Definition:

The teen pregnancy rate estimates the number of pregnancies (resulting in live births, still births and therapeutic abortions) per 1,000 females age 15 -19 years.

Data Source(s):

Formula:

Total number of deliveries (live births and stillbirths) and therapeutic abortions for females age 15-19 years (2007 calendar year) Total number of females age 15-19 years (2007 calendar year)

x 1,000

Notes:

• Intellihealth therapeutic abortions summary report was used to derive the number of therapeutic abortions for females ages 15-19 years
• IntelliHealth\ 20 - Ontario Special Reports\Therapeutic Abortion Summary. Report # 20-0001 was used to derive the number of therapeutic abortions
• Intellihealth\05 Inpatient Discharges\Hospital Births\ Deliveries - Ontario x Mother's Age: Report #: 05-0004 was used to derive the number of deliveries
• Analyzed by mother's usual place of residence, not place of birth
• Analyzed by ICD 10-CA codes containing Z37 for live births and stillbirths by mother's date of discharge, and mother's age at time of delivery
• Excludes births and therapeutic abortions to females residing out-of-province; excludes estimates of fetal loss; excludes abortions conducted with females residing out of province

Definition:

The low birth weight rate indicator estimates the rate of singleton live births weighing 500-2499 grams immediately upon birth, based on the mother's usual place of residence per the total for singleton live births weighing at least 500 grams per 1,000 births.

Data Source(s):

Formula:

Total number of singleton live births weighing between 500 and 2499 grams (2007 calendar year) Total number of singleton live births weighing at least 500 grams (2007 calendar year)

x 1,000

Notes:

• Excludes births with weights recorded under 500 grams due to possible entry errors with still born births
• Excludes multiple births
• PHPDB Qualifications: Newborns (entry code=N) at date of admission; Patient Diagnosis Codes (beginning with Z380, Z381, Z382) for the Calendar Year (2007). Weights for singleton live births (greater than or equal to 500); Weights for low births weights (greater than or equal to 500 grams and less than 2500 grams)
• Intellihealth\05 Inpatient Discharges\Hospital Births\ Low Birth Weight, Singleton Births: Report # 05?0004 was used to derive both the numerator and denominator
• The indicator is not limited to full-term births and also includes pre-term births
• Analyzed by mother's usual place of residence, not place of birth
• Excludes births to mothers who reside out of province

Definition:

The breastfeeding duration rate indicator estimates the proportion of mothers age 15-55 years who breastfed (not exclusively) their last baby (born within the past five years) for a duration of six months or more.

Data Source(s):

Formula:

Total weighted number of female respondents age 15-55 years who gave birth in the past five years and who breastfed (non-exclusively) their child for at least six months Total weighted number of female respondents age 15-55 years who gave birth in the past five years

x 100

Notes:

• This indicator was derived by combining three cycles of the Canadian Community Health Survey (CCHS) in order to obtain reportable and stable data for breastfeeding duration estimates at the public health unit level in Ontario. Simply using one survey to estimate for breastfeeding duration resulted in unstable estimates for the majority of public health units in Ontario, and in many cases the data was unreportable
• Numerator: MEX_06= Six Months (9), Seven to Nine Months(10), Ten to Twelve Months (11), One year or more (12)
• Denominator: MEX_01=Has given birth in the last five years (1)
• Excluded not applicable (96) and not stated (99) responses to MEX_01. Exclusion of women who are currently breastfeeding (MEXC_05=2)
• PHU 3545 was dropped, 3547 = North Bay, and 3560 = Simcoe in CCHS 2.1 due to amalgamations of public health units
• There was insufficient sample size to stratify the data for each public health unit for CCHS 2007, and therefore cycles 2.1, 3.1, and CCHS 2007 of the CCHS were combined according to methods outlined by Thomas and Wannell. Both the separate and pooled approaches to combining cycles of the CCHS were considered. The separate approach to combining cycles of CCHS was used in the report
• As there were not consistent trends over time over the 3 individual estimates for breastfeeding duration, combining the 3 cycles of the CCHS did not diminish the data output in any way

Definition:

The postpartum contact indicator is defined as the percentage of families who consented to a post-partum phone call under the Healthy Babies Healthy Children (HBHC) program and who received a post-partum phone call or contact from the health unit within 48 hours of release from hospital after giving birth.

