COMMUNITY 2015 HEALTH ASSESSMENT Prairie Mountain Health Community Health Assessment 2015 March 2015 Prairie Mountain Health Planning and Evaluation Jody Allan Nancy McPherson Colin Williams Pamela McTavish Amy Ostash Maggie Campbell Megan Gowans Jessa Baily P a g e | I Acknowledgements The Community Health Assessment (CHA) team was coordinated by Jody Allan, who is extremely grateful for the dedicated efforts of the following people: Maggie Campbell, Colin Williams, Nancy McPherson, Pamela McTavish, Amy Ostash, Jessa Baily, Michelle Gaber, Megan Gowans, Bonnie McKay, Dr. Sandra Allison, Gwynn Ketel and Sharon Basaraba. The members of the CHA Team wish to express our thanks to everyone who participated in the CHA process. Community members, clients, regional staff, and partner organizations gave of their time to provide us with information and opinions. We could not have completed the CHA without the partners who provided us with the data, in particular Manitoba Health, Healthy Living, and Seniors and Manitoba Centre for Health Policy. The CHA Team also wishes to thank the Board and Executive Management Team for their guidance and support, the collaborative efforts of the Community Health Assessment Network and the diligence of our external reviewer, Bev Cumming. This report is produced and published by the Prairie Mountain Health Planning and Evaluation team. It is available in PDF format on our website at: http://prairiemountainhealth.ca/ If you would like more information about the Community Health Assessment, please contact Prairie Mountain Health at: Prairie Mountain Health Corporate Office 192-1st Avenue West Box 579 Souris, Manitoba R0K 2C0 Toll-free: 1-888-682-2253 Website: www.prairiemountainhealth.ca How to cite this report: Allan J, McPherson N, Williams C, McTavish P, Ostash A, Campbell M, Gowans M, Baily J. Prairie Mountain Health Community Health Assessment 2015, March 2015 P a g e | II INTRODUCTION FROM MEDICAL OFFICER OF HEALTH Introduction from the Medical Officer of Health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organization, 1948). The Community Health Assessment (CHA) is a fundamental tool for both supporting what currently makes us healthy and outlining ways to improve our health. The CHA allows us to begin to understand ourselves: who we are, our strengths, our challenges; the CHA also allows us to understand our health system’s response to our needs. From this understanding, the CHA provides the opportunity for discussions and collaborative planning as a way to further support how we are currently healthy and to consider options on how our health can be improved. These inter-sectoral discussions, led by the CHA, can lead to priority setting and action planning; and this is where we will see ongoing support to what is making us healthy and also where we will see changes that lead to improvements in our health. The health of a population is determined by broad factors (determinants of health) such as income, social status, education, working environments, biology, genetics, and health services; also, physical, social, economic and cultural environments contribute to these determinants. The CHA outlines a number of these determinants of health. What are some things this report tells us about ourselves? Who are we? The most dramatic population change in Prairie Mountain Health (PMH) over the next 30 years will be seen in a major increase in the population 85 years of age and over – this will have a significant impact on health care services. Certain geographic areas within PMH have seen a significant amount of growth due to immigrants and newcomers joining the communities. Over the next 30 years, it is estimated that the provincial First Nation population will increase. What our some of our strengths? Our socioeconomic status has improved, cancer rates have slightly decreased, premature mortality rates have declined, PMH residents generally report a good perceived mental health state, and there are various health promotion programs and activities within both the community and hospital setting focusing on differing ways to improve well-being (i.e. injury prevention, mental health, chronic disease prevention and treatment). What are some of our needs and challenges within PMH? The top causes of premature death (before age 75) in PMH are cancer, circulatory and injury and poisoning. PMH’s unintentional injury hospitalizations are higher than the province and have been increasing. The number of clients requiring Inactive and Latent Tuberculosis Surveillance has increased significantly in PMH in recent years. Almost one-third of adult community mental health clients had an alcohol or drug-related diagnosis. Regarding health services, ongoing staff shortages (EMS, nursing, therapy, diagnostics) and physician resources are a significant challenge for PMH. PMH’s aging population is likely to result in the use of more cancer-related health services. Regarding home-care clients, staff have observed increases in the level of care required. P a g e | III COMMUNITY HEALTH ASSESSMENT 2015 The health of children is critical for the health of our communities. The early years of childhood are recognized as having a profound influence on the long-term health and development of individuals. Unfortunately, it is noticed that there are higher rates of pre and postnatal psychological distress in the North Zone and Brandon compared to Manitoba as a whole, which can have serious adverse effects on both mother and child. Alcohol consumption during pregnancy (higher than the Manitoba average in the South Zone and Brandon) and smoking during pregnancy (higher in the North Zone and Brandon) have the potential to lead to adverse outcomes for both mother and child. PMH students (grade 7-12) generally felt safe and supported by their community and school, and the majority of students reported positive mental health. Admissions of youth to the Crisis Stabilization Unit have been increasing; but, more supports are being offered through Teen Clinics and Early Intervention Services. PMH childhood immunization rates are higher than the provincial average. This CHA provides an excellent discussion on health equity within the Introduction section. It is valuable that the differences in health and risk factors across those in PMH be further identified and addressed; because, the health gap has continued to widen, whereby most of the improvement in health status occurred in healthy areas whilst there was a lack of improvement in the least healthy areas. Poverty underlies these unacceptable disparities in health and threatens the health and well-being of many, particularly our children (WRHA Community Health Assessment, 2009). Related to the impact of poverty, housing problems and a variety of social and behavioral risk factors, tuberculosis (TB) surveillance has increased and awareness of STIs, including HIV, has increased. Many of our citizens who face the highest risk to their health also face the most barriers in accessing preventive and health care services (WRHA Community Health Assessment, 2009). Those who experience barriers due to language, culture or low income, persons experiencing homelessness, people living with mental health issues (including addictions), and newcomers are among those facing higher risk of injury, infections, mental health problems and chronic diseases (WRHA Community Health Assessment, 2009). Newer risks affecting health are also important to continue to assess. Some examples are e-cigarettes, environmental issues (radon, climate change and severe weather events), and the effects on communities from an increase in the development of various industries. What can we do to support and improve our health? We need to continue to assess the health of our communities so that we can further understand the factors that are affecting our health and how our health system can assist in responding to this. We need to understand the health needs of all peoples of our communities. We need to take opportunities to listen and allow dialogue within our communities, schools, industries and homes to understand the realities of our heath and our lack of health. We need to foster community participation and partnerships with non-health organizations so that we can support our population’s health and move together towards change in areas that are impeding our health. We need to acknowledge that health services are solely one component of the broad factors that determine our health. We can strive for health – physical, mental and social well-being, and the absence of disease. We can be encouraged by projects in our region that have promoted overall well-being and have focused on our specific health needs, such as the Westman Immigrant Services, the Families First Home visiting P a g e | IV INTRODUCTION FROM MEDICAL OFFICER OF HEALTH program, the Parent-Child Coalitions, the Cancer Patient Journey Initiative, the Diabetes and Heart Health Program, the Community Mental Health Program and our Spiritual and Palliative Care Programs. Let us use this tool – the Community Health Assessment – to work together toward health by supporting what currently allows us to be healthy; and, let us use this tool to improve our health by leading change through innovatively responding together to the health needs of our communities and all peoples within these communities. Dr. Amy Frykoda, MD, CCFP, MSc Medical Officer of Health P a g e | V COMMUNITY HEALTH ASSESSMENT