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Welcome to HC Link's blog! Our blog will provide you with useful information on healthy community topics, news, and resources, as well as information on HC Link’s events, activities, and resources. Our bloggers include HC Link staff and consultants, as well as our partnering organizations, clients, and experts in the health promotion field. Please note: opinions in posts are those of the author and are not necessarily the opinions of HC Link or our funder.

We look forward to engaging in thought-provoking conversation with you!

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Setting Priorities: How do we decide what to do?

Andrea Bodkin, HC Link Coordinator

As soon as I hear the term “priority setting” my mind jumps to the tools or processes we can use to determine priorities. Dot-mocracy, anyone? But in doing some research on this topic to prepare for an upcoming consultation, I was reminded that there are a few more things that go into priority-setting than simply picking out the options that sound good.

Why set priorities?

First of all, setting priorities allows us to focus our efforts on what we can realistically achieve that will have impact. Otherwise, all issues seem important and we end up overworked, under resourced and run the risk of not accomplishing our goals.

In my opinion, a very critical step here is to make sure that you have a solid sense of what it is the group wants achieve together. It could be a vision statement, a goal, a mandate or a strategic priority- it doesn’t matter too much what you call it- it matters that the group has agreed on some kind of a statement of purpose that answers the question “what is it that we want to ACHIEVE as a result of our work?” This statement becomes an important touchstone that should help guide you in all decision-making moving forward.

At the prioritizing stage in the process, the community group/organization has already engaged in some research and planning conversations, and has identified or brainstormed a range of options for activities, initiatives or programs to pursue. Now it’s time to move from “blue sky thinking” to what the group can realistically achieve together.

How do we set priorities?

This excellent article from Health Promotion Capacity Building Services (HPCB) at Public Health Ontario (formerly THCU) outlines a simple, 3 step process for setting priorities BEFORE you begin:

  1. Identify criteria on which to compare options
  2. Select processes to vote/score/rank
  3. Clarify roles/ processes to make the final choice

Identify criteria

As a group, determine what criteria you’ll use to compare options and make decisions about what initiatives/activities/programs the group will move forward with. For example:

Fit with mandate/vision Urgency
Resources required Feasibility
Impact Reach
Importance Community need

This step allows us to identify how we’ll know what’s important. Otherwise we risk using the “ooooh sparkly thing!” method of prioritizing, which means we drop whatever we’re doing in favour of the new, shiny thing.

Select process to vote

Once you have your criteria, it’s time to talk tools. The tool you select will depend on the nature of your work, the type of group you’re working with and the time you have for the exercise.

Dotmocracy is a multi-voting technique. In its simplest form, you provide participants with one to three dots (usually stickers) and invite them to place a dot beside their top one to three options.

Paired comparisons is a snapshot process to be used with small to mid-sized groups to help narrow options further after dotmocracy.

Quadrant analysis is useful if you have two clear criteria upon which to make a decision (for example, effort and impact), and those two criteria can be qualified in a dichotomous way (for example, high versus low). The use of specific criteria means it is a slightly more rigorous and time-consuming method than the two previously described methods.

Grid analysis is useful when you must or might have to defend your program decisions with ample evidence. Also known as a decision matrix analysis, it is a great process for when you have many criteria.

Clarify roles/processes

At some point in time (hopefully, at the end of this process) the group is going to make a decision about how to move forward. It’s important to outline - before you actually begin your decision-making process - the roles and expectations of the group. For example, is the group making the decision, or are they making a recommendation that is going to another power authority? Is there someone in the group that has decision-making power?

Go forth and make decisions

Now that you have your vision, you’ve identified options and you’ve determined how to identify your priorities, you can go forth and start to make decisions as a group. Warning: this can be a slightly messy process. Acknowledge that this can be tricky, and create an open space for people to share their opinions and ideas. Having an external and neutral facilitator can be very helpful.

Good luck!

Resources

Setting Community Priorities Presentation. HC Link 2010

Priority Setting- Four methods for getting to what’s important. OHPE Feature article 2010

Priority Setting Process Checklist. PHO 2011

Focus on What’s Important. County Health Rankings & Roadmaps

Do you have tools, resources and/or experiences to share? Use the comment box to tell us your ideas!

 
 

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Election Talk – Why Health and Wealth are Inextricably Linked

A recent Ipsos poll asked Canadians what issue areas they felt party leaders should have a very clear plan on. Unsurprisingly, party leaders’ plans for the economy was a top issue that Canadians said they would consider before casting their ballot, but tied for second were “creating jobs” and “addressing the problems facing Canada’s health system”.

Although the economy scored first in the poll, and healthcare second, the two are inextricably linked. This week, the Toronto Star published a great opinion piece by Alex Munter about the importance of considering healthcare and economy together in the context of an upcoming federal election. We all know that healthcare has significant costs on government spending, but some of the points Munter made really made me realize that healthcare policy really is a bigger issue than party leaders are giving credit for.

Munter argues there are “worrisome signs that this generation might become sicker adults, not healthier, than us”. For example, if current trends continue, obesity, mental illness, and premature births will cost Canada $35.5 billion, $423 billion, and $27.8 billion over the next 10-20 years, respectively. I knew that mental health in Canada was a growing concern, but I had no idea that it has the potential to cost the country a whopping $423 billion. If 70% of today’s children really will be overweight or obese adults by 2040, then we are headed for trouble.

The return on investment for prioritizing healthcare is huge – preventing or delaying the onset of chronic illnesses saves time parents spend on caring for sick children, while promoting higher productivity and lower absenteeism. Further, as healthy youth age into healthy adults, they will be able to remain independent longer if they maintain strong health.

Just as investing in early childhood education has been proven to benefit the economy, a long-term investment in young people’s health today means preventing illnesses and saving tax dollars tomorrow.
With less than 60 days left until Election Day, it will be interesting to see if and how healthcare is presented during the election campaign…

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Fentanyl – A Deadly Drug on the Rise in Canada

A new bulletin published by the Canadian Community Epidemiology on Drug Use on August 11th 2015 reports that deaths from Fentanyl have been rising since 2009 across Canada.

What is Fentanyl?

