Community Conversations Spring 2010

Guysborough County Antigonish Town and County

Strait RichmondCommunity Health Boards

Presentation Staying Healthy Together, April 7, 2011

Planning Process

• Gathering information through community engagement

• Workshops to develop the plan

• Identify Strategic Directions and Recommendations

• Develop CHB Operational Plans

How did we engage the community?

• Community Conversations

• Understanding Our Health Survey

• Presentations from GASHA Departments and Community Agencies

• Direct links to community organizations and coalitions

• Reviewed other information and relevant reports

Community Conversations - Purpose

• Provide information and discussion on important health issues

• Identify factors affecting health

• Identify and prioritize the serious health issues

• Identify some ways to address health issues

• Identify effective communication strategies

Community Conversations

• 40 Focus Groups held across the district – 36 reports

• 344 participants

• Included geographic communities as well as specific populations: youth, young families, seniors, African Nova Scotians, Acadian/francophone and First Nation communities, the business sector, and community agencies.

Lack of Physical Activity - 50% (18/36)

For Youth, Seniors and Young Families • Access to motivational fitness and wellness leaders (ATC; SR)• Organized recreational activity in local communities (SR; ATC;

GC);• Leadership by those responsible for recreational activities (ATC);• Young people need more physical activity (ATC; SR); • Safe walking routes for seniors (ATC);• Accessible, affordable, local, and age appropriate programs and

facilities, including attention to the needs of seniors (SR);• Equipment, education, and some organized fitness programs

Introduce equipment better and at younger age (GC).

Poor Nutrition – Obesity: 78% (28/36)

• Poor nutrition, unhealthy eating, poor eating habits (ATC; SR; GC);

• Lack of awareness of healthy food choices (GC.);• Need good reliable information and knowledge of community

gardens (ATC; GC); • Easy access to junk food and convenience foods (ATC; SR); • Use of technology encourages inactivity and bad eating habits

(ATC; SR);• Lack of access to healthy food choices (GC).

Need for Prevention & Wellness: 39% (14/36)

• Need prevention and wellness activities in our communities (SR; ATC);

• Need for awareness and education about benefits of changing lifestyles (GC);

• Need more focus on relationship between physical activity and wellness (ATC).

Need for Supportive Environments: 39% (14/36)

• Need support systems and motivation to facilitate understanding that change is required (GC);

• Need support from friends, family, and extended family; for example, not giving kids unhealthy food. (GC.);

• Need to support and motivate youth (GC.);

• Need increased workplace wellness, physical activity opportunities at work, and support for employees and employers; for example a tool kit for employers (SR).

Addictions & Substance Abuse: 56% (20/36)

• Drugs, alcohol and gambling, both youth and adults (SR); • Drugs, smoking, alcohol concerning to youth (ATC); • Many adults are smoking and using drugs and alcohol (GC); • Access is easy for youth. Adults help youth get drugs, alcohol

and cigarettes (GC);• People have multiple addictions (GC);• High percentage of youth in school smoke (GC); • Smoking an issue, especially with young families (ATC); • Peer Pressure – youth want to fit in (GC); • Starting younger in usage (GC); • Lack of enforcement by police for smoking underage (GC).

Chronic Disease: 50% (18/36)

• In all three CHB areas, diabetes identified as a health issue; including, African Nova Scotians and First Nations communities.

• In the Guysborough County CHB area, cancer, and heart disease were also identified as priority health issues.

• In Antigonish County, cancer was identified as the top priority health issue by one focus group.

Factors Affecting Chronic Conditions

• Lack of physical activity

• Obesity, poor diet and lack of awareness of healthy food choices

• Mental health issues, such as stress

• Drugs, drinking and smoking

• Lack of education and information

• Access to services and transportation

• Lack of supports, programs and isolation

• Lack of motivation; people have difficulty making changes

• Economic issues, low and fixed income; high cost of healthy food and drugs

• Pollution

Mental Health – 58% (20/36)

Factors Contributing to Mental Health • Isolation and loneliness, particularly for elderly in rural

communities;• Stress and time management for students and young families; • Relationship between mental health and having a chronic

condition; • Other factors such as economic stress, relationship issues,

racism, stereotypes/stigma, low literacy, lack of physical activity, and family history.

Mental Health – 58% (21/36)

Access to Services• Lack of self awareness about mental health status and

conditions, hence the need for “mental health literacy;”• Lack of awareness about services available;• Stigma remains a barrier to accessing mental health services; • Need for more community-based programs, support and self

help groups;

First Nations Communities• Report mental health as a major health issue. Discharge

planning is of particular concern. • Memorandum of Understanding (MOU) - mental health one area

outlined for action

What We Heard from our Consultation - Access

Key challenges:

• Growing seniors population requiring supportive environments

• Homecare requires improvements

• Public transportation

• Better access to health information and services & programs

• Community-based services & programs closer to home

• Continue to improve services to communities that have been historically excluded and marginalized

• Implementation of Dr. John Ross report will require full community consultation and attention to recruitment and retention of staff.

