March 31, 2026

VIA ELECTRONIC MAIL

Honourable Minister Sylvia Jones
Deputy Premier and Minister of Health
Ministry of Health
5th Floor, 777 Bay Street
Toronto, ON M5G 2C8

Dear Minister Jones:

Re: Public Health Sudbury & Districts 2026–2028 Risk Management Plan

On behalf of the Board of Health for Public Health Sudbury & Districts, thank you for your consistent engagement and support of public health.

The Board of Health recently adopted a Risk Management Plan for 2026–2028. We take seriously this exercise as critical to protecting public dollars as well as enuring our agency is positioned to enhance the public’s health.

I am writing to share several system-level risks that go beyond the ability of a local agency to address, and to respectfully request the Province’s engagement and collaboration on these matters.

These risks remain rated as high despite the implementation of all feasible controls within the authority of a local public health agency. They reflect
structural and system-level challenges that affect public health and health system performance across Ontario and extend beyond the influence of any one
local agency.

• Public trust and misinformation
  The erosion of trust in public institutions and the scale of misinformation circulating in the current information environment pose ongoing risks to effective public health action. While local public health agencies continue to adapt communication strategies and strengthen community engagement, these challenges are fundamentally national and global in nature and would benefit from coordinated provincial and intergovernmental approaches.
• Service continuity and access to care
  Persistent gaps in service delivery—particularly where public health mandates intersect with primary care—continue to affect continuity of care and health outcomes for vulnerable populations. These challenges reflect broader health system capacity, governance, and accountability pressures, rather than local program design.
• Jurisdictional complexity and equity for First Nations communities
  Ongoing ambiguity between federal, provincial, and First Nations roles in service delivery continues to create inequities and operational uncertainty. Despite sustained local engagement and advocacy, progress remains limited, and meaningful resolution requires clearer policy direction, leadership and coordination at higher levels of government.
• Economic and geopolitical pressures affecting population health
  External forces, including tariffs and broader economic pressures, are contributing to increased costs and reduced access to essential goods such as nutritious food. These pressures disproportionately affect populations already experiencing vulnerability and are well beyond the scope of influence of local public health agencies. We are please that this is already a priority for your government, and we hope we collaborate to do even more to address them.
• Persistent systemic inequities
  Structural racism and long-standing societal barriers continue to harm health outcomes and trust in public systems. While local public health agencies are strengthening equity-focused practices, the underlying drivers of these risks require sustained, cross-sector and system-wide policy attention and collaboration. While financial sustainability is an underlying consideration in any risk environment, the Board’s primary purpose in writing is to underscore that many of the most significant risks facing public health are shared, province-wide challenges that require coordinated system-level engagement and provincial leadership to meaningfully address. The Board of Health would welcome the opportunity to meet with the Ministry to discuss these risks in greater detail and to share insights from local experience that may support provincial policy and planning efforts. Public Health Sudbury & Districts remains committed to working collaboratively with the Province to strengthen public trust, improve equity, and support resilient and effective public health and health systems across Ontario.

Thank you for your consideration of these important issues.

Sincerely,
Mark Signoretti
Chair, Board of Health

cc: Dr. M.M. Hirji, Medical Officer of Health and Chief Executive Officer
Dr. Kieran Moore, Chief Medical Officer of Health
Dr. Kate Bingham, Associate Chief Medical Officer of Health
France Gélinas, Member of Provincial Parliament, Nickel Belt
Jamie West, Member of Provincial Parliament, Sudbury
Bill Rosenberg, Member of Provincial Parliament, Algoma – Manitoulin
Association of Local Public Health Agencies
Local Municipalities
Ontario Boards of Health