Fentanyl is a synthetic opiate that is being used increasingly by both recreational and habitual drug users. It is a painkiller in patch form that is prescribed by doctors to patients in severe pain or post-surgery. It is estimated to be 80-100 times stronger than morphine. Doctors generally only prescribe the drug to cancer or chronic pain patients who have previously been treated with other opioids, as they have developed a tolerance to less potent opioids. For patients who have never taken opioids it can be very dangerous.

The drug is used in its original form by drug users, either by chewing the patches or scraping off the drug to smoke or inject it. The drug is also frequently mixed into other drugs being sold on the street such as heroin or cocaine or oxycodone. It is possibly best known as a substitution/imitation of OxyContin.

Fentanyl finds its way into the hands of user via two pathways – through diversion of pharmaceutical products and through importation of illicit pharmaceutical grade Fentanyl or fentanyl like compounds in powder form.

Recent Deaths

With the high cost and decreasing availability of OxyContin Fentanyl is being sold in a pill format and marketed as OxyContin. On August 1st a 17 year old boy died after taking Fentanyl he thought was OxyContin. A young couple in North Vancouver who were recreational users died in July 2015 after inhaling the drug. In injection drug users it is also dangerous; it is cut with heroin, unbeknownst to users, dramatically increasing the potency and risk. According to local police fentanyl was blamed for 16 overdose deaths on Sunday August 9th in Vancouver.

Deaths from 2009 – 2014

CCENDU Bulletin Deaths Involving Fentanyl in Canada, 2009–2014 reports that there were at least 655 deaths between 2009 – 2014 where Fentanyl was the cause or a contributing factor. In addition there were 1019 drug overdose deaths where Fentanyl was cited in the autopsy toxicology report. These results mean that one Canadian is dying of a Fentanyl overdose every three days.

Possible Solutions

The Vancouver Costal Health started the Know Your Source campaign aimed at educating recreational users about the risks of Fentanyl and teaching tips to prevent over dose. There is also a great solution – the drug Naloxone is an opioid antagonist and can be used to reverse the effects of overdose. The drug is easily administered by a doctor, family member or even a passerby.

This drug has the potential to save hundreds of lives and has been used for several years in the US but has been met with opposition in Canada and has not been widely adopted. A recent report Prescription for Life from the Municipal Drug Strategy Co-ordinator’s Network of Ontario urged the government to improve opioid safety and reduce deaths by expanding access to Naloxone. Ontario has had one pilot program that distributed to a limited number of ‘take home kits’ but the drug is not readily accessible. The Network recommends that the drug should be available to all Ontarians at risk for overdose and potential ‘Good Samaritans’ such as parents or friends. It should also be available to workers at in shelters, withdrawal management centers, addiction treatment centers and primary health care settings.

 

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Baby Boomers Are Reaching Retirement – How Will It Impact Senior Poverty?

As Canadian baby boomers reach retirement, how many of these soon-to-be seniors are financially prepared? Born between 1946 and 1965, baby boomers make up 29% of the Canadian population. Many of them have already retired and the youngest of them will reach retirement age in the next 15 years. By 2030 22% of the Canadian population will be over 65.

Canadians are living longer due to advances in medical care and overall quality of life. While returns on stock investments have been poor over the past 12 years and many Canadians many need to work past 65, most Canadians will not fall into poverty as they reach retirement. A new McKinsey report, Building on Canada’s Strong Retirement Readiness, states that 77% of households will be able to maintain their standard of living after retirement. While this is fantastic news and puts Canada well above many other developed countries, this still leaves 23% of households at risk of falling into poverty.

It should be noted this report does not take into account the amount of income it will take seniors to live comfortably in retirement. Some seniors will be relying solely on Guaranteed Income Supplements (GIS), Old Age Security (OAS), and the Canada Pension Plan (CPP).

Who is At Risk?

Two main groups are at risk – middle-high income earners who have not planned and saved for retirement by contributing to RRSPs and personal saving accounts and low-income earners, who have not been able to contribute to RRSP or personal savings and will reply solely on their government pension. Many lower-income and middle income families have not been able to adequately save for retirement. Reasoning behind this include an increasingly consumer lifestyle, labour market inequalities, and changes in family-structure (i.e. many single-parent families).

Women are particularly vulnerable

A new study by economists Curtis and Rybczynski, 2015 found that many female baby boomers are not ready for retirement. Many baby boomer women have a higher education and entered the work force after school but took time off to raise children. This created a rising labour supply but not an increase in demand, resulting in lower wages. Low-wages and their M-shaped career pattern mean that many women have very little retirement savings. These women are left relying on their husband’s petition meaning that divorce or the death of their spouse could leave them at risk of poverty.

According to a report  by the OECD,  senior poverty is increasing in Canada, and the most vulnerable group are single women, especially those who are widowed or divorced.

Senior Poverty

Compared with other OECD countries Canada still has one of the lowest rates of senior poverty but there has been an increase in the past few years. The OECD explains the reason for the disparity in income levels seen in Canadian seniors –

Incomes from capital, including private pensions, represent a larger share: around 42% – well above the OECD average of 18%. As private pensions are mainly concentrated among workers with higher earnings, the growing importance of private provision in the next decades may lead to higher income inequality among the elderly (OEDC, 2013).

A report by Statistics Canada using from the new Canada Income Survey (CIS) shows that 12.1% of seniors 65 and older are living below the poverty line, the rate for single seniors is 28%.

There are significant social safety nets in place for seniors in Canada, which is great – however it is debateable whether they are sufficient to keep seniors out of poverty.

Here is a breakdown of the programs: 

Guaranteed Income Supplements (GIS) – supplement available to low-income seniors


Old Age Security (OAS) – guaranteed pension paid monthly by the government to individuals over the age of 65 who meet the residency requirements. You do not need to have ever worked to receive this.

Canada Pension Plan (CPP) – Government pension plan that is contributed to by employees throughout the lifetime.

If a single individual were to receive the maximum GIS and OAS payments their monthly allowance would be - $1330.80. This is the reason 28% single seniors are living in poverty.

Policy Changes

CARP, a seniors advocacy organization, has called on financial ministers to make policy changes that will increase retirement security and reduce pension reform.