Data Source(s):

Formula:

# of families who were contacted by the health unit within 48 hours of hospital discharge (2007 calendar year) # of families (with or without a Parkyn) who consented to be contacted by the health unit (2007 calendar year)

x 100

Notes:

• Data extracted on July 27, 2008
• Not based on all live births. Families must have consented to receiving an HBHC phone call
• Items 21.1/21.0 on the ISCIS extract report were used

Definition:

The smoking prevalence indicator estimates the age-standardized proportion of people age 12 years and older who are current smokers (daily or occasional cigarette smokers).

• Current smoker - daily smoker or occasional smoker
• Daily smoker - smoking at least one cigarette per day
• Occasional smoker - does not have at least one cigarette per day

Data Source(s):

Formula:

Weighted number of respondents age 12+ years who are current (daily + occasional) cigarette smokers Weighted total number of respondents age 12+ years

x 100

Notes:

• Numerator: SMK_DSTY= Daily Smoker (1) or Occasional Smoker (former daily smoker) (2) and Occasional Smoker (3)
• Denominator: SMK_DSTY= Daily (1), Occasional (2) Occasional (3) Former Daily Smoker (4) Former Occasional Smoker (5) and Never Smoker (6)
• Not Answered ((99), based on Don't Know, Refusals, and Not Stated to at least one of the questions) responses were excluded
• Age groups in years used for direct age-standardization: 12-19, 20-34, 35-49, 50-64, 65-74, 75+
• Direct age-standardization to the 1991 Canadian population

Definition:

The youth lifetime smoking abstinence indicator estimates the proportion of young people age 12-19 years who have never smoked a whole cigarette.

Data Source(s):

Formula:

Weighted number of respondents age 12-19 years who have never smoked at least one whole cigarette Weighted total number of respondents age 12-19 years

x 100

Notes:

• Based on CCHS Question SMK_01B "Have you ever smoked a whole cigarette?"
• Numerator: SMK_01=No (2)
• Denominator: SMK_01= Yes (1), No (2) or Not Applicable (6)
• Refusals (8) and Not Stated (9) responses were excluded

Definition:

The adult heavy drinking episode indicator estimates the age-standardized proportion of people age 20 years and older who reported consuming five or more drinks on at least one occasion during the previous 12 months.

Data Source(s):

Formula:

Weighted number of respondents who are age 20+ years who reported consuming 5 or more drinks, on at least one occasion during the previous 12 months Weighted number of respondents age 20+ years who did or did not drink

x 100

Notes:

• Numerator ALC_3=Less than once per month(2), Once per month(3), 2-3 times per month(4), Once per week(5), More than once per week (6)
• Denominator: ALC_1= Yes (1), No (2)
• Don't Know (97), Refusal (98), Not Stated (99) responses were excluded
• Age groups in years used for direct age-standardization: 20-34, 35-49, 50-64, 65-74, 75+
• Direct age-standardization to the 1991 Canadian population

Definition:

The youth heavy drinking episode indicator identifies the proportion of people age 12-19 years who reported consuming five or more drinks on at least one occasion during the previous 12 months.

Data Source(s):

Formula:

Weighted number of respondents age 12-19 years who reported consuming 5 or more drinks on at least one occasion during the previous 12 months Weighted number of respondents age 12-19 years who did or did not drink

x 100

Notes:

• Numerator: ALC_3=Less than once per month(2), Once per month(3), 2-3 times per month(4), Once per week(5), More than once per week (6)
• Denominator: ALC_1= Yes (1) No (2)
• Don't Know (97), Refusal (98), Not Stated (99) responses were excluded

Definition:

The physical activity index indicator estimates the age-standardized proportion of the population age 12 years and older by level of energy expenditure in the categories active and moderately active in their leisure time physical activity.

