C O M M U N I T Y P I C T U R ER E P O R T

Ma r c h 2 0 1 1

A Healthy Sarnia-Lambton

P R E PA R E D FO R :The Ministry of Health Promotion and Sport Healthy Communities Fund – Partnership Stream

S U B M I T T E D BY :County of Lambton Community Health Services DepartmentHealthy Living Lambton - Healthy Communities Partnership

A H E A L T H YS A R N I A - L A M B T O N

C O M M U N I T YP I C T U R E

ii

E X EC U T I V E S U M M A RY • LambtonCountyishometoapproximately128,000residents. • Lambtonhasagreaterpercentageofadultsaged50yearsandolderthandoestherestofOntario. • Overthelastthreecensusperiods,therehasbeenaconsistentlossofyoungadultsaged20-29inallmunicipalities. • Lambtonhasalowproportionofrecentimmigrantscomparedtotheprovinceandvisibleminoritiesrepresentonly 2.7%ofthepopulation. • LambtonCounty’sAboriginalpopulationaccountedfor4.6%ofthetotalpopulation,comparedtoaprovincial averageof2.0%. • 2.4%ofthepopulationreportsthattheirmothertongueisFrenchorFrenchandEnglish. • WhileLambtonhasalowerproportionofuniversitygraduatescomparedtoOntario,ithasahigherproportionwith collegeorapprenticeshipcredentials. • 6.5%ofindividualsinLambtonCountywereclassifiedashavinglow-incomestatusin2005,including7.8%of childrenandyouthaged0-17years.

TheCountyofLambtonCommunityHealthServicesDepartmenthasprovidedcoordinationandsupportinbringingcommu-nitypartnerstogethertocreatetheHealthyLivingLambtonHealthyCommunitiesPartnership-workingtogethertomakeourcommunityahealthierplace,toliveworkandplay.

ThisCommunityPicturesummarizesinformationfromHealthyLivingLambton’scommunityplanningandassessmentactivi-tiesundertakenwithinthescopeandframeworkoftheMinistryofHealthPromotionandSport(MHPS)HealthyCommunitiesFund–PartnershipStream.TheHealthyCommunitiesFundfocusesonsixpriorityareas:(1)physicalactivity,sportandrecre-ation;(2)healthyeating;(3)tobaccouse/exposure;(4)injuryprevention;(5)substanceandalcoholmisuse;and(6)mentalhealthpromotion.

Communityconsultationwasconductedtoinformtherecommendedactionsineachofthesixpriorityareas.Methodsincluded: • keyinformantinterviewswithprioritypopulations:francophone,lowincome,youth,andolderadults • keyinformantinterviewswithcommunityleadersineachpriorityarea • networkmappingwithlocalorganizationsandnetworks • acommunitysurvey • areviewofexistingcommunityreports • ascanoflocalpoliciesthatsupporthealthinmunicipalities • areviewofstatisticsfeaturingsocio-demographicandhealthbehaviourdata • twocommunityprioritysettingexercises

ItishopedthattheRecommendedActionsservetofocustheeffortsofcommunityorganizationsworkingintheseareas,buildnewandstrongerpartnerships,andseektoaddresskeyissuesininnovative,effectiveways.

iii

L A M b To n Co U n T Y R ECo M M E n d E d AC T I o n S A n d Po L I CY d I R EC T I o n S

Physical Activity, Sport and Recreation Recommended Actions 1. Increasestudents’opportunitiestobeactiveintheschoolsetting,throughnon-competitiverecreationprogramming, supportstoeducators,andactivetransportationopportunitiesforstudents. 2. Increaseaccesstolowcost/nocostsportandrecreationalactivitieswithinthecommunityforallages.

Policy Directions • WorkwithParentCouncilsintheschoolsettingtoestablishanactivetravelpolicythatpromotessafe,activetravel toandfromschool. • Establishlocalpoliciesthatreducebarrierstoparticipationinsportandrecreationprograms,suchasprogramfees, equipmentcosts,transportation,etc.

Healthy EatingRecommended Actions 1. Increaseaccesstoaffordable,healthyfoodforallresidents. 2. Increasefoodskillsamongcommunitymembers,particularlyamongyouthandyoungadults.

Policy Direction • Establishmunicipalplanningandtransportationpoliciesthatincreaseaccesstohealthyfood.

Tobacco Use/ExposureRecommended Actions 1. Addresshighyouthsmokingratesthrougheducationaswellastheprovisionofsmokingcessationprograms. 2. Createsmoke-freepublicplacesandoutdoorareasincludingparks,sportsfieldsandbeaches,inadditiontoexpanding smoke-freeareasaroundentranceways.

Policy Direction • AmendtheLambtonCountytobaccobylawtoincludeoutdoorareas.

Alcohol and Substance MisuseRecommended Actions 1. Providepositiveoptionsandactivitiesforteensthatareincompatiblewithalcoholandsubstancemisuse. 2. Provideschool-based,preventionfocused,integratedstrategiesforchildrenandyouthandtheirfamilieswhichwill discouragealcoholandsubstancemisuse.

Policy Directions • Developpoliciestodesignateyouth-friendlyeventsasalcoholfree. • Developcomprehensiveschooldrugandalcoholpolicies.

Mental Health PromotionRecommended Actions 1. Providepositivementalhealthinitiativesforyouthwhichstrengthenself-esteem,provideskillsrelatedtohealthy relationshipsandangermanagement,andreducephysicalandpsychologicalisolation. 2. Increasethecoordinationofmentalhealthservices.

Injury PreventionRecommended Actions 1. Developlocalpolicytoaddressmodifiable“builtenvironment”factorswhichcontributetofallsandrelatedinjuries. Factorstobeaddressedincludesnowremovalonsidewalks,lightingandothersafetyfeaturesinpublicareas. 2. Developsafetyinitiativeswithafocusonincreasinghelmetusageforallsportandrecreationalactivities.

iv

TA b L E o f Co n T E n T S

Purpose of the Report....................................................................................................... 2

Overview of the Healthy Communities Fund.................................................... 4

MethodologyDocumentReview.................................................................................................................. 6StakeholderConsultation....................................................................................................... 6PriorityPopulations................................................................................................................ 6PolicyScanUpdate................................................................................................................. 7CommunitySurvey................................................................................................................ 7CommunityPlanningandPrioritySettingMeetings.............................................................. 7

Demographic ProfileLocal Government ........................................................................................................................ 9

Population Characteristics............................................................................................................. 9

Socio-economic Characteristics FamilyComposition....................................................................................................... 11 Income........................................................................................................................... 12 Employment&Workforce............................................................................................. 12 Education....................................................................................................................... 12 Housing......................................................................................................................... 12

Priority Populations FrancophoneResidents................................................................................................... 13 VisibleMinorities&EthnicPopulations........................................................................ 13 AboriginalResidents....................................................................................................... 14 OlderAdults................................................................................................................... 14 Youth.............................................................................................................................. 14

Health Status IndicatorsOverallHealthandWell-being............................................................................................. 16HealthBehaviourandRiskFactors....................................................................................... 16ChronicDiseases................................................................................................................. 17

Healthy Communities Fund Priority AreasTobacco Use/Exposure

• StatisticsandTrends....................................................................................................... 21• EmergingIssues.............................................................................................................. 23• SuggestedActions........................................................................................................... 24• ProgramsandServices.................................................................................................... 25• PolicyUpdate................................................................................................................. 27

Physical Activity, Sport and Recreation• StatisticsandTrends....................................................................................................... 27• EmergingIssues.............................................................................................................. 28• SuggestedActions........................................................................................................... 29• ProgramsandServices.................................................................................................... 31• PolicyUpdate................................................................................................................. 31

v

Healthy Eating• StatisticsandTrends....................................................................................................... 31• EmergingIssues.............................................................................................................. 33• SuggestedActions........................................................................................................... 33• ProgramsandServices.................................................................................................... 34• PolicyUpdate................................................................................................................. 34

Alcohol and Substance Misuse• StatisticsandTrends....................................................................................................... 35• EmergingIssues.............................................................................................................. 37• SuggestedActions........................................................................................................... 37• ProgramsandServices.................................................................................................... 39• PolicyUpdate................................................................................................................. 41

Mental Health Promotion• StatisticsandTrends....................................................................................................... 41• EmergingIssues.............................................................................................................. 43• SuggestedActions........................................................................................................... 43• ProgramsandServices.................................................................................................... 44• PolicyUpdate................................................................................................................. 47

Injury Prevention• StatisticsandTrends....................................................................................................... 47• EmergingIssues.............................................................................................................. 49• SuggestedActions........................................................................................................... 50• ProgramsandServices.................................................................................................... 50• PolicyUpdate................................................................................................................. 50

Setting Community Priorities • OverviewofthePrioritySettingProcess......................................................................... 52• LambtonCountyRecommendedActionsandPolicyDirections.................................... 52

Conclusion............................................................................................................................ 55

Acknowledgment ............................................................................................................. 57

References.............................................................................................................................. 59

Appendix A: Key Informant Survey Priority Area.............................................................. 62

Appendix B: Key Informant Survey Priority Population................................................... 63

Appendix C: Lambton County Policy Scan Update Table................................................. 64

Appendix D: Community Survey - Mind your Health Lambton County......................... 65

2

P U R Po S E o f T h E R E Po RT

ThisCommunityPicturereportsummarizesinformationfromHealthyLivingLambton’scommunityplanningandassessmentactivitiesundertakenwithinthescopeandframeworkoftheMinistryofHealthPromotionandSportHealthyCommunitiesFund–PartnershipStreaminitiative,betweenAugust2010andMarch2011.

Thisreportcontainsinformationonselectedchronicdiseasemorbidityandmortalityindicators,individualhealthbehaviourstatisticsaswellaskeysocialdeterminantofhealthstatusindicatorsforLambtonCountyresidents.Whileitisbroadlyrecognizedthatindividualsexperienceill-healthwithinamuchbroaderandcomplexarrayofsocio-economicconditions,thisreportplacesaspecificemphasisonchronicdiseaseriskfactorssuchastobaccouseandexposure,healthyeatingandaccesstonutritiousfoods,physicalactivity,sportandrecreation,substanceandalcoholmisuse,aswellasinjurypreventionandmentalhealthpromotion.Thesesixtopicareasarereferredtoas“priorityareas”throughoutthereport.

ThisCommunityPictureincorporatesthekeyfindingsandrecommendationsrelatedtothesesixpriorityareas,asoutlinedinrecent,localplanningdocumentsandprojectreports,inadditiontoinformationgatheredfromstakeholderconsultationandcommunityengagementactivities.Localcontentexpertsineachofthesixpriorityareaswereconsulted,andtheperspectivesofthosewhoservespecificprioritygroupswithinthecommunitywereactivelysolicited.Theopinionsofmunicipalleaders,administratorsandcommunityplanners,aswellasSarniaLambtonresidentsarealsoreflectedinthisdocument.

ThereportwilldescribethecommunitypriorityselectionprocessthathasledtoSarnia-Lambton’sRecommendedActionsineachofthesixpriorityareas.TheseRecommendedActionsarebeingsubmittedasthekeyissuesthatthiscommunitywilladdressinthecomingyears,andideally,willservetointegrateandstreamlineLambtonCounty’scommunity’shealthpromotionstrategiesandactivities.Inaddition,itishopedthattheserecommendedactionswillinformtheMHPSHealthyCommunitiesFund-GrantStreamallocationprocess.

ThisCommunityPictureispresentedasan“EvergreenDocument”withtheunderstandingthattheinformationandperspectivescontainedinthisreportwillbediscussed,refinedandupdatedtoreflectnewinformationthatbecomesavailablethroughouttheongoingcommunityplanningprocess.Thisreportreferencesandbuildsonseveralkeydocumentssummarizingrecentsituationalassessmentsandcommunityplanningprocesses.Whilekeyfindingsandrecommendationshavebeendistilledinthisreport,thereaderisreferredtotheseworksformoredetailedinformationonavarietyofLambtonCountyspecifictopics.

4

oV E RV I Ew o f T h E h E A L T h Y Co M M U n I T I E S f U n d

Inthesummerof2009,theMinistryofHealthPromotion[nowknownastheMinistryofHealthPromotionandSport(MHPS)]launchedtheHealthyCommunitiesFund(HCF)-aone-windowapproachtofundingcommunitypartnershipstoplananddeliverintegratedprogramsthatimprovethehealthofOntarians.ThevisionoftheHCFis:“HealthyCommunitiesworkingtogetherandOntariansleadinghealthyandactivelives.”TheHealthyCommunitiesFundhasfourexplicitgoals:

• Createacultureofhealthandwell-being • Buildhealthycommunitiesthroughcoordinatedaction • CreatepoliciesandprogramsthatmakeiteasierforOntarianstobehealthyand • Enhancethecapacityofcommunityleaderstoworktogetheronhealthyliving

TheobjectivesoftheHealthyCommunitiesFund–PartnershipsStreaminclude: 1. Identifyingrecommendedactionsthataresupportedbycommunitypartnersandcommunitymembers 2. Increasingtheknowledgewithinthecommunityofeffectiveinterventionsthatimpacthealthandtheroleof policiesininfluencinghealth 3. Increasingthequantityandimpactoflocalpoliciesthatsupporthealth 4. Strengtheningthecapacityofcommunitypartnershipstoplanandcreatesupportiveenvironmentsforhealth 5. Empoweringcommunitiestoensuresustainabilityofhealthissuesbeyondtime-limitedfundingprograms

TheHCFframeworkwasbuiltontheworkoftheOntarioHeartHealthinitiativewhere36Ontariocommunitieswereprovidedwithsupporttotakeactionintheareasoftobaccouse,physicalactivityandhealthyeating.TheHCFinitiativebroadenedthescopeofissuestobeaddressedtoincludementalhealthpromotion,alcoholandsubstancemisuse,aswellasinjurypreventionandplacedarenewedemphasisonworkingtowardshealthypublicpolicyatthelocallevel.Itisanticipatedthatthisprocesswillleadtoimprovedcoordinationandstrategicintegrationbetweencommunitiesandtheprovince.

TheHCFincludesthreecomponents:

Healthy Communities Fund (HCF) Grant Stream

Provincialandlocalcommunity-basedorganizationscanapplyforfundingtodevelopanddeliverhealthpromotioninitiativesinpartnershipwithother

organizations.

Healthy Communities Fund (HCF) Partnership Stream

Promotecoordinatedplanningandactionamongcommunitygroupstocreatepoliciesthatmakeiteasierfor

Ontarianstobehealthy.

Healthy Communities Fund (HCF) Consortium

HealthpromotionresourcecentreswillprovidetrainingandsupporttobuildcapacityforthoseworkingtoadvancehealthpromotioninOntario,includinglocalpartnershipsandorganizationsthatapplyforfundingthroughtheHCF.

IntheplanningprocessdevelopedbytheMHPS,communitypartnershipshavebeenaskedtocompileacomprehensivecommunitypicturedetailingthedemographicmakeup,healthstatusdata,currentinitiativesandpoliciesthatimpacthealthandwell-beingatalocallevel,withtheexpectationthatasaclearpictureemerges,communityassets,existingmobilizationstrategiesaswellaslocalprioritiesintheformofrecommendedactionsacrossallsixHealthyCommunitiespriorityareaswillbeidentified.

6

M E T h o d o Lo gY

Informationcontainedinthisreportcomesfromavarietyofsourcesandprocessincluding: • Areviewofidentifiedandrecommended,locallyrelevantreports • StakeholderConsultationswithlocalcontentexpertsineachofthesixpriorityareas,aswellaswithcommunity leaderswhoseorganizationsworkwiththeidentifiedprioritygroups • Discussionswithmunicipalofficialswithrespecttorecentpolicyworkrelatedtothesixpriorityareas • CommunityConsultationandEngagementactivitiesincluding:

o Communityresidentinputreceivedviaanonlinesurveyo CommunityPlanningandPrioritySettingmeetingswithkeystakeholdersand theHealthyLivingLambton’sCoordinatingCommittee

Document Review

Locallyrelevantcommunityreports,surveysandotherinformationwereidentifiedprimarilybyCountyofLambton’sCommunityHealthServices’HealthyCommunitiesCoordinator,EpidemiologistandResearchCoordinator.Additionalreportsandinformationwassuggestedbycommunitystakeholders(viaanetworkmappingsurveyconductedbyHealthNexus).Finally,aninternetsearchforissue-specificdocumentswasconducted.

Documentselectioncriteriawereestablishedincluding: 1. Reportswerenoolderthan5yearsold 2. Reportsaddressedatleastoneofthepriorityareasand/oroneofthesocialdeterminantsofhealth 3. Reportswerenotconsideredconfidential 4. Reportswereavailableelectronically(exceptionsmightbemade) 5. Internalagencydocumentsandothercorrespondence(i.e.recommendationstomunicipalorcountycouncils, schoolboardmeetingminutesetc.)wouldbeconsidered

Atotalof28documentswerereviewed.Thisreporthighlightstheresultsofpreviouscommunityhealthandissue-specificplanningactivitiesthathaverecentlytakenplacewithinSarniaLambton,anddrawsoninformationfromseveralrecentcommunityprofilesincluding:LambtonCounty’sCommunityHealthServices’HealthStatusReport,LIFEinSarnia-Lambton,CommunityProfile2010-2011,theSarnia-LambtonDrugStrategy(UnitedWay,2008);Trends,OpportunitiesandPriorities(Sarnia-LambtonWorkforceDevelopmentBoard,2009.ThereaderisreferredtothesedocumentsforadditionalinformationonmanyfacetsofcommunitylifeinLambtonCounty.