  • Creating a national supplementary Universal Pension Plan (UPP) with reliable, predictable benefits.
  • Eliminate mandatory minimum withdrawals from Registered Retirement Income Funds (RRIFs).
  • Replace OAS and GIS benefits that will be due to increasing OAS eligibility age.
  • Support single seniors, with particular regard to older women, with an equivalent to spousal allowance for single seniors in financial need.
  • Help low-income workers make pension contributions.
  • Consider a national Guaranteed Minimum Income to reduce poverty and replace multiple, complex, administratively expensive welfare programs.

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Racism & Mental Health - Why Andrew Loku's Shooting Matters to Health Promoters

Guest post by Anjum Sultana - MPH Student at UofT's Dalla Lana School of Public Health 

@anjumsultana 

What does it say about Toronto when politicians care more about‪ #‎DeadRaccoonTO than a police shooting?
On July 5th 2015, Andrew Loku, a father of five and an immigrant from South Sudan, was undergoing a mental health crisis when within 2 minutes of police interaction, he was fatally shot by the Toronto Police Service at his apartment building. The same apartment building that has units subsidized by the Canadian Mental Health Association for folks suffering from mental illness.

This is not just some one-off accident or unfortunate incident. Since 1988, over 50% of the deaths by Toronto Police Service of those experiencing a mental health crisis have been Black males. Over the past 26 years, 73% of those in mental distress killed by Toronto Police Service have been non-white. The statistics are staggering yet nothing is being done, the lack of public outrage is deafening.


It's time people wake up and take notice and understand that racism is an issue here in Canada as well. It is in all of our best interests to actively push our public servants to take a race-based lens when creating policy and when people have been vociferously advocating for recommendations, like the African Canadian Legal Clinic, you support them wholeheartedly and take active steps to amplify the voices of others.

Too often we stay in our 'issue bubbles' and fail to see how things are connected and the least we can do to demonstrate our solidarity is to show up - come to the vigil, donate to the fundraiser, discuss these issues with your friends and family, put it on your social media, actually engage in these issues. By not doing so, your silence speaks volumes and tells others, your fellow friends and colleagues that their struggle and fight to survive and be seen in this world, doesn't matter. Don't do that - do something. Show up.

If you have the capacity to, please support Andrew's family and help pay for his funeral. Canadian Mental Health Association and Across Boundaries has set up a funding campaign, so please support!

 

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Is Full Reconciliation with Canada’s Indigenous Peoples Even Possible?

Let me start by saying this: I am embarrassed that I indirectly benefit from the oppression of our country’s indigenous people.

As many know, just over a month ago, the Truth and Reconciliation Commission (TRC) published a scathing report about the impact of 150,000 First Nations, Metis and Inuit children that were forced to attend residential schools for over a century. The TRC found that the practice of residential schools amounted to “cultural genocide”, whereby the Canadian government intentionally destroyed the social and political structures and practices of Canada’s indigenous peoples in an effort to assimilate them. The list of policies by the government which allowed this to happen can be found in the TRC Report’s summary.

Reading about the physical, mental and sexual abuse of residential schools is painful - in some residential schools, the death rate was up to 75%.

What’s even more painful is this colonial history has meant that poverty, unemployment, abuse, and poor health are all rampant in Aboriginal communities today. Aboriginal families have over double the unemployment rate compared to non-Aboriginal families, and over half of First Nations children living off reserve live in low-income families. It comes as no surprise that low-income and inadequate housing is a risk factor that is linked to poor mental health and a disproportionately high number of Aboriginal children in the child welfare system.

Aboriginal people are also almost 9 times more likely than other Canadians to end up in the criminal justice system. As of last month, over one third of all women in prison are Aboriginal, while Aboriginals represent a tiny 4% of the overall Canadian female population. For First Nations children, this has significant implications, as the majority of Aboriginal inmates are parents, and often single parents.

In designing health-related interventions for Aboriginal communities, it is important to keep in mind the historical impact of colonization and trauma. Meaningful engagement with Aboriginal communities requires processes to be Aboriginal-led, where Aboriginal communities have decision-making authority. It is also important to recognize holistic approaches rooted in Aboriginal culture, which hold that, “Aboriginal people live and grow in families and communities with needs that span the full spectrum of spiritual, mental, physical, and emotional realms”. These are just a few of the recommendations I have found online, and I encourage anyone who is designing a health intervention for the Aboriginal community to consult with all relevant stakeholders on the best way to do so.

The report Open Hearts, Open Minds by the Best Start Resource Centre at Health Nexus notes the importance of ‘cultural safety’, which “recognizes power imbalances, political ideals and de-colonization efforts. It involves an understanding that the cultural values of the client are affected by their political past”. I think this is the most important aspect of working in Aboriginal communities – recognizing past traumas and putting Aboriginal stakeholders in a decision-making capacity.

While health interventions may improve outcomes in Aboriginal communities, the TRC Report details 94 “Calls to Action” to help the process of reconciliation. Even if we fulfill those 94 recommendations to redress the legacy of residential schools, will that make up for the dire situation of our indigenous peoples today? Clearly, we have a long way to go.

“Reconciliation is not an Aboriginal problem. It is a Canadian problem and involves all of us.”
– Justice Murray Sinclair, TRC Chairman

 

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Collective Impact: A way to build community together

By Heather Keam, Community Animator, The Learning Centre, Tamarack

I have been working in the field of community engagement for many years and I thought that I knew it all...that was until I attended the Collective Impact Summit in Toronto 2014 and realized that I have a lot to learn.

Collective Impact is not just a way of doing community engagement, it’s a foundation on how to do it. We are so used to building community and then asking people to live, work and play in them. It is time that we stop building and start having conversations on what is community, who is community and how can we do it together. This is not an easy task and won’t happen overnight.

I attended the Collective Impact Summit last year in Toronto and was inspired to do my work differently, to have conversations, to look at my community as a whole and not just pieces of it. There was almost 300 people from across the world who attended the summit and in those 5 days I learned more than in my 13 years doing community engagement. This event changed me professionally and personally...it is a must event for 2015 and worth every penny!!I would recommend this conference to everyone who is trying to make change...you won’t be disappointed.

