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Election Sign on a Front Lawn

October 24, 2022 is Municipal Election Day

Even if you don't follow politics, you can still show support for improved health and wellness in Oxford County, Elgin County and the City of St. Thomas by asking questions and raising issues with municipal leaders and candidates.

Municipalities are responsible for many areas that affect health and wellbeing, including social services, housing, transportation systems, police and emergency services, and recreation, to name a few.

Community members depend on our elected officials to make informed decisions that improve the health of our community and its residents. When it comes to health, Southwestern Public Health is highlighting six key topics that could  be talked about with candidates and community members during this election period.

What are the health priorities for our region?

The topics below have all been affected by the COVID-19 pandemic, which has likely changed local information and data. When speaking with your candidates, it is important to consider how the pandemic has affected each of these areas.

  • Poverty and Income
  • Housing and Homelessness
  • Climate and Planetary Change
  • Substance Use and Addictions
  • Mental Health and Well-being
  • Transportation

Poverty and Income

Income plays the biggest role in living a long and healthy life. How much money we have affects our ability to access:

  • healthy neighbourhoods
  • safe and healthy homes
  • food
  • transportation
  • childcare, and
  • other basic needs

Low income is a strong predictor of poor health outcomes. For example, people living in low income have a higher risk of diabetes, heart disease, and shorter life expectancy. In 2015, about 1 in 10 people (9.3%) living in the SWPH region were living in poverty.

As a household’s income increases, their risk of poor health outcomes decreases. Supporting solutions that increase people’s income allows them to meet their basic needs more easily.

A Living Wage reflects the hourly wage a worker needs based on the actual cost of living in a specific community. It ensures people have enough income to afford their rent or mortgage, nutritious food, transportation, childcare, and social and educational opportunities. The Living Wage in Elgin County and the City of St. Thomas ($16.57/hour) and Oxford County ($17.34/hour) are higher than the current provincial minimum wage ($15.00/hour).

What questions should I ask my candidate?
  • Poverty leads to bad health. How would you help move people out of poverty and what would you do to ensure a fair wage for everyone?
  • How will you ensure that people living in poverty have a voice in our community discussions, and how will their stakes in the issue be recognized?
  • What would you do to ensure everyone has access to healthy, affordable food in our community?
What answers might I be looking for?
  • Promote Living Wage to employers
  • Provide incentives encouraging local businesses to pay a Living Wage
  • Provide support and access to training for jobs with Living Wages and benefits
  • Provide free income tax filing assistance
  • Increase funding for safe & affordable housing
  • Increase funding for accessible public transportation
  • Increase access for affordable childcare
  • Support local Food Policy Councils
Learn more
  • Ontario Living Wage Network

  • Living Wage St. Thomas Elgin

  • Calculating a Living Wage for Oxford County

  • Ontario Dietitians in Public Health – No Money for Food is…Cent$less

  • PROOF – Household food insecurity in Canada

References

1Health Quality Ontario. Income and Health: Opportunities to achieve health equity in Ontario. Toronto, ON: Queen’s Printer for Ontario; 2016. Available from:
 http://www.hqontario.ca/portals/0/documents/system-performance/health-equity-report-en.pdf

2MacLeod M, Hussain H. Measuring opportunities for reducing health inequities. St. Thomas, ON: Southwestern Public Health; 2019 June. Available from: https://www.swpublichealth.ca/en/community-health/resources/Health-Equity-and-Fairness/measuring_opportunities_for_reducing_health_inequities.pdf

3Ontario Living Wage Network. What is the Living Wage? [Internet]; 2021 [cited 2022 Sept 9]. Available from: https://www.ontariolivingwage.ca/ 

4YWCA St. Thomas-Elgin. Living Wage St. Thomas-Elgin [Internet] St. Thomas, ON: Living Wage St. Thomas-Elgin; 2018. [cited 2022 Sept 9]. Available from:
https://ywcaste.ca/living-wage-st-thomas-elgin/

5Oxford County Public Health. Calculating a living wage for Oxford County. Woodstock, ON: Oxford County; 2018. Available from:
https://www.swpublichealth.ca/en/reports-and-statistics/resources/General---Archived-Reports/ph_201802_calculating_a_living_wage_for_oxford_county.pdf

 

Housing and Homelessness

Access to high-quality, safe, and affordable housing has a positive impact on health and well-being. Housing affects our health through:

  1. Physical conditions inside (i.e., presence of lead, allergens)
  2. The design of the neighbourhoods we live in – sidewalks, greenspace, recreation spaces, feeling of safety and access to healthy food can be different depending on where we live and what services are nearby.