Stakeholder Consultation

Inadditiontoidentifyingkeyissues,gapsandrecommendedactionsthroughthedocumentreview,theperspectivesoflocalcontentexpertsandthoseworkingwithidentifiedprioritygroupsweregatheredthroughkeyinformantsurveys.Communitycontentexpertsineachofthesixpriorityareaswereidentifiedandaskedtocompleteasurvey.Informationfromthesesurveysisincludedundertheissuespecificareaunder‘EmergingIssuesandSuggestedActions’.AsampleofakeyinformantsurveyquestionsisfoundinAppendixA.

Atotalof20keyinformantsurveyswithcontentexpertsandleaderswhoseorganizationsserveidentifiedprioritypopulationsinSarnia-LambtonwerecarriedoutbetweenDecember2010andJanuary2011.

Priority Populations

Theperspectivesofspecificprioritypopulationswerealsosolicited:AboriginalandFrancophoneresidents,olderadults,youthandindividualslivinginlowincomewereactivelysolicitedbyconnectingwithorganizationsthateitherrepresentedtheseindividuals,orwhoseorganizationsservedtheseprioritypopulations.Carewastakentoensurethatindividualswithinthesegroupswereapproachedinasensitive,respectfulmanner.TheperspectiveofmembersofthesegroupscanbefoundineachpriorityissueareaunderEmergingIssuesandSuggestedActions.AsampleofakeyinformantsurveyquestionscanbefoundinAppendixB.

7

Policy Scan Update

IntheFallof2009,theOntarioHeartHealthNetworkconductedascanforpoliciesacross37Ontariocommunitiesinfiveareas1)accesstonutritiousfoods;2)accesstorecreationandphysicalactivity;3)activetransportationandthebuiltenvironment;4)preventionofalcoholmisuseand5)preventionoftobaccouseandexposureacrossthreesectorsa)Government(district/region;county;municipality;township);b)Education:schoolboardsandc)HealthCare:hospitalsasaworksite(e.g.workplacehealthpolicies).

Eachofthe37communitiesthatparticipatedwithintheprovincewereprovidedwithasummaryreportofrelevantpolicieswithintheirjurisdiction(HealthyLivingLambtonPolicyScan,2009).WiththeMHPScontinuedemphasisonthedevelopmentofpolicyinitiativesineachofthesixpriorityareas,eachofLambtonCounty’s11municipalitieswascontactedtodetermineiftherewereanysignificant,newactivitiestobenotedinanyoftheissueareaspreviouslysurveyed.

TelephonemeetingswithmunicipalofficialsoccurredbetweenNovember2010andJanuary2011,andinformationonpolicy-relatedworkineachofthesixpriorityareaswasnotedinordertoupdatetheOntarioHeartHealthNetworkPolicyScan,2009(AppendixC).Informationonrecentpolicyactivitiesandrelevantupdatesarenotedintherespectivesectionswithinthereport.

Community Survey

ResidentsofLambtonCountyovertheageof18wereinvitedtorespondtoanonlinesurveytoprovidetheirideastoimprovethehealthofthecommunityrelativetothesixpriorityareasoftheHCF.AllhouseholdsreceivedamailedpostcardprovidinginformationonHealthyLivingLambton,includingtheaddressofanonlinesurvey.ThesurveywasavailablebetweenJanuary1andJanuary19,2011.Atotalof277peopleparticipatedinthesurvey,andthreewinnerswererewardedwitha$150prepaidVISAforprovidingbothpracticalandcreativesuggestionsforahealthierLambton.TheonlinesurveyquestionsandasummaryofthemedcommentsandsuggestionscanbefoundinAppendixD.

Community Planning and Priority Setting Meetings

Onceinformationfromtheliteraturereview,stakeholderconsultationsandonlinecommunitysurveyweresynthesized,thisinformationwaspresentedtokeystakeholdersattwocommunityplanningmeetingsheldintheCityofSarniainFebruary2011.

Asummaryofavailableinformationwascompiledanddistributedtocommunitystakeholdersforreviewanddiscussion.Attheendofaday-longfacilitatedplanningsession,RecommendedActionswereidentifiedineachofthesixpriorityareas.AtafollowupmeetingwiththeHealthyLivingLambtoncoordinatingcommitteetheseRecommendedActionswerefurtherreviewedandprioritizedwithpolicyactionstomoveforwardintheOperationalPlan.Thisprocessisexplainedingreaterdetaillaterinthereport.

9

d E M o g R A P h I C P Ro f I L E

SarniaLambtonislocatedatthesoutherntipofLakeHuronontheOntarioMichiganborder.Mostoftheregioniscomprisedofsmalltowns,villagesandagriculturallandwiththelargesturbanareabeingtheCityofSarnia.Theregionhasmanynaturalandinfrastructuralresourcesincludingfertilelandbase,directaccesstoAmericanmarketsbybridgeorrailtunnels,waterwaysfortransportationorrecreation,aswellasanexistinginfrastructureforheavyindustry(TOP,2009).Thecountyboastssomeoftherichestagriculturallandintheprovinceandproducesavarietyofcropsincludingcorn,soybeans,wheat,andsugarbeets.Lambtongrowersproducethousandsofacresofapples,peaches,cherries,strawberries,sweetcorn,onions,tomatoes,peppers,andmanyothertable-readyfruitsandvegetables(CommunityNutritioninAction,2009).

ThedistinctruralnatureandagriculturalheritageofSarnia-Lambton(i.e.asmallpopulationlivinginageographicallyvastarea)isasourceofprideforarearesidents,butlikeotherruralareasinOntario,ruralLambtonCountyresidentsfacetransportationchallenges,decreasedaccesstointernetaccess(whichhasimplicationsforemployment,informationandsocialconnectivity)andincreasingnumbersofresidentstraveltourbancentresforworkandchildcare.Socialisolationforstayathomeparentsandfarmfamilieshasalsobeennotedasimportantsocialissues(LIFEinSarnia-Lambton,2008).

Local Government

LambtonCountyiscomprisedof11municipalities,includingthecityofSarnia.Eachofthemunicipalitieshasanofficialwebsite,wherecommunitycharacteristics,amenitiesandthedetailsoflocalgovernmentareoutlined(http://www.lambtononline.com/local_municipalities).

TheCountyofLambtonhasan“upper-tier”anda“lower-tier”government.Theupper-tieristheCountygovernmentitself,whilethelower-tieriscomprisedofeleven“lowertier”or“local”municipalities.Thelocalmunicipalitiesareresponsibleforareassuchastaxcollection,recreation(arenas,parks,etc.),fireprotection,policing,animalcontrol,garbage&recyclingcollection,water,sewers,municipaldrainsandparkingenforcementamongothers.Membersoflocalmunicipalcouncilsareelectedeverythreeyearsbytheeligiblevotersofeachmunicipality.

TheCountygovernmentorupper-tierisresponsibleforProvincialOffencesCourtadministration,landuseplanning,long-termcarefacilities,communityhealthprotection,socialservices,housingservices,landfills,librariesandmuseumsamongothers.Boththeupper-tierandlower-tiergovernmentsshareresponsibilitiesforthecareandmaintenanceofroads,bridgesandbuildinginspection,zoningandadministration(www.lambtononline.com).

Population Characteristics

Accordingtothe2006Census,thepopulationofLambtonCountyhasreached128,204,anincreaseof1.0%overthe2001population(126,971).Incomparison,thepopulationofOntarioincreasedby6.6%overthesameperiod(StatisticsCanada,2007).Table1showsthepopulationcountsand%changeforeachmunicipalityinLambtonCounty.ThegreatestgrowthoccurredinPetroliaandLambtonShores,whilethelargestdeclineshavebeeninDawn-EuphemiaandOilSprings.

LambtonCountyhasalandareaof3,002squarekilometresandapopulationdensityof42.7personspersquarekm(StatisticsCanada,2007).AsshowninTable1,thepopulationdensityvariesgreatlybetweenmunicipalities,rangingfrom4.9persq.kminDawn-Euphemiato618.1persq.kminPointEdward.

10

Table 1: Population counts, percent change between 2001 and 2006 and population density (per sq. km), Lambton County municipalities (2006 Census).

Municipality 2006 % Change Pop. Density Pop. Population 2001 to 2006 Pop./Sq. Km Brooke-Alvinston 2,661 -4.5 8.5 Dawn-Euphemia 2,190 -7.6 4.9 Enniskillen 3,122 -4.2 9.2 Lambton Shores 11,150 5.5 33.7 Oil Springs 717 -5.4 87.7 Petrolia 5,222 7.7 411.7 Plympton-Wyoming 7,506 2.0 23.5 Point Edward 2,019 -3.9 618.1 Sarnia 71,419 0.8 433.8 St. Clair 14,649 -0.1 23.7 Warwick 3,945 -2.0 13.6

Total - Lambton County 128,204 1.0 42.7

Statistics Canada. 2007. Lambton & Municipalities (tables). 2006 Community Profiles. 2006 Census. Statistics Canada

Catalogue no. 92-591-XWE. Ottawa. Released March 13, 2007.

Accordingtothereport,Population:SummaryTrends&Projections,CensusYears2006-2031,asof2006,allLambtonmunicipalities,liketherestofOntarioshowageneral“boom,bustandecho”agedistribution–apeakinpopulationaroundages40-50,adeficitaroundages25-29andasmallerpeakaroundages15-19.LambtonasawholeisolderthanOntario.AsshowninFigure1,Lambton’sproportionofresidentsaged45-49isgenerallycomparabletoOntario,howeverLambtonhasagreaterpercentageof50+adultsandalowerpercentageofadults25-44thandoestherestofOntario.Lambtonalsohasalowerproportionofchildrenages0-9yearscomparedtoOntario.ThemedianageofLambtonCountyresidentswas42.8yearsin2006,upfromthe2001figureof40years.Themedianagefortheprovincein2006was39.0years,upfroma2001figureof37.2(StatisticsCanada,2007).

Source: Statistics Canada. 2007. Lambton, Ontario (Code3538) (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa.

Released March 13, 2007, (accessed March 8, 2011).

!

11

Overthelastthreecensusperiods,themostnote-worthypopulationtrendhasbeentheconsistentlossofyoungadultsaged20-29inallmunicipalitiesandthelossofyouthaged15-19inmostmunicipalities.Lossesinthe20-29yearagegroupshavegenerallybeenaround15-25%fromonecensustothenext.TheCityofSarniahaslowerbirthratesandappearstobelosingyoungfamilies(agegroups5-9and30-39).Incontrast,areassuchasLambtonShoresandtheruralareasaregrowingintheseagegroups.Theprojectionsproducedbythereport,Population:SummaryTrends&Projections,CensusYears2006-2031,suggestthat,ifthegrowthtrendsineachagegrouparesimilartotheratesofthelast3censusperiods,therecouldbesignificantpopulationdeclinefortheCountyasawholeby2031.

Socio-economic Characteristics

Table2providesanoverviewofthesocialanddemographiccharacteristicsofLambtonCounty.Comparedtotheprovince,Lambtonhasa: • higherproportionofseniors, • lowerproportionofpopulationinlowincome, • lowerproportionofuniversitygraduates, • higherproportionwithcollegeorapprenticeshipcredentials, • lowerproportionofimmigrantsandvisibleminorities,and • higherproportionidentifyingasAboriginals.

Table 2: Socio-demographic characteristics

Lambton Ontario

Families (with children) headed by a lone parent 14.3% 12.9%

Population in low income (after tax) 6.5% 11.1%

Population (age <18) in low income (after tax) 7.8% 13.7%

Unemployment rate (age 15+) 6.5% 6.4%

Labour force participation rate (age 15+) 64.3% 67.1%

Population (age 25-64) with less than high school education 13.0% 13.6%

Population (age 25-64) with completed postsecondary education 58.2% 61.4%

Population (age 25-64) with a university degree 13.3% 26.0%

Population (age 25-64) with a college certificate/diploma 28.2% 22.0%

Population (age 25-64) with apprenticeship/trades certificate/diploma 14.0% 8.8%

Population with mother tongue French or French and English 2.4% 4.3%

Population with no knowledge of English or French 0.2% 2.2%

Population who are immigrants 11.6% 28.3%

Population who are recent immigrants – within 5 years 0.8% 4.8%

Population who are visible minorities 2.7% 22.8%

Population of Aboriginal identity 4.6% 2.0%

Source: Statistics Canada. 2007. Lambton, Ontario (table). 2006 Community Profiles. 2006 Census. Statistics Canada Catalogue no. 92-591-XWE. Ottawa. Released March 13,

2007. (accessed May 11, 2010)

Family composition

In2006,5,355ofLambtonCounty’scensusfamilieswerelone-parentfamilies,representing14.3%ofallfamiliesintheCounty.Oftheseloneparentfamilies,81.7%wereledbyfemales,similartotheprovincialaverageof81.6%(StatisticsCanada,2007).

12

Income

In2005,themedianincomeforLambtonCountycensusfamilieswas$68,703,whichwaslowerthantheprovincialmedianincomeof$69,156.Lone-parentfamiliesinLambtonreportedamedianincomeof$35,370,whichwas$3,078lessthantheprovincialmedianincomeforthisgroup.Femalelone-parentfamilieshadlowermedianincomesatthelocal($33,159)andprovinciallevels($38,448)ascomparedtomalelone-parentfamilies($51,800and$50,339)(StatisticsCanada,2007).

Thelow-incomeincidence(aftertax)forindividualsinLambtonCountywas6.5%in2005,comparedtoaprovincialrateof11.1%(StatisticsCanada,2007).

Employment and Workforce

TheSarniaLambtonWorkforceDevelopmentBoard’swebsiteisanexcellentresourceforthelatestlabourforceinformation,includingcurrentparticipationrates,unemploymentratesandtrendsovertime(http://www.sltb.org/main/ns/34/doc/28/lang/EN).SarniaLambton’sunemploymentratehasrisensharplyoverthepastseveralyears,increasingfromanannualrateof6.5%in2006toapproximately10%in2010/2011.Peopleunderage25havehadthehighestrateoflabourforcewithdrawsincethebeginningoftherecentrecession(WorkforceFocus,2010).Accordingtothe2006census,theprimaryoccupationsheldbyLambtonCountyresidentswere:salesandserviceoccupations;trades,transportandequipmentoperatorsandrelatedoccupations;andbusiness,financeandadministrationoccupations(StatisticsCanada,2007).

The2009TOPSreport(Trends,OpportunitiesandPrioritiesreport)producedbytheSarniaLambtonWorkforceDevelopmentBoard,outlinesactionplansaddressingthefollowingsixpriorityareas: - Agingworkforce - Lackofessentialskillsamongcurrentandprospectiveemployees - Increasingrequirementforhigherlevelsofeducation - Economicdiversification - Rural–urbandisparity - Workforceshortages

Theyalsonotethatthiscommunitystruggleswithalackofskilledtrades’people,peopleleavingthecommunitytofindwork,andlocal,independentbusinessesstrugglingtocompetewithlargerbusinesschains,especiallyinthefaceofanincreasinglocaltaxburden(TOPSreport,2010).It’sestimatedthatareasoffutureemploymentgrowthinclude:renewableenergy,InformationTechnology,ContactCentres,tourism,andaerospace(WorkforceFocus,2010).

Education

Whiletheproportionofresidentswhohavepostsecondarycertificates,diplomasordegreesissimilarinLambton(48.4%)andOntario(50.0%),LambtonandOntariodifferwithrespecttothetypesofdiplomas/degreeobtained(StatisticsCanada,2007).Incomparisontotheprovince,LambtonCountyhasahigherpercentageofresidentshavingachievedahighschoolcertificateorequivalent,anapprenticeship/tradescertificateordiploma,andacollege,CEGEPorothernon-universitycertificateordiploma.However,therearealowerpercentageofresidentshavingachievedauniversitycertificate,diplomaordegree.

Housing

In2006,thetotalnumberofprivatedwellingsinLambtonCountywas51,955,aslightincreasefrom50,165in2001.In2006,24.0%ofalldwellingswererented.TheaveragevalueofanowneddwellinginLambtonwas$183,756,substantiallylowerthantheprovincialaverageof$297,479(StatisticsCanada,2007).

Thereisalimitedrangeofaffordablehousingoptionsavailabletoallsegmentsofthepopulation,andespeciallyforolderadultsandthosewithmentalillness(CommunitySummit2010,2010).

13

KeyfindingsfromtheCountyofLambtonLong-termAffordableHousingStrategy(2009)foundthat: • TheAffordableHousingAnalysisidentifiedthatalmost40%ofrenterhouseholdsinLambtonCountyearnlessthan $20,000andcanaffordtospendamaximumof$500onrent.Withtheaveragerentforaone-bedroomunit(Sarnia CA)at$497,manyfinditdifficulttoaffordaccommodations.Twoandthreebedroomunitsarenotaffordableforthe segmentofthepopulationthatearnslessthan$20,000perannum. • 43.2%ofrenterhouseholdsspendmorethan30%oftheirincomeonrentand20.8%spendmorethan50%oftheir incomeonrent. • Shortagesofappropriatehousingexistforindividualswhorequirebarrierfreelivingaccommodation.Thereisalsoa growingneedforsupportivehousingforindividualswithmentalillnesses,intellectualdelays,andotherlimitations. • Lambtonhasanaginghousingstock.Olderhomesaretypicallylessexpensivetopurchaseorrentbuthavehigh maintenanceandoperatingcosts.Thehighcostofmaintainingageinghousingstockwillaffecthouseholdswithfixed incomes,includingseniorsandpersonswithdisabilities,andthosewithlowincomes. • EmergencyshelterusageinSarnia-Lambtonaveraged250permonthbetweenJanuaryandSeptember2009.Forthe sameperiodoftimetherewere2,014requestsforassistancefromtherent/utilitybank.However,duetoeligibility requirements,only57%ofthoseindividualsactuallyreceivedhelp. • AsofSeptember30,2009therewere512householdsonthewaitinglistforRentGearedtoIncomeHousing(RGI). Waittimesvarybylocationandunittype.