Learn more about this year's summit 

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Faith-based Organizations Working Together to Combat Poverty

Faith-based groups have a long history of charitable work providing for the needs of those less fortunate. Historically, faith-based groups provided for the basic needs of those living in poverty and filling gaps in service delivery by running food banks, homeless shelters and community programs. Toronto’s Yonge Street Mission has been serving the poor since 1896 and now provides a variety of programs including services for homeless youth, supportive housing and community building. Holy Blossom Temple has been involved in social action since the mid 1800’s including advocacy, education, and direct services. The Muslim Welfare Centre provides services to those in need both in Canada and internationally. Programs include Halal Food and Essential Item Baskets, The Regent Park Lunch Program and Project Ramadan, a volunteer led group that provides families in need with food for a month.


Now numerous religious groups are coming together to combat poverty. Faith in the City, a multi-faith symposium for faith communities was held on April 30th 2015 at Toronto City Hall. Faith in the City began in 2013 and brings together faith leaders and city officials to encourage faith communities to work across boundaries with each other and with the City to address social issues. This year’s symposium was focused on poverty reduction, with a specific emphasis on child poverty. The result was Faith Communities’ Charter and Action Plan on Poverty Reduction. The action plan urges City Counsel to address:

1. Employment and Income Security
2. Affordable Housing
3. Affordable Transit
4. Access to Services
5. Food Security
6. Fair and Sustainable Taxation

Click here to read the full action plan.

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CCSA Releases Report on Cannabis Use in Youth

Cannabis is the most commonly used drug among Canadian youth, aged 15-24, and our previous work has revealed that many of these young people think that cannabis is natural and safe. Our latest report delivers a response to these findings and will be used to dispel this type of misinformation.  On June 17th, CCSA released the sixth issue in its signature Substance Abuse in Canada series, The Effects of Cannabis Use during Adolescence.  This report, compiled by well-known and respected experts in this field,

  • provides evidence that marijuana is not a benign substance

  • explains that regular cannabis use seriously disrupts the developing brain and is related to
    • poor academic performance and deficits in attention and memorysignificantly increased risk of motor vehicle collisions

    • significantly increased risk of motor vehicle collisions
    • experiencing psychotic symptoms and developing schizophrenia
  • reveals that cannabis can be addictive
  • discusses how primary care providers are optimally placed to screen youth for problematic cannabis use
  • outlines that therapies that focus on psychological well-being have resulted in reductions in cannabis use among youth as compared to use before treatment

To make informed decisions about cannabis use, youth and their support systems need to be aware of both the neurological and behavioural effects of cannabis.


Did you know cannabis could cause these harms, and even be addictive? Do your young clients? Do you have the information or resources to identify, treat, or refer youth with a cannabis use disorder? What would help you use this information?

Check out the report in short or the full technical report, if you would like to learn more about how cannabis affects a youth’s brain and the impacts on cognition, behaviour, driving abilities mental health, addiction and treatment options.


Contact me to chat about how you could use the findings in the report in your work - sgereghty@ccsa.ca 

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Webinar Recap: First Steps to FLS Planning

Recently HC Link presented the latest webinar in its French Language Services (FLS) Capacity Building series. We have delivered a number of these, on topics such as creating a bilingual organizational culture, recruiting and retaining bilingual staff, and engaging Francophone communities. While we’ve heard that this information is helpful, we’ve also heard that organizations need to get a better sense of where to START when planning FLS. To that end, we developed a new webinar called “First Steps to Planning French Language Services”, and will release a resource on the same topic later this summer.

Planning to deliver FLS can seem overwhelming, particularly if your organization is new to working in French/with Francophone communities. One of the important overarching principles to keep in mind is that you can start small, and grow delivery of French services over time. It’s also critical to work closely with partner organizations (be they Anglophone, bilingual or Francophone) who have close relationships with Francophone communities and deliver services in French.

Keeping those two things in mind, here are a few of the necessary steps to keep in mind as you begin your FLS journey. These steps will be expanded on in our upcoming resource on this topic.

FLS Planning Graphic

First Steps in FLS Planning Slides | Recording

Helpful Resources from HC Link

This new resource, Getting Started With……Planning French Language Services lists all of HC Link’s existing resources on FLS and engaging and working with Francophones.

Helpful Resources from our Members and Partners

HR Support Kit: Pathway to Bilingual Services developed by Risfssso

Moving towards a bilingual organization developed by Health Nexus and Reflet Salveo

Ontario 400 Website celebrating 400 of Francophone presence in Ontario

 

 

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Partnership Webinar Series Recap

On April 23rd, May 7th and May 28th, HC Link delivered three webinars as part of a series on Collaborative Partnerships. Hosted by HC Link’s Kim Hodgson and Gillian Kranias, every webinar offered the audience a mix of stories from the field, a bit of theory, and tips and tricks to optimize successful collaborative partnerships.

Each part covered one or more of the activities found in figure 1. These six activities work together with the model to create successful partnerships.

Highlights 

Overall, a major lesson to be learnt from the series is that there is no one-size-fits-all model to follow for partnerships. Even though hosts offered a model (figure 1), each activity is very adaptable and flexible to the unique needs of collaborative partnerships. Collaboration between organizations and community members vary depending on the nature and scope of the project. However, here are some key elements to keep in mind throughout every collaborative partnership that were highlighted in almost every webinar:

