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Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

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New Resource: Tools for supporting local action to reduce alcohol-related harms – Policy options and a resource inventory to support alcohol policy in Ontario

Submitted by Tamar Meyer, CAMH Resource Centre and Ben Rempel, Public Health Ontario

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Research evidence indicates that alcohol policies are effective measures in minimizing harms related to alcohol and can occur on both a large-scale (e.g. national/provincial policy) and a small-scale (e.g. municipal/community-based policy1) . Alcohol-related harms can often be seen at the local level - disorderly behaviour, public drunkenness, under-aged drinking, violence, addiction, criminal activity, and injuries. These harms directly affect our communities as they involve our neighbourhoods and roads, our sense of safety and wellbeing, our children, families and friends. Local problems are addressed by developing specific solutions to local alcohol issues and are best done in alignment with provincial and national alcohol policy initiatives.

Public Health Ontario and the Centre for Addiction and Mental Health (CAMH) Resource Centre have partnered on the development of a resource aimed at increasing awareness of and access to evidence-informed tools and resources regarding local/regional alcohol policy in Ontario. This resource also aligns with recommendations stemming from the Alcohol No Ordinary Commodity forum, specifically that: "Work can be done locally to build momentum towards an alcohol strategy: Initiatives include developing regional alcohol management strategies, creating and/or updating municipal alcohol policies, pressing for strong regulatory controls on alcohol, actively supporting alcohol-related health resolutions, and implementing proven interventions ..."2

Tools for supporting local action to reduce alcohol-related harms: Policy options and a resource inventory to support alcohol policy in Ontario consists of two tools which are intended to assist Healthy Communities Partnerships and public health stakeholders in the prevention of alcohol-related harms in their communities through increasing awareness of and the development of healthy public alcohol policies.

This resource contains a Policy options table based on the seven policy approaches identified by Babor et al.3, and is broken down into two levels. The first level identifies the evidence-informed local policy strategies that have been adapted primarily from the Centre for Addictions Research of British Columbia resource, Helping Municipal Governments Reduce Alcohol-Related Harms4 and Alcohol: No Ordinary Commodity – Research and public policy, second edition5.

The second level identifies evidence-informed local actions that municipalities, communities and local stakeholders can take to reduce harms related to alcohol in their communities.

The second part of this resource is the Resource inventory which was developed as a companion to support the implementation of identified strategies and actions. Organized according to level of government involved in policy development, the inventory includes a summary of evidence-informed tools as well as examples of existing drug strategies, pertinent publications and other resources to help inform local stakeholders with the development and implementation of local alcohol policy.

We want to hear from you!

This first phase of the inventory is being launched as a working document and will continue to evolve over time. With your feedback, we will be able to ultimately offer a robust, evidence-informed compilation of tools and resources to support the development and implementation of local alcohol policies. In order to ensure that this resource is relevant at a local level, we welcome and invite your feedback regarding usability, gaps, success stories in developing and implementing local alcohol policy, along with additional tools and resources you are aware of. Specifically, we are interested in:

What other Ontario-specific policy-related tools or resources do you know of or have developed that can help communities/municipalities prevent or reduce harms related to alcohol?

What kinds of local alcohol policy activities and/or initiatives have you, your Public Health Unit, Healthy Communities Partnership, municipality/community been involved with?

To suggest a new tool or resource or for any questions or comments, please contact Tamar Meyer at This email address is being protected from spambots. You need JavaScript enabled to view it. or Ben Rempel at This email address is being protected from spambots. You need JavaScript enabled to view it..

 

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1Centre for Addiction and Mental Health. (2004). "Alcohol Policy Framework for Reducing Alcohol-Related Problems" Centre for Addiction and Mental Health, Toronto.

2Rempel, B. July 20, 2012. Alcohol Policy in Ontario: The importance of on-going dialogue and discussions. Ontario Health Promotion E-Bulletin. 

3Babor, T., Caetano, R., Casswell, S., Edwards, G., Giesbrecht, N., Graham, K., et al. (2010). Alcohol: No Ordinary Commodity - Research and Public Policy. 2nd ed. Oxford: Oxford University Press.

4Centre for Addictions Research of BC (2010). Helping Municipal Governments Reduce Alcohol-Related Harms. Accessed March 16, 2012.

5Babor, T., Caetano, R., Casswell, S., Edwards, G., Giesbrecht, N., Graham, K., et al. (2010). Alcohol: No Ordinary Commodity - Research and Public Policy. 2nd ed. Oxford: Oxford University Press.

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Fairness in Policy

Last week I had the pleasure of attending the prestigious Hastings Lecture, named for Toronto's first Medical Officer of Health, Dr. Charles Hastings. The event was moderated by the current Medical Officer of Health, Dr. David McKeown, who introduced Sir Michael Marmot as a "health equity rockstar." The title is a fair for the man who is currently Director of the Institute of Health Equity and a Professor in Epidemiology at University College, London, UK. Sir Marmot is best known for his work on the Whitehall II study, as well as leading the World Health Organization's Commission on the Social Determinants of Health. Like the rest of the 350-person crowd I sat captivated, only breaking to laugh at Sir Marmot's well-delivered jokes – or at the panel's comments on local politics.

