Appendix D Profile 1
Appendix D: Profile The in the South West LHIN According to the 2006 Census, the Francophone population in the South West LHIN is approximately 11,000 people, representing 1.3% of the total population. It is important to note, however, that this number only refers to people whose mother tongue is French, and does not include Francophones who have emigrated from other countries for whom French is their first official language. This is why the Office of Francophone Affairs (Ontario) released on June 4, 2009 a new definition of Francophone that is more inclusive. For statistical purposes, Francophones are defined as those whose mother tongue is French and those whose mother tongue is neither French nor English, but who have a particular knowledge of French as an Official Language and use French at home. This will not only have an impact on the number of Francophones in the South West LHIN, but also in the type of services required. The number of Francophones in the South West LHIN who have emigrated from other countries is estimated at 7,000, bringing the actual number of Francophones in our LHIN to approximately 18,000. Recognizing the larger number of Francophone residents has implications for the types and capacity of French language services required in our LHIN. Distribution of the in the South West LHIN North Central South SW LHIN 1,375 0.96% of the North population 935 0.70% of the Central population 8,875 1.42% of the South population 11,185 1.24% of the SW LHIN population The Francophone population lives mostly in the South planning area, with 60% in the city of London. The graphs 1 below show that the Francophone population is slightly older than the general population. The average age of the Francophone population is 43 as compared to 39 for the general population. 1 Census, 2006 2
Population by Age Group, North Geographic Area 12.0 10.0 8.0 6.0 4.0 2.0 0.0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Age Groups Population by Age Group, Central Geographic Area 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Age Groups 3
Population by Age Group, South Geographic Area 10.0 9.0 8.0 7.0 6.0 5.0 4.0 3.0 2.0 1.0 0.0 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Age Groups Health Status of the South West LHIN Language is a health determinant. Language barriers have been demonstrated to have adverse effects on access to health care, quality of care, rights of patients, patient and provider satisfaction, and most importantly, on patient health outcomes. ((...)) There is also evidence that language barriers contribute to inefficiencies within the health system. 2 According to the Canadian Community Health Survey (2005 and 2007), a slightly higher proportion of Francophones in the South West LHIN report suffering from arthritis and diabetes compared to the non-francophone population. A slightly higher proportion of the South West LHIN Francophone population reports smoking daily or occasionally compared with non- Francophones, while a slightly lower proportion of Francophones report physical inactivity, obesity, and a poor diet compared to the non-francophone population in the South West LHIN. 3 2 Language Barriers in Access to Health Care, Health Canada, 2001. 3 Ontario & LHIN Canadian Community Health Survey (2005 & 2007): Health outcomes, risk factors and preventative care for Francophones and Non-Francophones. 4
Prevalence of Chronic Conditions in the South West LHIN Population 90 80 72.9 78.0 70 60 62.3 60.9 50 40 30 20 24.5 17.7 17.6 16.8 10 5.4 9.2 0 Self-rated health - very good or excellent Self-rated mental health - very good or excellent Arthritis High blood pressure Diabetes Chronic Conditions Lifestyle Habits of the South West LHIN Population 60 53.9 50 47 41.6 40 30 20 18.7 16.8 19.9 27.2 23.8 21.4 29.1 10 0 Obesity (age 18+) Smoking (daily or occasional) Heavy drinking Physical inactivy Poor diet Lifestyle Habits 5
French-Language Health Services in the South West LHIN Since the early 90 s, the Ministry of Health and Long-Term Care has mandated some health services providers to plan and deliver their services in French. Today there are 9 identified 4 health service providers for the provision of French language services in the South geographic area. The North and Central areas do not have any identified 5 or designated 6 health services providers at this time. The long-term goal is to provide the Francophone population with access to a continuum of care in French. Number of identified French language service providers, by sector and geographic area Community Care Access Centre Community Health Centers Community Support Services Hospitals Long-Term Care Homes Mental Health and Addictions Services Public Health Units LHIN-wide North Central South 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 4 0 0 0 1 A Health Human Resources mapping exercise completed in the South West LHIN in 2007 by French Language Health Services among all health service providers, except hospitals, showed that 0.9% of all health care professionals are French-speaking. Half of the French-speaking professionals identified were personal support workers, and the remaining ones were registered nurses and social workers. According to the College of Physicians and Surgeons of Ontario s website, there are 58 general physicians indicating that they can provide services in French across the South West LHIN. Although this number might appear to be sufficient to serve the Francophone population, factors such as practice location, type of practice (eg. hospital-based or independent), full practice (i.e. not accepting new patients), clientele not based on language of patients, and actual language skills of these professionals, limit access of the Francophone population to primary care in French. 