building healthier communities together...building healthier communities together: 2005 – 2008...

Building Healthier Communities

Together

Cobequid Health Board Map 3

Education Levels 6

Consultation with Cobequid 6

Projects to Support Community 7

Building Healthy Communities 7

Improving the Capacity of Health for Individuals 9

Quick Facts 10

Measuring the Impact of Income Security on Health 12

Recommendations to Capital Health 13

Recommendations for the CCHB 14

In Summary 15

Introduction 2

Diverse Population Base 4

Planning Services & Support for Cobequid 11

A Special Thanks ... 2

Questions from the Cobequid Health Plan 16

C o n t e n t s

2005-2008 Cobequid Health Plan

2 – Building Healthier Communities Together: 2005 – 2008 Cobequid Health Plan

The Cobequid Community Health Board (CCHB) has been very active over the past two years. To fulfill its mandate, the Board organized extensive local meetings to engage community to participate in our consultation process. Through this process we truly have become “the eyes, ears, and voice” of our community. We want to ensure Capital Health that the Board work will continue its mandate as we move forward with an even stronger focus and commitment to the community. We are very pleased to present this health report as it is reflective of the ideas, concerns and strategies by residents in the Cobequid Board area. We offer recommendations by both the Capital Health and the Cobequid Community Health Board towards fulfilling the vision of healthy people, healthy communities.

I n t r o d u c t i o n

Board Office 40 Freer Lane

Lower Sackville, Nova Scotia, B4C 0A2

Coordinator: Kelly Thompson Phone: 902.869.6115 | Fax: 902.865.7796 Email: [email protected]

www.cdha.nshealth.ca/communityhealth/cobequid

Volunteer board members who developed this report are:

♦ Claude Cajolais – Mount Uniacke

♦ Joy Goudge – Fall River

♦ Robin E. Haley – Lower Sackville

♦ Brian Johnson – Beaver Bank

♦ Diana Prosser-Lewis – Hammonds Plains

♦ Dr. Rosemarie Sampson – Bedford

♦ Deborah Sherren – Wellington

♦ Don Stewart – Bedford

♦ Julie Vials – Windsor Junction

♦ Lois Wiseman – Lower Sackville

Additional assistance provided by: Lillian Coshell & David Haley Staff support provided by: Kelly Thompson / Coordinator Design layout by: taybridge.communications

Published April 2006

A s p e c i a l t h a n k s

The Cobequid Community Health Board (CCHB) would like to thank the community who generously gave their time and shared their ideas with us through the consultation process. Without the input by the community this report would not have been possible. We hope this report captures the community imprint and vitality that came through in the consultation process this past year.

If you would like to make a difference in the health of your com-munity, consider volunteering on the Cobequid Community Health Board. The Community Health Board is looking for new members, from all ages and walks of life, who are interested in creating healthier communities.

Together with other groups, the Board supports many different community activities that aim to improve health.

It is a collective effort to build and maintain healthy communities! We need your help so come join the Board and support work in your community, and all the communities in our Board area. We do make an impact on the quality and enjoyment of daily living which has significant impact on the health of our residents.

We encourage you to come work with the Board. Please contact our coordinator, Kelly Thompson, for more information.

m a k e a d i f f e r e n c e i n y o u r c o m m u n i t y

A n n u a l P u b l i c M e e t i n g Join us for our annual meeting on Wednesday, May 31st. Time: 5:30 – 7:30pm Location: Cobequid Health Centre, room 3215 Agenda: - official presentation of the health plan - presentation of the 2006 Community Development Fund (CDF) cheques - activities and role of the Board Snacks and refreshments will be served

RSVP to: Leslie macDonald at 869-6162 or [email protected] Hope to see you there!

Building Healthier Communities Together: 2005 – 2008 Cobequid Health Plan – 3


D i v e r s e P o p u l a t i o n B a s e

The Cobequid CHB is comprised of a large geographic area with very diverse communities and a population of 104,000+. They include:

Beaver Bank Bedford

Beechville/Lakeside/ Timberlea (BLT) Fall River

Hammonds Plains Lower/Middle Sackville

Mount Uniacke Waverley

Wellington Windsor Junction

Upper Sackville

Growth in the CCHB follows closely with that of Capital Health overall:

♦ Largest increases are seen in ages 50-54 (108%). ♦ Large increases in numbers of individuals aged 35-59 are seen in the

region with an influx of 12,607 individuals in this age range. ♦ This represents 44% of the growth in Capital Health. ♦ Increases of 20% and 27% are seen in population aged 5-9 and

10-14 respectively. ♦ A decrease of 20% is seen for ages 25-29.


