Population health indicators across Ontario’s Public Health Units: a cross-sectional analysis of the Canadian Community Health Survey

Background Currently, 34 public health units (PHUs) in Ontario deliver public health programs and services to reduce preventable diseases, promote and protect health of their communities, and reduce persistent health inequities. Changes to the structure of Ontario PHUs have been proposed. This analysis compares the current 34 Ontario PHUs based on key health indicators for the purpose of determining local health needs in delivering public health programs and as a baseline for measuring the effect of any future changes to PHU structure. Methods We used data from the 2015–2016 Canadian Community Health Survey (CCHS), a voluntary cross-sectional survey about health status of Canadians. Twenty-one health indicators measured by the CCHS and particularly relevant to PHU responsibilities were identified and compared across units. In this descriptive, cross-sectional analyses we used survey-weighted frequency calculations of the selected indicator variables by PHU and χ2 analyses to test differences in indicator distribution across PHU. Results All indicators except for sex were distributed unevenly by PHU. We particularly highlight differences across units in modifiable indicators and risk factors such as obesity, fruit and vegetable consumption, physical inactivity, smoking, and access to primary care physicians. Impact of the study While all PHUs strive towards the same mandated responsibilities, considerable variations in health indicators exist between health units. This underscores the necessity for PHUs to tailor programs and deliver services based on local needs. Future changes to PHU structure must be tested against baseline to determine if they ameliorate or exacerbate health inequities in Ontario.

Wastewater-based epidemiology: current uses and future opportunities as a public health surveillance tool

Wastewater-based epidemiology (WBE) seeks to use biological or chemical indicators in sewage to provide information on the overall health of a community. This paper provides an overview of the range of applications of WBE over the past two decades, how it has been used to inform public health responses, and considerations for more integrated approaches to WBE based on a review of the literature. The review finds that WBE has been used extensively around the world for the estimation of consumption patterns of illicit drugs and other substances, but a range of novel applications also exist. As a result of the COVID-19 pandemic, many communities used WBE for the first time as a complementary public health surveillance tool, monitoring trends in SARS-CoV-2 prevalence in large cities, and for micro-surveillance on a more targeted level. WBE may continue to be a useful public health surveillance tool in the future; however, several limitations and challenges exist. Consideration of how information obtained through WBE can be used to inform public health responses is essential to understanding the potential costs and benefits compared with conventional public health surveillance techniques.

Overview of common infection prevention and control infractions and complaints in personal service settings in Ontario in 2018: a descriptive analysis

Objectives Aesthetic services can pose a potential risk of infection to clients if instruments are not discarded or reprocessed after each use. Public health inspectors (PHIs) inspect personal service settings (PSS) to monitor compliance with infection prevention and control (IPAC) requirements. This study aimed to assess the prevalence of various IPAC infractions in Ontario PSS that were identified during routine compliance inspections and whether these were similar to those identified during investigations in these settings in which an IPAC lapse was deemed to exist. Methods PSS inspection results were analyzed from three public health units (PHUs) in Ontario in 2018. Premises were grouped into three premises types (hairdressing/barbering, aesthetics, and body modification) and infractions from 16 IPAC compliance categories were compared. Results of IPAC lapse investigations for all of Ontario were also compared across premises types. Results There were 5,386 inspections conducted in 4,483 PSS by three PHUs in 2018. PSS offering aesthetics were most likely to have infractions identified. Common infractions were related to inappropriate reuse of single-use and reusable instruments. Of the 121 IPAC lapses reported by PHUs in 2018, 52 (43.0%) were in PSS, and 73.1% of these were associated with nail salons/spas. Conclusions Operators could benefit from increased awareness of infection control best practices and the potential for infections to occur if these are not followed. PHIs could consider an alternate frequency of PSS inspection to increase operator education and compliance with minimum IPAC requirements.

Experiences of case and contact management teams during the COVID-19 pandemic response in Ontario

Case and contact management (CCM) teams play a vital role in the COVID-19 pandemic response. This study aims to understand the experiences of CCM team members during the COVID-19 pandemic to identify areas of improvement for future crises. A mixed-methods, cross-sectional online survey was conducted from November 2020 to March 2021. There were a total of 49 relevant survey responses. Participants were CCM team members responding to the pandemic in Ontario. Frequency tabulations were used to analyze closed-ended survey responses, and both a conventional content analysis and thematic analysis were conducted on the open-ended responses. Study results revealed that inadequate planning and preparedness, poor communication, high workloads, and stress levels of CCM team members were notable areas of concern. These matters ultimately affected the well-being of CCM team members and acted as barriers to completing CCM work. It is imperative that adequate staffing and accessibility to mental health support from employers are improved in future times of crisis to ensure that CCM teams are able to meet the demands of their work. Further studies should be conducted to examine the experiences of CCM team members as well as barriers and facilitators to completing CCM work.