Seniors – Supportive Environments 39% (14/36)

• Growing Aging Population

• Homecare

• Elder abuse

• Poverty

• Cost barriers to programs & services

• Lack of communication & awareness about services & programs

• Adequate, affordable housing

• Rural transportation

• Safe places for walking & physical activity

• Housing supports for snow removal, lawn mowing, etc.

• Isolation: support systems for elderly and caregivers; smaller families and people moving away.

Access to Homecare

• Gap in supportive care upon leaving hospital and returning to home (ATC);

• Cost of and access to adequate caregivers which would allow seniors to stay in own home (ATC);

• Need support systems for elderly and their caregivers (SR; ATC);

• Home care services received are very limited and need to be expanded (SR);

• Housing supports for seniors and individuals living by themselves for snow removal, lawn mowing etc. (SR).

Transportation – 58% (21/36)

Antigonish Town & County CHB area: • Affordable and accessible transportation - over ½ of focus

groups. Lack of rural transportation, especially for seniors.

Strait Richmond CHB area, • Affordable transportation – in particular lack of access to

services

Guysborough County CHB area - one of priority health issues • Lack of transportation to appointments, clinics and education

programs as well as lack of access to programs and facilities. • African Nova Scotian community of Lincolnville - lack of public

transportation major issue in accessing services and programs as many residents do not have cars.

Communication and Engagement 47% (17/36)

• More information about community programs & services in local communities (GC; SR; ATC);

• Access to health information (AC; SR; GC)

• More promotion on what to do to improve health (SR).

• Suggestions to promote programs and services: brochures in communities; information on internet and website; CAP sites to have safe health links; pamphlets available on reliable health links; promotion of the 811 service. (GC; SR; ATC);

Supportive Environments for Young Families: 28% (10/36)

• Child and parenting supports

• Child care in order to access programs

• Locally organized recreational activities

• Isolation and stress - many young mom’s are on their own – ‘single moms’ while partners are working away

• Need to keep young families in our communities through support for economic sustainability

Community-based Services/Programs 83% (30/36)

• Chronic disease programs/self help groups, support programs (ATC, GC, SR)

• Health education (ATC, GC, SR)

• Screening programs - monthly clinics (ATC, GC, SR)

• Outreach health and wellness programs (ATC, GC, SR)

• Expanded hours at existing walk-in clinic; more walk-in clinics and clinical services, youth health centres (ATC, GC, SR)

• Community gardens; good nutrition, meal preparation, healthy meal planning (ATC, GC, SR)

Health Inequities Physical & Built Environments: 22% (8/36)

Strait Richmond CHB area:• Safe drinking water; particularly well water; education about

water testing; cost for well water test can be a barrier to testing.

Guysborough County CHB: • Education and better information about well water testing and

how the test works. • Lincolnville identified insufficient water supply as one of their

priority health issues.

Strait Richmond and Antigonish Town & County CHB areas• Safe areas for walking, particularly those living in rural areas.

Health Inequities – Poverty/Income 39% (14/36)

In all three CHB areas, poverty identified as a factor affecting health and linked to a number of other factors as follows:

• Food security and ability to buy nutritious food;

• Ability to access to services due to lack of transportation, especially in rural areas;

• Adequate and affordable housing;

• Ability to access recreation opportunities;

• Ability to participate in programs due to cost barriers;

• Access to prescriptions due to costs.

What We Heard from Consultation: Youth (7 gps)

• Most common health issues: (1) mental health (2) drugs, smoking and alcohol; and (3) obesity.

• Need places for youth to gather – youth health centres & after school recreational and social activities

• Affordability & transportation in rural areas critical to engaging youth

• Need to improve physical activity levels

• Healthy eating/obesity need to be addressed

• Readiness for change to improve health and wellbeing - identified factors to help increase physical activity levels

• Reseau Sante – Nouvelle Ecosse youth focus groups similar issues

Strategic Directions

1. Strengthening & Supporting Mental Health in Our Communities

2. Implementing a Comprehensive Community-based Chronic Disease Strategy

3. Promoting & Supporting Healthy Living

4. Building Bridges to Youth Health

5. Facilitating Access to Services & Programs

6. Addressing Inequities to Improve Health

7. Promoting Communication with Communities & with GASHA

8. Enabling Health Planning & Coordination

CHB Focus Group Conclusions

• Results reinforced issues from Understanding Our Health Survey

• Multiple factors contribute to health of populations (seniors, youth, those living in poverty)

• Access and health inequities critical to address in rural areas

• Need to consider determinants of health and health inequities in delivery of all services

• Need to focus on youth as our most critical health promotion and prevention strategy.

• Recommendations: community-based and collaborative services will ensure more wholistic approach to improving health

Thank you!

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