Priority PopulationsFrancophone Residents

LambtonCountyishometo3,105residentswhoreportthattheirmothertongueisFrenchorFrenchandEnglish.Thisrepresents2.4%ofthetotalpopulationofLambtonCounty,ascomparedtotheprovincialaverageof4.3%(StatisticsCanada,2007).

A2010OntarioTrilliumFoundationreportnotesthattheFrancophonecommunityinEssex,Kent,Lambton(EKL)facesuniquechallengesduetoitsrapidlyagingpopulation.Thereporthighlightsthefollowinglocaldataandtrends: • EKLhasalong-establishedFrancophonecommunity–butitsnumbersaredecreasing, • ComparedtoEKLoverallandOntario’sFrancophonecommunityingeneral,Francophone’sinEKLaremucholder andagingmorerapidly, • WhilenotasdiverseasotherFrancophonecommunitiesacrosstheprovince–6.8%ofFrancophone’sinEKL identifiedasmembersofavisibleminority, • Francophone’sinEKLwhoidentifyasvisibleminoritiesearnabouthalfthatoftheoverall,Francophone communityinEKL.

Visible Minorities and Ethnic Populations

In2006,2.7%ofLambtonCountyresidentsindicatedthattheybelongedtoavisibleminoritypopulation(aslightincreasefrom2.3%in2001).Attheprovinciallevel,visibleminoritiesaccountfor22.8%ofthetotalpopulation(StatisticsCanada,2007).ThemostcommonvisibleminoritygroupsincludedSouthAsian,ChineseandBlack,thoughthesepopulationseachonlyrepresented0.5-0.7%ofthetotalLambtonpopulation.ItshouldbenotedthattheAboriginalpopulationisnotincludedinthevisibleminoritypopulation.

In2006,Sarnia-Lambton’spopulationincluded14,700immigrants,whocombinetomakeup11.5%ofthetotalpopulation.Ontario’simmigrantpopulationaccountsfor28.3%oftheprovincialpopulation.MostofSarnia-Lambton’simmigrantpopulation(82.0%;12,060persons)arrivedbefore1991.Newlyarrivedimmigrants(2001-2006)accountfor0.8%ofSarnia-Lambton’stotalpopulationcomparedtoaprovincialaverageof4.8%(StatisticsCanada,2007).

ThemostcommonbirthplacesofrecentimmigrantstoSarniafortheperiod2001to2006wereIndiaandtheUnitedStates,accountingfor26.7%and17.6%ofallrecentimmigrantsrespectively(StatisticsCanada,2007b).

14

Aboriginal Residents

Accordingtothe2006Census,LambtonCounty’sAboriginalpopulationaccountedfor4.6%ofthetotalpopulation,comparedtoaprovincialaverageof2.0%(StatisticsCanada,2007).TheaverageageoftheAboriginalpopulationinLambtonCountyisapproximately29years,comparedto42.8yearsforallofOntario(BestStart,2009).

TherearethreeFirstNationsreserveslocatedinLambtonCounty:Aamjiwnaang(n=706),ChippewasofKettleandStonyPoint(n=1,020)andWalpoleIsland(n=1,878)(StatisticsCanada,2007).ThesepopulationcountsoftenunderestimatethetruepopulationduetotheincompleteenumerationonIndianreservesandsettlementswiththecensus.

Older Adults

In2006,thepercentageofthepopulationinLambtonCountythatwasofretirementage(65+years)was16.9%,anincreasefrom15.8%in2001.The2006figureishigherthantheprovincialaverageof13.6%(StatisticsCanada,2007).

Theseniordemographicdependencyratioistheratioofseniors(65+years)totheworking-agepopulation(20-64years).Asizeableshareofseniorsaged65orolderarelikelytobesociallyand/oreconomicallydependentonworking-ageCanadians,andtheymayputadditionaldemandsonhealthcareservices.Theseniordemographicdependencyratiomeasuresthesizeofthe“dependent”populationinrelationtothe“workingage”populationwhotheoreticallyprovidesocialandeconomicsupport(StatisticsCanada,2010).InLambtonthereareapproximately29seniorsforevery100working-agepeople,whichishigherthantheOntarioaverageof22seniorsper100.

Youth

In2006,childrenbetweentheagesof0to6madeup7%ofthetotalpopulationinLambtonCounty,representingapproximately8,870children(StatisticsCanada,2007).

16

h E A L T h S TAT U S I n d I CATo R S

Overall Health and Well-being

LambtonresidentsaresignificantlylesslikelythanOntarioresidentstoreportalotoflifestressandtheyaresignificantlymorelikelytoreportasenseofcommunitybelonging.Figure2showsseveralindicatorsofoverallhealthandwell-being.LambtonissimilartoOntariowithrespecttoperceivedhealth,perceivedmentalhealth,participationandactivitylimitationandlifesatisfaction.

*Significantly different from provincial rate

Source: Canadian Community Health Survey (CCHS), 2007/08

Health Behaviours & Risk Factors

Certainhealthbehavioursareknowntoberelatedtoincreasedriskofchronicdisease,mortalityanddisability.Figure3showsthat,relativetotheprovince,Lambtonresidentsaresignificantlymorelikelytobedailyoroccasionalsmokers,heavydrinkers,andoverweight/obese.BasedonBodyMassIndex(BMI),35.5%ofLambtonresidentsareclassifiedasoverweightand21.4%areclassifiedasobese.Comparedtotheprovince,Lambtonresidentsaresignificantlylesslikelytoreporteatingatleast5servingsoffruitsandvegetableseachday.InbothLambtonandOntario,approximatelyonehalfofresidentsreportthattheyarephysicallyinactive.

!

17

*Significantly different from provincial rateSource: Canadian Community Health Survey (CCHS), 2007/08

Chronic Diseases

Chronicconditionsplaceahighburdenonthehealthcaresystemandreducethequalityoflifeofthosewhosufferfromthecondition.BasedontheCountyofLambtonMortalityandChronicDiseaseReport(2008),cardiovasculardisease,particularlyischemicheartdisease,representsthegreatestburdenonthepopulation,thegreatestimpactonthehealthcaresystemandistheleadingcauseofdeath.WhilethiswastruethroughoutthesouthwestregionandOntario,malesandfemalesinLambtonareaffectedatsignificantlyhigherrates.

However,itisimportanttonotethatinCanadafrom2000to2007,thenumberofdeathscausedbymajorcardiovasculardiseaseshasbeendeclining,whilethenumberofdeathscausedbycancerhasbeenrising(Figure4)(StatisticsCanada,2010b).In2005,theage-standardizedrateofcancerexceededthatforcardiovasculardiseasesandin2007thenumberofdeathsduetocancerexceededthatduetocardiovasculardiseases.Localmortalitydataiscurrentlyonlyavailableupto2005,soitisnotknownwhethercancerhassurpassedcardiovasculardiseaseastheleadingcauseofdeathinLambton.

Note: Age-standardized mortality rates per 100,000 standard population (1991 Canadian population).Source: Statistics Canada, CANSIM table 102-0552.

!

!

18

Figure5showsthatcomparedtoOntario,Lambtonhasasignificantlyhigherprevalenceofosteoarthritis,asthma,COPD,arrhythmiaandischemicheartdisease.Prevalenceofdiabeteswasslightly,butsignificantlylowerinLambtoncomparedtoOntario.Prevalenceofcerebrovasculardisease(includingstroke)wassimilarinLambtonandOntario.

*Significantly different from provincial rateSources: ICES in Tool; Extracted June 2010 and January 2011 (asthma); age and sex standardized; osteoarthritis (2006/07, 20 years+), asthma (2006/07, all ages); diabetes

(2004/05, 20 years+), arrhythmia (2006/07, 20 years+), cerebrovascular disease (2006/07, 20 years+), ischemic heart disease (2006/07, 20 years+); COPD (2006/07, 35 years+).

ForacompletepictureofcancerratesinLambtonCounty,seetheLambtonCounty2007HealthStatusReportonCancer.BelowaresomehighlightsrelatedtospecificcancerswithknownlinkstothePriorityAreas.

LungCancer:(Figure6)IncidenceandmortalityratesinLambtonwereelevatedaboveOntarioratesinbothmalesandfemalesbetween1995and2003.RatesamongLambtonmaleshavebeendeclining,butnottothesameextentasOntariorates.RatesamongLambtonandOntariofemaleshavebeenincreasing,butLambtonrateshaveincreasedmoresharplysincethelate1990’s.Smokingandoccupationalexposures(particularlyasbestos)arelikelymaincontributorstoelevatedlungcancerratesinLambton.

Source: Cancer Incidence 1986-2003, Cancer Care Ontario, Release 5, October 2006.

!

!

19

ColorectalCancer:(Figure7)IncidencerateswerehigheramongmalesinLambtonversusOntariobetween1986and2003.NodifferencesinmalemortalityrateswereobservedandfemaleincidenceandmortalitydidnotdifferbetweenLambtonandOntario.Higherscreeningrates,dietandheavyalcoholconsumptionmayaccountforhigherratesamongLambtonmales.

Source: Cancer Incidence 1986-2003, Cancer Care Ontario, Release 5, October 2006.

!

21

h E A L T h Y Co M M U n I T I E S f U n d P R I o R I T Y A R E A S

TheHealthyCommunitiesFund–PartnershipStreaminitiativefocusesonsixPriorityAreasidentifiedbytheMinistryofHealthPromotionandSport.Eachofthesepriorityareaswillbeaddressedseparately.

Foreachpriorityarea,localdataandtrendswillbepresented,alongwithemergingissuesandsuggestedactionsidentifiedfromthedocumentreview,keyinformantsurveys,thecommunityonlinesurveyandstakeholderconsultations.Aninventoryofprogramsandservicesisalsoprovided,alongwithasummaryofrecentpolicyrelatedactivities.

To bACCo U S E / E X Po S U R E

Statistics and TrendsTobacco Use

InLambtonCounty,therehavebeennostatisticallysignificantchangesinthepercentageofcurrentdailyoroccasionalsmokersbetween2000and2008(Figure8).Also,formostyearsstudied,smokingrateswereslightlyorsignificantlyhigherinLambtonascomparedtoOntario.

*Significantly different from provincial rate

Source: Canadian Community Health Surveys 2000/01, 2003, 2005, 2007/08, 2009

In2007/08,smokingratesweresimilaramongLambtonandOntariomales(24.3%vs.23.6%),butsignificantlyhigheramongLambtonfemalescomparedtotheirprovincialcounterparts(24.5%vs.17.1%)(CCHS,2007/08).

!

22

Figure9showsdailyandoccasionalsmokingratesbyagegroup.In2007/08,smokingratesamongthose12-64wereslightlyhigheramongLambtonresidentscomparedtotheirprovincialcounterparts,butthesedifferenceswerenotstatisticallysignificant.InLambton,thehighestsmokingrateswereamongthoseaged20-44yearsofage,withapproximately31%ofLambtonresidentsinthisagegroupreportingsmoking.

*Significantly different from provincial rateSource: Canadian Community Health Surveys 2007/08

Tobacco Use during Pregnancy

Between2006and2009,thepercentageofLambtonresidentsgivingbirthatBluewaterHealthwhoreportedsmokingduringpregnancyrangedfrom22-24%.Figure10showstheratesofsmokingduringpregnancybyagecategory.Thehighestrateofsmokingwasamongthose19yearsofageandyounger(43%).Asmaternalageincreases,therateofsmokingduringpregnancydecreases.

Source: NIDAY Perinatal Database, Extracted August 2010.

!

!

23

Smoking Cessation

InOntarioin2009,58%ofsmokersingrades7to12reportedatleastonequitattemptduringthe12monthsbeforethesurvey.Amongthosewhoattemptedtoquit,mostreportattemptingtodosomorethanonce(OSDUHS2009).

Support for Smoke Free Public Places

AccordingtotheRapidRiskFactorSurveillanceSystem(RRFSS),Lambtonresidentssupportmakingvariouspublicplacessmokefree(Figure11).Thehighestlevelofsupportwasformakingdoorwaystopublicplacesandworkplacessmokefree.Nonsmokersweremoresupportivethansmokers.

Source: RRFSS (October 2008 – April 2009 & January 2010 – April 2010), Lambton Community Health Services Department and Institute for Social Research, York University.

Emerging IssuesSmoke-free outdoor public Spaces • Increasedsupportforsmoke-freeoutdoorpublicspaces

Easy, inexpensive, non-traditional tobacco • Availabilityofinexpensivecontrabandtobacco“cheapsmokes”underminespublichealtheffortstoreducesmoking rates,especiallyamongprioritypopulations(smokingrateshaveflat-lined) • Increaseduseofchewingtobaccobyyouth,especiallysportsteams,putsyouthatrisk • Newinterestincigars(especiallyyoungmales)isgainingpopularity • Hookahsandhookahbarsaregainingpopularityamongyouthadults

Ongoing need for Education • Continuingeffortstoeducatethepublicaboutthenegativehealtheffectsoftobaccouseandthehealthrisksof exposuretosecond-handsmoke,especiallyamongchildren

Tobacco Cessation and Relapse Prevention • Cessationprogramsforyouth • AccesstofreeNicotineReplacementTherapy(NRT),especiallyamongprioritypopulations,isabarrierto quittingsmoking • DifficultyservicingprioritypopulationsinruralpartsofLambton(cessationsprograms)impactsnegativelyon Lambton’ssmokingrates

!

24

• Smoker’sHelplineisanunder-utilizedprovincialresourcethatmustbepromotedtoyouth,adults,andpregnant womentoenhancelocalcessationeffortsandrelapsepreventionthroughfollow-upphonecalls,textmessaging,and onlinesupport

Smoking during Pregnancy • Youngwomensmokingduringpregnancy,puttingtheirchildatriskforSIDS,reducedbirthweight,ADHD, respiratoryandotherserioushealthproblems

Suggested ActionsDevelop more comprehensive policies and/or bylaws • InordertoensurethatallLambtonresidents(especiallychildren)areprotectedfromsecond-handsmokeinall outdoorspaces(throughenforceablelegislation),Lambton’sSmoke-freePublicPlacesandWorkplacesBylawneeds tobeenhanced • Buy-inisrequiredfromlocalmunicipalitiesforsmoke-freepublicspaces • Privatesectorpoliciesregardingsmoke-freepublicspacesshouldbeencouraged • Provisionofdesignatedsmokingareasinpublicoutdoorspacestoprotectthepublicfromexposuretosecond-hand smokeandprovisionofreceptaclestoeliminatelitter • Strengthenorexpandsmoke-freepublicspacesbyencouragingdevelopmentofa9-metrerulepolicyaroundentrances topublicbuildings • Bansmokinginparks,beaches,arenas,outdoorrestaurants,fleamarkets,parades,racetracks,zoos,busstops,andin locationswherechildrenplay

Engage Youth • Engagemorelocalyouthinpromotingsmoke-freeoutdoorspaces,peer-to-peertobaccousepreventioninitiativesand smokingcessationchallenges

Support people who want to quit • Developpubliceducation/awarenesscampaignfocusingonbehaviourchangestrategiesthatsupportsmokingcessation andhowtorecognizeanddealwithwithdrawalsymptoms • Provideeducationandawarenessonquittingmethodsandcommunityresources/partnersthatprovidecessation assistanceandsupport • Developasupportsystemtopreventrelapsetosmoking • Provideaccesstofreeorcost-reducednicotinereplacementtherapyandprescriptionmedicationforquittingsmoking • Engagedoctorsandotherhealthprofessionalsinsmokingcessationinterventionsandbriefcounsellingtomotivate smokingcessation • Providefreecounsellingforsmokingcessationandrelapseprevention

Enforcement and Education • Provideongoingeducation,especiallytonon-compliantandnewestablishments • Ensuresignagerelevanttolocationisinplace.Developcatchysigns-Oxygenneededhere,YoungLungsatWorkto “gently”remindpeoplenottosmoke

Other education efforts • Teachyouthearly–tobaccousepreventioneducationinschools(presentations,curriculumresources) • Provideseminars,workshops,andothereducationactivitiesinworkplaces • Focusededucationonpregnantwomenemphasizingthenegativehealtheffectsofsmokingonherhealthandthe baby’s;buildself-efficacyandcreateawarenessoftheimportanceofparental“rolemodelling”ofhealthybehaviours

25

Programs and ServicesProgram Name Description

Bylaw Development Smoke-freepublicspacesmunicipalcampaigninvolvesmeetingwithclerksof11municipalitiesinLambtonCountytoadvocateformunicipalby-lawdevelopmenttoprotectthepublicfromexposuretosecondhandsmokeindesignatedpublicoutdoorsettings(publicentrancestobuildings,parks,playgrounds,busshelters,playingfields,beaches).DiscussionsareunderwaywiththeTownofPetroliaandtheCityofSarniaregardingsmoke-freepublicspacesby-laws.AllmunicipalitiesreceivedTFSRinformationpackagesfromtheTFSRCollaborative(advocatingforby-lawdevelopment).

CHSDisintheprocessofpreparingareporttoLambtonCountyCouncilrequestinganamendmenttotheLambtonSmokingSmoke-FreePublicPlacesandWorkplacesBy-lawtoincludeoutdoorpublicspaces.

CHSDisdeveloping“NoSmoking”signsforplaygroundsandpublicentrances.Signswillbeprovidedtomunicipalitiesthatmoveforwardwithby-lawdevelopmentfortobacco-freeoutdoorpublicspaces.

