On Wednesday, November 27, OPSEU/SEFPO participated in a joint union roundtable discussion on key Public Health sector issues alongside the Ontario Nurses’ Association and Canadian Union of Public Employees (CUPE).
In attendance on behalf of OPSEU/SEFPO members were Lucy Morton, Chair of OPSEU/SEFPO’s Community Health Professionals Division and Janet Dawson, OPSEU/SEFPO Local 327 President from the Peterborough Public Health Unit.
The three unions met with MPPs to speak about issues affecting Public Health Units in Ontario (outlined in the Background and Context below) and presented the following four solutions necessary for supporting the Public Health sector:
- An immediate increase of 10% in annual base funding to public health units, followed by annual increases above the combined rate of inflation and population growth (currently around 5%) to allow service restoration and growth.
- Support fair and competitive wage structures that ensure compensation keeps pace with the rising cost of living. This would contribute to a motivated and stable workforce and alleviate the recruitment and retention crisis.
- Ensure the preservation of existing Public Health jobs and preventing layoffs, while using enhanced funding to create net new jobs that allow for expanded service delivery. Job security and sector growth are integral to sustaining and expanding the reach of Public Health initiatives, aligning with the Ontario Public Health Standards (OPHS) mandate.
- Provide full provincial funding for enhancements to Public Health services rather than downloading costs to municipalities who may not have the funding to provide additional services to the public.
Background and context on Public Health challenges in Ontario
Underfunding is the Central Issue
The Public Health sector plays a crucial role in advancing the well-being of individuals, preventing diseases and injuries, and safeguarding the overall health of the population. Its efforts contribute to a healthier society and alleviate the strain on the healthcare system. Unfortunately, the Public Health sector has faced chronic underfunding for decades, depriving communities of essential resources required for maintaining good health.
At current 1% increase per year, the Public Health sector is observing a reduction and elimination of services and programs, closures of service sites, and the elimination of jobs through attrition. The dedicated workers in this sector endure inadequate compensation, heightened workloads, burnout, and a substantial departure from the profession.
The rate of funding growth is well below the combined inflation and population growth rate of around 5%, meaning funding hikes of only 1% per year are a huge cut in real per-capita terms.
Right now, the Public Health sector is in crisis. Reversing this means government must do two things:
- An immediate injection of funds to stabilize the system, stop further cuts, and begin to undo the damage of years of underfunding; and
- A commitment to rebuild the public health system through a long-term commitment to steadily raise funding beyond the rate of inflation and population growth.
Public Health Investment Improves Quality of Life and Reduces Healthcare Costs
Austerity in the Public Health sector has both hurt quality of life for Ontario residents, and unnecessarily increased healthcare costs. Public Health spending has disproportionate benefits for both population health outcomes and downstream costs.
Public Health has a broad scope and mandate. The 6 core functions of public health are:
- health protection;
- disease and injury prevention;
- health promotion;
- emergency preparedness and response;
- population health assessment; and
- health surveillance.
All these areas directly impact both health outcomes for individuals, and costs in the health care system.
Public health is the first line of defense for the healthcare system. According to a 2022 Canadian Public Health Association (CPHA) report, “Every $1 invested in public health interventions brings a median return of over $14 saved in costs to health and economic sectors.”
Improving Service Delivery Means Supporting Public Health Workers
The core of the Public Health system is the workforce that delivers services across the province. The only way to ensure a strong public health system is to ensure adequate staffing levels and good working conditions.
At present, underfunding has led to understaffing and poor working conditions. Difficulties with recruitment and retention then only further compound these problems, particularly when employers use departures to cut jobs by attrition as is too frequently the case.
Only improved funding can restore and improve staffing levels, working conditions, and ultimately the quality of services provided to Ontario residents.
The broad scope of public health services — and the importance and value of these services to communities — becomes evident when reviewing just a sampling of the jobs in the sector and the associated job duties:
- Dental Assistants and Hygienists play crucial roles in preventive dental care and education in schools. They help in maintaining excellent oral health, providing critical support in dental practices, and educating patients about hygiene best practices.
- Public Health Inspectors ensure compliance with health regulations in various settings, including food establishments, salons, swimming pools, daycares, and long-term care facilities. They prevent health hazards, promote hygiene and safety in the community, and handle emergency preparedness and response in the community.
- Smoke-Free Ontario Inspectors keep tobacco and vaping products out of children’s hands through compliance inspections of retailers. By enforcing regulations, they support local policies aimed at reducing smoking rates and protecting vulnerable populations from secondhand smoke, such as children and those with respiratory conditions.
- Public Health Nurses provide immunization, healthcare services and education to communities, focusing on disease prevention and health promotion. They often work with at-risk populations and lead health initiatives that address community needs.
- Family Home Visitors offer support and education to families in their homes, focusing on maternal and child health. They guide families on child development, parenting skills, and accessing health services.
- Epidemiologists study the patterns, causes, and effects of health conditions within populations. They investigate outbreaks of disease and identify risk factors, ultimately informing public health interventions.
- Health Educators / Promoters develop programs and materials to teach communities about health topics and promote healthy behaviors. They work to empower individuals with knowledge that can lead to better health choices.
- Public Health Nutritionists and Dietitians work to improve the health of communities and populations through nutrition education. They support healthy eating in different settings including schools, daycares, and public spaces. They guide the development of policies and practices that promote healthy eating.
- Speech and Language Experts assess children’s speaking and language skills, provide language intervention and speech therapy. They help children with communication disorders achieve better reading, language, and listening skills.
- Environmental Health Specialists assess environmental factors that can affect human health, ensuring that air, water, and soil meet safety standards. They work on issues such as pollution control, waste management, and food safety.
- Support Staff provide administrative and business support to health units so that public health workers can focus on delivering services to the community. They include administrative assistants, communications and IT support staff, to name a few.
In sum, underfunding has meant cuts of these jobs and others like them, hurting service
delivery.