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PUBLIC HEALTH’S MAIN PARTNERS

MUNICIPALITIES The City of Montréal, its 19 boroughs and 14 linked cities are involved in land-use planning and regulations. They can also intervene in such key areas as eating habits, physical activity linked to transportation and recreation, air pollution, road accidents, affordability and access to housing.

DAYCARES AND SCHOOLSClose to 70,000 preschool-aged children attend early childhood daycare services. Montréal has 5 school boards, 400 elementary schools and 200 high schools. Schools and daycares can contribute to personal and social skills development, adoption of healthy lifestyle habits, as well as prevention of health risks such as injuries and infections.

COMMUNITY GROUPS Community groups provide front-line outreach services focused on living conditions; their services especially target vulnerable groups. They offer information, social support and assistance. Community groups play key roles on various community development consultative bodies.

WORKPLACES The Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST) is a major partner in matters of prevention in workplaces where individuals may be exposed to various risks. Those settings can also engage in the promotion of healthy lifestyle habits.

HEALTH AND SOCIAL SERVICES Professionals from the CIUSSS, the five non-merged institutions, and those providing front-line services (in clinics, family medicine groups, community pharmacies or dentists’ offices) help deliver preventive services such as follow-up for pregnant women, vaccination, smoking cessation or infection control in hospitals. They can detect threats, for example, by reporting sanitation problems, infectious diseases or poisonings.

Montréal Integrated Regional Public Health Action Plan Summary

Produced by Direction régionale de santé publique du CIUSSS du Centre-Sud-de-l’Île-de-Montréal, 2017

By targeting prevention, Montréal’s regional public health department and five integrated university health and social services centres (CIUSSS) are signifying their commitment to invest over the long-term in improving the health of Montrealers.

Prevention focuses first and foremost on the most common and severe preventable problems.

Some groups, such as young people, minorities and disadvantaged individuals, are disproportionately affected by some of those problems.

The Integrated Regional Action Plan describes public health interventions related to 30 priority determinants, or factors, that influence the onset of these problems. For example,

• individuals’ behaviours and lifestyle habits,

• characteristics and risks associated with these people’s living environments as well as their physical and social environments, and

• their use of available preventive services.

The determinants are categorized according to four action areas defined in the Québec Public Health Program:

Children’s and teens’ overall development

Adoption of healthy lifestyles and creation of safe and healthy environments

Prevention and control of infectious diseases

Management of health risks and threats, and emergency preparedness

The success of public health interventions largely depend on the collaboration and involvement of its partners. For this reason, decision makers and stakeholders from all sectors who have the power to act on determinants of health are called upon to get involved.

To access documents related to Montréal’s Integrated Regional Public Health Action Plan (PARI-SP), go to

dsp.santemontreal.qc.ca/PARI

20162021

CHILDREN’S AND TEENS’ OVERALL DEVELOPMENT

Many problems that can have lifelong consequences are preventable. They include prematurity, congenital malformations, growth retardation, infections, overweight, diabetes, traumas, dental health problems, psychological distress, addictions, difficulties at school and dropping out, delinquency, and alcohol and drug abuse.

In addition to providing preventive services for pregnant women, families, children and teens, public health also works to promote environments, lifestyle habits and interpersonal relationships that are conducive to healthy development.

In Montréal

1300 low-weight babies are born every year; 33% of children in kindergarten are considered to be vulnerable in at least one domain of development; 20% of high school students show signs of psychological distress.

ADOPTION OF HEALTHY LIFESTYLES AND CREATION OF SAFE AND HEALTHY ENVIRONMENTS

Living environments have an influence on lifestyle habits, behaviours and social relationships. When it comes to diet, the practice of physical activity, smoking, alcohol and drug use, and gambling, people’s lifestyles are determined by the choices available to them. Physical and built environments might also be sources of exposure to harmful risks, such as unsanitary public housing and buildings, air pollution, contaminated water or soil and contaminants in workplaces.

While offering various preventive services to help people who want to change their lifestyle habits and behaviours, public health favours interventions designed to change environments so as to have an impact on all Montrealers.

In Montréal

148,000 adults suffer from diabetes; 2000 pedestrians and cyclists are injured in road accidents every year; 40% of renter households live in homes where there are sanitation problems.

INFECTIOUS DISEASE PREVENTION AND CONTROL

Infectious diseases are caused by biological agents such as bacteria, viruses and parasites; they can be grouped into two broad categories:

1. Diseases for which there are vaccines that create immunity against the infectious agents; 2. Diseases for which there are no vaccines, but that can be prevented by blocking exposure to infectious agents transmitted from person to person or that are in the environment.

Public health acts on both fronts to reduce the frequency and consequences of those diseases among the population.

In Montréal

In 2015, 175 new cases of HIV were diagnosed, as well as 118 cases of tuberculosis and 1500 cases of enteric infections.

MANAGEMENT OF HEALTH RISKS AND THREATS, AND EMERGENCY PREPAREDNESS

The public health department is responsible for protecting the health of Montrealers when there is a threat, and works in close collaboration with other professionals from health and social services. Public health must frequently assess various health risks and, if needed, intervene quickly with individuals, groups or the population as a whole. When dealing with major emergencies, it must be ready to act at all times, in collaboration with its partners from various sectors of society.

In Montréal

12,500 cases of notifiable disease are reported yearly; episodes of extreme heat or extreme cold can occur, as can epidemics such as influenza A(H1N1).

SURVEILLANCEPublic health monitors the health of Montrealers, identifies priority issues, and documents disparities between various territories or population groups. Surveillance results are used to improve public health interventions, inform the population, guide partners’ actions, and promote public policies that foster health.

Note – The magnitude of partner involvement is represented by the size of the dots.

Determinants

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1 – Children’s and teens’ overall development

Preventive perinatal and early childhood services

Breastfeeding

Family environment

Quality educational daycare services

Dental health habits of 0- to 17-year-olds

Preventive dental services for children

Specific preventive services for teens

Teens and interpersonal violence and bullying

Teens and romantic relationships and sexuality

2 – Adoption of healthy lifestyles and creation of safe and healthy environments

Diet

Physical activity, safe active transportation and sedentary lifestyle

Smoking and exposure to tobacco smoke

Alcohol and drug use, and gambling

Healthy and affordable housing

Healthy institutional settings

Exposure to risks in the workplace

Exposure to extreme heat

Exposure to noise and outdoor air pollution

Exposure to risks in the air, water and soil

Community suicide prevention services

Clinical chronic disease and fall prevention services

Social participation of older people

Empowerment of local communities

3 – Prevention and control of infectious diseases

Vaccination services and vaccine coverage

STBBI prevention and treatment services, and drug-related harm reduction

Tuberculosis prevention and treatment services

Exposure to risks of infection in healthcare settings

Exposure to risks of infection in the environment and living environments

4 – Management of health risks and threats, and emergency preparedness

Health protection and risk monitoring, investigation and evaluation services

Major emergency preparedness and response