Community Education and Awareness AcommunityadvocacycampaignisunderwayinLambtontohelpadvocateforsmoke-free/tobacco-freepublicspaces.TheconceptofSmoke-freeparks/playgroundswillbeintroducedtothepublicinSarniaataTownHallmeeting(hostedbyCHSD)inearlyMarch2011.

Radioadsadvocatingforsmoke-freepublicspacesairedthroughthemonthofNovember2010(Isn’tittimeforLambton).Printadswerepublishedin2localnewspapersduringthemonthsofNovemberandDecember2010.Aking-sizebusadpromotingTFSRwillrununtilJuly2011.TFSRrinkboardswerepurchasedattheSarniaArena.

YouthCHAT(YouthCommunityHealthActionTeam)hostspubliceventstopromoteTFSRacrossourcommunity.Eventsincludeinformationbooths/promotionalgiveawaysatGirlsSilverstick,SarniaStinggames,CanadaDay,BrigdenFair,Bayfest,NovaSafetyDays,CaptainKidDaysandotherlargecommunityevents.

RadioadscreatingawarenessthatundertheSmoke-FreeOntarioActitisillegaltoselltobaccotominorsranfor3weeksinJanuary2011.

26

Program Name Description

Research and Surveillance at the local level RapidRiskFactorSurveillanceSystemsurvey(RRFSS)hasbeenconductedlocallytogatherdataonpublicsupportforthefollowing:

-SFpublicplaygrounds

-SFpublicbeaches

-SFpublicsportfieldsandspectatorareas

-SFdoorwaystopublicplaces

-SFoutdoorpublicpatios

DatahasbeengatheredsinceOctober2008,andresearchisongoing.

Cessation Programs, Community Education and Awareness HealthCareProviderCampaigniscurrentlyunderwaywithagoaltoencourageallhealthcareproviderstoaskpatientsabouttobaccouseandreferthemtolocalprogramsandservices--thisbriefinterventionstrategyusesthe4-A’sapproach(Ask,Advise,Assess,Assist).

CHSDisdeliveringapresentationtoSarnia-LambtonOccupationalHealthNursestoadviseoflocalcessationservicesandencouragebriefsmokingcessationinterventionstrategies.

CHSDofferstheiquitSmokingProgramforadults(6sessionsovera3weekperiod)onaquarterlybasis.

CHSDisestablishinga‘pilot’NRTCouponProgramwhere25clientswillreceive5-weeksoffreeNicotineReplacementTherapy.CouponswillbeacceptedatHoganPharmacieswherePharmacistswillprovidecounsellingonaweeklybasis.

CHSDpartnerswiththeCentreforAddictionandMentalHealth(CAMH)todistributefreeNRTthroughtheSTOPstudy.

CHSDwasinstrumentalinmobilizingcommunitypartnerstoformtheLambtonTobaccoNetwork(LTN).LTNisacommunitypartnershipmadeupofrepresentativesfromvariouscommunitysectorsthatcollaboratetoreducesmokingratesinLambton.Formedin2006,thiscommunitypartnershipbringstogethercessationprogramfacilitatorsandothercommunitypartnerstoshareresourcesandcoordinatecomprehensivesmokingcessationprogramsandservicedelivery.

27

Program Name Description

Cessation Programs, Community Education and Awareness, continued

PromotionoftheprovincialCanadianCancerSocietyDriventoQuitContesttakesplacefromDec.2010toFeb.28,2011.Manycommunitypartners,employers,communityagenciesparticipateinpromotingtheDriventoQuitChallenge.

ThroughtheSmoke-freeOntarioYouthEngagementStrategy,CHSD’syouthcoalition(Y-CHAT)areinvolvedindevelopingpromotionalmaterial,andmonitoringthewebsiteforthesouthwest“Inthenic-o-time”youthsmokingcessation,reductionortotalabstinencecontestfor14–19yearolds.

Y-CHATispartneringwithLambtonCollegetosupportthe“LeavethePackBehind”quitsmokingcontest.

Policy Update • Severalmunicipalitiesexpressedinterestinexpandingsmoke-freepublicplacestoincluderecreationalandsport facilitieswherekidsplay • CommunityHealthServiceshasexpressedinterestinexpandingsmoke-freeplacestooutdoorareas • TheCountyhasadoptedasmoke-freepolicyinsubsidizedhousing(2010)

P h YS I CA L AC T I V I T Y , S Po RT A n d R EC R E AT I o n

Statistics and TrendsPhysical Activity

Between2000/01and2007/08,therehasbeennosignificantchangeintheproportionofLambtonandOntarioresidentswhoreportbeingmoderatelyactiveoractive(Figure12).LambtondidnotdiffersignificantlyfromOntariowithrespecttotheproportionofresidentswhoareactive.Malesaremorelikelythanfemalestoreportbeingmoderatelyactiveoractive(56.2%ofLambtonmalesand43.9%ofLambtonfemalesareactive).

Source: Canadian Community Health Surveys 2007/08

In2007/08,LambtonandOntarioresidentsages12-19yearsweremostlikelytoreportbeingactive(Figure13).Physicalactivitydecreasessharplyasageincreasesfrom12-19yearsto35-44years.Lambtonresidentsages12-34appearmorelikelythantheirprovincialcounterpartstoreportbeingactive,whilethoseages35-65yearsappearlesslikely,thoughthesedifferencesarenotstatisticallysignificant.

Source: Canadian Community Health Surveys 2007/08.

ItisimportanttonotethattwoarticlesintheJanuary2011issueofHealthReportsfoundthatself-reportedphysicalactivitylevelsmaybegreatlyoverestimated(Colleyetal.2011a&2011b).Whiletheaboveestimatesindicatedthatapproximately50%ofthepopulationisinactive,objectivemeasurementsofphysicalactivityusingaccelerometersindicatethat85%ofCanadianadultsarenotactiveenoughtomeetCanada’snewphysicalactivityrecommendationof150minutesofmoderate-to-vigorousactivityperweek.Furthermore,theauthorsfoundthatonly7%ofCanadianchildrenaged5to17achievedtherecommended60minutesofmoderate-to-vigorousactivitydaily.

Overall,adultsandchildren/youthspendanaverageof9.5and8.6hoursadayinsedentarypursuits.Amongteenagersaged15to19,sedentarytimesurpasses9hoursaday.Over60%ofourwakinghoursarespentsedentary.

28

Recreational Opportunities

In2008/09,90.8%(±2.2)ofLambtonresidentsreportedthattheywereawareofwalking,bikingornaturetrailsintheirneighbourhood,while57.8%(±3.7)reportedusingatrailinthepast12months(RRFSS,October2008–April2009,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

In2010,Lambtonresidents(18yearsandolder)reportedwalkingaroundtheirneighbourhoodatvaryingfrequenciesinatypicalweek(reasonforwalkingcouldbeforfunandexerciseortogofromplacetoplace): • 30.7%(±3.2)walkedonehourorless • 47.2%(±3.4)walkedfrom1to5hours • 12.9%(±2.3)walkedfrom6to10hours • 7.7%(±1.8)walkedmorethan10hours

Frequencyofwalkingaroundtheneighbourhooddidnotvarybetweenmalesandfemales,butdiddecreasewithage.Thepercentageofadultswalking1hourormoreinatypicalweekwereasfollows: • 18-24years 84.0%(±10.2) • 25-44years 71.7%(±5.8) • 45-64years 70.4%(±4.8) • 65yearsandolder 52.9%(±7.5)

(RRFSS,January2010–August2010,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

Active Transportation

In2006,7.0%ofLambton’semployedlabourforce(15yearsandolder)reportedwalkingorbikingtogettowork(StatisticsCanada,2007).

Beingwithinwalkingdistancetoschools,grocerystoresandparks,trailsandopenspacesareviewedasmostimportantwhenmakingdecisionsaboutwheretolive(RRFSS,January2010–April2010,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

Accordingtothesamesurvey: • 90.6%(±2.8)ofLambtonresidentsfeelthattheirneighbourhoodisanexcellent,verygood,orgoodplace towalkforleisure. • 69.4%(±4.4)ofLambtonresidentsfeelthattheirneighbourhoodisanexcellent,verygood,orgoodplacetowalkto forreasonsotherthanleisure. • Moredataisrequiredtoassesswalkabilitybymunicipality.PreliminaryresultssuggestthatPointEdward,Lambton ShoresandSt.Clairareratedhighestasplacestowalkforleisure.PointEdwardandPetroliaappeartoberatedthe highestasplacestowalkforreasonsotherthanleisure.

Emerging IssuesActive Transportation to School • “SafeRoutestoSchool”.Thereisagapforpromotingsaferoutestoschoolwithinbothschoolboards.Theconcerns withliabilitylimitswhatcanbedonetopromotesafeschooltravel.Thereislimitededucationonbicycling safetywithinschools

Low Cost/No Cost Recreational Opportunities • Residentswantopportunitiestoparticipateinactivitiesthatarelowornocost,availableintheirneighbourhoodsand organizedforsmallgroupsorfamilies • Fundstoparticipateinsportsforkids-thecostofequipmentandtravel

29

Focus on Recreation, not Competition • Morenon-competitivesportsforkidsPickupsports(“Tiredofhavingto“makeateamtoplaysports”;Toomuch emphasisonsportandnotactivity;Stigmaattachedwithoutplayingtravelorthetopteam) • Therearefewopportunitiesavailableforages13–30s,unstructured/unorganizedsport

Increased Access for Certain Groups (Disabled, Older Adult, Youth/Young Adults) • Peoplewithdisabilitieswouldliketheopportunitytohaveaccesstothesesameprogramsthroughimproved transportationandmodificationstotheprogramstosuittheirabilities • Greaterneedsfortheolderadultstohaveaccesstoprogramsandfacilitiesthatpromotephysicalactivity

Communication of available Programs • Therearemany(recreation)opportunitieswithinSarniaLambtonbutakeycomponentisthelackofawarenessof thoseopportunities.Thereisnocentral,one-stopshoppingsourceofavailableactivities

Suggestions for Actions Increase awareness of Physical Activity • Continuewithincreasingcommunitiesawarenessoftheimportanceofbeingphysicallyactive • Promotephysicalactivityintoeverydayliving

Increase access • Develop“EverybodyGetstoPlay”policiestoremovefinancialbarrierstoaccessingrecreation

Consider different Recreation Programs, or ways of Offering Programs • Morecommunitywalks • Exercisestationsatlocalparks • Freeexerciseprogramsinparkswithfamilyactivities • Outdoorfreerinksforskatingandsummerforballhockey-havevolunteers/adults/seniorshelpteachkids howtoskate • Offermorerecreationalteams-certaintimeseachweek,samespot • Morewinterprogramming(winterbreakcamps,SaturdayFunDays),Indoorwalkingtrack • Morefreeswims • Placestorentequipment-skiing,bikes,canoes,paddleboats,etc • Exercisestationsinthearenaswhenyouaretherewatchingkidsplayhockey • Addmorenaturetrails • Openschoolgymnasiumsduringtheeveningsorsomeweekends • Mallwalkersprograms-morepromotionandmoreorganizedandFUN! • Selfguidedorgroupdirectedwalkingtourshighlightingthehistoryoftheareas • Needmultipurposefacilitiestomeetavarietyofneeds–i.e.washstationsincommunitycentresforart,suitable flooringforexerciseprograms,etc. • Accesstounorganizedsport/fitnessopportunitiesi.e.pavedtrails,dirttrails • Encouragepeopletotrysomethingdifferent.Clubs,organizations,associationsshouldofferafreetry-itevent throughoutthecountyandatappropriatetimesoftheyear

Focus on Specific Groups • Recruitandtrainvolunteerstoorganizeandmodifyrecreationalopportunitiesforyoungpeople,olderadults,and peoplewithdisabilities • Bringbackprogrammingforages3to13tore-engagetheyouth • Focusonpregnantwomanandpregnancyweight

30

Promotion/Incentives • Monthlychallengesinourcommunity-introducenewwaystobeactive • Taxcreditforadultssimilartochildren • Offerfreefamilydaypassesforcommunityreccentres/pools/gyms,etc.MorepassesthatareFREE

Communication of Existing Programs/Services • Developaninformationwebsite-easytofindprogramtimes,costs,locations • Createadirectoryofwhatphysicalactivities/recreationisavailableinthecommunity.Thedirectoryshouldcoverall agegroupsandincludethecostofmembershipandavailablefundingorfeereduction.Thedirectorycouldhave informationontransportationi.e.busroutesorweblinks.Thedirectorycouldbeonlineordiscandupdatedyearly • Createaresourceforolderadultsforhealthpromotionservices

Active Transportation to School • ImplementWalktoSchoolprograms.ThesecouldlinkintoaBacktoSchoolSafetycampaignthatwouldeducate roadusers • InvestigateActive&SafeRoutestoschoolpolicywithMinistryofEducationthatrequiresallschoolstohaveASRTS Plan/Policy.Promotesaferoutestoschool,bike/pedestriansafetyandreadytolearnbenefits • Advocateforpolicyonschool-based,mandatorybikesafetyprogramsmandatoryforstudents

Built Environment/Urban Design • Officialplans(andtheMinistryofEducation)shouldlocatenewschoolstofavourwalking/bikingtoschooland reduceriskofcrossingbusystreetsetc • Createtransportationmasterplansthatincludeactivetransportation,trails,pedestrians,cyclistsandpersonswith accessibilityissues • Developwalk-able,compactneighbourhoodsthroughmixedlanduses,live-workoptions,diversebuildingformsand wide-rangingtransportationoptions • Walkablesidewalks(bettermaintained)sidewalkswithdipsforstrollers,wheelchairs • Sidewalksoneverystreet-betterlighting.Cleansidewalksofsnow • Crosswalksigns.Bettermarkingforcrossings-morepaint! • CloseFrontStreettotrafficonweekends.Novehiclezonesforsomeevents/activities • Morebikelanes/multi-purposelanes • BetterpromotionofSarnia’sbikerackprogram • Availabilityofbikes-rentabikeprogram-refurbishesbikesforkidsunder12 • Moretrails-lightingontrails • Streetsdesignedwithbikinglanesandclearlymarked.Chargeayearlybikingfeetoimprovepaths.Connectwith serviceclubs,localbusinessestohelpsupport • Morebikeracksoutsidecommunityestablishments • Establishbikeroutesthatconnect-scenicroutethroughoutthecityandpromotetotourism • Betterbusroutes-accessibility.Morebussing • Free/discountedbusservicetoparks

31

Programs and Services

Program Name Description

Municipal Sports and Recreation Guides Eachmunicipalityoffersavarietyofrecreationprograms,andproducesaWinterandSpringbrochuretoinformsresidents(theseareavailableonlineoneachofthemunicipality’ssites.

http://www.lambtononline.com/local_municipalities

Community Health Centre CommunityHealthCentresprovidegreatprogramsatnocost,mostlytargettoolderadultsandyouthunder13years.

Trails Map InformationonLambtonCountyparkandtraillocationscanbefoundatwww.lambtongis.ca/lambtontrails.

LambtonCountyTrailMapsareavailableatallLambtonCountylibraries.

Policy Update • Mostmunicipalitieshadapractice(ifnotpolicies)inplacelocallytoensurethatallresidentswereabletoparticipate inorganizedrecreationalactivitiesregardlessoffinancialability

h E A L T h Y E AT I n g

Statistics and TrendsFruit and Vegetable Consumption

Between2000/01and2007/08,therehasbeennosignificantchangeintheproportionofLambtonandOntarioresidentswhoreporteatingtherecommendednumberofservingsoffruitsandvegetableseachday.Furthermore,itappearsthattherehasbeenlittlechangesince1990,whenonly32%ofLambtonresidentsreportedconsuming5ormoreservingsperday(OntarioHealthSurvey1990).In2005and2007/08,LambtonresidentsweresignificantlylesslikelythanOntarioresidentstoreporteatingfiveormoreservingsoffruitsandvegetableseachday(Figure14).

32

*Significantly different from provincial rateSource: Canadian Community Health Surveys 2000/01, 2003, 2005, 2007/08

Malesaresignificantlylesslikelythanfemalestoeattherecommendednumberofservingsoffruitsandvegetablesperday(Lambton:28.4%vs.44.3%)(CCHS2007/08).WhilebothLambtonmalesandfemaleswerelesslikelythanOntariocounterpartstoeattherecommendednumberofservings,thisdifferencewasonlystatisticallysignificantformales(28.4%vs.35.1%).

Whiletherewasnotgreatvariabilitybetweenagegroups,LambtonandOntarioresidentsages65yearsandolderweremostlikelytoeattherecommendednumberofservingsoffruitsandvegetableseachday(Figure15).

*Significantly different from provincial rate; ‘ : Interpret with caution, large variabilitySource: Canadian Community Health Survey 2007/08

!

!

33

Restaurant and Fast Food Frequency

In2008,81.0%(±3.6)ofLambtonresidentsreportedeatingatarestaurantorfastfoodestablishmentorpickingupready-to-eatmealsatleastonceinthepastweekand55.6%(±4.5)didsotwoormoretimesinthepastweek(RRFSS,July2008–December2008,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

Food Security

In2008-09,8.0%(±2.0)ofLambtonresidentsexperiencedsomedegreeoffoodinsecurity-worryingabouthavingenoughfood,runningshortonfood,orsacrificingthequalityoffood(RRFSS,October2008–April2009,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

The2010NutritiousFoodBasket,basedonthelowestpricesof67fooditemsatnineLambtongrocerystores,founditcostsaLambtonCountyfamilyoffour(twoparentswithasonandadaughter)$708.99permonthtobuygroceriesforanutritionallyadequatediet.Thecosttofeedafamilyoffourhasbeenrisingsteadily.Between2000and2009,thecostrose39.5%or$42.38perweek.