Demographics Population by 5-year Age Groups Cobequid Community Health Board

1991 Census 1996 Census 2001 Census 1991 - 2001

Total Total Total Change

# % # % # % # %

Total Reporting 73,549 100 82,768 100 91,247 100 17,698 24.1

By 5-year Age Groups 0

0-4 yrs 6,384 8.7 6,504 7.9 6,226 6.8 (158) -2.5

5-9 yrs 5,870 8 6,829 8.3 7,053 7.7 1,183 20.2

10-14 yrs 5,740 7.8 6,242 7.5 7,304 8 1,564 27.2

15-19 yrs 5,893 8 5,873 7.1 6,406 7 513 8.7

20-24 yrs 4,927 6.7 5,034 6.1 4,807 5.3 (120) -2.4

25-29 yrs 6,655 9 5,727 6.9 5,327 5.8 (1,328) -20

30-34 yrs 7,776 10.6 8,568 10.4 7,477 8.2 (299) -3.8

35-39 yrs 7,052 9.6 8,468 10.2 9,643 10.6 2,591 36.7

40-44 yrs 6,935 9.4 7,359 8.9 8,865 9.7 1,930 27.8

45-49 yrs 5,115 7 6,966 8.4 7,371 8.1 2,256 44.1

50-54 yrs 3,310 4.5 4,986 6 6,873 7.5 3,563 107.6

55-59 yrs 2,471 3.4 3,193 3.9 4,738 5.2 2,267 91.7

60-64 yrs 1,801 2.4 2,376 2.9 3,145 3.4 1,344 74.6

65-69 yrs 1,381 1.9 1,711 2.1 2,257 2.5 876 63.4

70-74 yrs 1,081 1.5 1,280 1.5 1,558 1.7 477 44.1

75+ yrs 1,214 1.7 1,636 2 2,233 2.4 1,019 83.9

D i v e r s e P o p u l a t i o n B a s e — C o n t i n u e d


E d u c a t i o n L e v e l s

Source: Statistics Canada, www.statcan.ca, retrieved June 30, 2005

As well as hosting local community meetings, the Cobequid Board has been involved in a number of projects over the past year. To gather input and offer leadership to its communities, two important projects, Partners Assisting Youth (PAY) and the Cobequid Long-Term Care Project, as well as the Omnifacts Bristol Public Opinion Survey outlined issues and strategies for many age groups and income levels. We are very pleased with the results of the community dia-logues as they reflect the response of our local residents.

Community Dialogues

This past year the Board hosted 8 local meetings in various communi-ties in order to identify the concerns by of local residents. Over 140 people attended these initial meetings. These combined consultation efforts brought forward a real validation of issues affecting our com-munities. Through working committees, the Board members re-viewed and analyzed issues, reports, and solutions. This committee process led to the identification of five broad themes which included:

♦ Building Dynamic Communities

♦ Changing Family Dynamics

♦ Engaging Youth in Our Communities

♦ Developing Healthy Lifestyles

♦ Measuring the Implications of Aging

The Board sought further clarification of these broad issues by assem-

bling a large Community Café meeting on May 6, 2005. Forty-five individuals representing various groups and residents were assigned to one issue to share realities, to prioritize issues, and to offer solutions that could be effective in community.

The Board is pleased that the various strategies lent true credibility to the inclusion of community and netted insight into the key themes important to community focused health care planning, health promo-tion, and the determinants of health. These core themes provided the framework for this report.

C o n s u l t a t i o n s w i t h i n C o b e q u i d


1. Partners Assisting Youth (PAY)

Project

In 2004, community individuals approached the Board to establish a network of community partners and providers to look at the barriers behind youth employment. The Board partnered with Human Re-sources Skills & Development Canada (HRSDC) to initiate the PAY Project. The project vision is to build employability skills for youth to access employment and to gain knowledge leading towards a success-ful career path. Specific objectives include: strengthening community networks that serve youth in Sackville and Bedford areas; improving education tools and resources for youth and parents; and connecting with business, government, and organizations to create work and volunteer opportunities for youth.

2. Cobequid Long Term Care Project

A steering committee, comprised of Northwood Care, Capital Health, NS Department of Health, and Cobequid Board members was established by the Department of Health (Continuing Care Branch) to conduct a feasibility study for a multi-use continuing care facility in the Cobequid Board area. Between December 2004 and December 2005, eleven consultations were held in the Cobequid Board area. These were led by consultant, Wayne Marsh. These consultations resulted in ideas for the planning process for a new long term care facility in the Cobequid area. CCH Board members promoted the consultations throughout the board area as well as attended meetings to identify community needs. Considerable recommendations were made to support three significant areas which included: setting and

overall layout of the facility; accommodations; and services and sup-ports needed to support community residents living in the Cobequid region.

3. Omnifacts Bristol Public

Opinion Survey

The Cobequid Community Health Board reviewed the results of a telephone survey conducted in October 2004. This survey was to support community planning processes for the Capital Health district. Omnifacts Research was hired and polled 1422 re-spondents from the Capital District, of which 202 (14%) were directly from the Cobequid area.

The survey points to the health care system leading the way in providing educa-tion and information for individuals, families, and communities. It also identi-fies a number of other part-ners such as the School Board, business, and the Municipality in assisting communities to improve overall lifestyles.

P r o j e c t s t o S u p p o r t C o m m u n i t y

In order to build vitality and health in communities, there needs to be a more collective effort in all planning and designing processes.

