vaccines. While the government addresses some health provider costs related to the pandemic in the budget, there are few specifics as to how this will directly aid primary care providers in their operations and in managing additional costs related to the pandemic. Provincial investments are still needed for community-driven outreach and testing, flu vaccination, wrap-around social supports, virtual wellness checks, as well as core healthcare and health promotion services. Alliance members’ delivery of comprehensive primary health care is vital to keeping people healthy and safe during the pandemic, especially considering additional barriers people continue to face, and their work will be vital to healthy and sustainable community recoveries.

As recognized in a Healthy Debate article published this week, Ontario's plan to contain second wave "needs a dose of primary care engagement". The Alliance will continue to advocate with its members and sector partners for the critical work of comprehensive primary health care to be recognized and adequately resourced by this government.

Opioid and Overdose Crisis

We are very concerned about the lack of mention of the opioid poisoning and overdose crisis, safer supply, harm reduction, or any related measures to support communities. With no recognition or funding, there is no acknowledgement or plan of action in this budget for the worsening crisis and its impact on people and communities across the province. People continue to die; the rate of deaths from overdose in Ontario is the highest since the crisis worsened several years ago. Mental health and harm reduction providers need investments to address this ongoing and worsening crisis. We need concrete support for effective programs like safer supply. This work is and will continue to be an active priority for the Alliance in all our conversations with the Ministry of Health and in our continued advocacy work.

Black Health and Anti-Black Racism

When addressing the house yesterday, Ontario’s Minister of Finance Rod Phillips acknowledged that he had “been reflecting on the important conversations that have been happening in communities about anti-Black racism.” He also stated that “Ontario is a place where every person deserves respect and the opportunity to be all that they can be. Unfortunately, systemic racism and other forms of hate still get in the way, and that is simply unacceptable. In many cases, COVID-19 has exacerbated existing inequities. Important work is already underway to address these issues.”

However, aside from the welcomed increase to funding for the Black Youth Action Plan, there is no other investments being made in Black Health or anti-Black racism strategies or programs. As the Alliance laid out in our pre-budget submission to the government, creating and funding a provincial Black health strategy is essential to enabling change and addressing anti-Black racism in health care and other sectors.

Conclusion

We increasingly hear people talking about the looming “pandemic deficit”. The notion of a lack of resources during this time goes beyond the purely financial. When communities are forced to make cutbacks and deliver more services with the same funding, it’s generally marginalized people and communities who aren’t served and end up with poorer health outcomes. This budget, with its lack of any meaningful focus on community-driven solutions, primary care, interprofessional teams and the social determinants of health, leaves Ontario at risk of a “community deficit” due to COVID-19. In addition, the budget doesn’t take any meaningful action on health equity priorities, such as anti-racism or the social determinants of health (SDOH), including poverty reduction, food security, fair and stable employment, affordable housing or safer schools. The Alliance remains concerned that a lack of action and leadership from the provincial government on health equity will mean that future community deficits are felt most deeply by those who can least afford to carry more burden from the pandemic. We will continue to work with our partners to seek out action and resources on health equity.

Delhi Family Health Team awarded AFHTO Bright Lights Award for dedication and nimble work with partners to support COVID-19 response for farm workers

le Jeudi 22 Octobre 2020

Nurses from Delhi FHT who worked as part of primary care response team serving seasonal agricultural workers during COVID-19. The team has won an AFHTO Bright Lights Award for their efforts.

When the Medical Officer of Health for Haldimand and Norfolk called her on a Saturday morning last spring as COVID-19 outbreaks were overtaking many Ontario farms, Robin Mackie, a registered nurse and executive director of Delhi Family Health Team, didn't hesitate for a moment.

"I said, 'OK, what do you need?' and Dr. [Shanker] Nesathurai said, 'We need you guys in the field, can you go out and do this?' I thought he meant Monday, but then he asked, "Can you get out there today? We need to flatten the curve as much as we can."

Mackie, who herself had battled a serious COVID-19 infection that resulted in a transfer to hospital in March, said it clicked in her head in a split second, given the barriers that seasonal agricultural workers face in terms of language, access, housing and co-morbidities.

"Even though we have a seasonal agricultural program (to serve workers in need of primary care, the FHT operates a clinic serving 3,300 workers), it’s very dependent on the workers getting to us. With this virus, and its ability to spread so quickly, how were the farm workers going to get to us safely?" Mackie explained in a recent interview with the Alliance. "When Dr. Nesathurai suggested going to the farms, the first thing I thought was, 'That’s a fantastic idea. Bring health care to them.' I didn’t even think of the logistics of how we were going to do it. I just knew that we were going to do it. Honestly, there was no option."

In the next few hours, Mackie called her team and assembled a plan. One thing there was never any doubt about was the dedication of the Delhi Family Health Team doctors, nurses and other staff.