  • Communicate: this is key. In each webinar, all speakers spoke about the importance of communication. It is vital for all parties in collaborative partnerships to communicate their vision, expectations and their level of involvement in a project. Without clear and continuous communication, collaborative partnerships can become challenging and inefficient. Therefore, make sure to share with your partners your thoughts right from the start and throughout the collaboration in order to avoid future issues.
  • Listen: while communicating your perceptions is important, being on the receiving end is also essential. Listening is important throughout all collaborative partnership activities. You need to be able to listen to your partners when connecting, creating a common vision and fostering understanding. You need to listen to the community when figuring out what are the priority needs and where you should focus future efforts, as well as what is working and what isn’t of the current projects being carried out. As much as speaking up about your own thoughts and ideas is important, being open to receiving those of others are as equally crucial for successful collaborations.
  • Flexibility and adaptability: Not all partners in collaboration will have the same perceptions, expertise, resources and levels of involvement. This is why communication and listening is so important! Every partner needs to be understanding and flexible of other partners’ position in the collaboration. Doing so will avoid hurdles and unexpected loads of work.
  • Self-reflect: this key element was brought up several times throughout speakers discussions during the webinars. Self-reflection is not only important during the evaluation part of partnerships, but at the start and throughout. It is important to self-reflect on the position you want to take in collaboration at the start of a partnership and while preparing the work plan. It is important to self-reflect on the progression of the collaboration once the project is implemented. It is important to self-reflect on the deliverables of the collaboration at the end, and on future directions. Self-reflection should be integrated in all parts of the collaboration!
  • Commit: commitment from all parties of the collaboration is essential for the success of the partnership. All partners need to stay committed to the project to ensure success. This is where communication, listening and self-reflection are important players. Each partner needs to understand their own level of commitment within the collaboration and communicate these to other partners. Each partners needs to listen to other partners on these matters. By doing these, it will ensure that all partners are comfortable with their roles and levels of involvement, and ensure that each partner will stay committed to the partnership and the project.
  • Celebrate: while only the third webinar touched upon celebration in greater depth, every story from the field shared some form of celebration that they did towards a collaborative partnership project. Whether it was simply cheering the success of their collaboration or telling the audience of a gathering of the community to celebrate a project, celebrating the positives of collaboration was incorporated by all members. So remember, celebrate your successes, whether big or small!

 Learn more, listen to the webinars and access the resources!

Part 1: The Genius of Partnerships: New relationships & diverse perspectives within a common vision

Guest Speakers:
Joanne Dubois, Community Developer at Grand River Community Health Centre
Stephanie Glyon, works with the Centre for Addiction and Mental Health (CAMH) and is the Regional Implementation Coordinator with the Durham Service Collaborative

Part 2: An Eye on the Vision, an Eye on the Road: Working together for Change

Guest Speakers
Amy Mak, public health nurse at the Middlesex-London Heath Unit
Jane Harrington, Injury prevention specialist at the London Health Sciences Centre.

Part 3: Thinking Back, Moving Forward: Celebrate and Evaluate…to Renew

Guest speakers:
 Denise Bishop-Earle, works with Art Starts and is Co-Chair for the Lawrence Heights Inter-Organizational Network (LHION)
Owen Hinds, Pathways to Education at Unison Health and Community Services, and is a steering committee member for the LHION

Resources 

Also check out our revised resource on Parternship Development

 

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Webinar Recap: YouthREX’s 10 Ways to Meaningfully Engage Underrepresented Youth

On May 28th, YouthREX hosted a webinar titled “10 Ways to Meaningfully Engage Underrepresented Youth”. It was a great learning event that included perspectives from service providers, social enterprises (such as Spoke N’ Heard), academia, and of course, youth!

Without further ado, here are YouthREX’s top 10 tips for meaningfully engaging underrepresented youth:

  1. Let youth self-identify. Labels like “marginalized”, “at-risk”, “vulnerable” can be strong words, and these labels are all circumstantial.

  2. One-off consultations with youth don’t create youth leaders. We need to embed youth in decision making, advising and brainstorming processes.

  3. Create the sandbox from the get-go. Give youth creative freedom to express themselves       

  4. Recognize your power and their power. Three powers are always at play – personal, local, and global. Power can come in the form of speaking English, being Caucasian, living in a developed country, and how you carry yourself. Be aware of micro-aggressions
  5. Experience is not a form of payment. Compensate youth for their time (ex. Public transit, food, snacks). Don’t expect young people have the time and resources to commit to meetings.

  6. Silence is a part of the conversation. Sometimes young people only speak when ask or are prompted to. So, ask for youth contributions. It can be intimidating to bring new ideas when you are the only young person in the room.

  7. Make all resources known. Marginalized youth may not always feel safe because of various forms of violence they have experienced in the past. Make them aware of the available resources before they have to ask, so it’s as safe a space as possible to work optimally. For example, tell youth if you will be paying for lunch or subway fare.

  8. Give a job title to youth who are involved in your organization. This clarifies responsibilities and helps youth in future jobs if they are able to say exactly what they did while working with you.

  9. Get to know the youth’s interest and goals. If they enjoy what they are doing, they will offer more to the organization.

  10. Appreciate and foster their intangibles. Marginalization prompts skills that may not be tangible, such as a distinct world view, knowledge of neighborhood experience, youth perspective, or creativity they may have developed due to lack of resources.

The second part of the webinar focused on an academic perspective on youth engagement, and was presented by Rebecca Houwer. Rebecca has produced a model of youth engagement on promising, evidence based practices to build leadership capacity of marginalized youth. She noted that structurally marginalized youth want opportunities to be part of their communities and have access to share in the work of addressing root causes of marginalization. When developing models for youth engagement, there is a danger of reproducing a patriarchal, euro-centric, adult-centric model that is exclusionary. Youth engagement needs to focus on skill development that moves young individuals, and although we may aim for a collaborative approach to leadership development, we also need to integrate personal and social development needs. Equally as important, Rebecca noted that it is important to contextualize programs within youths’ individual, cultural, political and gendered experiences. Lastly, I found it interesting that Rebecca mentioned the need to cultivate 21st century skills when working with youth, such as collaboration, innovation, and participatory practices, among others. With the world of work changing, developing these skills is crucial.

Overall, it was a great webinar jam packed with tons of resources and information. I’m definitely looking forward to attending YouthREX’s next webinar! 

You can watch a recording of the webinar here 

 

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Poverty Reduction Blog Chat

Poverty Reduction Blog Chat

June 4th 10:00am – 11:00am

Join us for an online discussion on reducing poverty at the local level. Learn tips and strategies to address poverty in your own community.

Guests joining us include:
Greg deGroot-Maggetti - People in Poverty Program Coordinator Mennonite Central Committee Ontario
Mary Lou Mills - SDOH Nurse, Haliburton Kawartha Pine Ridge District Health Unit
Lyn Smith - Coordinator, Renfrew Country Child Poverty Action Network

Facilitated by:
Suzanne Schwenger – Manager, Health Nexus
Lisa Brown – Communications Coordinator, HC Link

Follow this link to participate http://www.hclinkontario.ca/blog/entry/poverty-reduction-blog-chat.html

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Today is Bike to Work Day!

Although many HC Link staff cycle for much or all of the year, it's nice to take time on Bike to Work day to celebrate our favourite mode of transportation. I asked a few HC Link staff and other colleagues for a few comments.