Did you know, for housing to be considered “affordable”, it should cost less than 30% of your before tax income? In the Southwestern Public Health region:

  • 13.0% of owner households spent 30% or more of their income on shelter costs
  • 41.1% of tenant households spent 30% or more of their income on shelter costs
  • About one in ten households live in an unsuitable, inadequate or unaffordable housing. These households cannot afford a suitable alternative due to their income.
  • In Elgin St. Thomas, there is a wait time of 7 to 10 years for one-bedroom and two-bedroom rent-geared-to-income (RGI) units. In Oxford County, there is a wait time of three to five years for one-bedroom RGI units, which are the types of units with the most people on the waitlist.

Homelessness is also a concern within our communities but is not always visible. Some people experiencing homelessness stay in friends' homes, cars, and temporary shelters. 

What questions should I ask my candidate?
  • What interventions would you consider to support families and residents who need safe, adequate, and affordable housing?
  • What strategies will the municipality support to address homelessness in our community? 
  • How will the municipality work together with people experiencing homelessness to develop solutions?
What answers might I be looking for?
Housing and homelessness are complex issues. Our community needs to work together to support people and families who are at risk for or experiencing homelessness. “Housing, social services, health, and employment sectors all have a role to play in preventing homelessness”. 1

Our communities can work to improve conditions that can prevent homelessness such as: 1

  • A mix of affordable housing options and housing stability
  • Income and job security – receiving a living wage
  • Affordable childcare
  • Affordable healthy foods
  • Support for people experiencing domestic violence or trauma through community-based resources
Learn more
  • Fact Sheet: Homelessness and Poverty in St. Thomas and Elgin County
  • St. Thomas Housing and Homelessness Services
  • Elgin St. Thomas Coalition to End Poverty
  • Zero-Poverty Oxford
  • United Way Oxford
References
 1 Gaetz, S.; & Dej, E. A new direction – A framework for Homelessness Prevention. Toronto, ON: Canadian Observatory on Homelessness; [no date]. Available from: https://www.homelesshub.ca/sites/default/files/attachments/PreventionFramework-Summary.pdf

2 MacLeod M.; Hussain, H. Measuring opportunities for reducing health inequities. St. Thomas, ON: Southwestern Public Health; 2019 June. Available from: https://www.swpublichealth.ca/en/community-health/resources/Health-Equity-and-Fairness/measuring_opportunities_for_reducing_health_inequities.pdf

3 Org-Code. St. Thomas – Elgin homelessness enumeration report 2021, St Thomas, ON: Org-Code; 2021. Available from: https://cdn5-hosted.civiclive.com/UserFiles/Servers/Server_12189721/File/Living%20Here/St.%20Thomas%20Elgin%20Social%20Services/Social%20Housing/St.%20Thomas-Elgin%202021%20Homelessness%20Enumeration%20Report%20%20-%20Final.pdf

4 Southwestern Public Health. Health equity and fairness [Internet]. St. Thomas, ON: Southwestern Public Health; 2020 [cited 2022 Sept 15]. Available from: https://www.swpublichealth.ca/en/community-health/health-equity-and-fairness.aspx

5 United Way Elgin St. Thomas; Fact sheet: Homelessness and poverty in St. Thomas and Elgin County. St. Thomas, ON; United Way Elgin St. Thomas [cited 2022 Sept 15]. Available from: https://unitedwayem.ca/wp-content/uploads/2019/01/FactsSheet-Elgin-FINAL.pdf

Climate and Planetary Change

Climate changes are affecting the health of our residents in many ways.  The effects are felt most by:

  • People with pre-existing health conditions
  • Children and seniors
  • People with low income
  • Indigenous communities
  • Those experiencing homelessness

Impacts of climate change include:

  • More heat-related illnesses and heart and lung disorders due to higher temperatures and lower air quality
  • Increased risk of diseases transmitted by mosquitoes and ticks due to rising summer temperatures, shorter winters, and environmental changes
  • Increased risk of food and waterborne illnesses
  • Worsening allergy symptoms and respiratory conditions due to increased pollen and spore production as summer temperatures increase and the winters become shorter
  • Injury, illness, or loss of life due to damage from extreme weather events such as flooding, ice, and windstorms
  • Mental health impacts can include post-traumatic stress disorder (PTSD), depression, anxiety, grief, and substance use 
What questions should I ask my candidate?
  • What actions will you take to ensure that our vulnerable populations are protected from the impacts of climate change?
  • What are your main concerns for our area related to climate change, and how do you plan to address these concerns?
What answers might I be looking for?