Emerging IssuesFarm to Table Education • Needforpubliceducationaboutwherefoodcomesfrom,andhowit’sgrown

Nutrition Education • Lackofknowledgeabout“Whatishealthy”,limitedaccesstoinformationonhealthyeating • Confusionabout“what’sinfastfood”andhowtomakebetterchoicesthatarequickandeasy • YouthfeelCanada’sFoodGuidetoHealthyEatingislame,toomuchtoread,complicatedlookingeven thoughitisn’t,neverlookatitevenwhenit’shandedout,anditishardtogetcopies,notaccessibleforyouth

Access to Healthy food • Foodisnotavailablethroughoutourcommunity.“FoodDesserts”existinourcommunityalthoughthishas notbeenformallymappedout • Transportationisanissueinruralcommunitiesandeveninthecity,togettoagrocerystore • Costofhealthyfood • Accesstotransportationtogettoagrocerystoreifyouhavemobilityissues(wheelchair) • Limitedhealthychoicesinvendingmachines

Food Skills • Lackoffoodpreparationskills:canning/freezingskills(generalpopulation);labelreading;cookingskillsingeneral makinghealthyeatingeasierespeciallycookingforone

Suggestions for Actions Food Skill Development • DevelopFoodSkills(Children,youthandyoungadults,collegestudents-programstosupportfoodskills,budgeting, mealplanningetc..;CookingClubsateveryschool;Communitykitchens,forseniorpopulation.Onemealfocus “dinnersclubs” • SchoolBoardstosupportFoodskills.ReintroduceHomeEconomicsintoschool • Morecommunitygardens-teachpeoplehowtogrowfood

Education • Requirefastfoodrestaurantstopostnutritionalinformationoffoodbyfooditems • Promotehealthydinnerideas,shoppingonbudget,oncommunityhealthwebsite.Updatetipsmonthly • Needprogramstoteachabouteatingwell-abalanceddiet-followingCanada’sFoodGuide • Providefieldtripsforstudentstolocalfarms

34

Access • EncourageCityofSarniatodonatelandforcommunitygardens/increasecommunitygardens • DecreasethenumberoffastfoodrestaurantsinSarnia • DeveloppolicyforLocal/healthyfoodinrecreation/arenasinLambtonCounty • Developmunicipalbylawstodecrease“fooddesserts”inLambtonCounty • ContinuedevelopingaFoodCharterin2011. • ImplementandsupportOntarioMinistryofEducation-PPM150-healthyeatingpolicy forschoolsimplementedinSept2011 • Increaseadvertisingofprogramsavailableinourcommunity-GoodFoodBox(GardenFreshBox) • Increaseaccesstolocalfoodinourgrocerystores • IncreaseFarmersMarketsinourcommunity-throughoutLambtonCounty.Offermobilefarmersmarket • Offerhealthyfoodchoicesatpublicevents-Bayfestandparks • Connectwithtourismtopromotelocalfood:farmersmarkets,etc. • Lobbytoincreasecostof“junkfood”tobecomparabletohealthyfoodcosts • Requiregrocerystorestohavehealthyfoodateyelevel,versusunhealthyfood • Removeunhealthyfoodatcheckout • Healthierfoodchoicesatschool,work,publicplaces,hospitals • VendingmachinesinLambtonCountythatcarryONLYhealthyfood

Programs and ServicesProgram Name Description

Good Food Box (Garden Fresh Box) Amonthlyfruitandvegetablebuyingprogramwithcentralizedbuyingandco-ordinationthroughtheCountyofLambtonCommunityHealthServicesDepartment(CHSD).

Student Nutrition Programs StudentNutritionProgramsarepromotedandsupportedbytheCountyofLambtonCommunityHealthServicesDepartment(CHSD)andtheLambtonStudentNutritionAdvisoryCommittee(LSNAC).

Peer Nutrition Program Themainpurposeistotrainlaypeopletoencouragehealthyeatingamongcommunitypeersthroughcookingclasses,fooddemonstrations,andotherfood-relatedopportunities.

Lambton County Farm Map LambtonCountyFarmMap.NutritionstaffhavepartneredwiththeLambtonFederationofAgriculturetoproduceaLambtonCountyFarmMap.

Cooking on a Shoe String CookingonaShoestringisa4weekhandsoncookingclassheldinpartnershipwithlocalcommunityagencies.Thegoalistoteachprioritygroupsbasiccookingskillsonalimitedbudget.

Policy Update • Nopolicyupdateswerenotedintheareaofhealthyeatingandaccesstonutritiousfood,althoughattheCountylevel, thereisinterestinaddressingtheissueofcommunitymarketsasawaytoaddressaccesstofood • ThereisaninterestindevelopingaFoodCharterforLambtonCounty

35

A LCo h o L A n d S U b S TA n C E M I S U S E

Statistics and TrendsAlcohol Use

Frequentheavydrinkingiscommonlydefinedashaving5ormoredrinksononeoccasion,atleastonceamonthinthepastyear.Between2000and2008,ahigherproportionofLambtonresidentsreportfrequentheavydrinkingcomparedtotheprovincialaverage(Figure16).Thisdifferencewasstatisticallysignificantin2000/01,2005and2007/08.

*Significantly different from provincial rateSource: Canadian Community Health Survey 2007/08

Heavydrinkingismorecommonamongmalesthanfemales(Lambton:33.4%vs.12.6%)(CCHS,2007/08).Heavydrinkingismostcommonamong20-34yearolds(Figure17),with54.3%ofLambtonmalesand26.0%ofLambtonfemalesinthisagegroupreportingheavydrinkingoverthepastyear(CCHS2007/08).

!

36

*Significantly different from provincial rate; NR: Not Released; ‘ : Interpret with caution, large variabilitySource: Canadian Community Health Survey 2007/08

DatacollectedthroughtheOntarioStudentDrugUseandHealthSurvey(OSDUHS)suggeststhatalcoholuseandbingedrinkingisevenmorewidespreadamongyouththanfoundintheCCHS.OSDUHSdefines“binge”drinkingashaving5ormoredrinksononeoccasioninthepast4weeks.In2009,46.5%(34.0-59.0)ofsecondaryschoolstudents(Grades9to12)intheErieSt.ClairandSouthWestLHINs1reportedbingedrinking.Thiswassignificantlyhigherthantheprovincialaverage(32.9%(95%CI:30.3-35.6)).Thisratehasremainedconstantintheregionandtheprovinceduringthe10yearperiod,1999-2009.

Substance Use and Driving

In2008,7.2%(±2.0)ofLambtonresidents,aged18yearsandolder,reporteddrivingamotorvehicleinthepastyearafterhaving2ormoredrinksinthehourbeforetheydrove,including11.6%(±3.7)ofmalesand3.5%†(±1.9)offemales(RRFSS,June2008–December2008,LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity).

In2009,OntariostudentsinGrades10-12weremorelikelytoreportdrivingamotorvehicleaftercannabisuse(16.6%)thanwithinanhourofdrinking2ormoredrinksofalcohol(11.9%)(Paglia-Boaketal.2009).Malesweresignificantlymorelikelytoreportbothbehavioursthanfemales.Amongstudents,therehasbeennosignificantchangeintherateofdrivingafteralcoholorcannabisuseinthepastdecade(1999-2009);however,drinkinganddrivingrateshavedecreasedsignificantlysincemonitoringbeganinthe1970s(highof46%in1979)(Paglia-Boaketal.2009).

Substance Misuse

AccordingtotheOSDUHS(2009),cannabisisthemostoftenusedillicitdrugin2009,with38.8%(32.0-46.1)ofsecondaryschoolstudents(Grades9-12)intheErieSt.ClairandSouthWestLHINs1reportinguseinthepastyear(Paglia-Boaketal.2009).Therehasbeennosignificantchangeintheprevalenceofcannabisuseoverthepastdecade(1999-2009)intheregionortheprovince.-----------------------------------------------------------------

1Erie St. Clair and South West LHIN include: Lambton, Chatham-Kent, Windsor-Essex, London-Middlesex, Huron, Grey Bruce, Perth, Elgin, Norfolk

!

37

ThesecondmostcommonlyuseddrugsareopioidpainrelieverssuchasPercocet,Percodan,Tylenol#3,Demerol,OxyContinandcodeine.IntheErieSt.ClairandSouthWestLHINs,22.0%(14.9-31.1)ofstudentsreportedthenon-medicaluseofthesedrugsinthepastyear.WhiletherateofOxyContinuseisnotavailableattheLHINlevel,provincialrateswere2.2%(1.8-2.7),indicatingthatotheropioidsaremorecommonamongthestudentpopulation.Therehasbeennostatisticallysignificantchangeinopioidusebetween2007and2009intheregionortheprovince.Attheprovinciallevel,females(20%)aremorelikelythanmales(16%)touseanopioidpainrelievernon-medically.

InthemergedLHINarea,38.6%(31.1-46.7)ofstudents(Grades9-12)reportedusingopioidpainrelieversformedicalpurposes,withaprescriptionorastoldbyadoctor.Three-quartersofthosewhousedanopioidpainrelievernon-medicallyreportobtainingitfromhome.

Opioiduseisalsoaconcernamongtheadultpopulation.TheagerangeofclientsattheBluewaterMethadoneClinic(BMC)is18-30years,witharecenttrendtowardsmoreclientsinthe18-25agerange.Whilethereareapproximately820methadoneclientslocally,thisisnotaclearindicationofthelocalsituationsincesomeLambtonresidentsusefacilitiesinLondon,St.ThomasorChatham.BMCalsoservicesoutoftownclients.

Emerging Issues • Lackoflocaldata.WhileCAMH’sstudentdrugusesurvey,doneeverytwoyears,providessubstancemisusedata,the dataarenotspecifictoourcommunitybutratherlumpedintoregionalstats • Opiateaddictionisaprobleminourcommunity,andmethadoneisbeingdeliveredasalifeline.Thereisalackof methadonesupportgroupsorcounsellingservices

Education • Thereisalackofeducationopportunities/publicforumsforstudents,parents,community,professionals

Availability of Drugs in Schools • Steroidsrampantinschools;cangetdrugseasilyanytimetheywant,cheap/sellingPerk’sandOxy’s.

Coordination of Services • Anoverlapandalackofco-ordinationofservices,lackoffundingandpartnerships

Professional support for Prescription Meds Misuse • Needthesupport/educationofphysicians/pharmacists,etc.“Firstdealwiththeaddictionsand otherissueswillbeeasier”

Suggested ActionsEducation for Health Professionals • EducatethehealthcaresectoronappropriateprescribinganddispensingofOpiotes,Percocet,Oxycotinforpainrelief throughworkshops,educationalcredits,seminars

Education and skill building for parents • Educationtoparents-howtotalktoyourkidaboutdrugsandalcohol • Provideeducationonparent-teenrelationships–i.e.talkingtoaparentorteen,suchaswhenateenasksquestions aboutdrugs

Education • Schoolboardsmustrecognizeandencourageactiveparticipationinsubstancemisuseactivities • Programsmusttargetyouthearlierratherthanlatertomitigatetheriskofdevelopingmentalhealthillnessordrug abuse.Targetchildren,youthandparentsinanintensivemanner.Foryouthintroubleordroppedout,keepingthem engagedintheschoolsystemisessential • FetalAlcoholSpectrumDisorder.Needtoinformandremindwomenthatnoalcohol,noamount,atnotimeduring pregnancyisthesafestbet • Thelink/relationshipbetweenalcoholandchronicdiseaserequiresgreateremphasis

38

• Peertopeerpresentations.Storytelling,sharingexperiencesfromthosethatbeenchangedbyalcoholanddrugmisuse. Olderadultseducatingyoungeryouth • Educationearly-assembliesatschoolsguestspeakerswhoarerecoveringaddicts.Videosinschool • Mandatoryseminarforallgrades(8).Smallgroupstoallowdiscussion • Increaseawarenessofexistingprograms

More Alcohol-free Events in the Community • Affordable/freeactivitiesforyouth/freesportsprograms/afterschoolprogramming • Morecommunityeventsthatarealcoholfree • Moreyoutheventsforyouth-youthnightSarniaStinggames(reduceprice) • Morefungatheringplaceforyouthtohangoutalcoholanddrugfree-socialactivities

Priority populations and Youth Engagement • Needtoimprovewayweworkwithprioritypopulations.Youthforumtogetinput • Usegraphicimagessuchas(liverdamage)toengageandeducate • Haveyouthwritearticlesinlocalmediaonconcernsofalcoholanddrugs/troublewithit • Localindustrytosupportcompetitionforschoolstodevelopthemosteffectiveantidrugalcoholor smokingvideo(YouTube) • Youthcoalitiontoaddressthepreventionandusageofalcoholandotherdrugs • Mentorsintheschooltosupportyouth;Counsellorsinelementaryschoolaswellashighschool • Websiteforyouth-linktosupport

Implement Previous Recommendations in Drug Strategy • ThereisaneedforthecreationofanAlcohol/DrugStrategyTaskForceasindentifiedintheSarnia-LambtonDrug Strategy,andwhichwasrecognizedandsupportedbyLambtonCountycouncil

Alcohol and Recreation Policy Development • Developmentofalcoholpolicies,tohelpcommunitiesandgolfcoursesinLambton,reducerisksandliabilityfrom alcoholconsumption

Policy development restricting Advertising • Developpolicyrestrictingalcoholadvertisingwithinacertaindistanceofschools,playgrounds • Developpolicyrestrictingalcoholadvertisingonmunicipally-ownedproperty,parks,buses,etc

Workplace Policies • Updateorcreatesubstancemisusepolicieswithinworkplaces,municipalities

Drinking and Driving • MorefrequentRideChecks(notjustonholidays) • Alcoholfreedriverprogram • Nonalcoholdrinksforfreetothedesignateddriver

Police Enforcement • Regular-randomdrugsearchesatschool

Treatment Facilities • Morecounselling/treatmentprogramsandservicesandaDetoxfacility

39

Programs and ServicesProgram Name Description

SarniaRebound Providesanumberofpositiveprogramsthatareproactiveandreactivetorelatingtoanumberofissuesincludingsubstancemisuse.

Racing Against Drugs RacingAgainstDrugsisafun,interactive,learningexperiencethatgiveselementarystudents(Grade5)inourcommunityinformationtheyneedtostayontrackandtolivedrug-free.

Racing Against Drugs, held during National Drug Awareness Week in late November,promotespublicawarenessofsubstancemisuseissuesandhealthylifestylealternativesforchildren.TheRoyal Canadian Mounted Policesponsoredeventnowusesdigitalracingtechnologywithsixvideoconsolesinsteadofaslot-carracetrack.Notdoesonlyitcapturetheattentionofyoungpeople,ithelpscommunicateamessageofhealthy,drug-freelivingthroughautoracing–ahigh-profileandexcitingsportthatdoesnottoleratesubstanceabuse.

Communityagenciesandorganizationsman“pit stops” topromotehealthy,drug-freelifestyles.Studentsactivelyparticipateastheyworkwithpeersinafun,competitiveandchallengingsetting.

Students Acting Against Drugs Audience:Grades7/8students.ProgramdeliveredbyGrades11/12secondaryschoolstudentsinconjunctionwithCHSD,policeandLDAAC.

Thetransitionfromelementaryschooltohighschoolisfraughtwithexcitement,changingsocialrolesandrelationships,experiences,expectationsandexperimentationthathelpdevelopskillsforadulthood.

Althoughadolescenceisgenerallyatimeofgoodhealth,teenyearscanbeatimeofexperimentationinpotentiallyharmfulactivitiesthatcanresultininjury,depression,substanceuse,violenceandriskysexualactivitiesthatposethreatstothehealthandwell-beingofthisagegroup.

Grades 7 and 8(usuallyages12-13)areimportantyearsforsubstancemisusepreventionformanyreasons.Typically,druguseincreasessignificantlybetweenseniorgradesofelementaryschoolandsecondaryschool,andstudentsaremorevulnerableduetodevelopmentalchangesandchangesinschool,friends,academicpressures,andtheirenvironment(e.g.,greateraccessibilitytovarioussubstances).Preventiveeffortsneedtobedonepriortothetransitiontosecondaryschool.

Dramaisapowerfultooltoconveythatmessage.

40

Program Name Description

Students Acting Against Drugs, continued SAADisapeer-to-peersocialdramainitiativeleadbyseniordramastudentsatthesecondaryschoollevel.Theywrite,directandperformaplaythatdealswiththerisksandtheconsequencesofsubstanceuseandabuse.

Aquestionandanswerperiod,withquestionsfromtheaudience,ishandledbythehighschoolperformers.

Students Acting Against Drugs,underthedirectionofCountyofLambtonCommunityHealthServicesDepartment,LambtonDrugAwarenessActionCommitteeandpolice,isdesignedto:•increaseknowledgeaboutsubstancemisuseandtheconsequences•improvelifestyle,educationalandsocialbehavioursinourcommunities•providepositivepeermessaging•emphasizeconsequencesratherthanportraypartyingasattractive•translateknowledgeintopositivebehavioursamongLambtonyouth.

Alcohol Free Family New Year celebration The Alcohol-Free Family New Year’s CelebrationoffersfamiliesanaffordablealternativetoringintheNewYeartogether,asafamily,inasmoke-freeandalcohol-freeenvironment.

Eventhasbeenheldfor12yearsonDecember31,inlatemorningearlyafternoon.Attendancevariesfrom1200-2000.