Toronto has several group rides that head downtown from various parts of the city, ending at City Hall for a pancake breakfast. Those festivities start too early for my night-owl habits, but lots of HC Link staff will be there.

What will you be doing for Bike to Work day?

Alison Stirling says: I'll be at CPHA in Vancouver this year and not on a bike! But if I were in Toronto, I would be riding my bike to work and all other parts.
Sam: I'm going to bike to work. Unless it's really pouring rain.
Sara: On Bike to Work day I will be riding with the pack and loving every moment of it.
Andrea: I will be biking to work- first ride of the season as I have been quite sick over the winter. I can't wait!
Amanda: I will be commuting into Toronto on the GO train...I would rather be biking but it`s too far!
Lisa B: I will definitely be biking to work and I am planning on attending the Bike to Work Day Group Commute & Pancake Breakfast at Nathan Phillips Square.

One of the advantages of living in Toronto is its transit system -- our buses, streetcars, subways, intercity trains, and ferries. Of course we all love to complain about it, but it gives us options that just don't exist in some other parts of Ontario. If the weather is bad or if we're tired or ill, we don't have to ride our bikes or resort to car travel.

How do you usually get to work?

Lisa B: I commute to work by bike in spring, summer, and fall weather permitting. If it is raining or too cold I take the TTC. I now work at PAD and bike from High Park to north of Keele and Wilson! I ride on main streets with heavy traffic but go out of my way to stay off of Keele, the ride takes me about 45 minutes each way.
Alison: To get to work I take my bike on the Toronto Island ferry and then head up Bay Street if I am in a hurry or further west to Simcoe where there's a bike lane -- a much safer way to go.
Sara: I usually walk, TTC or ride depending on the weather and my body.
Sam: Bicycle! Mostly main streets, like Bathurst and Bloor
Andrea: Usually I bike from March to December and take public transit the rest of the time. The nice things about public transit are that a) I live in a city with public transit and b) that it allows me to "bookend" transit trips with walking. The not-so-nice thing is how crowded it is. Biking is THE BEST way to get to work!

Once people start cycling, it's hard to get them to stop. But getting people to start can be challenging: it can seem scary and intimidating to put your small, squishy, un-armored self out there in traffic with large metal boxes on wheels.

Joanne: I just got a bike -- it's my mom's old bike. I think it has 21 gears. I just need to work up the nerve to ride it to work! I've never ridden in the city.

Matthuschka: I'd have to work my way up to it. We can get down to the waterfront easily but not into the core.

Remember, though, that downtown traffic moves quite slowly much of the time, so the speed differential between bikes and cars is very low. In fact, cyclists typically find they're faster from point A to point B than a car making the same trip.

What would you say to non-cyclists on Bike to Work day?

Sara: I would tell non-riders that riding in the city is not as scary as many believe. The benefits of riding extend beyond improving your mental and physical health, it is also great for getting to know your city, for reducing emissions and saving money. As well, the more cyclists there are, the better cars will get at sharing the road. Join the fun!
Alison: Try it, you'll like it! Cycling is fun, fast and a healthy way to get around.
Sam: since you have to go to work anyway you might as well exercise and get there for free!
Matthuschka: support the bike to work movement! even if you can't, make it so others can. If it's fear, then find ways to get over that fear -- work on creating a safe bike network in the core of the city.
Andrea: I'd say: be brave and give it a try. Bike to Work day is a great day to try it out especially if there is a group bike happening. Also the pancakes at City Hall are delicious. But really: map out your route and try it on a weekend; pay attention and be safe and: most importantly have an awesome ride!
Amanda: Share the road! Biking is fun and great exercise.
Lisa B: I would say try cycling! Especially if you live and work in the downtown core, it is not nearly as intimidating as you might think and a great way to get some fresh air and physical activity.

Want to give it a try? Here are a few resources to help you get started:

Yvonne Bambrick's book The urban cycling survival guide : need-to-know skills and strategies for biking in the city. Yvonne headed up Cycle Toronto for several years and is a sane, calm, and encouraging voice for beginning city riders.

The City of Toronto runs CAN-Bike courses which cover both the legal and practical issues involved in city riding.

Cycle Toronto has a Start Cycling site (http://startcycling.ca/) with stories and tips for new cyclists. Through Cycle Toronto you can keep up to date on cycling initiatives across Toronto or you can connect with your Ward group for more local updates.

Happy cycling!

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What is Food Insecurity?

Food security is the secure access to sufficient food (both in quality and in quantity) and is considered a basic human right (UN, 1998). At the World Food Summit in 1996 a widely accepted definition of food security was established and is used in Canada’s Action Plan for Food Security –
Food security exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life (1998).
Food insecurity is the lack of access to these resources and can range from worrying about being able to buy nutritious foods to not eating for an entire day because of inadequate funds to buy food.

Kids eating

 What does food insecurity look like in developed countries like Canada?


In countries like the US and Canada it is common practice to measure food insecurity at the household level. The most resent statistics from Statistics Canada show that 8.3% of Canadian households are food insecure. Food insecurity is much more common in low-income households - over 40% of people in low and lower-middle income households reported at least one aspect of food insecurity while only 11% of middle income households and 4% of high income households reported having problems.

People who are food insecure might:

  • Be worried about having enough money to purchase food
  • Have limited or uncertain ability to acquire food
  • Go hungry because they do not have enough income to buy food
  • Eat less nutritious food because it is cheaper
  • Not be able to provide balanced meals for their children

What impacts food insecurity?

Women report higher levels of food insecurity than men do, as do younger people. Some people live in geographical areas with less access to food known as food deserts. Families with children are more likely to be food insecure and Aboriginal households with or without children are also at an increased risk of food insecurity. Lone-parent led households have some of the highest rates of food insecurity in Canada, at 21.4%. Household food insecurity often begins when another person joins the family (such as a baby or an elderly grandparent), when a family member is ill, or when a job is lost.

Consequences of Food Insecurity

There are some very obvious consequences of food insecurity such as going hungry, weight loss, and stunted growth in children. However food insecurity affects overall health status in a variety of ways. Recent research suggests that early life circumstances can have a substantial affect on adulthood health. Food insecurity is also correlated with obesity and chronic diseases - possible reasoning for this includes the cheap “junk” food that is high in calories and carbohydrates and low in nutrients that many low-income (and food insecure) families eat.