Municipalities can support:

  • Energy-efficient buildings,
  • Low carbon public transport,
  • Active transportation such as cycling and walking, and
  • Greening cities with parks and gardens. This helps to reduce CO2, cool urban areas and reduce flooding.
“Thinking and acting at a local level helps communities fight climate change and build resilience to climate impacts. For instance, producing goods and food locally can lower the cost of transportation, reduce waste, and help local economies.“4
Learn more
  • https://www.canada.ca/en/health-canada/services/climate-change-health.html
  • https://www.epa.gov/climate-indicators/understanding-connections-between-climate-change-and-human-health
References

1Berry, P., & Schnitter, R. (Eds.). (2022). Health of Canadians in a Changing Climate: Advancing our Knowledge for Action. Ottawa, ON: Government of Canada

2Gough W, Anderson V, Herod K. Ontario climate change and health modelling study: report. Ontario Ministry of Health and Long-Term Care, Queen’s Printer for Ontario. Toronto, ON, Canada 2016. 30 p. Report number: ISBN. 2016:978-1.

3Hayes K, Blashki G, Wiseman J, Burke S, Reifels L. Climate change and mental health: Risks, impacts and priority actions. Int J Ment Health Syst. 2018 Dec;12(1):1-2

4United Nations Framework Convention on Climate Change. Cities and local action to combat climate change [Internet]. Bonn; 2022 [cited 2022 Sept 13]. Available from: https://unfccc.int/topics/education-youth/youth-engagement/global-youth-video-competition/global-youth-video-competition-2019/cities-and-local-action-to-combat-climate-change  

Substance Use and Addictions

Chronic diseases cause about three-quarters of deaths in Ontario. Most of these deaths were due to four major chronic diseases: cancers, cardiovascular diseases, chronic lower respiratory diseases, and diabetes. These reduce the quality and length of life and are expensive to treat, costing an estimated $46 billion in Canada4 and $10.5 billion/year in Ontario alone.1 Alcohol, tobacco and opioids account for the highest costs within those amounts.1,2,4

Modifiable risk factors for these chronic diseases include tobacco and alcohol use, physical inactivity, and unhealthy eating. Therefore, addressing these risk factors is critical to reducing the health and economic burden of chronic diseases, minimizing hospital overcrowding and hallway medicine in Ontario.1

Drinking alcohol is linked to chronic diseases such as cancer, high blood pressure and stroke. It is also linked to injuries and deaths because of falls, car crashes, violence, suicide and fires. The SWPH region, including Oxford County, Elgin County, and the City of St. Thomas, averaged 95 deaths per 100,000 from alcohol. In the SWPH region, deaths from opioid overdoses almost doubled between 2019 and 2021. In the first quarter of 2021 the rates of opioid overdose related emergency department visits and deaths in our region was higher than the rates for Ontario.1,3

What questions should I ask my candidates?
  • How do you plan on promoting easier access to local health and substance use services?
  • There is a needed focus on treatment and harm reduction for substance use; How will the municipality work with the community, researchers, and public health to prevent substance use?
  • Research has proven that increasing access and locations for alcohol use, leads to harms to the public. How will the Municipality balance the need to protect people, with changing alcohol policies?
  • How do you plan on supporting and implementing policies to reduce the risks for people who use substances? 

What answers might I be looking for?
  • Policies and practices that support work-life balance
  • Zoning policies to reduce harmful consumption of cannabis, vaping, and alcohol
  • Enforcement and promotion of Smoke-Free Spaces
  • A coordinated approach to culturally and trauma-informed services - i.e., mental health, police services, health care providers and social services.
  • Support access to safer supply prescribing of pharmaceutical-grade opioids
  • Support for harm reduction services such as consumption and treatment sites, needle syringe programs, naloxone training and distribution
  • Decriminalization of substances
  • Support local data collection to develop substance prevention strategies
  • Provide support and access to training for jobs with Living Wages and benefits
  • Increase funding for safe & affordable housing
Learn more
  • Alcohol, Drugs and Tobacco
  • Harm Reduction: Needle Exchange Program
  • Harm Reduction: Opioids, Naloxone, and Needle Exchange
References
 1CCO and Ontario Agency for Health Protection and Promotion (Public Health Ontario). The burden of chronic diseases in Ontario: key estimates to support efforts in prevention. Toronto: Queen’s Printer for Ontario; 2019.

2Queen's Printer for Ontario; 2017. Smoke-Free Ontario Scientific Advisory Committee, Ontario Agency for Health Protection and Promotion (Public Health Ontario). Evidence to guide action: Comprehensive tobacco control in Ontario (2016). Toronto, ON: Queens Printer for Ontario; 2017.