Community residents believe that Capital Health and the Cobequid Board should play a leadership role by providing expertise towards building and supporting healthy communities. This was a strong message that we received through out the consultation process. Many residents we spoke to believe this is also the responsibility of the Halifax Regional Municipality (HRM) Planning, Halifax Regional School Board, Councilors, Halifax Regional Development Agency, and other government agencies. As part of the observations from The Omnifacts Survey, results identified that the health care system in conjunction with schools and the business community, lead the way in providing information and education when it comes to ad-dressing the issues facing children and youth, promoting healthy eating, addressing job stress and increasing physical activity in the workplace.

Throughout our consultations, residents cited the on-going process with the HRM Planning Department and the substantial effect it will have on all communities in HRM. Some residents were excited

about the process while others saw more restrictions being enforced. It was clear at these meetings that community residents are con-cerned about a variety of elements that will have indirect but adverse health effects due to the redesigning of HRM communities. Although all the factors and issues stated by residents are not the direct respon-sibility of the Municipality, they do have an important role. Resi-dents stated that they want to see Capital Health more involved in this process to improve open communication with the Municipality about needs important to community.

A number of factors were identified that limit access, enjoyment, services, and facilities for community residents.

Designing Communities

A crucial element that contributes to the quality of life and the health of community is community design. This concept must be utilized to support and promote active lifestyles. Research indicates that land use patterns, transportation systems, and the presence of recrea-tional and fitness facilities have significant impacts on health. Hence residents are concerned over the large condo developments in Bed-

(Continued on page 8)

B u i l d i n g H e a l t h y C o m m u n i t i e s


ford, and large housing subdivisions in Hammonds Plains and Fall River in the Cobequid Board area.

Residents want to see more walking routes, sidewalks, and open spaces such as parks, playgrounds, and accessible community spaces. The Board has given modest CDF funding for The Bedford/Sackville Greenway Connector Trails, The Second Lake Provincial Park, and Waverley AAA Charlie MacDonald Park Trails, as well as the Berry Hill Skate Park, and the Sackville Centennial Outdoor Play pad to help encourage residents to live more actively.

Building Sense of Ownership

When asked to describe their community, residents used the word “fractured”. Residents stated that government and health organiza-tions need to help build a stronger sense of ownership. This was seen as a critical factor by residents who admitted being unclear on how to do this or how to get involved.

Community is very positive and appreciative of the Community Development Funds (CDF) as it is a process supporting true community needs. Past projects have in-cluded funding neighborhood associations and community events that bring the com-munity together to build stronger partner-ships and ownership. Residents suggested having more opportunities to get to know their neighbors as the best idea to building ownership in community and inspiring more local volunteers to get involved with local initiatives.

Improving Transportation Routes

A poor transportation system is the most significant barrier to access-ing health services, recreation, and employment opportunities. Through all the consultation meetings we heard this issue expressed more than any other. Most communities in our Board area reported that inadequate system routes are the problem. Some residents even reported that they have relocated to different communities to resolve this issue, mainly for employment reasons, but also to be closer to health and recreational services.

Limited bus routes in our urban communities, namely Waverley and Fall River, but also in the rural communities of Upper Sackville, Mount Uniacke, and Beaver Bank, leave seniors and youth feeling isolated and neglected. In Cobequid, residents expressed that shop-ping and community centres are too far for them to walk to. Most communities in our Board area don’t have sidewalks which make it unsafe. Finding volunteer drivers or community bus programs are either non-existent or limited in services. The Book-A-Ride program run by the Sackville Seniors Advisory Council provides travel to sen-iors for only medical appointments. It is booked to its maximum capacity and has no additional funding to offer rides for leisure, so-cial, recreational, and shopping needs. VON and Access-A-Bus ser-vices are either limited or too restrictive to be effective or reliable

services to residents in our communities.

Partnering with Schools

Schools were also identified as a key factor in building healthier com-munities. Residents want the School Board to take a leadership and partnership role with community to provide communication and linkages to information, activities and events. Residents expressed that schools need to take on a more active role to support family and community life.

Engaging All Residents

Engaging residents, particularly youth, seniors and the diverse popu-lations in our communities is also imperative in the planning process. Residents want to connect with all of its Cobequid communities. Youth have expressed feeling less engaged in community and being

disconnected from school. Seniors feel trapped due to limited incomes and lack of transportation resulting in their being so-cially isolated from friends, family, and their communities. Both groups are strug-gling to be seen as valuable and as being able to make worthwhile contributions to renewal of their community.

While we heard from a limited amount of the culturally diverse populations in our Board area, these populations did state that they felt excluded from community, health, employment, and education sys-tems. A lot of work needs to be done to connect with these growing populations in the Cobequid region. These issues will

only give rise to difficulties for all communities and higher health risks for the health system.

Supporting the Voluntary Sector

Community groups provide a lot of support and connection in com-munity. They foster key building blocks towards social supports, programming, networking, and ownership for residents to enhance the health of communities. Yet these groups are frustrated with not being able to support themselves. Individuals and groups believe this lack of capacity is seen in the “disengagement” of individuals in volun-teering. Organizations are relying on volunteers to deliver core ser-vices which keeps operating costs down. This trend is seen as a detri-ment to the stability of the organization. According to the National Survey of Giving, Volunteering and Participating (NSGVP) Survey only 8% volunteer for the Arts, Culture and Recreation organiza-tions, while about 7% volunteer for social service organizations and 5% for health organizations.