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Sir Marmot opened with the bold statement that "social injustice is killing on a grand scale." He asserted that a society's success can be judged by the health of its population. Governments, however, tend to focus on only lowest end of the gradient in society, even though health inequality affects all of us. A health system for the poor is a poor health system. Sir Marmot stressed that while inequality exists on a national level, it can also be seen within the same city. In Glasgow, the life expectancy differs by as much as 28 years in different neighbourhoods. In the small town of Lenzie, the average male life expectancy is 82. In the district of Calton, the male life expectancy is only 54 years of age.

To counter this imbalance, Sir Marmot suggested that all ministers operate as ministers of health - as is the practise in Norway, where health performs as a social accountant. Governments should focus on policies which increase the standard of living for all:

  1. Give every child the best start in life.
  2. Enable all children, young people and adults to maximise their capabilities and have control over their lives.
  3. Create fair employment and good work for all. (Marmot shared some disturbing statistics about unemployment and the damaging effects of health – and on economics)
  4. Ensure healthy standard of living for all.
  5. Create and develop healthy and sustainable places and communities.
  6. Strengthen the role and impact of ill health prevention.

Individuals can only be responsible (and be held responsible) when they have the conditions to do so. Fair policies create the necessary conditions. Fairness should sit at the very core of health policies. Ever the evidence-based optimist, Sir Marmot closed his lecture with words of encouragement, "Dream of a world where social justice is taken seriously. Then take the pragmatic steps necessary to achieve it."

Following the inspirational lecture, Sir Marmot was joined in discussion by Dr. Kwame McKenzie and Dr. Charles Pascal. Dr. McKenzie, the director of the Canada Institutes of Health Research Social Aetiology of Mental Illness Training Centre and a senior scientist of Social Equity and Health Research at the Centre for Addiction and Mental Health, used John David Hulchanski's theory of the three Torontos to draw local relevance to Marmots remarks. Dr. Pascal, a professor of Human Development and Applied Psychology at OISE/University of Toronto, bemoaned short term thinking about policy, and advocated for policies with "teeth."

 

Resources:

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Good Ideas for Making Policy Succeed

Last Thursday, I joined roughly 200 policy wonks during a "lunch and learn" event with the Maytree Foundation's Five Good Ideas series. For each session, Maytree invites a different expert to share five practical ideas, and to discuss how these thoughts can be put into action. Sherri Torjman, vice-president of the Caledon Institute, presented the final session in the current series.

Sherri, drawing on her background in poverty eradication and disability issues, shared that the purpose of policy work is to improve the quality of life for all citizens. Policy work aims to effect change, in the public interest. Policy work promotes the inclusion of those who are under-represented in a community.

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Policy development is a critical area for HC Link's clients. Last year, approximately 10% of our consultations concentrated on policy development. Even consultations that do not focus on policy work often have a small policy component.

I was reminded of some of HC Link's recent work as Sherri shared her thoughts. Earlier this year, HC Link worked closely with an elderly-friendly village initiative, which was having difficulty implementing an action plan that was developed several years prior. The village's aim is to improve the quality of life for elderly citizens by providing an inclusive and secure environment that encourages a vibrant and enriching life. HC Link was able to provide training sessions, which addressed motivation of volunteers in the development of community projects, how to recruit volunteers, how to access resources, and how to influence health promotion policies.

Sherri's good ideas hold true not only for policy work, but community work in general, and the principles can (and have been) applied to HC Link initiatives.

1. Trust your knowledge. In this case, our consultant Estelle Duchon's expertise in engaging Francophone communities was extremely valuable in revealing the community leaders' needs.

2. Dream big. Big ideas mean big results. As a partner mused "Crazy ideas are ideas that are destabilizing at first, but end up making a difference. They serve as a trigger in the community."

3. Go the extra mile. Implementing an action plan seemed particularly challenging to the involved committees. In order to ensure progress, they contacted HC Link for assistance.

4. Hold that thought. Timing is essential. Sometimes it's worth waiting for a ripe opportunity. In this case, the community was able to implement an action plan after several training sessions which equipped them with the right knowledge and tools for action.

5. Find your Karasima. Find inspiration in your work. In Sherri's case, it was a comment from Karasima, a women on crutches, which validated Sherri's work. In Noëlville and Verner, it meant understanding that addressing seniors concerns also meant addressing the needs of other vulnerable populations, such as children and people with disabilities.

HC Link has delivered webinars and created educational resources involving policy development. We also have a resource bank with a wide variety of relevant readings.

Selected resources include:

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