Issue
The behaviours initiated in youth create a foundation for health through the life course (Toronto Public Health, 2015). Enabling Ontario’s children and youth to reach their full potential and reduce the current and future burden of disease, is a vision shared across multiple sectors including health and education. Addressing the health of this age group requires a comprehensive approach, involving strategies built upon evidence that includes local population health data. Collecting, analyzing and reporting these data at the local level is essential for planning, delivering and evaluating effective and efficient services that meet the unique needs of children and youth and to ensure the responsible public stewardship of the resources allocated to these services (Windsor-Essex, 2017).
At present, there are approximately 50 federal programs collecting health data on the Canadian population, many of which include school age children and youth (Public Health Agency of Canada, 2013). Notable programs operating in Canada include the National Longitudinal Survey of Children and Youth (NLSCY) (Statistics Canada, 2010), the COMPASS study (Leatherdale et al., 2014), the McMaster University Ontario Child Health Study (OCHS) (Statistics Canada, 2015), the Ontario Student Drug Use and Health Survey (OSDUHS) (Centre for Addiction and Mental Health, 2013), the Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) (University of Waterloo, 2017), and the Health Behaviour in School Age Children (HBSC) survey. Notwithstanding the number of sources, data collected from these surveys are not always collected in a way that provides representative results at the regional and local levels, thus creating challenges for public health units and related stakeholders to generate meaningful information on their specific population of interest. This often results from insufficient sample sizes at the sub-provincial level, and the prohibitive cost of purchasing additional local data (i.e. oversamples) from national or provincial sources (Windsor-Essex County Health Unit, 2017). Understanding trends and differences at the local level is a necessary foundation on which to build tailored intervention strategies that improve health and well-being outcomes.
The lack of a well-coordinated system for monitoring of child and youth health in Ontario at the local and regional level contributes to disorganization, duplication of efforts and inefficiency of population health assessment initiatives created to fill these gaps (Windsor-Essex County Health Unit, 2017). These issues not only affect local public health units, but other stakeholders as well, including provincial-level government institutions, schools, researchers, and end-users of data due to a lack of interface or forum for stakeholder to communicate and collaborate (PHO, 2013; PHO, 2015; Windsor-Essex County Health Unit, 2017).
Further coordination and improvement of Ontario’s system for child and youth health monitoring would deliver:
- Greater impact and use of public funds
- Improved evidence in decision-making at all levels (local, regional, provincial)
- Better efficiency, accountability, and collaboration between sectors
- Improved health and well-being of children and youth
Background
The Ontario Public Health Standards (OPHS) require that Boards of Health collect and analyze health data for the purpose of monitoring trends over time and informing programs and services tailored to local needs (OPHS, 2018). The results of the 2017 report, Children Count: Assessing Child and Youth Surveillance Gaps for Ontario Public Health Units, which surveyed 34 of 36 health units and over 377 professionals and key informants, found that public health units (PHU) need better local data on mental health, physical activity and healthy eating for children and youth (Windsor-Essex County Health Unit, 2017). Key stakeholders in education, academia and government validated these data needs. Additionally, the 2017 Annual Report of the Ontario Auditor General acknowledged that children and youth are a public health priority population, and that epidemiological data on children are not readily available to public health units for planning and measuring effective programming for this population (Office of the Auditor General of Ontario, 2017).
The 2017 Children Count report recommended expanding or augmenting existing monitoring efforts, and improving collaboration on child and youth health monitoring between public health, education and academic sectors (Windsor-Essex County Health Unit, 2017). This recommendation included the development of a task force, comprised of key stakeholders from across Ontario and sectors who were able to identify tangible next steps for system improvements for monitoring child and youth health and well-being in Ontario.
With modest funding from Public Health Ontario, the Children Count research team established the Children Count Task Force with leaders from public health, education, non-governmental organizations (NGOs), government agencies, academia and provincial ministries. The Children Count Task Force met four times from June 2017 to January 2018 to: 1) review and discuss the 2017 Children Count report findings and recommendations; 2) review current systems and assess opportunities to find and improve system-wide efficiencies; and 3) construct and refine recommended actions that would improve monitoring of children and youth health and well-being in Ontario.
The Children Count Task Force recommendations were released in spring 2018 to key Ministry representatives and provincial stakeholder groups, such as the Council of Directors of Education (CODE) and Council of Medical Officers of Health (COMOH). In fall 2018; following consultation with the Children Count Task Force, recommendations were re-released with further minor revisions in January 2019.