• Active = respondents who average 3.0+ kcal/kg/day of energy expenditure
• Moderately active = respondents who average 1.5-2.9 kcal/kg/day
• Inactive = respondents with energy expenditure levels less than 1.5 kcal/kg/day

Data Source(s):

Formula:

Weighted number of respondents age 12+ years by physical activity index categories active and moderately active Weighted number of respondents age 12+ years

x 100

Notes:

• Numerator: PACDPAI= active (1) or moderately active (2)
• Denominator: PACDPAI= active (1) and moderately active (2) and inactive (3)
• Excluded not stated responses (9) from denominator
• Age groups in years used for direct age-standardization: 12-19, 20-34, 35-49, 50-64, 65-74, 75+
• Direct age-standardization to the 1991 Canadian population
• Respondents were asked about their participation in various types of physical activities in the previous three-month period, as well as the frequency and duration of each activity

Definition:

The healthy body mass index indicator estimates the age-standardized proportion of people age 18 years and older whose self reported height and weight denote a healthy body mass index (BMI). BMI is calculated using the person's weight in kilograms divided by their height in metres squared. The International Standard for BMI is: <18.5 (underweight), 18.5-24.9 (acceptable weight), 25-29.9 (overweight), and 30 or higher (obese). The World Health Organization considers a BMI in the range of 18.5-24.9 to be healthy for most adults.

Data Source(s):

Formula:

Weighted number of respondents age 18+ years (excluding pregnant women and breastfeeding women) with BMI of 18.5-24.9 Weighted number of respondents age 18+ years (excluding pregnant women and breastfeeding women)

x 100

Notes:

• CCHS excludes pregnant women, as well as women age 18-49 years who did not answer the pregnancy question. The index is calculated for those age 18 years and over, excluding pregnant and lactating women, as well as persons less than 3 feet tall or greater than 6 feet 11 inches. There was an additional exclusion of women who were currently breastfeeding (MEX_05=1), and respondents who chose 'Not applicable' (96) or Not Stated (99) responses in the indicator calculation
• Numerator: HWTDISW = Normal or healthy weight (2)
• Denominator: HWTDISW = Underweight (1), Normal or healthy weight (2), Overweight (3), and Obese (4-6)
• Age groups in years used for direct age-standardization: 18-34, 35-49, 50-64, 65-74, 75+
• Direct age-standardization to the 1991 Canadian population

Definition:

The fruit and vegetable consumption indicator estimates the age-standardized proportion of the population age 12 years and older that reported consuming fruits and vegetables five or more times per day.

Data Source(s):

Formula:

Weighted number of respondents age 12+ years who Consumed fruit and vegetables five or more times per day Weighted number of respondents age 12+ years

x 100

Notes:

• Numerator: FVCGTOT= 5 to 10 "servings" of fruit and vegetables (2) and more than 10 "servings" of vegetables (3)
• Denominator: FVCGTOT= less than 5 "servings" (1), 5 to 10 "servings" of fruit and vegetables (2) and more than 10 "servings" of vegetables (3)
• Excluded if answer was not stated
• Age groups in years used for direct age-standardization: 12-19, 20-34, 35-49, 50-64, 65-74, 75+
• Direct age-standardization to the 1991 Canadian population

Definition:

The fall-related hospitalization rate indicator estimates the age-standardized number of injury-related hospital separations that are due to falls in seniors age 65 years and older per 100,000 population.

Data Source(s):

Formula:

Number of hospital separations due to falls In those age 65+ years (2007 calendar year) Total population age 65+ years (2007 calendar year)

x 100,000

Notes:

• Age groups in years for direct age-standardization: 65-74, 75-85, and 85+
• Direct age-standardization to the 1991 Canadian population
• Includes Accidental Falls (ICD-10-CA: W00-W19) with external causes
• PHPDB Qualifications: Calendar Year (2007); Ages (greater than or equal to 65); Patient diagnosis beginning with W0 or W1 in ICD-10-CA Block Codes including diagnosis with external cause diagnoses
• IntelliHealth\Shared Reports\PHU\Fall Related Hospitalizations 65120

Definition:

The enteric illnesses age-standardized incidence rate estimates the total number of reported cases of selected enteric illnesses per 100,000 population.

