Northern Health Authority: Public Health in a rural RHA in BC. Dr. Sandra Allison MPH CCFP FRCPC DABPM Chief Medical Health Officer October 6, 2016

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Northern Health Authority: Public Health in a rural RHA in BC Dr. Sandra Allison MPH CCFP FRCPC DABPM Chief Medical Health Officer October 6, 2016

Objectives Describe the structure and function of the public health programs in Northern Health Authority - BC Situate the NHA in the Public Health System in BC Describe unique opportunities and challenges of rural public health

Northern BC facts 620 000 km 2 288 000 people 18% Aboriginal population ~3400 children per year of age Over 80 FN Communities 30 Municipalities 3 HSDAs/ 17 LHAs School Districts RCMP Districts Regional Districts and Regional Hospital DIstricts

Northern Health Senior Executive Leadership Northern Health Board CEO Provincial Health Officer Senior Executive Team Chief Medical Health Officer (VP Public Health) Population and Public Health Portfolio

Functions of Public Health Disease Prevention Injury Prevention Health Promotion Health Protection Health Needs Assessment Emergency Preparedness

Population and Public Health Portfolio CMHO PH Protection Preventive PH Population Health Surveillance MHO EPH Licensing Health and RD CD Immunizations ECD Health Behaviours Settings and populations

Public Health Protection Environmental Public Health Air and water quality, food safety, personal service establishments Enteric disease investigations Community Care Facility Licensing Residential care facilities Daycares Health and Resource Development Mitigating impacts of industrial development

Preventive Public Health Communicable Disease Control Immunization programs Healthy Child Development Prenatal to school age Sexual and Reproductive Health Harm Reduction

Population Health Programs Healthy Living and Chronic Disease Prevention Tobacco reduction Physical activity Healthy nutrition Mental Wellness Injury Prevention Healthy Communities and Schools Comprehensive School Health Healthy Community Development Healthy Public Policy

Surveillance and Reporting Medical Health Officers Public Health Emergency Preparedness

Guiding Framework for PH in BC

Healthy Families BC Policy Framework Key Outcomes Achieve Measures & Targets Improve Health Outcomes Decrease Inequities Increase Sustainability Reduce System Demand

BC Ministry of Health Overview It s complicated. Premier Minister of Health Deputy Minister Office of the Provincial Health Officer Associate DM Health Services Associate DM Corporate Services Assistant DM Population and Public Health Other Assistant DMs Emergency Management Unit Healthy Living and Health Promotion Health Protection Public Health Services and Office of Aboriginal Health Population Health Surveillance..

Health Partners in BC Ministry of Health Office of the Provincial Health Officer Health Authorities Regional Health Authorities (5) First Nations Health Authority Provincial Health Services Authority (It s complicated.) Don t forget: Health Insurance BC Patients Colleges, Boards, Commissions Vendors

Health Partners in BC Ministry of Health Office of the Provincial Health Officer Health Authorities Regional Health Authorities (5) First Nations Health Authority Provincial Health Services Authority (It s complicated.) Don t Forget: Health Insurance BC Patients Colleges, Boards, Commissions Vendors

Provincial Health Services Authority Agencies BC Cancer Agency BC Children's Hospital & Sunny Hill Health Centre for Children BC Emergency Health Services BC Mental Health and Addiction Services BC Centre for Disease Control BC Renal Agency BC Transplant BC Women's Hospital & Health Centre Cardiac Services BC Perinatal Services BC

Provincial Health Services Authority Programs and Services Provincial Occupational Health and Safety Services BC Autism Assessment Network BC Early Hearing Program BC Surgical Patient Registry Indigenous Health LML Pathology and Lab Medicine Mobile Medical Unit Health Emergency Management BC Population and Public Health Provincial Language Services Services Francophones Stroke Services BC Trans Care BC Trauma Services BC Provincial Infection Control Network of BC

BC Centre for Disease Control Services Clinical Prevention Services TB services STI/HIV prevention and control Hepatitis services Communicable disease prevention and control services PH Emergency Management Environmental Health Immunization Programs

BC Centre for Disease Control Resources Clinical Resources Professional Resource Antimicrobial Resistance Case Definitions Communicable disease control Harm Reduction Immunization guidance Laboratory Services Surveillance Forms Vaccine and Pharmacy Services Health Equity and Environmental Health Data and Reports Education and Development

Rural PH opportunities and challenges

How Healthy Are Rural Canadians? https://secure.cihi.ca/free_products/rural_canadians_2006_report_e.pdf Geography and weather, health HR, service allocation, funding models Impacts access to preventive and diagnostic services and providers Determinants of health, including lower incomes and levels of education Impacts health behaviours Higher overall mortality rates are a consequence. Cardiovascular disease, respiratory disease, injuries, suicide

Northern Health Authority: Addressing Challenges in Rural Primary Health Care Implementation of an integrated primary health care system inclusive of: Public health Home and community care Mental Health and addictions Providing coordinated services for key populations: Perinatal and children, frail elderly, chronic diseases, mental health and substance use

The Vision of Primary Health Care in Northern BC Holistic cradle to grave, full scope primary health care Person and family centered manner Generalist community health nurse full scope of competency Supported by inter-professional care teams and specialized programs Facilitated by technology, EMRs, and outreach Embedded in healthy communities Applying an equity lens, and Focused on improving population health

Thank you!!