Let’s make health in Algoma matter during the 2018 provincial election

The provincial government plays an important role in shaping the health and wellbeing of our communities. Across there are many public health issues of importance, the following being especially relevant in Algoma:

• mental health and addictions • tobacco use • food insecurity

Addressing these issues will give us an incredible return on investment. Our communities become strong, healthy, and vibrant when each every person has the opportunity to achieve their full health potential.

Let’s make health in Algoma matter during the 2018 provincial election. Provincial/local actions to date: Mental health and addictions • In 2011 Ontario released its Comprehensive Mental Health and Addictions Strategy, called Our ask to the candidates Open Minds, Healthy Minds.3 • In Ontario, opioids were involved in 1 in every 6 deaths among young adults in 2015.4 What is your plan for addressing the burden of mental health and addictions, • In October of 2016, Ontario announced its Opioid Strategy to prevent opioid addiction and including problematic opioid use, in Algoma? overdose.5 • In August of 2017, the Ontario government announced a commitment of $222 million over Return on investment three years to enhance the provincial Opioid Strategy.6 • To date, Ontario has responded to opioid-related problems by: contributing to Chronic Nearly 1 in 3 people in Ontario will experience a mental health or addictions Pain Networks and Rapid Access Addiction Medicine (RAMM) Clinics, hiring more front-line 1 issue in their lifetime. workers, funding research, and committing to an expansion of harm reduction services such as naloxone and the provision of temporary Overdose Prevention Sites (as per the federal Investing in mental health and addictions will help divert more people from the government’s exemption). judicial system by providing more timely responses and care for those in crisis. • The North East Local Health Integration Network launched its Opioid Strategy in January of 2018, which focuses on the expansion and/or creation of RAMM Clinics, Community Based The issue Withdrawal Management Programs, and addiction counselling services.7 • In Algoma, Sault Area Hospital oversees the RAMM Clinic located at the Algoma Treatment Mental health and addiction services in many rural and Centre. Outreach supports are provided to Blind River, , St. Joseph’s Island, Elliot communities are less comprehensive, available, and accessible; further Lake, Wawa, and . 2 exacerbating mental health and addiction issues. • In March of 2018, Ontario committed to an additional $2.1 billion over four years to address mental health and addictions care.1 Algoma’s rate of hospitalizations for mental health and addictions, self-harm, and deaths from suicides are much higher than Ontario’s. In fact, rates of References hospitalization due to mental health or addictions are rising in Algoma, with females being more likely to be hospitalized than males. 1. Government of Ontario. (2018, March 21). Ontario Making Historic Investment in Mental Health Care [News release]. Available from: https://news.ontario.ca/opo/en/2018/03/ontario-making-historic-investment-in-men- tal-health-care.html Additionally, rates of opioid-related emergency room visits, hospitalizations, and 2. Mental Health Association, Ontario. (2009). Rural and Northern Community Issues in Mental Health [Back- deaths are higher in Algoma, compared to Ontario. grounder]. Available from: https://ontario.cmha.ca/wp-content/uploads/2009/09/cmha_on_rural_northern_men- tal_health_issues_20090827.pdf Visit Algoma’s opioid-related health harms to learn more. 3. Government of Ontario. (2011). Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy. : Queen’s Printer for Ontario. Available from: http://www.health.gov.on.ca/en/common/ministry/ publications/reports/mental_health2011/mentalhealth_rep2011.pdf 4. Gomes T, Greaves S, Martins D, et al. (2018). Measuring the Burden of Opioid-related Mortality in Ontario, Canada [letter to the editor]. Journal of Addiction Medicine, April 25. Available from: https://journals.lww.com/journaladdic- tionmedicine/Citation/publishahead/Measuring_the_Burden_of_Opioid_related_Mortality.99474.aspx 5. Government of Ontario. (2016, October 12). Ontario Taking Action to Prevent Opioid Abuse [News release]. Available from: https://news.ontario.ca/mohltc/en/2016/10/ontario-taking-action-to-prevent-opioid-abuse.html 6. Government of Ontario. (2017, August 29). Ontario Providing Support to Those Affected by Opioid Crisis [News release]. Available from: https://news.ontario.ca/mohltc/en/2017/08/ontario-providing-support-to-those-affect- ed-by-opioid-crisis.html 7. North East Local Health Integration Network. (2018, Jan.16). North East LHIN launches opioid strategy [News re- lease]. Available from: https://www.sootoday.com/local-news/north-east-lhin-launches-opioid-strategy-814601 Provincial/local actions to date Food Insecurity • Ontario’s first Poverty Reduction Strategy, Breaking the Cycle, was released in 2008.4 Our Ask to the Candidates • In April of 2017 Ontario launched the Basic Income Pilot project in three communities: Thunder Bay, Hamilton, and Lindsay.5 How will you address food insecurity in the North? Will you prioritize social • In October of 2017 the minimum wage in Ontario rose to $11.60/hour.6 assistance reform in Ontario, as recommended in the Income Security: A • The Poverty Reduction Strategy Annual Report for 2017 was released in April of 2018, which Roadmap for Change report? Do you support the Basic Income Pilot Project? highlights progress to date and next steps regarding issues such as poverty, employment, and food insecurity in Ontario.7 Return on Investment • In Algoma, the Central Algoma Food for Everyone (CAFFE) project seeks to address food insecurity issues in rural northern Ontario communities, including Echo Bay, St. Joesph • Food insecurity affects 1 in 8 households in Ontario; 1 in 6 children in Ontario Island, , Thessalon, and Iron Bridge.9 live in a household that is food insecure.1 • By investing in policies that address income, social assistance, and References employment, the overall wellbeing of people living in Northern Ontario will improve, alleviating strain on the health system and reducing its costs 1. Ontario Dietitians in Public Health. (2018). No Money for Good is…Cent$less. Available considerably. from: https://www.odph.ca/centsless 2. Canadian Community Health Survey [2013-2014], Statistics Canada, Share File, Ontario The Issue: MOHLTC. 3. PROOF Food Insecurity Research. (2018). Household Food Insecurity in Canada, 2012. • Food insecurity means not having enough money to buy food. In Algoma, Available from: http://proof.utoronto.ca/ rates of moderate to severe food insecurity are higher than in Ontario.2 4. Government of Ontario. (2008). Breaking the Cycle: Ontario’s Poverty Reduction - Ontario: 8.2% Strategy. Available from: http://www.children.gov.on.ca/htdocs/English/documents/ - Algoma: 11.8% breakingthecycle/Poverty_Report_EN.pdf • Adults who are food insecure are at a greater risk for developing diabetes, 5. Government of Ontario. (2017, April 24). Giving More People an Opportunity to Get Ahead high blood pressure, and anxiety.1 and Stay Ahead [News release]. Available from: https://news.ontario.ca/opo/en/2017/04/ • Children and youth who are food insecure are at a greater risk for suffering giving-more-people-an-opportunity-to-get-ahead-and-stay-ahead.html from a variety of mental health problems, including anxiety, depression, and 6. Government of Ontario. (2017, March 24). Ontario Increasing Minimum Wage to Support suicide.1 Workers and Families [News release]. Available from: https://news.ontario.ca/mol/ • Ontario is one of three provinces/territories in Canada that opted-out of the en/2017/03/ontario-increasing-minimum-wage-to-support-workers-and-families-1.html national food insecurity measure in 2015.3 7. Government of Ontario. (2018, April 11). Ontario Building a Better Future for People Living in Poverty [News release]. Available from: https://news.ontario.ca/prs/en/2018/04/ontario- building-a-better-future-for-people-living-in-poverty-1.html 8. Sault Ste. Marie Innovation Centre/Rural Agri-Innovation Network. (n.d.) Central Algoma Food for Everyone (CAFFE). Available from: http://rainalgoma.ca/research/central-algoma- food-for-everyone-caffe/