Community groups, residents, and volunteers throughout our consul-tations cited the lack of meeting space in community as problematic. Constant relocating and searching for space is wasteful for volunteers and staff. The lack of access to schools for community meetings, pro-jects, and activities is a huge concern by community residents.

(Continued from page 7)

Fewer volunteers are contribut-ing, however for those that are, they volunteer more hours than ever before. Canadians aged 35-54 (30%) are the largest groups of volunteers, followed by those aged 15 to 24 (29%) and then

those aged 55 to 64 (28%).


Programs that are designed for promotion and prevention of health are crucial to improving the continuum of health for individuals.

The best solution to improving health is to build the capacity of indi-viduals to make good choices towards leading a healthier lifestyle. Ultimately the health of an individual is a result of their own health practices and the impact of physical and social environments in which they live. A lot of information and education issues emerged around building health practices with community residents.

Connecting Health

Promotion Partners

Community residents we spoke to sug-gested building health promotion strategies with all levels of government, community partners, and Capital Health. Major players such as the Halifax Regional Municipality Recreation, Tourism and Culture, Public Health, Nova Scotia Office of Health Pro-motion, Sport and Recreation, Public Health Agency of Canada, Halifax Regional School Board, and other key partners were named by residents. These partners are needed to be more proactive in planning and partnering on health promotion strategies with com-munities.

Limited Healthy Lifestyle

Information & Programs

As part of the observations from The Omnifacts Survey, results identi-fied that the health care system, in conjunction with schools and the business community, lead the way in providing information and edu-cation when it comes to addressing the issues facing children and youth, promoting healthy eating, addressing job stress, and increasing physical activity in the workplace

In our dialogues, residents reported great difficulty navigating through systems for health education and resources. The Omnifacts Telephone Survey reported 17% of Cobequid respondents stated that Capital Health needs to take a primary role in educating the public on health-ier lifestyles. We also heard this reported by residents throughout our community café meeting. Residents stated being unsure of what is accurate information on nutrition and dieting, fitness/exercise rou-tines, and general health and wellness.

Individuals we spoke to are keen to have health information and attend workshops not only to benefit their individual well-being, but also for the well-being of their families. The Omnifacts Telephone Survey reported 22% of Cobequid respondents stated they want more infor-mation and education on how to live a healthy lifestyle. It was not uncommon for residents to state they “did not know” what is available for workshops and programs offered by Capital Health, Public Health,

and its partners.

Community groups in Mount Uniacke, Beaver Bank and Fall River look after a local newsletter, and/or directory, to serve the informa-tion needs of local residents. However developing and revising directories becomes a time consuming task for any organization. Resi-dents asked about the status of the 211 service and are greatly looking

forward to its inception. Another sugges-tion included developing a health series through wellness centres, libraries, and schools.

Limited Community

Wellness Centres

Although vast growth is being seen in the Cobequid communities, residents are con-cerned that services and supports will not keep up. In Cobequid, there are few rec-reation facilities to encourage daily social, health, and physical activity. Most facilities are only in the Sackville or Bedford com-munities. Seniors and youth reported that transportation to these centres and facilities prohibits them from participating in well-ness programs. Seniors stated that these

types of facilities are often disconnected and isolated from other key community destinations. If these types of centres were located by a network of places, such as shopping centres, medical or business cen-tres, or strip malls, people could move about the community more actively and effectively.

Limited Physical Activity Opportunities

Many residents cited two issues that were important to them. These included limited opportunities and limited affordable programs in their local community. The Omnifacts Telephone Survey supports these issues as 34% of Cobequid respondents stated affordable, low-cost recreation programs as an issue to accessing physical activity. Another 13% of the Cobequid respondents from the telephone survey suggested community access to school gyms as a solution to support local opportunities to promote the health of individuals.

Finding year-round physical activities was another issue for youth and children. Parents reported that most programs are only offered in the summer season, leaving the children to become inactive in the winter season.

Research shows that low physical activity rates are at an all time high. According to Nova Scotia Research, by the time Nova Scotia students reach Grade 11, only one in 10 is getting the activity they need to achieve health benefits, which is 60 minutes of moderate or vigorous physical activity every day.

(Continued on page 10)

I m p r o v i n g t h e C a p a c i t y o f H e a l t h f o r I n d i v i d u a l s

Health promotion is the process of ena-bling people to increase control over,

and to improve their health. To reach a state of complete physical, mental, and social well-being, an individual must be

able to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is therefore a re-source for everyday life, a positive con-

cept emphasizing social and personal resources, as well as physical capacities

(WHO, 2001).


Q u i c k F a c t s

Lack of physicians in rural areas. Residents of rural areas have less contact and fewer visits with physicians. Although 30 percent of Canadians and over 50 percent of Nova Scotian’s live in rural areas, only 9 percent of the nation’s physicians practice in rural areas.