Resources 

Want to learn more about food insecurity in Canada? Check out some of these great websites -

Food Secure Canada 

Provincial Health Service Authority

Foodnet Ontario 

(Image credit, Flickr, USDA 20120907-FNS-LSC-0544 https://goo.gl/0LduuW

 

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Promoting healthy weights in children and youth – What are the impacts of childhood obesity?

The Ontario government’s Healthy Kids Strategy is well underway and HC Link is involved supporting the communities doing the Healthy Kids Community Challenge. Obesity in children and youth is a public health concern in Canada and globally. Currently one-third of children and youth in Canada are overweight or obese (PHO, 2013). Childhood obesity is a complex problem that is influenced by a wide range psychological, biological, and socioeconomic factors and is an important health equity issue. What are some of the impacts of unhealthy weights on children and youth?

Bullying

Mental health challenges and bullying is one of the less talked about effects of childhood obesity. Kids who are overweight are at a much greater risk of experiencing bullying, being socially rejected, and having low self-esteem. In a recent study of high school students in the US 58 percent of boys and 63 percent of girls experienced bullying.

Kids who are bullied are at increased risk of mental health problems like depression and eating disorders, substance use problems, and of being bullies themselves.

Difficulty in school and behavioral problems

Stigma, social discrimination, and bullying can make it difficult for kids to function in school and hinder academic success. Overweight children are at risk of being held back a grade and poor test results in math. Kids may act out behaviorally or socially withdraw and miss classes.

Increased risk of disease in adulthood 

Kids who are overweight are at a significantly increased risk of becoming obese and developing metabolic syndrome and other physical conditions.

Physical complications in childhood

Complications of obesity that were typically not seen in youth are now being seen in children and include:

  •  Type II Diabetes 
  • High cholesterol and high blood pressure
  • Asthma 
  • Early puberty 
  • Bone and joint problems
  • Fatigue
  •  Sleeping disorders

To read more about healthy weights in children and youth check out the report Addressing Obesity in Children and Youth from Public Health Ontario or check out our resource on the Health Kids Strategy.

 

 

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Mental Illnesses in Canada: Can Mental Health First Aid Training Help?

Did you know that in any given year in Canada, one in five people experience a mental illness? Further, one in three people will experience it at some point in their lives. Here’s something equally as shocking: according to CAMH, in 2013, 2.2% of Ontario adults seriously considered suicide, which is roughly 230,000 people a year. These are just some of the statistics that show the increased need for understanding mental illness, as well as public education around mental health. To address this need, Mental Health First Aid training is becoming increasingly common in Canada.

To learn more about this topic, I listened to Suzanne Witt-Foley’s radio interview (https://www.youtube.com/watch?v=_WYt6Hg_lQI) about mental illnesses in Canada, and her experience running Mental Health First Aid training. Here’s what I learned. 

Public education about mental health is extremely important. Mental illness is common, and many times it begins during adolescence. Early interventions can produce stronger mental health outcomes in later years. If treatment comes too late, then ingrained brain pathways are developed and are much harder to change. Early intervention makes those pathways easier to shift, so it is easier to address mental health symptoms when they arise. Public education on mental health also reduces stigma. There are a lot of myths, and when we don’t understand something we tend to fear it. Suzanne believes that if we don’t understand mental illness, we fear, and that means we avoid it.

There are many strategies that exist to address mental health issues, and Suzanne believes these strategies are like ingredients for soup; you need a whole tool kit, and strategies that work for some people don’t work with others.

Mental Health First Aid training is one such “ingredient”. Mental Health First Aid training is a 12 hour course developed to help provide initial support for someone experiencing a mental health problem. It was developed in Australia in 2001, has been extensively evaluated, and is an evidence-based course with a certificate for participants at the end. The course has been shown to improve participants’ knowledge of mental health, and has also contributed to a reduction in stigma.

We take a physical first aid course so why not mental health course? When we think of prevalence of mental illness in Canada, it makes sense to learn about it. Topics in the Mental Health First Aid Training include:

  • Introduction to health and mental health
  • Substance related disorders, addictions, mood disorders, anxiety, psychotic disorders
  • Signs, symptoms, and risk factors for mental illnesses
  • Overdose, panic attacks suicidal behaviour, psychotic episodes
  • Action steps
  • Information about treatment and current resources

To learn more about Mental Health First Aid training in Canada, visit http://www.mentalhealthfirstaid.ca/.
Suzanne Witt-Foley is an HC Link Consultant. To learn more about HC Link Consultants or to request a service, visit http://www.hclinkontario.ca/consulting-services/consultants.html

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Smart Growth 2015 Forum

On March 24, 2015, the Smart Growth 2015 Forum took place in Toronto. The Forum was hosted by the Ontario Smart Growth Networkork (OSGN), a project of the Ontario Healthy Communities Coalition.

OSGNThe Forum built on the work that the OSGN had done over the preceding months, which included a survey on smart growth issues and a webinar on Smart Growth in Ontario and Why it Matters.

The Ontario Smart Growth Network (OSGN) is a non-profit network of organizations, businesses and individuals in Ontario that are working to promote a smarter approach to community design. Essentially, “smart growth” aims to reduce urban sprawl and promote the development of compact, livable communities. It encompasses complete communities, complete streets, transit-oriented development, new urbanism, resilient cities and walkable communities.

The purpose of the Forum was to bring government representatives, planners, community leaders, advocates, developers, educators and others together to share information about smart growth initiatives, strategies for engaging the public and ways to measure our progress. It was also an opportunity to hear from staff of the Ontario Growth Secretariat about the 10-year coordinated review of the Greenbelt Plan and the Growth Plan for the Greater Golden Horseshoe and the public consultation process that is now underway.

In the morning, two panel presentations featuring a number of speakers gave their thoughts on public engagement around smart growth and how to evaluate smart growth principles. One key thought that was raised was to consider how much has changed over the past 20 to 30 years in terms of politics, economics, demographics, amenities, and the environment and whether the current review of the Ontario greenbelt plans and Growth Plan will prepare us for the next 20 to 30 years. As well, participants also heard about the importance of the greenbelt to Ontario and Ontarians, the threats to the greenbelt, and the challenges that some developers have when trying to build smart growth developments.

