Issue
The upcoming provincial election presents the opportunity to promote the endorsement of healthy public policies to key stakeholders vying for seats in Ontario’s Legislative Assembly. The Association of Local Public Health Agencies (alPHa) has released a set of provincial election priorities, spanning across numerous public health topic areas, to call on candidates in the 2018 provincial election to commit their support for a healthier Ontario through a strong local public health system. These priorities were previously shared with provincial party leaders in December of 2017. The promotion of these priorities is an important step in continuing to advance the profile of public health issues. Topical public health issues which would benefit from increased regulation, funding, or renewed attention include, tobacco, oral health, opioids, cannabis, and mental health.
In addition, The Centre for Addiction and Mental Health (CAMH) has called upon the three main political parties to “Erase the Difference” in funding between physical health and mental health/addictions. This proposal, in recognition that mental health and addiction agencies currently receive only 6.5% of Ontario’s health budget, is supported by the disproportionately high rates of mental health issues or mental illness as well as the relative burden of these conditions.
Background
The Association of Local Public Health Agencies have outlined five key areas of election policy priorities that focus on improving Ontarians’ health:
- Tobacco Endgame in Ontario
- Oral Health for Adults in Ontario
- Universal Pharmacare Program
- Public Health Approach to Cannabis in Ontario
- Opioid Strategy Action Plan for Ontario
Tobacco
Tobacco remains the leading cause of preventable death and illness in Ontario with approximately 36 deaths per day as a result of tobacco use or related conditions. As one of the primary causes of lung disease, heart disease, lung cancer and many other illnesses there is growing support in Canada and globally for a tobacco endgame, with the adoption of endgame targets in Ireland, Scotland, Finland, and New Zealand. A Steering Committee for Canada’s Tobacco Endgame was convened in 2015 and identified an endgame goal of less than 5% tobacco use by 2035.
Oral Health
According to the World Health Organization (WHO), oral health is essential to general health and quality of life. In spite of this, many low income, and middle income Canadians suffer from pain, discomfort, disability, and loss of opportunity because of poor oral health. With under one-third of Ontario workers without employer dental benefits, and 13.9% of the Ontario population living on a low income, there exist significant and impactful financial barriers which prevent many marginalized and low-income adults from accessing preventive and acute dental care. Many acute dental complications which result in emergency department visits are avoidable with timely preventive care such as cleanings and fluoride treatments as well as fillings and extractions. In order to address the underlying causes of the disproportionate number of low-income adults and seniors without access to preventative dental treatments, we recommend that the Ontario government commit to a provincially funded oral health program for low-income adults and seniors in Ontario before 2025.
Opioids
Ontario has one of the highest prescription rates in Canada for opioids, a class of drugs that includes pain relievers such as fentanyl, morphine and OxyContin. While these drugs can be an effective part of pain management for some medically supervised patients, opioids can be harmful and result in addiction and overdoses. Over the past 13 years, the province of Ontario has experience increasing opioid overdose fatalities and opioids have risen to become the third leading cause of accidental death in the province. In June 2016, Ontario made naloxone, a medicine designed to quickly reverse the effects of opioid overdose, available without a prescription at pharmacies across the province. In October of the same year, Ontario announced its Opioid Strategy to prevent opioid addiction and overdose. Recognizing that lives can be saved through a coordinated prevention, treatment, harm reduction, and enforcement response, many health regions, including Windsor-Essex County, have adopted this four pillar approach in their communities.
Cannabis
Cannabis use carries health risks, including problems with brain functioning (e.g., drug-impaired driving), respiratory problems, and dependence. Canadian youth are among the top users of cannabis in the developed world. In April 2017, the federal government introduced Bill C-45, An Act respecting cannabis and to amend the Controlled Substances Act, the Criminal Act and other Acts. The Act seeks to legalize and regulate recreational cannabis in order to keep cannabis out of the hands of Canadian youth and to prevent organized crime from profiting from the illegal cannabis market. As provinces and territories will be responsible for licensing and overseeing the distribution and sale of cannabis, there exists the opportunity to develop stringent regulations on promotions, advertising, and marketing, particularly to children and youth These policies have proven effective in tobacco control and should be applied to cannabis legalization. In addition, the government should develop a comprehensive framework to address and prevent cannabis-impaired driving. Indeed, the government should fund a public health approach to cannabis legalization including public education on: risk factors; safer consumption; and a strategy to address impaired driving; would help to mitigate concerns associated with the anticipated increased use as a result of legalization.
Mental Health (Erase the Difference)
Similar to physical health, mental health and illness can take many forms including anxiety disorders, depression/bipolar disorder, eating disorder, obsessive compulsive disorder, phobias/panic disorders, post-traumatic stress disorder, schizophrenia, and suicide. Mental health issues and mental illness affect one in five Ontarians every year however only 6.5% of Ontario’s health budget is allocated to the treatment of these conditions. Inadequate service systems and social alienation are a reality for those affected with poor mental health. A recognition of the importance and prevalence of mental illness and mental health issues warrants a reallocation of resources to help address the treatment “bottle neck”, which acts as a barrier to so many looking for help.
PROPOSED MOTION
Whereas, tobacco use remains the number one preventable cause of death in Ontario; and
Whereas, oral diseases, including dental caries and periodontal disease, are among the most prevalent and preventable chronic diseases; and
Whereas, Ontario’s universal health care system does not include dental care for adults and nearly 1 in 3 Windsor-Essex County residents report having no form of dental insurance coverage; and
Whereas, rates of opioid use and opioid-related harms continue to increase in Windsor-Essex County and across the province; and
Whereas, cannabis legalization presents a number of public health concerns and a comprehensive education, harm reduction, and regulatory framework would help to reduce risks associated with youth; and
Whereas, 1 in 5 Canadians struggle with mental health issues and illness every year and the difference in funding between mental and physical health has led to a dearth of services available to those struggling with mental health issues and illness; and
Now therefore be it resolved that the Windsor-Essex County Board of Health supports the Association of Local Public Health Agency’s five areas of provincial election priorities; and
FURTHER THAT, the Windsor-Essex County Board of Health supports a provincial focus on the Tobacco Endgame, tobacco usage rate of less than 5% in Ontario by 2035, and a shift from tobacco “control” to a future that is free from commercial tobacco; and
FURTHER THAT, the Windsor-Essex County Board of Health encourages the Ontario government to fund a, comprehensive, multifaceted action plan for the Ontario Opioid Strategy, including education, harm reduction and treatment. The action plan should include targets, deliverables, timelines and an evaluation component and be supported by Public Health Units and key community stakeholders; and
FURTHER THAT, the Windsor-Essex County Board of Health encourages the provincial government to adopt and fund a comprehensive public health approach to cannabis legalization, regulation, restriction of access, education and harm reduction in Ontario. This approach should align the regulatory restrictions on cannabis with those on tobacco, as provided in the Smoke-Free Ontario Act; and
FURTHER THAT, the Windsor-Essex County Board of Health supports CAMH’s request for the provincial government to address ongoing financial support inequities and “Erase the Difference” between physical and mental health funding in the Ontario.
Approved by:
Theresa Marentette