Unequal treatment for minorities. Research has show that even when racial/ethnic minorities are insured at levels comparable to whites, they tend to receive a lower quality of health care for the same health conditions.

Lack of diversity among health care providers. Lack of diver-sity among health care providers can be a barrier to communication. In 2001, minorities made up 13 percent of the Canadian population but only 3 percent of medical school faculty.

Lack of insurance. Uninsured women receive fewer prenatal ser-vices and needed care than women with insurance.

Exposure to environmental risks. People in low-income commu-nities often have less healthy surroundings than people in other com-munities. Low-income communities are often located in or near pol-luting industrial areas and have cheap older housing where lead paint and pests are a threat.

Income related to poverty and cancer. The Canadian Cancer Society estimates that the cancer survival rate of poor individuals is 10 to 15 percent lower than those of other Canadians. Low income women are less likely to have mammography and Pap test screening.

Household Income by Community within Cobequid

Source: Community Counts Website 2001 http://www.gov.ns.ca/finance/communitycounts/default.asp

Community Household Income

Nova Scotia Average $48,457

Bedford $78,026

Hammonds Plains $76,617

Waverly $76,109

Fall River $75,086

Tantallon $74,423

Upper Sackville $60,916

Timberlea $60,308

Beaverbank $58,108

Lower/Middle Sackville

$57,461

Mount Uniacke $51,196

Engage Youth in Our Communities

The “Engaging Youth in our Communities” café topic discussed how youth have the poorest outcome of the determinants of health and how bleak their situation looks compared to other age groups. Three key factors surfaced from our dialogues which included risky behav-iors, poor eating practices, and lack of coping skills. The Omnifacts Telephone Survey supports this finding as 30% of Cobequid respon-dents stated the need for alcohol, drug, and tobacco use as important issues facing youth today. The increase in drug use and obesity levels puts youth in a risky health category. Many youth cited family prob-lems and parental pressure as the basis for their stress levels. Also there appears to be a misconception by youth that cannabis is not as harmful as tobacco.

Low Literacy Levels

According to The Adult Literacy and Life Skills (All) Survey 2004, literacy remains the same as it was 5 years ago. This means that signifi-cant numbers of adults have low literacy levels that hinder their par-ticipation in society and in the economy. This issue was cited as an obstacle to improving the health of residents.

Being able to read and understand information is crucial to making

decisions and coping with every day life and work.

Low health literacy. People with poor health literacy may have problems communicating with their physician, reading instructions and labels on medicines, completing medical and insurance forms and understanding many other aspects of health care. Over half of the people living in Canada are affected by low health literacy. 26% of patients cannot understand appointment slips; 60% don’t understand informed consent; 25% of Nova Scotian’s are functionally illiterate with another 27% only understanding simple materials. (GASHA 2004; Statscan 2001).

(Continued from page 9)

Location of Physical Activity When asked where their children do most of their physical activ-

ity, the majority of parents said either outdoors (22%) or at school (22%). A further 17% of parents said that their children

do most of their physical activity at home and an additional 15% of those surveyed said that it occurred at a public facility.

These are followed by playgrounds or parks (10%), private facili-ties (7%), and walking or bicycling

trails (4%). Source: NS Health Promotion & Protection website on Active Kids Healthy Kids.


The need for creating and delivering supports and services in community is fundamental to building healthy popu-lations.

It is no surprise that the need for community-based services and programs resolve access and transportation issues for most residents in all communities. Although residents are very happy with the asthma and youth clinic at the Cobequid Community Health Centre, they would like to see programs on the major dis-eases such as heart health in their local com-munity. Residents we spoke to also want more information about their health condi-tion.

Once again, we heard community residents ask that the new Cobequid Center be open for longer hours. Their principle wish would be to have the centre open 24/7. Or they sug-gested extended weekend hours to accommo-date their communities. Another suggestion included additional walk-in clinics that are open after-hours from the community physi-cians. Residents like the private Superstore format.

Utilizing Community

Based Models

Community residents are excited about new models like the North Preston Centre. They are hoping that the new Cobequid Centre will be a similar model with health education and monitoring for their community. Residents see the new Cobequid Center as an opportu-nity to expand the team beyond management of diseases to a real population health model. The care team should include resources by multi-disciplined health workers and multi-sectoral approaches. Community partners such as the RCMP and the School Board can offer expertise and contribute to the commu-nity perspective. Since physicians offer most of the primary care to community, residents want to see them involved as part of the team as well. This will improve communication about primary health care needs for the com-munity for future planning.

Utilizing Nurse

Practitioners

Residents asked about the status of the nurse practitioner issue. This issue was raised a number of years ago and the community is

very much behind it. Throughout our dia-logues, residents asked why Department of Health is not revising the policy around utiliz-ing nurse practitioners to save expenses within the health care system. As well as utilizing nurse practitioners in community, they want Capital Health to offer supportive environ-ments that promote the use of these services in community.

Improving Mental

Health Services

Another area identified by individuals and families was the need for improved mental and emotional health services for all age groups. Most residents would like to see shorter wait times for treatment. Most resi-dents stated that more local resources are needed. They would like to see community resource networks in place to support the growing mental health needs in the Cobequid region. Mental health issues for youth are still a top priority issue. The Omnifacts Telephone Survey supports this finding as 27% of Cobe-quid respondents stated the need for mental health services for youth to reduce self-esteem, peer pressure, and depression.