Selected reporting fields include:

• Amebiasis
• Botulism
• Campylobacter Enteritis
• Cholera
• Cryptosporidiosis
• Cyclosporariasis
• Food Poisoning, All Causes
• Gastroenteritis, Institutional Outbreaks
• Giardiasis
• Hepatitis A
• Listeriosis
• Paratyphoid fever
• Typhoid Fever
• Salmonellosis
• Shigellosis
• Trichinosis
• Verotoxin producing E.coli including Hemolytic Uremic syndrome (HUS)
• Yersiniosis

Data Source(s):

Formula:

Total number of new reported cases of selected enteric illnesses (2007 Calendar year) Total population (2007 Calendar year)

x 100,000

Notes:

• Data was extracted on February 3, 2009 from the Integrated Public Health Information System
• Includes both sporadic and outbreak reportable enteric cases that met the provincial surveillance case definition
• Age groups in years used for direct age-standardization: 0-4, 5-9, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, 85-89, 90+
• Direct age-standardization to the 1991 Canadian population

Definition:

The respiratory infection outbreak indicator estimates the number of confirmed respiratory infection outbreaks in long-term care homes between September 1, 2006 and August 31, 2007.

Data Source(s):

Integrated Public Health Information System, Ministry of Health and Long-Term Care

Formula:

Number of confirmed respiratory infection outbreaks in Long-Term Care homes for the 2006/2007 respiratory virus surveillance season.

Notes:

• Data was extracted on February 2, 2009 from the Integrated Public Health Information System.
• Indicated by selecting Long-Term Care Home option in the Exposure Setting Type Field for outbreaks in iPHIS
• Outbreaks that do not meet the case definition for a confirmed respiratory infection outbreak in a long-term care home were removed
• The report is called: List of created Outbreaks - Child Care Facilities Highlighted - for HU use
• Cognos ReportNet path: Public Folders > CRN 1.0 > Shared Communicable Diseases Reports > Management Reports > QA Reports

Definition:

The age-standardized chlamydia incidence rate indicator estimates the total number of reported chlamydia cases per 100,000 population.

Data Source(s):

Formula:

Total number of new reported cases of chlamydia (2007 calendar year) Total population (2007 calendar year)

x 100,000

Notes:

• Data was extracted on February 3, 2009 from iPHIS.
• Age groups in years used for direct age-standardization: <10, 10-14, 15-19, 20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65+
• Direct age-standardization to the 1991 Canadian population

Definition:

The immunization coverage for hepatitis B indicator estimates the proportion of grade 7 students who have completed the immunization series against hepatitis B by the end of grade 7.

Data Source(s):

Formula:

# of grade 7 students who have completed the immunization series against hepatitis B by the end of grade 7 (vaccinated before or during grade 7 by physician or public health) (2007/2008 school year) Total number of Grade 7 students (2007/2008 school year)

x 100

Notes:

• Data as complete as of June 30, 2008 (2007/2008 school year) for grade 7 students (birth year 1995)
• Hepatitis B immunization is not a designated disease under the ISPA (Immunization of School Pupils Act) and therefore health units are not required to report Hepatitis B immunization rates; reporting is voluntary
• All public health units are required to report Hepatitis B coverage rates to the Ministry of Health and Long-Term Care. Some public health units also record Hepatitis B coverage rates in the IRIS reporting data system; use of this system is voluntary
• This indicator is specific to the school-based immunization program, and does not include all immunizations against Hepatitis B as administered by the public health unit (e.g. doses administered in other setting or populations/age groups, such as sexual health clinics)

Definition:

The immunization coverage for measles, mumps and rubella indicator estimates the proportion of school children age 7 years who are known to be complete for age for vaccination against measles, mumps and rubella.

Data Source(s):

Formula:

Number of school children age seven years who are known by the health unit to be complete for age for vaccination against measles, mumps and rubella (2007/2008 school year) Number of children enrolled in school (2007/2008 school year)

x 100

Notes:

• Data as complete on June 30, 2008 (2007/2008 school year) for 7 year olds (birth year 2000)
• Data was extracted from IRIS, August 2008 to January 2009
• Vaccination information is collected only for children attending schools that public health units have screened
• Some children/students may not be eligible for a vaccine due to medical contraindication. This information may be collected and recorded in IRIS. However, ineligible children are not excluded from the denominator of vaccine coverage calculations since not all IRIS vaccine coverage reports summarize this information
• Children/students with exemptions (medical, philosophical, conscience or religious) or with no information are treated as incomplete

Definition:

Number of adverse water quality incidents from drinking water systems subject to O.Reg 170/03/O.Reg 252/05 and unregistered drinking water systems.