Tobacco Provincial/local actions to date

Our Ask to the Candidates • In 2015 Ontario created the Electronic Cigarettes Act (ECA) to regulate vapour products.6

• In 2016 Ontario raised tobacco taxes by $3/carton, applying a 2% inflation that began on What is your plan for addressing the high rate of tobacco use in the North? Given June 1, 2017, and will continue annually until June 2021.4 that this rate is much higher in Algoma (compared to Ontario), how will you • Other policy measures implemented in 2016 and 2017 include: ban on flavoured tobacco ensure that this doesn’t get worse? What groups will you prioritize, knowing that products, expansion of outdoor smoke-free spaces such as hospitals, and a ban on menthol many are at risk for serious illness and diseases due to tobacco use? and clove-flavoured tobacco products.6

• The Smoke-Free Ontario Act, 2017 regulates tobacco, vapour products, and the smoking Return on Investment and vaping of medical cannabis.6 • On January 1, 2018, all hospitals in the province became smoke-free.6 • In Ontario, 16,000 people die each year due to tobacco-related disease; that’s • In May of 2018 Ontario shared Smoke-Free Ontario: The Next Chapter-2018, which focuses 44 lives every day.1 on individual, program/service level, and system level strategies to help reduce the burden • An estimated $2.2 billion in direct health care costs are due to tobacco-related of tobacco use in Ontario.6 disease, with an additional $5.3 billion in indirect costs, including time off work.2 • Investing in targeted, comprehensive health promotion initiatives that address References tobacco prevention, protection, cessation, and enforcement will help save lives and reduce tobacco’s financial burden on the health system. 1. Jaczek, Helena. (2018). Letter from the Minister of Health and Long-Term Care re: Smoke-

Free Ontario Strategy. The Issue 2. Government of Ontario. (2017, October 17). Smoke-Free Ontario [Government website]. Available from: https://www.ontario.ca/page/smoke-free-ontario#section-4 • Tobacco remains the leading cause of preventable illness and death in 3. Canadian Community Health Survey [2015-2016], Statistics Canada, Share File, Ontario Ontario. While provincial rates are at the lowest they have ever been, the rate MOHLTC. of tobacco use in Algoma is not:3 4. Ontario Campaign for Action on Tobacco. (n.d). What’s New [Government website]. o Smokers in Ontario: 15% Available from: http://www.ocat.org/whatsnew.html o Smokers in Algoma: 29.9% 5. Government of Ontario. (2018, March 28). Chapter V, Section C: Revenue Integrity • In adults, tobacco use is responsible for cancers such as lung, liver, and breast, [Government website]. Available from: http://budget.ontario.ca/2018/chapter-5c.html?_ as well as heart disease, stroke, and a host of respiratory diseases such as ga=2.4777395.120557195.1526476135-753261030.1526318848#s-2 Chronic Obstructive Pulmonary Disease (COPD) and asthma.4 6. Government of Ontario. (2018). Smoke-Free Ontario: The Next Chapter-2018. Toronto: • Unborn babies, infants, and children who are exposed to second-hand Queen’s Printer for Ontario. tobacco smoke and/or use tobacco are at an increased risk of developing asthma, middle ear disease, or Sudden Infant Death Syndrome (SIDS).4 • Currently, Ontario has the second lowest tobacco tax rate in the country;5 more must be done to reduce the health, social, and financial burden of tobacco use.