"I knew that my team was that good, that they were that prepared, and I knew that they were that dedicated," Mackie said. "So I put out a call saying, 'I have no idea how we’re going to do this, but this community needs us. This vulnerable population needs us.' And my team just said, 'Where do you want us, and when?' "

Within hours, Mackie had gathered a team of two doctors and four nurses with PPE and they headed to the farm’s bunkhouses. Later, efficiencies were created by utilizing medical directives, onsite Nurse Practitioners, translators and nurses who often traveled to multiple bunkhouses by way of their own a pickup truck. In the coming weeks, staff relied on interpreters and translation apps to assess the needs of the farm workers. Their work encompassed physical screening, testing, assessment, and treatment of workers -- but also went beyond those public health imperatives.

The Delhi team would conduct 673 "in the field" visits on the farm in 30 days, with Mackie noting that she remained on call for her team, which often spanned 12-14 hours with some evenings in June until 10 p.m. Together with strong, trusted community partners from the Canadian Mental Health Association, Grand River CHC, and community parademics, along with public health, the core Primary Care Mobile Response Team led by Delhi FHT was able to put in place supports and interventions to help prevent outbreaks, serious illness and hospitalizations. Over time, the workers opened up to staff about more than just medical concerns -- also speaking of missing families and children, their fears about money and health. One evening, nurse Practitioner Rebecca Spencer-Knight was already finished her shift when she texted Mackie for permission to stay longer. “A gentleman was crying, he was so home sick. She didn’t think he should be alone,” Mackie said.

The nurses “were the heroes here,” said Dr. William Thorogood, assistant professor and Simcoe site lead for McMaster University’s Department of Family Medicine and preceptor with the Delhi Family Health Team., “and this is a story of their collaboration with Emergency Medical Services and Public Health in a broad community effort. It’s the story of nurses who gave much more than medicine.”

Earlier this month, the Association of Family Health Teams of Ontario recognized and honoured this amazing group and their partners with its highest honour, a Bright Lights Award. The recognition means a lot to Mackie, not just as a health leader, but also for her team and team-based health care in general.

"Team-based care has always been behind the scenes doing work and we don’t seem to be noticed, and we’re kind of a humble group. We know what the right thing to do is, and we do it," Mackie said. "This award isn’t about ourselves, it’s about our community. And it’s about recognizing how well team-based care can work."

Mackie also credits the community governance at the Delhi Family Health Team for their trust and support of her leadership and staff, and being an important enabler of the nimble response for farm workers.

"For our board, their gut response is always to support community. They trust me to do what’s right for the people we serve and our broader community."

Alliance 2020 Budget Recommendations

Date:

le Mercredi 21 Octobre 2020

The Alliance for Healthier Communities provides team-based health and social services, under one roof and close to home, for Ontario’s most marginalized residents. Our 106 Community Health Centres, Aboriginal Health Access Centres, Community Family Health Teams and Nurse Practitioner-Led Clinics have demonstrated our ability to help the province meet the complex challenge of ending hallway healthcare with a focus on health equity and community wellbeing. Read our budget recommendations.

#CHWW2020: Learn about the impact of arts on health & wellbeing - webinar recording and inspirational ballet video

le Vendredi 9 Octobre 2020

Isolation and COVID-19 measures are often difficult and can harm mental and physical health. Taking steps to mitigate the effects of the measures on health and wellbeing is important, and that's why Alliance members work with many partners, such as through the social prescribing Rx Community project, to find novel ways to get people connected, moving, and feeling good.

For Community Health and Wellbeing Week, the Alliance partnered with Canada's National Ballet School, to bring you a webinar earlier this week: Arts on Prescription: Improving health and wellbeing through arts participation.

If you missed the webinar, wish to review it, or would like to share it with colleagues and community partners, you can access the webinar recording, slide deck, and additional resources online. Contact information for all panelists are included in the additional resources document, you are welcome to reach out and connect further.

Before you check out the webinar recording, slide deck, and amazing additional resources above from Arts on Prescription, we encourage you to check out the video at the top of this post for some inspiration and ideas for feeling good, courtesy of the team at Canada's National Ballet School who produced the video along with students across Canada. It's truly an uplifting three minutes, and helped to remind us what joy can come from moving around, even if it's just in front of your own mirror at home.

We are grateful to our webinar panelists Melissa Smith (AGO), Megan Ferris (Canada National Ballet School), Rebecca Barnstaple (CHIGAMIK Community Health Centre), Sabrina La Tona (North York Family Health Team), and Surkhab Peerzada (South Riverdale community Health Centre) for sharing a wide range of innovative integration between arts and health through different perspectives and contexts.

We hope this webinar will help to spark new inspirations and further dialogue in your practices and teams!

Logos of Alliance, Canada's National Ballet School, AGO, South Riverdale CHC, CSC CHIGAMIK CHC, and North York FHT