Data Source(s):

Drinking Water Programs Branch, Ministry of the Environment

Formula:

Number of adverse water quality incidents from drinking water systems subject to O.Reg 170/03/O.Reg 252/05 and unregistered drinking water systems for the 2007 calendar year

Notes:

• Exceedances from schools and day cares subject to O.Reg 243/07 not included in this summary
• O.Reg 170/03, a.k.a. Drinking Water Systems included year round residential systems as well as designated facilities including schools, daycares and nursing homes
• O.Reg 252/05 a.k.a. Non-Residential and Non-Municipal Seasonal Residential Systems That Do Not Serve Designated Facilities

Definition:

Total board of health expenditures in 2007 for "core and related public health programs and services", including spending based on revenue from all sources including all government funding (federal, provincial and municipal), user fees (such as Part 8 inspection fees), one time funding, fee for service contracts, research funding, and all other grants and donations. Excludes projected expenditures for EMS and animal control services, which are not part of the public health mandate.

Data Source(s):

Survey of boards of health, 2008

Formula:

Total board of health actual expenditures from all sources

Notes:

• Consolidates reporting on existing board of health funding levels
• In this report and survey "related programs" refers to a group of programs that are defined by public health units as ancillary to their core public health programs and services. This definition was used in the data collection for this indicator in order to allow public health units to provide information on all current programs regardless of funding source. However, when used in the context of the Program Based Grants (PBG) funding agreement "Related Programs" refers to a specific group of programs that are funded through the PBG grant and these are: Infectious Diseases Control, West Nile Virus / VBD, PHRED, Unorganized Territories, AIDS Hotline, SIECCAN, Infection Prevention and Control Nurses (new in 2008/09), Small Drinking Water Systems, and one time funding received through PBG.
• The inclusion of one time or time limited funding may skew the reporting for some boards of health
• Lack of clear definition of categories of funding by "core public health", "public health related" and "other services delivered by public health" resulted in some lack of congruence in categorization across all boards of health
• Data were collected on expenditures by program, but did not include information on funding sources or cost sharing arrangements

Definition:

Percent variance between a board of health's projected annual budget for "core and related public health programs and services", and year-end actual expenditures in with revenue from all sources in 2007.

Data Source(s):

Survey of boards of health, 2008

Formula:

(year-end actual expenditures - projected annual expenditures) projected annual expenditures

x 100

Notes:

• Note that these categories do not align with those used by the ministry in its Program Based Grant funding package, where "Related Programs" has a specific meaning; see notes under Total Board of Health Expenditures for further detail.
• Boards report that variances are usually program or funding source specific
• There has historically been underspending in board of health budgets due to the local municipal council control on the overall budget and the timing of ministry budget approvals. In some places, councils insist that program spending cannot exceed the prior year amount until ministry final budget approval is received
• Unexpected in year activities will impact actual expenditures of some boards of health, and therefore skew their variances

Definition:

Percent of board of health total actual expenditures for "core and related public health programs and services" used to support staff training and professional development in 2007.

Staff training and professional development costs include training and educational services for vocational, technical training, professional courses and seminars; may include payments to external trainers, conference registration fees, tuition fees and payments for associated textbooks, registration and course delivery costs such as library access fees, costs associated with conferences, seminars and internally developed courses, as well as associated event costs such as payments to guest speakers, trainers, catering and space rental fees. Excludes any associated travel costs and any fees paid to register with a professional regulatory body.