Improving Services &

Supports for Families

In the “Changing Family Dynamics” café topic many new issues were raised. A lot of feed-back focused on additional supports for par-ents, developing parenting skill and connect-ing with their children. Parents expressed growing pressure as a result of coping to raise children, supporting teenager needs, and sup-porting aging parents. The stress levels felt by parents is taking a toll on their own health.

Due to long working hours, parents struggle to maintain the family structure. Parents re-ported finding difficulty balancing work and family. Parents also stated they have few fam-ily members to provide babysitting for their children as most family members live in other communities. Families reported becoming exhausted by looking after aging parents due to lack of home, day, and respite care ser-vices. Transportation to and from these other communities makes it prohibitive for parents to access family support. Parents with teenag-ers struggle with providing time for assistance with homework and school projects, arranging family meal times together, and arranging

leisure and recreation time with their chil-dren. Parents admitted feeling uncomfortable dealing with sexual and drug issues with their children.

Out of nine communities, Sackville is the only community to have a Family Resource Centre or Family Service Association. Parenting sup-port programs are non-existent in the Cobe-quid Board region.

Challenges increase when speaking with low-income or single parent families. While sup-porting their families, parents reported that they have no time or money for their chil-dren’s needs. They feel stressed over main-taining a “minimum life” with little money for food since housing costs take most of their paychecks. Limited subsidized day care space was also stated as a big issue for single mothers and families. There is also a need for non-traditional child-care hours (after hours, weekends, and overnight care).

Additional Health

Programs for Women

and men

In the Healthy Lifestyles café topic, women stated they are less likely to report health issues because they are worried more about their children. These women reported that since they look after their family’s health first, they tend to ignore their own health needs. Women at various meetings expressed “having no life” for themselves. Other adults cited ignoring their health until a crisis situation occurs for them to deal with. Adults reported being frequently ill due to stress.

P l a n n i n g S e r v i c e s & S u p p o r t s f o r C o b e q u i d

A few men stated that they generally do not discuss their

health, even with their doctor, and often prefer their pastor.


M e a s u r i n g t h e I m p a c t o f i n c o m e s e c u r i t y o n h e a l t h

Comprehensive policies and integrated programs that sup-port low-income individuals and families need to be im-proved upon.

The Poverty and Health: Links to Action Proceedings Re-port by the Canadian Population Health Initiative (CPHI March 2002) states that it is clear that poor health status is related to low income or lack of financial resources. The report also suggests a “societal outcome” approach may help address activities across sectors that contribute to the overall goal of raising the health status of those living in poverty. Comprehensive approaches with a mix of health care and health promotion strategies for action are critical.

In the Federation of Canadian Municipalities Report (2001), HRM continues to be a less affordable community in both the general population and the modest income population. Incomes have been steadily declining since the 1990s for low to middle income class peo-ple in Nova Scotia. This growing disparity for low to middle income classes is very evident to residents who have stated concern over what they see as a “crumbling society”. Hence, district strategies need to look beyond individual factors to the broader social and economic determinants. Income security affects not only the health of individu-als, but also has great impact in community.

Provinces whose populations are more heavily concentrated in small cities and rural areas, like Atlantic Canada, tend to have significantly lower per capita employment incomes, according to a study called “Provincial Income Disparities through an Urban-Rural Lens, 2001”. Urban labour markets appear to be more dynamic, in that a signifi-cantly higher proportion of their working-age population was em-ployed and were compensated with higher wages than those in smaller cities and rural regions.

Community residents in our dialogues stated that a “sufficient income” is needed to buy healthy food, join athletic, social or recreation pro-grams, and live in appropriate housing. Low income and single parent families suggested supports like food programs, and community kitch-ens. They also stated that they have little money for medications, dental work, or recreational pursuits.

Average household incomes are considerably higher in all of our Co-bequid Communities compared to the Nova Scotia average of $48,457 (Community Counts, 2001). This lends further discussion into the extra costs of living in primarily rural living conditions. With greater than 75% of the population of Nova Scotia living in rural areas (Statistics Canada, 2001), health disparities become unavoidable. Some of these disparities include issues that have been identified throughout this document and which surfaced in all of our consulta-tions: unequal access to medical care, health, and community services; lack of affordable transportation (limited or non-existent busing and the need for multiple family cars); isolation within communities af-fecting all citizens, particularly our youth and seniors; lack of access to affordable shopping as convenience stores tend to be more expensive; no recreational or meeting spaces (community schools aren’t even open for public use); and the increased taxes that go along with larger

rural properties with drastically fewer services to name a few.

Reworking Public Policies

Policies and programs by Department of Community Services were cited as problematic, especially for low-income and single parent families. Residents are frustrated with the limited progress made and feel that greater cooperation is needed by this social service to in-crease their program rates for housing, food, and travel allowances. Individuals living on Income Assistance are struggling with inadequate amounts to meet their basic living needs. Community would like CH and the CHBs to put pressure on government to address these issues.