Theeventpromotes,educatesandraisesawarenessofsubstanceuseissuesalongwithpromoting/encouraginghealthylifestylechoicesvitaltofamiliesandyouth.Thecommunitycelebrationincludesskating,musicalentertainment,crafts,facepainting,inflatableamusements,gamesandpopularchildren’scharactersincostume.FestivitiesincludeaNewYear’scountdowncompletewithaballoondrop,gingeraletoastandcake.

LDAACalsoprovidesresidents-in-needwithticketsandtransportationtoensureeveryoneisabletoattend.

Values Influence and Peers (VIP) - Sarnia Police, OPP School-basedprogramforyouthtobuildresiliencyandavoidinfluencestouse/abusesubstances.

Skills Link Skilldevelopmentforindividuals18-30yearsold

Narcotics Anonymous Peersupportprogramforthosemisusingsubstances

Alcoholics Anonymous Peersupportprogramforsobriety519-337-5211for meetingschedules

41

Policy Update • Severalmunicipalitiesdid,infact,havemunicipalalcoholpoliciesinplace

M E n TA L h E A L T h P Ro M oT I o n

Statistics and TrendsSelf Perceived Mental Health

ThemajorityofLambtonandOntarioresidentsperceivetheirmentalhealthasgood,verygoodorexcellent.In2007/08,2.6%ofmalesand4.8%offemalesratedtheirmentalhealthasfairorpoor(Figure18).Localrateswerelowerthanprovincialratesand

thisdifferencewasstatisticallysignificantformales.

*Significantly different from provincial rateSource: Canadian Community Health Surveys 2007/08

BasedontheOSDUHS(2009),16.3%(11.8-22.1)ofstudents(Grades9-12)inthecombinedLHINregion(ErieSt.ClairandSouthWest)ratedtheirmentalhealthasfairorpoor(Paglia-Boaketal.2010).Whileslightlyhigherthantheprovincialaverage(13.1%),thedifferencewasnotstatisticallysignificant.Furthermore,35.0%(31.0-39.2)ofstudentsintheregionreportedelevatedpsychologicaldistress.Thiswassimilartotheprovincialaverage(35.1%).Approximately23%ofstudentsintheregionandtheprovincereoprtedthattheyvisitedamentalhealthprofessionalinthepast12months.

Life Stress and Satisfaction

In2007/08,16.4%ofLambtonresidentsreportedthattheyhad“quitealot”oflifestress(Figure19).Thiswassignificantlylowerthantheprovincialaverage(22.2%).IncomparisontoOntario,Lambtonrateswereparticularlylowforthose35-64yearsofage.RatesoflifestresswereslightlyhigherinLambtonvs.Ontarioforyouthages12-19years,buttherewashighvariabilityinthisestimateduetoasmallsamplesize,soresultsmustbeinterpretedwithcaution.

Also,in2007/08,92.8%ofLambtonresidentsreportedbeingsatisfiedorverysatisfiedwithlife.Thiswassimilartotheprovincialaverage(90.7%).

!

42

*Significantly different from provincial rateSource: Canadian Community Health Surveys 2007/08

Suicide

Atthelocallevel,thereissubstantialvariationintheannualrateofdeathduetosuicide(Figure20).Insomeyears,localrateswillbehigherorlowerthanprovincialrates.Onaverage,between2000and2005therewereapproximately3suicidesperyearamongLambtonfemales(range:1-4peryear)and10suicidesperyearamongLambtonmales(range:6-18peryear).RatesforLambtonfemalesduringthisperiodweresimilartotheprovincialrate.RatesforLambtonmaleswereslightlyhigherthanOntariomales;however,thedifferenceisnotconsideredstatisticallysignificant.Between2000and2005,5.6%ofsuicidedeathsoccurredinyouthaged10-19years.

Data Source: intelliHealth, Ontario Mortality Database, 1986-2005, Extracted August 10, 2010

!

!

43

Bullying

RatesofbullyingvictimizationandbullyingperpetrationatschoolweresignificantlyhigherinthemergedLHINarea(ErieSt.ClairandSouthWest)ascomparedtotheprovincialaverage(Paglia-Boaketal.2010).Intheregion,38.6%(31.0-46.8)ofstudentsreportedbeingbulliedand38.4%(30.0-47.4)ofstudentsreportedbullyingothers(comparedto27.9%and25.8%ofOntariostudentsrespectively).

OfthetypesofmaltreatmentexperiencedbyLambtonCountychildren,66%wereduetoexposuretodomesticviolence(AReportontheWell-BeingofLambtonCounty’sYoungChildren,2008).

Approximately7outof10familiesreferredtoCASaresingleparentmother-ledhouseholds.1outof5womenhavebeendiagnosedwith,ordescribedas,havinglevelsofclinicaldepressionthatinterferewiththeirparentingabilities(AReportontheWell-BeingofLambtonCounty’sYoungChildren,2008).

Emerging IssuesEducation and Awareness • Greaterawarenessofmentalhealthissuesamongstyouthincludingsubstanceuseandabuse;informationavailable onlineisnotalwaysaccurateorhelpful,thecommunitiesabilitytocorrectinaccurateinfoandrespondquicklyor proactivelyisverylimited

Stigma • Mentalhealthisnotselfidentified,thereisstigmaassociatedandyoudon’twanttohavethat“label”

Children’s Mental Health • Children’smentalhealthiscriticalwiththerecentsuicidesinourcommunity • BullyingaproblemespeciallywithGaypeopleintheolderyouthage.Youngerkidssaybullying“Ok“ifitisnotreally mean,butjustteasing • Believethatolderadultsandthemediapainta“perfectimageofyouth”andfindithardtoliveuptotheimage,infact don’twantto.Wanttobeheard • (We,i.e.youth)areover–organizedbyAdults.Notsurewhattodobecauseadultsintheschoolswanteverythingso organizedthatyouthseemhelplesstoorganizesomething • Notsureoftheagenciesavailableandwheretheyareandcanyoujustshowupandaskforhelp

Older Adult’s Mental Health • Socialisolation,lackofmobilityforolderadultscanleadtodepression.“Ifyoudon’thaveyourmentalhealth,there’s notmuchyoucando!”

Treatment Issues • Oneofthegreatestgapsisatrendtowarddiagnosisofseriousmentalillnessamongyouthatayoungerage.However, traditionalchildren’smentalhealthserviceshavenotadaptedtheirresponsetoabiopyschosocialintegratedtreatment modeltobettertreatseriousmentalillnessamongyouth

Suggested Actions Education and Awareness • Increasepublicawarenessofmentalillnessthruads.MindYouthHealthsectioninthenewspaper,TVads,and handoutsatschool • Morepromotionaboutmentalhealthissues,radiobroadcasts,TV,printads.Developflyersformail • Increaseawarenessofcurrentserviceagenciesinthecommunity • Developfacebookaccounttoshareinformation/opinions/services,etc • Callinradioshowformat.Toanexpert(whocouldprovideadviceontheair)

44

Destigmitization • Discrimination–Thereisastruggletomakethecommunitymoreinclusiveandtoaddressbiasesaroundallages, culturesandpersonswithspecialneeds

Education, Support and Counselling for Youth • Peersupportprogramfacilitatedbylocalagencies,socialworkers • Leadershipprogramsforyouthinschoolstohelpoutyouth(mentoring) • Createmoreafterschoolprogramming • Counsellorsinschoolsforyouthandoutsideschools(dropincentres)whereyouthplay/socialize • Moreworkshopsatschools/speakers • Bringyouthandelderstogetherforstorytellingaboutlife • Morehouseleaguesportsencouragefunplay,socialinteraction • Educationintheclassroomineverygrade(mandatory)toteachkidsatayoungageaboutcopingskills,lifestress,etc • Help/Hotlineestablished

Older Adults • Socialprogramsforolderadultsinor“closetohome”tokeepthemengagedandinteractingwithothers

Workplace Mental Health Promotion • Eachworkplacetohavemandatorymentalhealthworkshopsforemployees • Workshops/speakerseries/lunchandlearnsessions

Early Support and Counselling • Developsupportgroupsforstressmanagement,notjustaddiction • HotlineforfreecounsellinglikeCMHAoffers • Improvedtrainingandcommunityawarenesstoidentifyandtreatseriousmentalillnessandserious substanceabuseearlier

Recreation as a Protective Factor • Increaseaccesstolowcostphysicalactivity

Programs and ServicesProgram Name Description

Community Mental Health Services – Lambton County Branch

(http://www.cmhalambton.org/)

Anextensiverangeofmentalhealthprograms,servicesandsupportsareofferedthroughCommunityMentalHealthServices–LambtonCountyBranch.Areviewoftheirwebsiteidentifiednumerousprogramsaimedatincreasingawarenessandunderstandingofmentalhealthissues,aswellasidentifyingspecificprogramsandsupportsforthoseaffectedbymentalillness.

Preventive Education Program (PEP) PresentationsdeliveredthroughthePreventiveEducationProgramaredesignedtoenhancethepublic’sgeneralunderstandingofmentalillness,toreducethestigmathatissooftenassociated,andtopromoteemotionalwellnessinschools,workplaces,andthecommunity.

Mental Illness Awareness Presentations MentalIllnessAwarenessPresentationsprovideanoverviewofseriousmentalillnessincludingdetaileddiscussionofMoodDisorders

45

Program Name Description

Mental Health Works ThisfulldayworkshopisofferedtoManagers,Supervisors,andHumanResourceRepresentatives,andisspecificallydesignedtohelpemployersidentifywarningsignsofmentalillness;discussmentalillnesswithemployees;assessrisks;separateperformanceissuesfrommentalhealthissues;makeappropriateaccommodationsintheworkplace,andavoidHumanRightsviolations.

Suicide Awareness Thisstandardizededucationpackagepromotesaconsistentknowledgebasewithrespectto:suicidewarningsigns,assessmenttechniques,andcommunityresources

Mental health Promotion Thishalf-dayworkshopexploresfivekeycharacteristicsofgoodmentalhealthandassistsindividualsinidentifying,andpromoting,theirownlevelofmentalhealthfitness.

Mental Illness Awareness: Partnership Speakers Bureau Apanelpresentationfeaturesthepersonalstoriesofindividualsandtheirfamilymembers,livingwithamentalillness.

Self-Esteem is Elementary Thissix-weekclassroomseriesisdesignedtogivechildrentheconfidencetofacelife’schallenges.

Kids Have Stress Too Astressmanagementprogramdesignedtohelpparents,andcaregivers,identifyandunderstandstressinchildren,andtoempowerthemtoteachtheirchildreneffectivewaysofmanagingstress.

Crisis Intervention and Specialized Short-term Services 24 hour Telephone and Mobile Crisis Intervention: Telephoneandmobile(in-personsupportisavailablewithintheCityofSarnia)crisisresponseisavailable24hoursperday,365daysayear(includingholidays)toanyonewhomaybesufferingfrommentalillness.

Short-term Services:TogetherwithaCommunityNurseorSocialWorker,individualswithmoderatementalillness,includingAnxietyDisordersandDepression,willworkonsymptommanagement,healtheducation,andcrisis/relapsepreventionplanning,onashort-termbasis..

Discharge Planning:DischargePlanningservicesareavailableforallreferredpatientsfromtheMentalHealthUnitatBluewaterHealth.

Court Diversion Services:SupportisprovidedtoindividualswhohaveamentalillnessandareinvolvedwiththeJusticeSystem.

Release from Custody:In-reachservicesandfollow-upcareareprovidedtoindividualsinsecurecustody.

Crisis Safe Beds and Emergency Housing:Immediatesupportandoutreachisprovidedtoindividualssufferingfrommentalhealthissueswhoareinneedofemergency,orstable,housing.

46

Program Name Description

Crisis Intervention and Specialized Short-term Services. continued

Dual Diagnosis Nurse Specialist:Nursingassessmentandsupportisprovidedtoduallydiagnosedindividuals(individualswithamentalillnessandadiagnosisofdevelopmentaldelay).TheNurseworkswithindividuals,theirfamiliesandotherserviceproviderstodevelopcrisispreventionplans,facilitatecommunityintegrationandcoordinatedevelopmentalandmentalhealthservices.

ACCESS Committee / Intake and Assessment:TheAccessCommitteeprovidesasinglepointofaccess,andinitialassessment,forallcommunity-basedadult(16yearsandolder)mentalhealthservicesinLambtonCounty.

Community Case ManagerprovidesassistancetoreferredindividualswhoarepreparingfordischargefromtheIn-patientUnitatBluewaterHealth(commonlyknownas“3-East”).Assistancemayincludehelpwithhousingandfinances,aswellasreferralstoappropriatecommunityresources.

Intensive Case Management:Rehabilitation(knownas“biopsycho-socialrehabilitation”)emphasizingclientchoice,empowerment,andindividualstrengths,isprovidedona1:1ratio.

Vocational Program:Individualswithmentalillnessareassistedtoexplore,secureandmaintaineducational,volunteerandemploymentrelatedactivities.

Depot/Clozaril Clinic Services:Administrationofpsychiatricmedication,aswellasassessmentandmonitoringofindividualsreceivinginjectionsandoralClozaril,isprovided.

Diabetic Clinic:AmultidisciplinaryDiabetesscreening,preventionandsupportprogram,includingfootcare,thesupportofaNursePractitioner,andhealthteachingrelatedtonutritionandlifestylechanges.

Early Detection and Intervention Services (EDIS):providesearlyinterventionservicestoindividualswhoareexperiencingafirstonsetofPsychosis.Servicesinclude:screening,comprehensiveassessment,linkagewithapsychiatristandothercommunitysupport.

Concurrent Disorders Case Manager:ProvidesscreeningofallclientsinreceiptofCMHAServicesforconcurrentdisorders(mentalillnessandaddiction).

Psycho-educational Groups:Openandclosed-endedgroupsprovideeducationandsupporttoclients.Educationtopicsareidentifiedbymembersanddealwithavarietyofissues.Groupsmeetonaweeklybasis.

47

Program Name Description

Crisis Intervention and Specialized Short-term Services. continued

Trustee Services:Individualswithseriousmentalillnessareassistedtodevelopthenecessaryskillstomanagetheirfinancialaffairs.

First Nations Community Support Services:IntensiveCaseManagementsupportisalsoofferedonsiteattheKettlePointHealthCentre.

After Care Program:TheAftercareProgramprovidessupporttoindividualsthatnolongerrequireIntensiveCaseManagementServices.Theprogramisinitiatedafteranindividual’streatmentplanhasbeencompleted,andastheyareapproachingdischargefromservices.

Lambton Family Initiative LambtonFamilyInitiativeisasupportserviceforfamilymembers,significantothersandconcernedfriendsofindividualswithanyformofmentalillness.Itisaplacetoreceiveinformation,supportandunderstandinginaconfidentialatmosphere.

The ‘St Clair Child and Youth’ Agency St.Clair&YouthServicesisachildren’smentalhealthcentreandisregardedastheprimaryadvocateandsourceforservicesrelatedtothementalhealthofourchildrenandyouth.St.Clair&YouthServicesisamemberofChildren’sMentalHealthOntario

Policy Update • Nopolicyupdateswereidentifiedinthestakeholderconsultationorcommunityengagementactivitiesintheareaof mentalhealthpromotion

I n j U RY P R EV E n T I o n

Statistics and Trends

BasedontheOntarioStudentDrugUseHealthSurvey(2009),40.5%(31.7-49.9)ofstudents(Grades9-12)inthemergedLHINarea(ErieSt.ClairandSouthWest)reportedthattheyhadbeentreatedforaninjuryatleastonceinthepast12months(Paglia-Boaketal.2009).Thiswasequaltotheprovincialrate(40.6%).

Falls

In2009,therewere5,164visitstotheEmergencyRoom(ER)forfallrelatedinjuriesbyLambtonCountyresidents.ERvisitsweremostcommonamongthoseaged1-4and10-14years,butage-specificrateswerehighestforthose80yearsandolder(Figure21).Anothernoticeablepeakoccurredat50-54years.Malesandfemalesunder40yearsofagevisitedtheemergencyroomatasimilarrate,butafterage40,femalesweremorelikelythanmalestovisittheERforfall-relatedinjuries.

48

Data Source: intelliHealth Ontario, Ontario Ambulatory Visits Database, 2002-2009, Extracted November 16, 2010

InLambton,6.9%(±1.9)ofadults,18yearsandolder,reportedhavingaseriousfallinthepast12monthsand12.4%(±2.5)ofadultshadafallthatwasnotserious(i.e.didnotaffectabilitytododay-to-dayactivities)(RRFSSJune-December2008).

Motor Vehicle Traffic Collisions

In2009,therewere606visitstotheEmergencyRoomforinjuriesduetoMotorVehicleTrafficCollisions(MVTC)byLambtonCountyresidents.Youthaged15-19weremostlikelytovisittheERforMVTCrelatedinjuries,andratesdecreasedwithageafterthispoint(Figure22).MalesandfemaleswereequallylikelytovisittheERforMVTCrelatedinjuries.

Data Source: intelliHealth Ontario, Ontario Ambulatory Visits Database, 2002-2009, Extracted November 16, 2010

Pedestrian (traffic-related) Injuries

In2009,therewere220visitstotheEmergencyRoomforpedestrian(traffic-related)injuriesbyLambtonCountyresidents.ERvisitswerehighestamongthoseaged15-19,accountingfor20%ofallvisits.ERvisitsforpedestrianinjuriesweresimilaramongmalesandfemales.

!

!

49

Cycling Injuries

In2009,therewere401visitstotheEmergencyRoomforpedalcycleinjuriesbyLambtonCountyresidents.Over50%ofvisitswereamongchildrenandyouth19yearsandunder,withthehighestratesamongthose10-14yearsold(Figure23).Nearly75%ofallvisitswereamongmales.