Data Source(s):

Survey of boards of health, 2008

Formula:

Board of health actual expenditures on staff training and professional development Total board of health actual expenditures

x 100

Notes:

• Larger public health units may be able to achieve economies of scale that would lower their per staff cost for training and development
• Survey did not collect information on the number of staff trained or number of days of training purchased
• Reported expenditures may be estimates due to complexity of accessing training and development expenses that meet the proposed definition within the timeframe
• Excluding travel costs may limit the ability to interpret the overall impact of training costs on the budgets of health units with high travel costs (i.e. northern health units)

Definition:

Indicates the number of full time equivalent (FTE) positions in 2007 in each of the following specified professional job categories. FTE is defined by local board of health HR policies.

1. Public Health Nurse
2. Registered Nurse
3. Registered Practical Nurse
4. Nurse Practitioner
5. Public Health Inspector
6. Dentist
7. Dental Hygienist/Dental Assistant
8. Health Promoter
9. Dietitian/Public Health Nutritionist
10. Speech-Language Pathologist
11. Epidemiologist
12. Heart Health Coordinator
13. Librarian

Data Source(s):

Survey of boards of health, 2008

Formula:

Number of FTEs per professional job category

Notes:

• Indicator does not cover all job categories within a board of health; a decision was made to collect data on direct service job categories of interest in relation to assessing local service capacity
• The number of FTEs does not necessarily reflect the number of staff working in these positions due to job sharing or part-time work
• Differences in local use of job titles may result in under-reporting or inconsistencies between categories
• Managers were excluded from this reporting, which may affect reporting on capacity where managers also work directly in programs

Definition:

The number of job vacancies for staff positions in the following job categories for which there had been a job posting and that had remained vacant between May 1, 2008 and date of survey in November, 2008.

1. Associate Medical Officer of Health
2. Public Health Nurse
3. Registered Nurse
4. Registered Practical Nurse
5. Nurse Practitioner
6. Public Health Inspector
7. Dentist
8. Dental Hygienist/Dental Assistant
9. Health Promoter
10. Dietitian/Public Health Nutritionist
11. Speech-Language Pathologist
12. Epidemiologist
13. Heart Health Coordinator
14. Librarian

Data Source(s):

Survey of boards of health, 2008

Formula:

Number of vacant positions by job category

Notes:

• Indicator does not cover all job categories within a board of health; a decision was made to collect data on direct service job categories of interest in relation to assessing local service capacity
• Does not capture full length of vacancies that began before May 1, 2008
• Does not show full extent of lack of local capacity where vacancies are being managed by reassignment and backfilling by existing staff

Definition:

Indicates where a medical officer of health is employed on a permanent, full time basis with a board of health. FTE is defined by local board of health HR policies.

Data Source(s):

Survey of boards of health, 2008

Formula:

Number of positions by full time status, with values to not exceed 1.0 FTE

Notes:

• Some boards of health consider MOH time spent providing on call service to contribute to or exceed the requirement for full time status
• There is no standardized definition of "full time" across all boards of health

Definition:

Indicates the percentage of current full and part time public health unit staff who have been employed continuously by the public health unit by length of service in years.

Periods of time for employment include: up to 1 year; more than 1 year but less than 5 years; more than 5 years but less than 10 years; more than 10 years but less than 20 years; and more than 20 years.

Data Source(s):

Survey of boards of health, 2008

Formula:

Number of public health unit staff employed for specific periods of time Total number of public health unit staff

x 100

Notes:

• Staff length of service may be influenced by overall demographics of the local workforce or the presence of training programs (influenced by recruitment through placements)
• Regionally and municipally based boards of health will not be able to disaggregate the data on employment length of service for staff that have worked for the organization in different departments throughout their careers. This will affect primarily administrative and information management staff, however, the overall effect on total employee length of service will be small

Definition:

Indicates whether a board of health has assessed local community members' familiarity with any of the public health unit's programs and services.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes, with year and method of most recent assessment; no

Notes:

• Original intent was to report on degree of community members' familiarity with public health unit programs and services based on local surveys
  • Although data was collected by most health units (through Rapid Risk Factor Surveillance System (RRFSS) or local survey), consent to share this data was not included in the instructions of the original surveys, and therefore local results are not available
  • RRFSS module includes seeking information on community members' basic familiarity with the existence of public health services, use of health unit service, how respondent has heard about health unit program and service, and satisfaction with use of health unit program and service
• Lack of a consistent definition of "assessing community members' familiarity with public health unit programs and services" may contribute to inconsistency in reporting

Definition:

Indicates whether a board of health has issued a health status report or other health intelligence or information product that considered inequities in health outcomes and health determinants at any time in the past.