The five recommendations of the Task Force are:
Overarching Recommendation: Create a secretariat responsible for overseeing the implementation of the systems, tools, and resources required to improve the surveillance of child and youth health and well-being. The secretariat shall be enabled to:
- Guide the implementation of the five recommendations of the task force.
- Develop a process to ensure that assessment and surveillance systems remain effective and relevant over time by addressing emerging issues and data gaps.
Recommendation 1: Create an interactive web-based registry of database profiles resulting from child and youth health and well-being data collection in Ontario schools.
Recommendation 2: Mandate the use of a standardized School Climate Survey template in Ontario schools and a coordinated survey implementation process across Ontario.
Recommendation 3: Develop and formalize knowledge exchange practise through the use of centrally coordinated data sharing agreements.
Recommendation 4: Develop and implement a centralized research ethics review process to support research activities in Ontario school boards.
Recommendation 5: Work with the Information and Privacy Commissioner (IPC) of Ontario to develop a guideline for the interpretation of privacy legislation related to student health and well-being data collection in schools.
The Children Count Task Force recommendations represent key steps to improving the system of data collection and assessment for child and youth well-being in Ontario. The recommendations will better enable public health units, boards of education and related stakeholders to improve the planning, implementation and evaluation of local programs and services that meet the diverse and unique needs of children and youth across the province.
Proposed Motion
Whereas, boards of health are required under the Ontario Public Health Standards (OPHS) to collect and analyze health data for children and youth to monitor trends overtime, and
Whereas, boards of health require local population health data for planning evidence-informed, culturally and locally appropriate health services and programs, and
Whereas, addressing child and youth health and well-being is a priority across multiple sectors, including education and health, and
Whereas, Ontario lacks a single coordinated system for the monitoring and assessment of child and youth health and well-being, and
Whereas, there is insufficient data on child and youth health and well-being at the local, regional and provincial level, and
Whereas, the Children Count Task Force recommendations build upon years of previous work and recommendations, identifying gaps and priorities for improving data on child and youth health and wellbeing,
Now therefore be it resolved that the Windsor-Essex County Board of Health receives and endorses the recommendations of the Children Count Task Force, and
FURTHER THAT, the Windsor-Essex County Board of Health urges the provincial government to take steps to improve the ways in which population health data for children and youth is currently collected and reported in Ontario.
- Leatherdale, S.T., Brown, K.S., Carson, V., Childs, R.A., Dubin, J.A., Elliott, S.J., Faulkner, G., Hammond, D., Manske, S., Sabiston, C.M., Laxer, R.E., Bredin, C., Thompson-Haile, A. (2014). The COMPASS study: a longitudinal hierarchical research platform for evaluating natural experiments related to changes in school-level programs, policies and built environment resources. BMC Public Health, 14:331.
- CAMH. (2013). Centre for Addiction and Mental Health. Retrieved August 2017, from Centre for Addiction and Mental Health: http://www.camh.ca/en/research/Pages/research.aspx
- Children Count Task Force. (2019). Children Count: Task Force Recommendations. Windsor, ON: Windsor-Essex County Health Unit.
- Office of the Auditor General (2017). Annual Report 2017. Toronto: Queen’s Printer for Ontario.
- Ministry of Health and Long-Term Care. (2018). Ontario Public Health Standards: Requirements for Programs, Services, and Accountability. Toronto: Queen’s Printer for Ontario.
- PHAC. (2013). Retrieved August 2017, from Public Health Agency of Canada: https://www.canada.ca/en/public-health.html
- Population Health Assessment LDCP Team (2017). Children Count: Assessing Child and youth Surveillance Gaps for Ontario Public Health Units. Windsor, ON: Windsor-Essex County Health Unit
- Public Health Ontario. (2015). Child and Youth Health Data Sources Project: Summary of findings. Toronto: Queen’s Printer for Ontario.
- Public Health Ontario, Propel Center for Population Health Impact. (2013). Youth Population Health Assessment Visioning: recommendations and next steps. Toronto. Queen’s Printer for Ontario.
- Statistics Canada. (2010). List of Surveys in Collection. Retrieved August 2017, from Statistics Canada: http://www.statcan.gc.ca/eng/survey/list
- Toronto Public Health. (2015). Healthy Futures: 2014 Toronto Public Health Student Survey. Toronto: Toronto Public Health