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Final Report Aboriginal Health Programs and Services Analysis & Strategies: Final Report SUBMITTED BY: DPRA CANADA 7501 KEELE ST. SUITE 300 CONCORD, ON L4K 1Y2 NW LHIN Aboriginal Health Programs and Services Analysis and Strategy Final Report April 2010 TABLE OF CONTENTS EXECUTIVE SUMMARY ............................................................................................................................. IV ACRONYMS .............................................................................................................................................. VIII 1.0 INTRODUCTION .............................................................................................................................. 1 1.1 PURPOSE OF THE PROJECT ............................................................................................................ 1 1.2 STRUCTURE OF THE REPORT .......................................................................................................... 1 2.0 BACKGROUND ............................................................................................................................... 2 2.1 LOCAL HEALTH INTEGRATION NETWORK ......................................................................................... 2 2.1.1 Brief Overview of the Local Health Integration Network.......................................................... 2 2.1.2 The North West Local Health Integration Network .................................................................. 3 2.2 NW LHIN POPULATION .................................................................................................................. 5 2.2.1 Socio-Demographic Profile of the NW LHIN Population ......................................................... 5 2.2.2 Health Profile of the NW LHIN Population .............................................................................. 8 3.0 METHODOLOGY ........................................................................................................................... 12 3.1 KEY RESEARCH QUESTIONS ......................................................................................................... 12 3.2 PROJECT METHODOLOGY ............................................................................................................. 13 3.2.1 Environmental Scan .............................................................................................................. 13 3.2.2 Literature Review................................................................................................................... 15 3.2.3 Community Engagement Sessions ....................................................................................... 16 3.2.4 Community Telephone Interviews ......................................................................................... 18 3.2.5 Key Stakeholder Interviews ................................................................................................... 18 4.0 LIMITATIONS AND CHALLENGES ............................................................................................. 20 4.1 PROJECT CHALLENGES ................................................................................................................ 20 4.2 DATA LIMITATIONS ....................................................................................................................... 21 5.0 KEY FINDINGS .............................................................................................................................. 23 5.1 HEALTH STATUS OF ABORIGINAL PEOPLE ...................................................................................... 23 5.1.1 Brief Overview of Aboriginal Health in Canada ..................................................................... 23 5.1.2 Aboriginal Health in the NW LHIN ......................................................................................... 24 5.2 ABORIGINAL HEALTH PROGRAMS AND SERVICES ........................................................................... 27 5.2.1 Service Providers .................................................................................................................. 27 5.2.2 Inventory of Health Programs and Resources ...................................................................... 31 5.2.3 Utilization Patterns ................................................................................................................ 36 5.2.4 Referral Patterns and Wait Times for Access ....................................................................... 36 5.3 GAPS IN ABORIGINAL PROGRAMS AND SERVICES ........................................................................... 36 5.3.1 Mental Health and Addictions ................................................................................................ 37 5.3.2 Chronic Disease Diagnosis and Management ...................................................................... 40 5.3.3 Acute Disease / Accidents and Injuries ................................................................................. 42 5.3.4 Active and Engaged Parenting .............................................................................................. 43 5.3.5 Children’s Programs and Services ........................................................................................ 44 5.3.6 Youth Programs and Services ............................................................................................... 44 5.3.7 Seniors Programs and Services ............................................................................................ 45 5.3.8 Continuity of Care / Provision of Essential Services and Specialized Care .......................... 46 5.3.9 Infrastructure ......................................................................................................................... 46 5.3.10 Culturally Appropriate Services ......................................................................................... 47 5.3.11 Transitional Assistance ..................................................................................................... 47 5.3.12 Wellness Education and Preventative Health Care .......................................................... 47 5.4 DUPLICATIONS IN ABORIGINAL PROGRAMS AND SERVICES ............................................................. 48 5.5 CHALLENGES TO DELIVERY AND ACCESS ...................................................................................... 48 5.5.1 Challenges Associated with the Delivery of Health Programs and Service On-Reserve ..... 48 5.5.2 Challenges Associated with the Access of Health Programs and Services On-Reserve ..... 49 i NW LHIN Aboriginal Health Programs and Services Analysis and Strategy Final Report April 2010 5.5.3 Challenges Associated with the Delivery of Aboriginal Health Programs and Services Off- Reserve .............................................................................................................................................. 51 5.5.4 Challenges Associated with the Access of Aboriginal Health Programs and Services Off- Reserve .............................................................................................................................................. 52 5.5.5 Challenges Associated with Aboriginal Health Planning ....................................................... 54 5.6 HEALTH PROGRAM AND SERVICE OPPORTUNITIES ......................................................................... 54 5.6.1 Current and Potential Partnerships ....................................................................................... 54 5.6.2 Opportunities for Integration .................................................................................................. 56 5.6.3 Health Care Technology Usage ............................................................................................ 57 5.6.4 Expansion of Technology and Innovation in Aboriginal Communities .................................. 58 5.7 BEST PRACTICES AND LESSONS LEARNED .................................................................................... 58 5.7.1 Best Practices / Lessons Learned – The Project Participants .............................................. 59 5.7.2 Successes / Lessons Learned – The 2009 Aboriginal Health Forum ................................... 61 5.7.3 Best/Promising Practices – The Literature ............................................................................ 63 6.0 CONCLUSIONS ............................................................................................................................. 69 7.0 RECOMMENDATIONS .................................................................................................................. 72 LIST OF TABLES Table 1: Percentage of Population 15 Years and Older ............................................................................... 6 Table 2: Median Age of Population in NW LHIN and Ontario ....................................................................... 7 Table 3: Health Status of the Overall Northwest and Ontario Populations ................................................... 9 Table 4: Age Standardized Mortality Rates by ICD-10 per 100,000 for the Overall Northwest and Ontario Populations (2004) ...................................................................................................................................... 10 Table 5: Potential Years of Lost Life Rate by ICD-10 per 100,000 for the Overall Northwest and Ontario Populations (2004) .....................................................................................................................................
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