Data Source: intelliHealth Ontario, Ontario Ambulatory Visits Database, 2002-2009, Extracted November 16, 2010

Bicycle Helmet Use

In2008/09,parentsinLambtonreportthat56.9%(±6.8)ofchildrenages5-17whorideabicyclealwayswearahelmet.Thoseaged5-12yearsweremorelikelythanthoseaged13-17yearstowearahelmetallthetime(69.5%±11.7vs.40.0%†±13.6)(RRFSSJuly2008–April2009).

In2009,Lambtonresidents,ages12andolder,werelesslikelythanOntarioresidentstoreportalwayswearingahelmetwhenridingabicycleinthepastyear(23.5%†vs.34.3%)(CCHS2009).

Activity Limitation

In2009,17.9%ofLambtonresidentsreportedhavinganinjurywithinthepast12monthscausinglimitationofnormalactivities,including22.5%†ofmalesand13.4%†offemales.Theserateswerehigherthantheprovincialaverage,butthedifferencewasnotstatisticallysignificant(CCHS2009).

Emerging IssuesSidewalks and Snow • Oftensidewalksarenotclearedofsnow,unevensurfaces,andcrumbling

Wearing the Gear “Not Cool” • InjuryPreventionis“Uncool”i.e.nohelmetsunlessinextremesports.Youthappeartounderstandthebenefitsbut taketheriskanyway • Properequipmentforsportsisimportant

Built Environment and Senior Safety • Lackofstrategiesthatidentifyandreduceareasofriskinthepublicenvironmentthatcontributestofallsandfall- relatedinjuriesamongseniorsinLambtonCounty

!

50

Suggestions for Actions Make Seniors Safety a Priority • Organizationsandgovernmentneedtorecognizeremoveandreduceenvironmentalhazardsthatseniorsface • Makeexistingpublicenvironmentssaferforseniors:promotesafetyandreducedriskofinjuryorharminthedesign ofpublicplaces,publictransportationandinfrastructurethatisappropriatetoseniors’needsandabilities • Organizationsandgovernmentneedtorecognize,removeandreduceenvironmentalhazardsthatseniorsface (beproactive)

Create or Improve “Safe Environments”/ Built Environment • Regularinspectionsofplaygroundsandpublicspaces • Playgroundsandsportfieldswelllit • Ensureparksaremaintained-safeequipment/upgraded-noneedles.Providesoftgroundcoveringsaroundplayareas • Sidewalksmaintained,clearedsnowandice • Morecrosswalksandwellpainted • Dedicatedbikelanes-clearlymarked • Morecrossingguards • InstituteBlockparent-neighbourhoodwatchprogram

Skills Training to Improve Safety • Safetytrainingforeverygrade • Teachhighschoolstudentsaboutworkplacesafety(CPR/firstaid) • Enforcehelmetuseforeveryone • Allschoolagechildrenshouldlearnhowtoswim • Cyclingprogramtoteachpeoplehowtocyclesafely

Programs and ServicesProgram Name Description

Learn to Swim SwimmingLessonsofferedthroughouttheCountyandpublicizedthroughRecreationandLeisureGuides

City of Sarnia /Parks and Rec. BikeSafetyCamp-age7-12years/1week

Community Health Services Department /Sarnia Police BicycleSafetyProgramisofferedtoelementaryschoolsintheSpringforgrade4students.Wearhelmetproperly,roadrules,howtorideandbikemaintenance.

Lambton County Catholic Women’s League Indorsethewearingofbikehelmetsforeveryone.Importanceofwearinghelmeteducationcampaignsprovidedatindividualchurches.

Community Health Services Department promotes Safe Kids Week

Awarenessandeducationcampaign.Helmetuse

Policy Update • NoInjuryPreventionrelatedpolicieswereidentifiedinthecommunitystakeholderandengagementactivities

52

S E T T I n g Co M M U n I T Y P R I o R I T I E S

oV E RV I Ew o f T h E P R I o R I T Y S E T T I n g P Ro C E S S

OnFeb7,2011,twenty-fiverepresentativesfromadiversegroupofsectorscametogetherforafulldayplanningsessiontoreviewstatistics,trendsandcurrentinitiativesineachofthesixpriorityareas,provideadditionalinformationonprogramsandservicesavailableinthecommunity,andtoparticipateinaprioritysettingexercisewhichwouldidentifyRecommendedActionsineachofthesixpriorityareas.Participantsrepresentedadiversenumberofsectorsincluding:communityandpublichealth,education,lawenforcement,municipalplanning,nutrition,recreation,andcommunityandsocialservices.Representativeswithcontentexpertiseintheareaoftobacco,nutrition,physicalactivity,mentalhealth,alcoholandsubstanceabuseandinjurypreventionwereinattendance.

LambtonCounty’sepidemiologistprovidedanoverviewofkeystatisticsandtrendsineachofthesixpriorityareas,andsummarysheetsforeachissueareawereprovidedforfurtherreviewandsmallgroupdiscussion.Eachsmallgroupwasaskedtodiscusstheinformationthatwaspresentedtothem,andthentoreachconsensusontheirtoptwoissuesineachofthesixpriorityareas.Alistofeachgroups“toptwo”issueswerepostedonflipchartpaperforreviewanddiscussionbythewholegroup.Then,participantswereaskedtocasttheir“vote”onwhattheyfeltwerethetoptwoissuesineachofthesixareas.ThisdotmocracyexerciseallowedthegrouptoselecttwoRecommendedActionsineachofthesixpriorityareas.

AtasubsequentplanningmeetingoftheHealthyLivingLambtonCoordinatingCommitteeonFebruary22,2011theseRecommendedActionswerebroughtforwardforfurtherreviewandendorsement.ThegroupthenconsideredavarietyofpossiblepolicyoptionsthatalignedwitheachoftheRecommendedActions.ThesepolicyoptionswerepreselectedfromtheOntarioChronicDiseasePreventionAlliance’sKeyMessagedocument(2010)andtheaccompanyingdraftworkbook(2010).Thesewerepresentedasevidence-informedpolicyoptionsforconsiderationbythegroup,withthecaveatthatthislistwasnotexhaustive.Afternarrowingdownthelistofpolicyoptionstoonesthatweremostrelevantandcommunityappropriate,eachmemberofthecoordinatingcommitteethenvotedontheirtoptwopoliciesthatshouldbemovedforwardbythePartnership.Theresultsofthecommunityprioritysettingprocessareoutlinedbelow,andincludetwoRecommendedActionsforeachofthesixpriorityareas,aswellaspotentialpolicydirections.ThetoptworecommendedpoliciestomoveforwardthroughtheOperationalPlansubmissionare: • Establishlocalpoliciesthatreducebarrierstoparticipationinsportandrecreationprograms,suchasprogramfees, equipmentcosts,transportation,etc;and • Establishmunicipalplanningandtransportationpoliciesthatincreaseaccesstohealthyfood.

L A M b To n Co U n T Y R ECo M M E n d E d AC T I o n S A n d Po L I CY d I R EC T I o n S

Physical Activity, Sport and Recreation Recommended Actions 1. Increasestudents’opportunitiestobeactiveintheschoolsetting,throughnon-competitiverecreationprogramming, supportstoeducators,andactivetransportationopportunitiesforstudents. 2. Increaseaccesstolowcost/nocostsportandrecreationalactivitieswithinthecommunityforallages.

Policy directions • WorkwithParentCouncilsintheschoolsettingtoestablishanactivetravelpolicythatpromotessafe,activetravelto andfromschool. • Establishlocalpoliciesthatreducebarrierstoparticipationinsportandrecreationprograms,suchasprogramfees, equipmentcosts,transportation,etc.

53

Healthy EatingRecommended Actions 1. Increaseaccesstoaffordable,healthyfoodforallresidents. 2. Increasefoodskillsamongcommunitymembers,particularlyamongyouthandyoungadults.

Policy direction • Establishmunicipalplanningandtransportationpoliciesthatincreaseaccesstohealthyfood.

Tobacco Use/ExposureRecommended Actions 1. Addresshighyouthsmokingratesthrougheducationaswellastheprovisionofsmokingcessationprograms. 2. Createsmoke-freepublicplacesandoutdoorareasincludingparks,sportsfieldsandbeaches,inadditiontoexpanding smoke-freeareasaroundentranceways.

Policy Direction • AmendtheLambtonCountytobaccobylawtoincludeoutdoorareas.

Alcohol and Substance MisuseRecommended Actions 1. Providepositiveoptionsandactivitiesforteensthatareincompatiblewithalcoholandsubstancemisuse. 2. Provideschool-based,preventionfocused,integratedstrategiesforchildrenandyouthandtheirfamilieswhichwill discouragealcoholandsubstancemisuse.

Policy Direction • Developpoliciestodesignateyouth-friendlyeventsasalcoholfree. • Developcomprehensiveschooldrugandalcoholpolicies.

Mental Health PromotionRecommended Actions 1. Providepositivementalhealthinitiativesforyouthwhichstrengthenself-esteem,provideskillsrelatedtohealthy relationshipsandangermanagement,andreducephysicalandpsychologicalisolation. 2. Increasethecoordinationofmentalhealthservices.

Injury PreventionRecommended Actions 1. Developlocalpolicytoaddressmodifiable“builtenvironment”factorswhichcontributetofallsandrelatedinjuries. Factorstobeaddressedincludesnowremovalonsidewalks,lightingandothersafetyfeaturesinpublicareas. 2. Developsafetyinitiativeswithafocusonincreasinghelmetusageforallsportandrecreationalactivities.

55

Co n C LU S I o n

TheHealthyCommunitiesFundInitiativehasprovidedcommunitiesacrosstheprovince,withtheopportunitytobeginabroad-basedcommunityplanningprocesswhichbuildsonpastlocalplanningefforts,andfocusesinonseveralkeyriskfactorsandconditionswhichcontributetotheburdenofchronicdisease.

InSarnia-Lambton,thereappearstobegeneralconsensusontheareaswherethecommunityisinterested,motivatedandhasthecapacitytoaddresskeyissuesintheareaofaccesstorecreationandhealthyfoods,broadeningthereachofexistingtobaccocontrolinitiatives,buildingoninjurypreventionawarenessissuesandensuringenforcementofexistingmunicipalbylawswhichcontributetofall-specificinjuries.

Mentalhealthpromotionisseenasanimportantissueinthiscommunity,andwhileaccesstoprimarycareprogramsandservicesisidentifiedasakeyissuetobeaddressed,increasingyouthresiliencyandreducingthestigmaofmentalillnessemergeasimportant,addressablecommunityissues.ItishopedthattheRecommendedActionsoutlinedinthisCommunityPictureservetofocustheeffortsofcommunityorganizationsworkingintheseareas,buildnewandstrongerpartnerships,andseektoaddresskeyissuesininnovative,effectiveways.ThisCommunityPicturewillberefinedintheyearsaheadasnewinformationand“communitylearnings”becomeapparent.

57

AC k n ow L E d g M E n T S

WewouldliketothankmembersoftheHealthyLivingLambton,HealthyCommunitiesPartnership:

Alison Mahon

Dave Brown

Dave Posliff

Ian Foss

Kevin Churchill

Kevin Edwards

Lola Dudley

Lorri Kerrigan

Lise Ruest

Myles Vanni

Aswellas,CommunityHealthServicesDepartmentstaffforprovidingtheirtimeandexpertisetowardsthesuccessfulcompletionofthisreport.

Aspecialthanksgoestothereportdevelopmentteam: • Kim Hodgson,Consultant • Crystal Palleschi,Epidemiologist,CommunityHealthServicesDepartment • Patti Sisler,ResourceCoordinator,CommunityHealthServicesDepartment • Lana Smith,PublicHealthNutritionist,CommunityHealthServicesDepartment

FundedbytheGovernmentofOntario.

59

R E f E R E n C E S

A Report on the Community Focus Group to End Poverty.Consultation,June18,2008inSarnia,Ontario.[Sarnia-LambtonPovertyReductionReport]:2008.Print.

A Report on the Well-Being of Lambton County’s Young Children.PointEdward,Ontario:CountyofLambton:2008.Web.2011.http://www.lambtonhealth.on.ca/resources/Report_Card%20_Well_Being_Of_Lambton_County_Young%20Children_2008.pdf

AtlasofLambtonCounty;2006EstimatedVisibleMinorityPopulation.Wyoming,ON:CountyofLambton,InformationTechnologyDepartment:2009.Web.2011.http://www.lclmg.org/lclmg/Portals/0/Museums%20Documents/Visible_Minority_Population_2006.pdf

BORNOntario,NIDAYPerinatalDatabase(2009),ExtractedAugust2010.

CancerCareOntario.Ontario Cancer Registry: Cancer Incidence 1986-2003,Release5(October2006).

Circles™ Model in The County of Lambton; A Report of the Child Poverty Task Force.CountyofLambton:2008.Print.

Colley,Rachel,Garriguet,Didier,Janssen,Ian,Craig,Cora,Clarke,JanineandMarkTremblay.2011a.“PhysicalactivityofCanadianadults:Accelerometerresultsfromthe2007to2009CanadianHealthMeasuresSurvey”Health Reports.Vol.22No.1.StatisticsCanadaCatalogueno.82-003-X.http://www.statcan.gc.ca/pub/82-003-x/2011001/article/11396-eng.pdf(accessedJanuary,2011).

Colley,Rachel,Garriguet,Didier,Janssen,Ian,Craig,Cora,Clarke,JanineandMarkTremblay.2011b.“PhysicalactivityofCanadianchildrenandyouth:Accelerometerresultsfromthe2007to2009CanadianHealthMeasuresSurvey”Health Reports. Vol.22No.1.StatisticsCanadaCatalogueno.82-003-X.http://www.statcan.gc.ca/pub/82-003-x/2011001/article/11397-eng.pdf(accessedJanuary,2011).

Community Nutrition in Action- How does Lambton Measure up? PointEdward,ON:CountyofLambton,CommunityHealthServicesDepartment:2009.Web.2011.http://www.lambtonhealth.on.ca/resources/CNAR/PDF/A_CHSD_HPPS_Information_Report_Community_Nutrition_Part_2_Aug_2009_(4).pdf

Community Profile Life in Sarnia-Lambton 2008.3rdedition:Sarnia,Ontario:SarniaLambtonWorkforceDevelopmentBoard(SLWDB):2008.Web.2011.http://www.slwdb.org/documents/profile_SLlife_2008.pdf

Community Profile Life in Sarnia-Lambton 2010-2011.Sarnia,Ontario:Sarnia-LambtonWorkforceDevelopmentBoard.4thed:2010.Web.2011. http://www.theunitedway.on.ca/documents/LIFE%20Full%20Profile%202010%20Book-FINAL.pdf

Community Summit 2010 : Developing Future Directions for Sarnia-Lambton: City of Sarnia, County of Lambton, Community Roundtable, Summary Notes: 2010.Web.2011. http://sarnia.civicweb.net/FileStorage/9922418891D84433BB43D9373C5DDF6C-Sarnia%202010%20Community%20Summit%20Report.%20no%20cover.pdf

EatRight Ontario ERO Health Unit/Stakeholder Report.Vol.II.EatrightOntario,DietitiansofCanada,[2010].Print.

Living and working in Sarnia Lambton; A NextGen green paper.Sarnia,Ontario:SarniaLambtonWorkforceDevelopmentBoard,etal:2010.Web.2011. http://www.sltb.org/documents/NextGen_greenpaper_final.pdf

60

Long-Term Affordable Housing Strategy - Submission to the Ministry of Municipal Affairs and Housing on the Affordable Housing Strategy Consultations held in the County of Lambton, October 2009:December2009.Print.

Moogk-Soulis,Carol.Schoolyard and Public Space Heat Islands: A Study in Windsor-Essex, Sarnia-Lambton and Chatham-Kent, Ontario:September15,2010.Print.

OHHN - Collaborative Policy Scan Project, Summary Report for Healthy Living Lambton:OntarioHeartHealthNetwork:[2010].Print.

OntarioAmbulatoryVisitsDatabase[2002-2009],OntarioMinistryofHealthandLong-TermCare,IntelliHEALTHONTARIO,DateExtracted:[November16,2010].

OntarioMortalityDatabase[1986-2005],OntarioMinistryofHealthandLong-TermCare,IntelliHEALTHONTARIO,DateExtracted:[August10,2010].

OntarioTrilliumFoundation.2010.Profile of the Francophone Community in Essex, Kent, Lambton. http://www.trilliumfoundation.org/franco/PDFs/EKL_Francophone_EN.pdf

Paglia-Boak,A.etal.Drug Use Among Ontario Students, 1977-2009: Detailed OSDUHS findings. (CAMH Research Document Series No. 27).Toronto,ON:CentreforAddictionandMentalHealth.2009.Web.2011. http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/~Detailed_DrugReport_2009OSDUHS_Final.pdf

Paglia-Boak,A.etal.The Mental Health and Well-Being of Ontario Students, 1991-2009: Detailed OSDUHS findings (CAMH Research Document Series No. 29). Toronto,ON:CentreforAddictionandMentalHealth,2010.Web.2011. http://www.camh.net/Research/Areas_of_research/Population_Life_Course_Studies/OSDUS/Detailed_MHReport_2009OSDUHS_Final_Corrected.pdf

Palleschi,Crystal.Lambton County 2007 Health Status Report - Cancer.PointEdward,Ontario:CountyofLambton,CommunityHealthServicesDepartment:2007.Web.2011. http://www.lambtonhealth.on.ca/resources/HSR/PDF/Cancer%20HSR_Released%20November%2021.2007.pdf

Palleschi,Crystal.Lambton County 2008 Health Status Report - Mortality & Chronic Disease.PointEdward,Ontario:CountyofLambton,CommunityHealthServicesDepartment:2008.Web.2011. http://www.lambtonhealth.on.ca/resources/HSR/PDF/Mortality_and_Chronic_Disease_July_2008_Health_Status_Report.pdf

Population: Summary Trends & Projections, Census Years 2006 to 2031. Wyoming,Ontario:CountyofLambton,PlanningandDevelopmentServices:2010.Web.2011. http://www.city.sarnia.on.ca/pdf/Planning/2006DemographicsandProjectionsFINALREPORT.pdf

RapidRiskFactorSurveillanceSystem(RRFSS).2008-2010.LambtonCommunityHealthServicesDepartmentandInstituteforSocialResearch,YorkUniversity.