A health status report or other health intelligence or information product is defined as including any publication that was designed for distribution to the public that used health status statistics and provided analysis of these statistics to describe the equity of health outcomes or health determinants.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes and year; no

Notes:

• Many public health units publish high quality local health status reports that are available on their websites
• There is no standardized definition of inequities in health outcomes in order to compare results between health units
• Assessing only the existence of a report without assessment of the scope of the publication
• Relevance of the data in local reports is time sensitive; older reports may not be reflective of current situations
• Reporting includes both focused health issue reports and comprehensive community wide health status reports

Definition:

Indicates whether a board of health reports having a strategic plan in place that covers the current period (2008).

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes, with years of strategic plan; no

Notes:

• Having a strategic plan will improve organizational performance only where it is well implemented and amended over time in response to emerging situations
• Assesses only the existence of a strategic plan without assessment of the scope of the plan
• Lack of consistency in the content and rigor of strategic planning makes compilation of results difficult to interpret
• Does not provide information on how the strategic plan is used to influence operations and achieve strategic goals

Definition:

Indicates whether a board of health has an internal board of health emergency response plan and whether the plan was tested between January 1, 2007 and the date of the survey in November, 2008. Testing an emergency response plan includes activities such as running a table top exercise, testing a telephone call out list of all staff, and holding a mock emergency scenario.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes, with description of testing method; no

Notes:

• Included as a measure of public health unit emergency preparedness; provides a starting point for the development of possible future indicators, which may relate to community awareness of public health's role in emergency preparedness or effectiveness of staff training in emergency preparedness
• Because municipalities are required to have an organizational emergency response plan, nil responses were not anticipated
• Criteria for testing the plan were self-defined and described by boards of health
• Lack of a threshold for adequacy of testing an emergency response plan will limit interpretation of results

Definition:

Indicates whether a board of health participates in an accreditation process by accrediting body and current accreditation status.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes, by specific accrediting body, by accreditation status; no

Notes:

• Boards of health may have been accredited in the past, but not currently accredited
• There are differences in scope of accreditation standards across different organizations
• Numbers include boards of health that are both accredited and currently in the process of becoming accredited

Definition:

Indicates completion of a regularly scheduled performance evaluation of the medical officer of health, by type of evaluator, and year of the most recent evaluation.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes, with date of most recent evaluation and type of evaluator; no

Notes:

• Capacity Review Committee (CRC) survey of board of health management governance practices found wide variations in depth and scope of MOH performance evaluation practices
• The methods of staff evaluations used and the rigor of the processes is influenced by different governance models across boards of health
• Does not capture performance evaluation practices relating to other executive officers, such as CAOs and CEOs

Definition:

Indicates medical officer of health attendance at board of health meetings and/or standing committee meetings, and whether he of she participated in the meetings. Participation includes attending meetings and providing reports, advice or presentations to the board.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes on reporting to board of health, standing committee or both; no

Yes on attending specific meetings; no

Notes:

• Survey data indicate that some medical officers of health participate in meetings of a standing committee as well as meetings of the board of health
• Does not describe the quality of the medical officer of health's interaction with the board

Definition:

Indicates situations where new board of health members are provided with an orientation to the roles and responsibilities of the board of health, the duties of members and information to understand public health functions and issues.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes; no

Notes:

• Presence of board orientation does not indicate whether orientations are influencing governance capacity or effectiveness
• Lack of consistency in the content and rigor of orientation of board members makes results difficult to interpret

Definition:

Indicates whether a board of health has engaged in a process to evaluate its governance processes and organizational effectiveness.

Data Source(s):

Survey of boards of health, 2008

Formula:

Yes; no

Notes:

• Presence of board self evaluation does not indicate whether board self evaluations influence governance practices or effectiveness
• Lack of consistency in the content and rigor of board self evaluation makes results difficult to interpret