Improving supports for Seniors

on a fixed income

Seniors expressed difficulties resulting from living on a fixed incomes or low pensions. Not only did they report not eating regularly or nutritionally, but also stated house repairs as a cause of falls and slips due to limited income for necessary repairs. We heard stories from seniors regarding their inability to drive due to the high cost of insur-ance for their vehicles, gas, and maintenance which further limits their access to all activities and facilities. Seniors hope to see more health and wellness programs in their local community.

Resolving Barriers for Youth

Employment

Issues around income and education levels were also raised through out our youth dialogues. The PAY project consultations identified a number of employment barriers and issues for youth. Employers have complained that youth with lower levels of education or literacy issues are more likely to experience greater barriers to employment, low –paid jobs, and more periods of unemployment. The employment agencies and partners revealed that education and skill development are critical to long-term health and well-being for youth. Substantial feedback by parents, teachers, co-op counselors, and administrators was raised over the concern that youth are experiencing what they termed “employment unreadiness”. These groups wonder how well we are preparing our youth for success in the work world. Without vital skills and knowledge, youth will be among the lowest wage earn-ers which will certainly impact their health.

Incomes in Nova Scotia are lower than the National average, and the gap between

rural and urban incomes is larger than in any other province. In 1995 the gap was

$4309 (RCIP, 2001).


1. Build a population health model which addresses the full range of

health determinants in order to support the population health

model approach.

2. Build a strategic framework around the population health model

which includes new directions towards collaborations with its

Executive Management Team, Program Directors, and the Com-

munity Health Boards (CHBs) to enhance relationships in com-

munities.

3. Have the Community Health Directors build key relationships

with HRM, HRSB, IWK, Dalhousie School of Social Work,

HRM Recreation, health promotion partners, provincial govern-

ment, and social and economic sectors, as part of a new commu-

nity development model.

4. Allocate resources through a partnership fund to build and sup-

port key social and economic community issues that build cohe-

sive, safe, and supportive communities.

5. Allocate that Public Health, Mental Health and other key portfo-

lios increase health promotion and education resources to

schools, libraries, youth groups, and community centres, particu-

larly serving youth and parents.

6. Work with the Halifax Regional School Board to enhance inte-

grated health education programs and workshops in the school

curriculum with broad community partners and health promo-

tion partners.

7. Support implementation of and provide resources at the new

Cobequid Centre to offer appropriate health links and health

promotion information and workshops with partner organiza-

tions to build clear and consistent communication

health messages.

8. Establish a health care team at the new Cobequid Center to de-

velop a population health approach in meeting the needs of the

community.

9. Advocate to Department of Health about changing the regulation

to allow more use of nurse practitioners in Nova Scotia.

10. Advocate and influence government, particularly Department of

Community Services, to develop a framework for integrated

policy approaches with increases for allowances on food, hous-

ing, and basic needs to support low-income individuals

and families.

11. Develop a partnership with parent organizations, family resource

centres, IWK and Public Health to provide parenting programs

for parents through local community centres or the new Cobe-

quid Centre.

12. Advocate for more subsidized day care programs with flexible

nights and weekends to address the needs of parents.

13. Act as a lead agency, through the Community Health Directors

positions, to advocate for mandatory physical education programs

with the School Board, and other key partner organizations to

increase after school recreation opportunities, competitive sports

teams, and sports for fun programs for junior and high school

students.

14. Expand Public Health services to support and increase health

programs at the Youth Health Centre for junior high students.

15. Support the Mental Health Strategy Framework to develop Com-

munity Resource Networks in the Cobequid region.

16. Support the implementation of the Healthy Eating Action Group

at the community level by working with NS Health Promotion

and Alliance members to support shared ownership and account-

ability through action plans for the four priority areas on strate-

gies for our communities.

17. Allocate more resources and staff positions for the Healthy Be-

ginnings program from Public Health to support Cobequid.

18. Advocate, through the Council of Chairs, and host meetings with

HRM, Metro Transit, and community partners to explore trans-

portation needs for additional services to serve all

HRM communities.

19. Advocate the promotion of cultural competency in

health professionals.

20. Advocate to government for funding for the 211 initiative to

connect residents to all health, emergency and social services

in NS.

21. Advocate for a reduced payment for the senior’s share

of Pharmacare.

R e c o m m e n d a t i o n s t o C a p i t a l H e a l t h


1. Support Homeowners Associations in local communities through

CDF grants to promote community leadership, communication,

and focus for local community action.

2. Advocate for more affordable housing options for low income

families and individuals with provincial government, Department

of Community Services, and Councilors.

3. Advocate to HRM regarding additional sidewalk, bike lanes, and

trails to improve physical environments in local communities in

Cobequid.

4. Support programs that improve healthy eating and physical activ-

ity for all age groups through Community Development Funds.

5. Work with other Community Health Boards to lobby provincial

government to increase funding for Parent/Family Resource

Centres in Cobequid.

6. Work with the Cobequid Facility staff to support health informa-

tion to improve community links at the new Centre.

