Ontario Public Health Standards

Chronic Disease Prevention

Goal

  • To reduce the burden of preventable chronic diseases of public health importance.5

Societal Outcomes

  • An increased proportion of the population lives, works, plays, and learns in healthy environments that contribute to chronic disease prevention.
  • There is increased adoption of behaviours and skills associated with reducing the risk of chronic diseases of public health importance.
  • There is increased community participation in developing integrated and comprehensive local programs that reduce chronic diseases of public health importance.
  • Community partners have the capacity to address the risk factors associated with chronic diseases, including poor diet, obesity, tobacco use, physical inactivity, alcohol misuse, and exposure to ultraviolet radiation.

Board of Health Outcomes

  • The board of health is aware of and uses epidemiology to influence the development of healthy public policy and its programs and services for chronic disease prevention.
  • There is increased awareness among community partners about the factors associated with chronic diseases that are required to inform program planning and policy development, including the following:
    • Community health status;
    • Risk, protective, and resiliency factors; and
    • The importance of creating healthy environments.
  • Policy-makers have the information required to enable them to amend current policies or develop new policies that would have an impact on the prevention of chronic diseases.
  • The public is aware of the importance of healthy eating, healthy weights, comprehensive tobacco control, physical activity, reduced alcohol use, and reduced exposure to ultraviolet radiation.
  • The public is aware of the benefits of screening for early detection of cancers and other chronic diseases of public health importance.
  • Priority populations have food skills and adopt healthy eating behaviours.
  • Priority populations adopt tobacco-free living.
  • Tobacco vendors are in compliance with the Smoke-Free Ontario Act.
  • Youth have reduced access to tobacco products.

Assessment and Surveillance

Requirements

  1. The board of health shall conduct epidemiological analysis of surveillance data, including monitoring of trends over time, emerging trends, and priority populations, in accordance with the Population Health Assessment and Surveillance Protocol, 2008 (or as current) [PDF], in the areas of:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control6;
    • Physical activity;
    • Alcohol use; and
    • Exposure to ultraviolet radiation.
  2. The board of health shall monitor food affordability in accordance with the Nutritious Food Basket Protocol, 2008 (or as current) [PDF] and the Population Health Assessment and Surveillance Protocol, 2008 (or as current) [PDF].

Health Promotion and Policy Development

Requirements

  1. The board of health shall work with school boards and/or staff of elementary, secondary, and post-secondary educational settings, using a comprehensive health promotion approach, to influence the development and implementation of healthy policies, and the creation or enhancement of supportive environments to address the following topics:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use; and
    • Exposure to ultraviolet radiation.
    These efforts shall include :
    1. Assessing the needs of educational settings; and
    2. Assisting with the development and/or review of curriculum support.
  2. The board of health shall use a comprehensive health promotion approach to increase the capacity of workplaces to develop and implement healthy policies and programs, and to create or enhance supportive environments to address the following topics:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use;
    • Work stress; and
    • Exposure to ultraviolet radiation.
    These efforts shall include:
    1. Conducting a situational assessment in accordance with the Population Health Assessment and Surveillance Protocol, 2008 (or as current) [PDF]; and
    2. Reviewing, adapting, and/or providing behaviour change support resources and programs.
  3. The board of health shall collaborate with local food premises to provide information and support environmental changes through policy development related to healthy eating and protection from environmental tobacco smoke.
  4. The board of health shall work with municipalities to support healthy public policies and the creation or enhancement of supportive environments in recreational settings and the built environment regarding the following topics:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use; and
    • Exposure to ultraviolet radiation.
  5. The board of health shall increase the capacity of community partners to coordinate and develop regional/local programs and services related to:
    • Healthy eating, including community-based food activities;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use; and
    • Exposure to ultraviolet radiation;

    These efforts shall include:
    1. Mobilizing and promoting access to community resources;
    2. Providing skill-building opportunities; and
    3. Sharing best practices and evidence for the prevention of chronic diseases.
  6. The board of health shall provide opportunities for skill development in the areas of food skills and healthy eating practices for priority populations.7
  7. The board of health shall ensure the provision of tobacco use cessation programs and services for priority populations.
  8. The board of health shall collaborate with community partners to promote provincially approved screening programs related to the early detection of cancers.
  9. The board of health shall increase public awareness in the following areas:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use;
    • Exposure to ultraviolet radiation;
    • Benefits of screening for early detection of cancers and other chronic diseases of public health importance; and
    • Health inequities that contribute to chronic diseases.