In the afternoon, Walk Friendly Ontario announced their 2015 award recipients. Congratulations to the Town of Smith Falls and the City of Kitchener on being recognized as WALK Friendly Communities!

Finally, the afternoon session allowed for more intimate discussion as participants shared their own experiences and reflected on the challenges and opportunities to encouraging more smart growth in Ontario. Some of the top issues raised were: how language and terminology varied leading to confusion about what smart growth really means; the number of plans, government ministries, and legislation that has changed and continue to change over time creating uncertainty over who is in charge; and the age-old issue of political will and the influence of politics in planning decisions.

The Forum proved to be a great experience in bringing together a number of diverse stakeholders representing the provincial government, municipalities, non-profits, academics, and developers among others.

For those that were unable to attend, presenter slides as well as notes from the event can be found here.
Anyone can join the OSGN for free. Membership in the network will help you to stay up-to-date on the latest news, promote your own initiatives and share ideas with others. You can also follow the OSGN on Twitter (@OSGN1).

The OSGN is a provincial network of organizations and individuals working to promote a smarter approach to urban design.

OSGNpicture

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Community Forum: Breaking Down Barriers

On March 31st, the San Romanoway Revitalization Association held a community forum through their “Pathways to Health Choices” project funded by Health Canada. The event was titled “Breaking Down Barriers: Mental Health and Drugs Among Marginalized Youth”.

The keynote for the forum was Dr. Akwatu Khenti, the Director of Transformative Global Health at CAMH. Dr. Khenti’s presentation was titled “Drugs, Social Construction and Policing Unequal Justice and Health for Racialized Youth”. He started off his presentation by stating that race and the perception of race matters, because it drives public policy and the public agenda. He noted that racism impacts everyone, and that we are all part of the solution.

He spent much of his presentation going through Canada’s history with racism, and then discussed the history of Canada’s national drug strategy which started in the late 1980s. Because of the drug strategy, by the 1990s, Canada was number 2 in the worlds in terms of drug arrests. He made the point that the harms of cannabis in particular are negligible to the harms of incarceration. Dr. Khenti noted that between 2002-2012, Black incarceration increased by 75%, and “white incarceration went down… even though blacks and whites use the same amount of drugs” in Canada.

He argued that most people age out of cannabis use as they get older and take on more responsibilities such as jobs, university, marriage and children, but that Black people are more likely to get arrested before they “age out” of drug use. Further, Dr. Khenti argued that Black people are also perceived as older by the police, so if a 13-year-old is caught doing drugs, he (and Dr. Khenti noted that it is most often Black men who get stopped by the police) is more likely to be seen as age 16 and thus having more responsibility. Dr. Khenti repeatedly made the point that in order to make strong policies that help racialized youth, more race-based police data is needed.

After a Q&A, there was a panel discussion on Strategies to Reduce Drug Use and Enhance Youth Mental Health. There were five discussants from very different backgrounds ranging from a mental health/addictions case manager, a police officer, a lawyer, and youth outreach workers. The panel touched on issues relating to youth engagement, the importance of accessing resources for racialized youth, and a heartfelt story about one panelist’s experience in the incarceration system and how he changed his trajectory after being released.

The event closed off with a networking session and lunch. It was a great forum to bring together those working in the mental health and addictions sector, and a great learning event!

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March 24 Mental Health and Healthy Weights for Children and Youth: A TOPHC Preconvention Forum

On March 24th HC Link had the privilege of participating in a one day event hosted by Public Health Ontario (PHO) and the CAMH Health Promotion Resource Centre. The focus of the event was the intersection of public health activities to promote mental health and healthy weights. Innovative projects from public health units across Ontario were showcased and many engaging presenters spoke. The role of health equity was integrated into discussions and learning throughout the entire day.

Dr. Chris Mackie, CEO and Medial Officer of Health at the Middlesex-London Health Unit gave the keynote address. He provided an overview of areas where we are seeing interactions between mental health and healthy weights, these included childhood bullying, outreach and home visits to new and expectant mothers, breast feeding, and the built environment. He noted the importance of understanding the unintended impacts of labelling people as “overweight” such as double stigmatization.

We also heard from Dr. Ed Adlaf, a Senior Research Scientist at CAMH, who spoke about The Ontario Student Drug Use and Health Survey (OSDUHS) and his research on the association between Subject Social Standing (SSS) and health and mental health outcomes. Dr. Ingrid Tyler from PHO and Sherry Nigro, Manager of Health Promotion and Disease Prevention at Ottawa Public Health participated in a panel discussion on the role of healthy equity in addressing heathy weights and mental health. Highlights of the discussion included:

 

  • The many interlocking systems that influence obesity as illustrated through this Obesity Systems Map
  • The idea of Proportionate Universalism – we should be intervening at an intensity that is proportionate to the level of disadvantage in order to reduce health inequities.
  • “Don’t make things worse” – be aware that talking about obesity is stigmatizing and that we need to be sensitive to body image issues when talking to children and youth about their weight. Dr. Gail McVey from Sick Kids also discussed this issue throughout the day emphasizing the need to be aware of weight bias in our messages around “healthy weight”.
  • Improving access to physical activity and healthy eating, especially to those with disabilities.

Promising Projects and Programs 

 
The afternoon was comprised of a World Café where we got the opportunity to learn about promising programs, projects, and tools being used in the field. These included.
  1. Nutristep – Sudbury and District Health Unit
  2. Sparking Life Niagara – Niagara Region Public Health
  3. F.U.E.L. -  Niagara Region Public Health
  4. Eat Well, Be Active, Feel Good Manual – Ottawa Public Healt
  5. CAMH Best Practices Guidelines for Mental Health Promotion Programs: Children and Youth

Overall the day provided a wonderful opportunity for public health units and those working in health promotion to begin to think about the intersection between mental health and healthy weights. We need to think about how we can address the pathways that lead to obesity and mental health challenges using a healthy equity perspective. We also need to be aware of mental health implications of our messaging to the public around obesity and implications for issues such as stigmatization, body image, and eating disorders.

 

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