3Public Health Ontario. Interactive Opioid Tool [Internet]. Ottawa: Ontario Agency for Health Protection and Promotion; 2022 [cited: 2022 Sept 15]. Available from:  https://www.publichealthontario.ca/en/data-and-analysis/substance-use/interactive-opioid-tool

4Canadian Substance Use Costs and Harms Scientific Working Group. (2020). Canadian substance use costs and harms 2015–2017. (Prepared by the Canadian Institute for Substance Use Research and the Canadian Centre on Substance Use and Addiction.) Ottawa, Ont.: Canadian Centre on Substance Use and Addiction.

Mental Health and Wellbeing

There is no health without mental health. Mental health promotion is a key component of individual and community health. As a country, Canada was already experiencing a mental health crisis prior to the pandemic. The pandemic added to this crisis and highlighted how important it is that we address mental health promotion and care for overall well-being.3

People can experience negative long-term health and well-being effects when they have a low sense of belonging. For example, isolated people are 50% more likely to die early than those with strong social connections. This is about the same impact as smoking 15 cigarettes a day.2

Mental Health is positively impacted by:1,3

  • Getting enough sleep
  • Eating enough healthy foods
  • Feeling safe
  • A sense of belonging and connection to the community
  • Meaningful engagement and/or employment
  • Healthy coping skills 
 What questions should I ask my candidates?
  • How do you plan to support the Community safety and well-being strategy developed for our region? What resources or opportunities have you considered that can enhance Municipal policies and practices with community mental well-being?
 What answers might I be looking for?
  • Municipal social services that focus on reducing adverse childhood experiences
  • Equitable access to mental health and wellbeing supports
  • Green spaces within walking distance of every neighbourhood
  • Creating safe opportunities to talk about mental health (For example listening, asking open-ended questions, and normalizing all emotions and conversations around mental health) 
  • Meaningful community engagement that promotes the celebration of differences and a sense of connection
  • Policies and practices that support work-life balance
  • Provide support and access to training for jobs with Living Wages and benefits
  • Increase funding for safe & affordable housing
  • Increase funding for accessible public transportation
  • Increase access to affordable childcare 
 Learn more
  • Mental Health
 References
Southwestern Public Health; Pathways to Promoting Mental Well-being:  An Action Plan for COVID-19 Recovery and Beyond 2021. St.Thomas, ON: Southwestern Public Health; 2021.

 

3Shields, R. Mental health in Canada: Covid-19 and Beyond: CAMH Policy Advice. Toronto, ON: Centre for Addiction and Mental Health; 2021. 

Transportation

Transportation is required for people to access employment, healthy foods, medical appointments, recreation, childcare and school. Walking or driving may not always be practical in rural areas where people are going further distances. Safe transportation also provides mobility and independence for those who cannot or do not drive.

Our rural communities create unique challenges in a community approach to transportation as people and places are further apart. Areas with smaller populations that are more spread out will require a unique approach. For example: volunteer services, car-sharing, shuttles, or regular community trips to a particular location (i.e., large grocery stores). While larger areas like St. Thomas and Woodstock provide scheduled bus services, there is a need to consider cost, scheduling, and amount of users. There are not necessarily one size fits all approaches.

Accessible and safe sidewalks and multi-use trails connecting neighbourhoods, recreation, retail, schools, beaches and parks can help to promote active transportation. Trails and sidewalks that are well lit and include spaces for sitting or rest help to increase active transportation.2

What questions should I ask my candidate?
  • What actions would you take to make active transportation easier and safer in our community for people of all ages, backgrounds, and abilities?
  • What can you do to improve transportation options for those in our community who cannot or do not drive?
  • How do you plan to address transportation issues in rural communities?
 What answers might I be looking for?
  • Create accessible and safe sidewalks and multi-use trails
  • Unique and tailored transportation systems that meet the needs of the wider community.
  • Support road safety strategies to reduce and prevent injury. ‘Vision Zero’ is an example of a strategy that involves the community coming together to address the complex problem of road safety. Vision Zero was started in Sweden in the 1990s with the goal of “eliminating all traffic fatalities and serious injuries while increasing safe, healthy, equitable mobility for all”2 
 Learn more
  • Walking, Biking and Hiking
  • 8-80 Cities
 References
 1 Former Elgin St. Thomas Public Health. Addressing affordable access to transportation in Elgin St. Thomas – Executive summary. St Thomas, ON; Elgin St. Thomas Public Health; 2017.

2 Southwestern Public Health.Position statement: Built environment. St. Thomas, ON: Southwestern Public Health; 2019 [cited 2022 Sept 15]. Available from:  https://www.swpublichealth.ca/en/reports-and-statistics/resources/Position-Statements/Position-Statement---Built-Environement.pdf

Additional Resources:

  • SWPH Dashboard: Local Mapping of Chronic Disease Risk Factors
  • SWPH Dashboard: Local Opioid Monitoring
  • SWPH Reports and Statistics
  • SWPH Position Statements
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