    These efforts shall include:
    1. Adapting and/or supplementing national and provincial health communications strategies; and/or
    2. Developing and implementing regional/local communications strategies.
  10. The board of health shall provide advice and information to link people to community programs and services on the following topics:
    • Healthy eating;
    • Healthy weights;
    • Comprehensive tobacco control;
    • Physical activity;
    • Alcohol use;
    • Screening for chronic diseases and early detection of cancers; and
    • Exposure to ultraviolet radiation.

Health Protections

Requirements

  1. The board of health shall implement and enforce the Smoke-Free Ontario Act8 in accordance with provincial protocols, including but not limited to the Tobacco Compliance Protocol, 2008 (or as current) [PDF].
  2. The board of health shall implement and enforce the Skin Cancer Prevention Act (Tanning Beds), 20139 in accordance with provincial protocols, including but not limited to the Tanning Beds Compliance Protocol, 2014 (or as current) [PDF].
  3. The board of health shall implement and enforce the Electronic Cigarettes Actin accordance with provincial protocols, including but not limited to the Electronic Cigarettes Compliance Protocol, 2016 (or as current).10
  4. The board of health shall implement and enforce the Healthy Menu Choices Act, 201511 in accordance with the Menu Labelling Compliance Protocol, 2017 (or as current).

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5 Chronic diseases of public health importance include cardiovascular diseases, cancer, respiratory diseases, and type 2 diabetes. Risk factors for chronic diseases include but are not limited to poor diet, obesity, tobacco use, physical inactivity, alcohol misuse, and exposure to ultraviolet radiation.
6 Comprehensive tobacco control includes preventing the initiation of tobacco use among young people; promoting quitting among young people and adults; eliminating non-smokers' exposure to environmental tobacco smoke; and identifying and eliminating disparities related to tobacco use and its societal outcomes among different population groups.
7 This may include pregnant and postpartum women, individuals of low socio-economic status and youth.
8 This shall include, but not be limited to: inspection and re-inspection, including enforcement/compliance checks of all tobacco vendors; inspection and re-inspection of appropriate public places and workplaces; inquiries into all complaints under the Smoke-Free Ontario Act; maintenance of a supporting database related to enforcement of the Smoke-Free Ontario Act, and provision of Smoke-Free Ontario Act education and information to the community. It is recommended that boards of health also offer to develop a written agreement with every school board covering all local schools and outlining the roles and responsibilities of the board of health and school officials and the procedures related to the Smoke-Free Ontario Act.
9 This shall include, but not be limited to: inquiries into all complaints under the Skin Cancer Prevention Act (Tanning Beds), 2013; maintenance of inspection records; and provision of the Skin Cancer Prevention Act (Tanning Beds), 2013 education and information to vendors and to the community.
10 This shall include, but not be limited to: inquiries into all complaints under the Skin Cancer Prevention Act (Tanning Beds), 2013; maintenance of inspection records; and provision of the Skin Cancer Prevention Act (Tanning Beds), 2013 education and information to vendors and to the community.
11This shall include, but not be limited to: provision of education and information related to the Healthy Menu Choices Act, 2015 to regulated food service premises and to the community; inspection, including enforcement/compliance checks of regulated food service premises; provision of information on regulated food service premises to the ministry on an annual basis; inquiries into all complaints under the Healthy Menu Choices Act, 2015; and maintenance of inspection records.

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