4 Addiction Services of Thames Valley; Canadian Mental Health Association, London-Middlesex Branch; London Health Sciences Centre; London InterCommunity Health Centre; Middlesex-London Health Unit; Mission Services of London; St. Joseph s Healthcare, London; South West Community Care Access Centre; Western Ontario Therapeutic Community Hostel (WOTCH). 5 Identified health service provider means a health service provider that has been mandated to provide some or all of its services in French by the Ministry of Health and Long-Term Care, either through the former district health council, the Health Restructuring Commission or the LHIN. 6 Designated health service provider means a health service provider who has received an official designation under the French Language Services Act by regulation. The designation recognizes the capacity of the provider to deliver its services in French. 6
However, it is to be noted that the above figures need to be interpreted with caution because they were collected through self-identification. The actual language skills of these professionals were not formally assessed. Current Health Care Issues and Needs facing the Issues There is a general lack of health services offered in French and, where French language services are provided, the delivery is fragmented and uncoordinated. There is a lack of cultural awareness and sensitivity among health service providers to the right of the Francophone population to receive quality services in French. Less than 1% of the healthcare workforce is French-speaking. This amount is insufficient to provide an appropriate level of health services to the Francophone population, particularly in designated areas such as London. Mechanisms are not in place to ensure that health care providers, particularly those who are identified to provide services in French, are held accountable for the delivery of services in French. Needs and Priorities The provision of services in French in a culturally sensitive manner is of the utmost importance to the Francophone community. Due to language barriers, the Francophone population often experiences difficulties communicating with health care workers, extended wait times and some feelings of being treated as a second class citizen when accessing health services. A culture change must occur within the health system so that health service providers respond appropriately to the language and health care needs of their French populations. Accountability and adequate allocation of resources (human and financial) are essential to ensure the delivery and the sustainability of health services in French. Based on the results of consultations held with the Francophone community and advice from the Francophone Health Action Committee, four sectors are identified as priorities: Primary health care: As the first point of entry to the health system, primary health care services are essential to the health and vitality of the Francophone population. Long-term care and support services for seniors: As the Francophone population ages, it is important to help seniors stay healthy in their own home as long as possible by providing them with support services in French. When living at home is no longer possible, it is important for Francophone seniors to have the option of a French-speaking living environment inside a long-term care home. Mental health services: Mental health services are lacking for all age groups, but there is a more urgent need of services targeting children and youth. As well, many Francophone immigrants need counselling services to deal with the trauma of war, abuse, etc. Pregnancy and perinatal care: Services to expecting mothers and new mothers are important during this joyful, but stressful part of life. It is also important to give babies the best possible start in life. 7
Current Health Care Successes (within the past year) The London InterCommunity Health Centre has implemented the Seniors WrapAround Program for Immigrants and Francophones. Through partnerships with health care and community organizations, this program helps seniors stay at home as long as possible by facilitating the creation of a support team around them. Services are delivered in French by a Francophone facilitator. The Future State In three years, identified health service providers will be more responsive to the needs of the Francophone population. Other providers will also be encouraged to provide their services in French, where appropriate. The French Language Health Services Regional Consultant will have established formal relationships with existing networks, in particular the London area provider table, to facilitate the implementation and delivery of health services in French. Mechanisms will be implemented to improve access to and sustainability of quality health services in French. The South West LHIN will continue to work with the Francophone community to improve availability of and access to services in French. 8