StatisticsCanada.Nodate.Table105-0501Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2007 boundaries) and peer groups, occasional (table). CANSIM (database). Last updated September 23, 2010. http://www5.statcan.gc.ca/cansim/pick-choisir?lang=eng&id=1050501&pattern=1050501&searchTypeByValue=1.

StatisticsCanada.Nodate.Table105-0502Health indicator profile, two year period estimates, by age group and sex, Canada, provinces, territories, health regions (2007 boundaries) and peer groups, occasional (table). CANSIM (database). Last updated June 29, 2010. http://www5.statcan.gc.ca/cansim/pick-choisir?lang=eng&id=1050502&pattern=1050502&searchTypeByValue=1

StatisticsCanada.Nodate.Table102-0552Deaths and mortality rate, by selected grouped causes and sex, Canada, provinces and territories, annual(table).CANSIM(database).LastupdatedNovember15,2010. http://www5.statcan.gc.ca/cansim/a05?lang=eng&id=1020552&paSer=&pattern=1020552&stByVal=1&csid(accessedJanuary2011).

61

StatisticsCanada.2007.2006CommunityProfiles.2006Census.StatisticsCanadacatalogueno.92-591-XWE.Ottawa.ReleasedMarch13,2007. http://www12.statcan.ca/census-recensement/2006/dp-pd/prof/92-591/index.cfm?Lang=E(AccessedMarch7,2011).

StatisticsCanada.2007b.Place of Birth, Period of Immigration, Sex and Age Groups for the Immigrant Population of Canada, Provinces, Territories, Census Metropolitan Areas and Census Agglomerations, 2006 Census - 20% Sample Data (table). Topic Based Tabulations: Immigration and citizenship.Catalogueno.:97-557-XCB2006019.Ottawa.December4. http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/tbt/index-eng.cfm(accessedMarch8,2011).

StatisticsCanada.2010.Healthy people, Healthy Places: Dependency Ratio.Catalogueno.:82-229-XWEOttawa:MinisterofIndustry.ReleasedJanuary11,2010. http://www.statcan.gc.ca/pub/82-229-x/2009001/demo/dep-eng.htm(accessedMarch8,2011).

StatisticsCanada.2010b.Mortality, Summary List of Causes,CatalogueNo.84F0209X,2007,pages6-7.

Sarnia-Lambton Drug Strategy; Approach to Alcohol and Other Drugs in Our Community.Sarnia,Ontario:UnitedWayofSarnia-Lambton:2007.Web.2011. http://www.theunitedway.on.ca/documents/drugstrategyforsarnia-lambton.pdf

SarniaLambtonWorkforceDevelopmentBoard(SLWDB).2010,November.Non-ParticipantsintheLabourForce.Workforce Focus,5(4).

Top Report, Trends, Opportunities, Priorities [of Sarnia Lambton].Sarnia,Ontario:SarniaLambtonWorkforceDevelopmentBoard(SLWDB):March,2009.Web.2011. http://www.slwdb.org/documents/TOP_2009.pdf

VanDorp,Renateetal.Alcohol Consumption in Lambton County: A Community Profile.PointEdward:CountyofLambton,CommunityHealthServicesDepartment:2007.Web.2011. http://www.lambtonhealth.on.ca/resources/Alcohol%20report/Local_Alcohol_HPPS%20Committee%20Report%20May%202007%20_3_.pdf

62

A P P E n d I X A

k EY I n fo R M A n T S U RV EY - P R I o R I T Y A R E A - M E n TA L h E A L T h P Ro M oT I o nIntro

TheHealthyLivingLambtonaHealthyCommunitiesPartnershipisengagingwithnetworks,communityleaders/membersanddecisionmakerstodevelopaCommunityPicturethatidentifiesrecommendedactionsrelatedto a. TobaccoUseandExposure b. Healthyeating c. Physicalactivity,SportandRecreation d. Mental Health Promotion - Increase resiliency in youth e. InjuryPrevention f. Substance&AlcoholMisuse

Thisprocesswillassistustocreateasharedvisiontobuildahealthiercommunity

1. What do you think are the emerging Needs in our community based on Mental Health Promotion (Increase resiliency in youth)?

2. What programs or services are currently available in our community to support this?

3. What Gaps do you think exist in each of this area?

4. Are there specific types of policies that should be created in our community to address these areas?

5. Do you know of any organizations or agencies that are currently addressing policy?

6. Do you think a representative of your organization would want to be involved in playing a leading role as a member of the HLL Coordinating Committee or join our distribution list to receive updates on opportunities, events, and new developments? If yes, please provide name and contact.

7. Are there any other points that you would like to make?

63

A P P E n d I X b

k EY I n fo R M A n T S U RV EY - P R I o R I T Y Po P U L AT I o nIntro

TheHealthyLivingLambtonaHealthyCommunitiesPartnershipisengagingwithpeoplefromdiversegroupsinourcommunitytoidentifycommunitypriorities/localneedsrelatedto: a. TobaccoUseandExposure b. Healthyeating c. Physicalactivity,SportandRecreation d. MentalHealthPromotion e. InjuryPrevention f. Substance&AlcoholMisuse

Thisprocesswillassistinidentifyingrecommendedactionsthataresupportedbyourcommunitytocreateasharedvisiontobuildahealthiercommunity.

1. Whatdoyouthinkthatthemain issues or needsareineachoftheseareasinourcommunity?

2. Which,ifanyoftheseissues,doyouthinkismost importanttoyouandwhy?

ACommunitymeetingwillbeheldinJanuary2011,todeterminewheretofocusoureffortsinordertocreateahealthierSarnia-Lambton.Ifyouwouldliketobeinvolvedwiththisprocess,pleaseprovideyournameandcontactinformationtobeaddedtoouremaildistributionlist.

64

A P P E n d I X C

L A M b To n Co U n T Y Po L I CY S CA n U P dAT E TA b L E

Municipality Nutrition Recreation & Physical Activity

Active Transportation/ Built Environment

Alcohol Misuse Tobacco

Oil Springs Trailspromotion

Trailspromotion Seekingapprovaltopostsignageforsmoke-freesportsandrecreationareastoprotectchildrenfromsecond-handsmoke

Brooke-Alvinston Amunicipalalcoholpolicywaspresentedtocouncillastyear,butnotadopted

Localpolicyprohibitingcoachesfromsmokingindug-outsforbaseball

Dawn-Euphemia MunicipalAlcoholPolicyisineffect(notnotedpreviouslyinscan)

Plymtom-Wyoming NewMunicipalAlcoholPolicy

Enniskillin Township

Petrolia

Warwick Township UpdatedMunicipalAlcoholPolicy

Point Edward

Lambton Shores DraftRecreationandLeisureMasterPlanreleasedOctober2010

MunicipalAlcoholPolicyisineffect(notnotedinpreviousscan)

St. Clair Township Townshipwebpagepromotesthetrailsystemthatrunsthroughouttheirtownship(activetransportation)http://www.stclairrivertrail.com/

County of Lambton Increasedinterestintrailsystemdevelopmentandconnectivity,andpromotion

LambtonCountyRegionalTrailSystem

OfficialPlanincludesstrongemphasisonactivetransportation.

Smoke-freesubsidizedhousingpolicyineffect(2010)

Appearstobeinterestinmovingforwardonsmoke-freeoutdoorspaces,butnotyetatformallydevelopingapolicy.

65

A P P E n d I X d

Co M M U n I T Y S U RV EY - M I n d Yo U R h E A L T h L A M b To n Co U n T Y

Injury Prevention:

How can we make Lambton County a safer place to live, work and play?

Safetytrainingforeverygrade

Teachhighschoolstudentsaboutworkplacesafety(cpr/firstaid)

Regularinspectionsofplaygroundsandpublicspaces

Playgroundsandsportfieldswelllit

Enforcehelmetuseforeveryone

Allschoolagechildrenshouldlearnhowtoswim

Sidewalksmaintained,clearedsnow,ice

Morecrosswalksandwellpainted

Morewalkingandbiketrails

InstituteBlockparent-neighbourhoodwatchprogram

Ensureparksaremaintained-safeequipment/upgraded-noneedles.Providesoftgroundcoveringsaroundplayareas.

Moresidewalks

Dedicatedbikelanes-clearlymarked

Morecrossingguards

Cyclingprogramtoteachpeoplehowtocyclesafely

Healthy Eating:

What can be done in our community that would allow people to buy healthier food for themselves and their families?

Morecommunitygardens-teachpeoplehowtogrowfood

Increaseaccesstolocalfoodinourgrocerystores

Increaseadvertisingofprogramsavailableinourcommunity-GoodFoodBox

IncreaseFarmersMarketsinourcommunity-throughoutLambtonCounty.Mobilefamersmarket

Offerhealthyfoodchoicesatpublicevents-Bayfestandparks

66

Connectwithtourismtopromotelocalfood:farmersmarkets,etc.

Lobbytoincreasecostof“junkfood”tobecomparabletohealthyfoodcosts

Requirefastfoodrestaurantstopostnutritionalinformationoffoodbyfooditems

Requiregrocerystorestohavehealthyfoodateyelevel,versusunhealthyfood

Removeunhealthyfoodatcheckout

Betterfoodchoicesatschool,work,publicplaces,hospitals

OnlyhealthyvendingmachinesinLambtonCounty

How can we improve “food skills” among members of our community (food skills include: menu planning, food budgeting, grocery shopping, food preparation and cooking)

Offercookingclasses.Developcookingskills

Promotehealthydinnerideas,shoppingonbudget,oncommunityhealthwebsite.Updatetipsmonthly

Educationtochildreninschoolabouthealthyeatingandtoteachchildrenhowtocook,labelread

Mental Health Promotion:

How can we help youth deal with stress and cope with challenging life situations?

Peersupportprogramfacilitatedbylocalagencies,socialworkers,

Leadershipprogramsforyouthinschoolstohelpoutyouth(mentoring)

Createmoreafterschoolprogramming

Counsellorsinschoolsforyouthandoutsideschools(dropincentres)whereyouthplay/socialize

Increasepublicawarenessofmentalillnessthruads.MindYouthHealthsectioninthenewspaper,TVads,andhandoutsatschool

Educationintheclassroomineverygrade(mandatory)toteachkidsatayoungageaboutcopingskills,lifestress,etc

Moreworkshopsatschools/speakers

Bringyouthandelderstogetherforstorytellingaboutlife

Morehouseleaguesportsencouragefunplay,socialinteraction

Help/Hotlineestablished

How can we help adults deal with stress and cope with challenging life situations?

Eachworkplacetohavemandatorymentalhealthworkshopsforemployees

Increaseaccesstolowcostphysicalactivity

Developsupportgroupsforstressmanagement,notjustaddiction

HotlineforfreecounsellinglikeCMHAoffers

Workshops/speakerseries/lunchandlearnsessions

67

Morepromotionaboutmentalhealthissues,radiobroadcasts,TV,printads.Developflyersformail

Increaseawarenessofcurrentserviceagenciesinthecommunity.

Developfacebookaccounttoshareinformation/opinions/services,etc

Callinradioshowformat.Toanexpert(whocouldprovideadviceontheair)

Physical Activity Sport and Recreation:

What could be done in our community that would allow more people to participate in recreational and physical activities?

Morecommunitywalks

Offerfreefamilydaypassesforcommunityreccentres/pools/gyms,etc.MorepassesthatareFREE

Freeexerciseprogramsinparkswithfamilyactivities

Exercisestationsatlocalparks

Monthlychallengesinourcommunity-introducenewwaystobeactive.Promotephysicalactivityintoeverydayliving

Outdoorfreerinksforskatingandsummerforballhockey-havevolunteers/adults/seniorshelpteachkidshowtoskate

Offermorerecreationalteams-certaintimeseachweek,samespot

Placestorentequipment-skiing,bikes,canoes,paddleboats,etc

Addmorenaturetrails

Promotionofwhatisavailable-annualmailerteamsevents,etc(LambtonCountyDirectory)

Morewinterprogramming(winterbreakcamps,SaturdayFunDays),Indoorwalkingtrack

Morefreeswims

Taxcreditforadultssimilartochildren

Exercisestationsinthearenaswhenyouaretherewatchingkidsplayhockey

Developaninformationwebsite-easytofindprogramtimes,costs,locations

Openschoolgymnasiumsduringtheeveningsorsomeweekends

Mallwalkersprograms-morepromotionandmoreorganizedandFUN!

Selfguidedorgroupdirectedwalkingtourshighlightingthehistoryoftheareas

What changes can we make in our community that will make it easier to get from place to place while being active (e.g. biking, walking, inline skating)?

Walkablesidewalks(bettermaintained)sidewalkswithdipsforstrollers,wheelchairs

Morebikelanes/multi-purposelanes

CloseFrontStreettotrafficonweekends.Novehiclezonesforsomeevents/activities

Betterbusroutes-accessibility.Morebussing

68

Sidewalksoneverystreet-betterlighting.

BetterpromotionofSarnia’sbikerakeprogram

Availabilityofbikes-rentabikeprogram-refurbishesbikesforkidsunder12

Moretrails-lightingontrails

Streetsdesignedwithbikinglanesandclearlymarked.ChargeayearlybikingfeetoimprovepathsConnectwithserviceclubs,localbusinessestohelpsupport

Morebikeracksoutsidecommunityestablishments

Cleansidewalksofsnow

Crosswalksigns.Bettermarkingforcrossings-morepaint!

Free/discountedbusservicetoparks

Establishbikeroutesthatconnect-scenicroutethroughoutthecityandpromotetotourism

Substance & Alcohol Misuse:

How can we prevent youth from using alcohol and other drugs? How can we involve youth in these prevention strategies?

Peertopeerpresentations.Storytelling,sharingexperiencesfromthosethatbeenchangedbyalcoholanddrugmisuse.Olderadultseducatingyoungeryouth

Educationearly-assembliesatschoolsguestspeakerswhoarerecoveringaddicts.Videosinschools

Mandatoryseminarforallgrades(8).Smallgroupstoallowdiscussion

Affordable/freeactivitiesforyouth/freesportsprograms/afterschoolprogramming

Mentorsintheschooltosupportyouth

Localindustrytosupportcompetitionforschoolstodevelopthemosteffectiveantidrugalcoholorsmokingvideo(YouTube)

Morecommunityeventsthatarealcoholfree

Moreyoutheventsforyouth-youthnightSarniaStinggames(reduceprice)

Youthforumtogetinput

Educationtoparents-howtotalktoyourkidaboutdrugsandalcohol

Graphicimages(liverdamage)

Haveyouthwritearticlesinlocalmediaonconcernsofalcoholanddrugs/troublewithit

Morefungatheringplaceforyouthtohangoutalcoholanddrugfree-socialactivities

EducationtodoctorshandingoutPercocetandOxycotinforpainrelief-overprescribingdrugs

Youthcoalitiontoaddressthepreventionandusageofalcoholandotherdrugs

Moretreatmentfacilities

69

Regular-randomdrugsearchesatschool

Websiteforyouth-linktosupport

Increaseawarenessofexistingprograms

Counsellorsinelementaryschoolaswellashighschool

How can we prevent adults from misusing alcohol and other drugs?

Detoxfacility.Bettertreatmentcentres

EducationtoDr’soverprescribingpainreliefdrugs

Promotionalmaterialsinworkplaces

Peersupport

UsetheRIDEprogrammoreextensively!Notjustonholidays

Morecommunityactivitieswithnoalcohol-FirstMondayisagreat

Moreyouthfocusforstrategiestopreventolderadultissues/abuse

Alcoholfreedriverprogram

Nonalcoholdrinksforfreetothedesignateddriver

Morerehabprograms-increaseavailabilityofcounselling

Tobacco Use/ Exposure:

What ideas do you have to create more tobacco-free spaces?

Bansmokinginallpublicspace(Bylaws)parks,beaches,arenas,outdoorrestaurants,fleamarkets,parades,racetracks,zoos,etc

Nosmokingatbusstops

Increasedistanceofsmokinginfrontofdoorways.

Laws-nosmokingkidssportactivities

Enforcingcurrentbylawentrancesfornonsmoking-actuallyhandoutfines

Putupsigns“Nonsmoking”.Developcatchysigns-Oxygenneededhere,YoungLungsatWork

Getyouthinvolvedinchallengesandcleaningupsmokingareas

What do people need to help them quit smoking or no longer use tobacco products (i.e. chew)?

Supportsystem

Freequitsmokingproducts(nicoret,patches)

Education/Awareness-howtoquit,dealwithwithdrawal,programs

Doctorsupport

70

Freecounselling

How can we better educate the public about the risks of tobacco use?

Teachingyouthearly-educationinschools(pamphlets,speakers)

Campaigns-graphicimagesaffectsoftobacco

Seminarsinworkplaces

Educatepeopleonmethodsforquitting,options,wheretogoforhelp

Focusededucationonpregnantwomen-emphasizingtheeffectsonadevelopingbaby