7. Work with the HRM Recreation and youth groups in our Board

area to involve and engage youth where every possible for com-

munity events or projects.

8. Partner with other CHBs in the province to tackle increases to

minimum wage levels, increased benefits for Income Assistance

recipients, affordable housing solutions and other

poverty related issues.

9. Partner with schools, family organi-

zations, and family centres to ex-

plore ways to improve resources, to

host parent nights, and to develop

programs to improve parenting

skills.

10. Support community groups and

organizations that build stronger

family and community connections

such as Churches, clubs and Centres.

11. Support food banks, churches to

provide supports and programs for

low-income individuals and families,

as well as explore solutions to allevi-

ate the effects of poverty in Cobequid.

12. Advocate to Department of Community Services for increased

and subsidized day care programs.

13. Advocate to HRSB to partner with Department of Community

Services to organize day care within schools so teen mothers can

continue going to school.

14. Advocate and partner with other CHBs to increase the tax credit,

or change to tax deduction, for sport and health programs and

extend the credit to include adults.

15. Work with Northwood Care to endorse the vision of the Cobe-

quid Long Term Care Project and model framework that sup-

ports community aging issues.

16. Partner with other CHBs and community partners to advocate

that the HRSB utilize schools as community schools and be avail-

able and open to community residents and groups.

17. Work with community and government partners to support

community centres that offer opportunities for healthy living

through social, recreation, mental, and primary health programs

for all ages.

18. Support networks, partnerships and environments for youth to

encourage youth ownership of projects through the CDF pro-

gram and community events.

R e c o m m e n d a t i o n s f o r t h e C o b e q u i d C o m m u n i t y H e a l t h B o a r d


While the community is discovering their assets and individuals are showing renewed interest, the Cobequid Board sees communities rally-ing together to rebuild a community vision. Communities are ready for change and they want Capital Health to play an integral part of rebuild-ing a new model that addresses the key elements of the population health model.

The CDF program has greatly improved the understanding of the broad determinants of health by community individuals and groups. The in-creased awareness of Capital Health and the role of the Community Health Board towards all factors that contribute to the individuals’ health have increased partnerships, volunteer capacity, and community leader-ship. The end result from the CDF funds has been to strengthen the community’s capacity to look after some of its health needs. Conse-quently, the health plan comes at a critical time for community.

The Board has had a busy year consulting with its community residents and is pleased with the priority issues that we have identified in this re-port to support our communities. The recommendations to Capital Health and the Board to take action on key community themes will have successful outcomes in saved health dollars.

Community health is a shared responsibility that requires on-going dia-logue with key social, economic, physical, and health partners if we are to develop healthy public policies. We suggest that Capital Health be a leader and strong player at both provincial and local government levels. The Board is confident that Capital Health will look at its future vision-ing process and incorporate the data, findings, and recommendations outlined in this plan. Important gains are possible and can be achieved for all communities by focusing on community priorities and utilizing the population health model. The Board is encouraged by the work that has been done by Capital Health to date. We will continue to support action with Capital Health, and its diverse partners.

In community, the Cobequid Community Health Board

I n S u m m a r y

After reading through the Cobequid Health Plan, please complete the following short questionnaire regarding the five core themes. Please return it via fax (902.865.7796) or complete the form online at:

http://www.cdha.nshealth.ca/communityhealth/cobequid

1. Under the Building Healthy Communities theme (page 7), residents suggested a number of elements towards improving the enjoyment and quality of life in their community. Please choose your top three from the list below:

Do you have any other suggestions on how we can improve the quality of life in your community? ______________________________________________________________________________________

2. Organizations rely heavily on volunteers to support services. However only 5-8% of people volunteer for health or social service organizations in Nova Scotia. How do we motivate individuals to become involved in their community? ______________________________________________________________________________________

3. Under the Improving Capacity theme (page 9), what types of programs, choices, and practices are critical to improving the health and well being of individuals?

What strategies or resources can you suggest for any of the above topics? ______________________________________________________________________________________

4. Under the Planning Services and Supports for Cobequid theme (page 11), what type of supports and services are crucial for you at the new Cobequid Centre?

5. What type of advocacy efforts should the Cobequid Board follow up on to support community? ____________________________________________________________________________________

Thank you for completing this questionnaire!

Q u e s t i o n s f r o m t h e C o b e q u i d H e a l t h P l a n

Transportation Services Walking trails /Bike routes Organized sport programs Social programs

Subdivision development Sidewalks and playgrounds Fitness facilities Connection to schools

Social opportunities Type(s) : _______________________________________________

Disease prevention Topic(s): _______________________________________________

Diet and nutrition Topic(s): _______________________________________________

Physical activity Type(s): _______________________________________________

Stress management and coping Topic(s): _______________________________________________

Depression and self-esteem Topic(s): _______________________________________________

Healthy Lifestyle Topic(s): _______________________________________________

Health management and prevention Topic(s): _______________________________________________

Outreach programs What do you suggest: ________________________________________________

Services and clinics What do you suggest: ________________________________________________

Health resources What do you suggest: ________________________________________________

building healthier communities together...building healthier communities together: 2005 – 2008...

Documents