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A Cost-benefit and Cost-effectiveness Analysis of Potential Supervised Injection Facilities in Victoria, BC

A Cost-benefit and Cost-effectiveness Analysis of Potential Supervised Injection Facilities in Victoria, British Columbia, Canada – Ehsan Jozaghi, Dr. Martin A Andresen

Richard Wilkinson Presentation -Income Inequity and the Community Response: Creating a Healthy and Productive Society

A Video Conference Forum with Richard Wilkinson

December 14, 2010

SFU Harbour Centre

View Video

Health Status Statistics

Health status is arguably at least one sizable measure of human well being. This website is quite instructive in terms of how US states are currently performing in terms of common health care statistics. It is interesting to crosswalk these with the political coloring of the various states.

http://statehealthstats.americashealthrankings.org/

The Impact of The Cost of Eating in BC report

The Impact of The Cost of Eating in BC report (PDF)

The Evolution of Seniors’ Falls Prevention in British Columbia

BC Health Act Renewal Project

Rationale for the Project

• SARS, the Walkerton tainted water crisis, the threat of pandemic influenza, and challenges of preventing chronic diseases have intensified the need to develop a new Public Health Act.
• Public health legislation is a cornerstone of effective public health action.
• Current legislation is outdated, fragmented, and has many gaps.
• New health challenges require new public health legislation that is modern, coherent and connected, comprehensive, and flexible to meet emerging needs.
• Failure to update the act may have the following consequences:
  • Public health practitioners lack tools available in other jurisdictions.
  • Public health service delivery barriers.
  • Reduced ability of government to protect and improve health, and respond adequately to public health issues and emergencies, with potential serious consequences for the government and the public.

Structures

• Steering Committee – Chaired by Dr. Perry Kendall, Provincial Health Officer
• Working Committee – Chaired by Dr. Brian Emerson, Medical Consultant
• Public health service delivery barriers.
• Task Groups – for specific issues

Processes

• Policy analysis, discussion papers
• Targeted consultation – email, attend meetings, teleconferences, conference presentations
• Website http://www.healthservices.gov.bc.ca/phact/
• Public Health law network – national network of people working with public health law

Timeline

• Project initiated in spring, 2003
• Discussion papers, preliminary consultations during 2003/04
• Website launched January, 2005
• Consultation Public Health Act posted November 2005
• Drafting bill fall/winter 2005

Consultations that have occurred

• Medical Health Officers
• Health Protection Directors
• Public Health Nurses
• BC Centre for Disease Control
• Union of BC Municipalities
• Health Canada – First Nations Inuit Health Branch
• First Nations health policy group
• BC Health Promotion Coalition
• Public Health Dental staff
• Tobacco enforcement officers and coordinators
• Nutritionists

Feedback from consultations

• Good opportunity to clarify roles, responsibilities, and relationships
• Important to have modern legislative tools
• Be careful not to lose strengths of existing Act
• Focus on outcomes of how this will improve health
• Ensure complements other related legislation
• Avoid enshrining structures that may change in the future – should be useful for many years.

Content of proposed Public Health Act

Overview

• Establish powers, duties, functions of minister, PH officials, health agencies, local government etc.
• Define requirements for core programs and population health promotion planning.
• Provide for measures central to public health protection and improvement i.e. Communicable Disease
• Control, Health Hazards, Public Health Threats and Emergencies
• Provide for regulations and other procedures to deal with specific issues.
• Ensure individual privacy protection and public interest information release.
• Provide for penalties, immunities, and administrative processes.
• Establish a common terminology.

Proposed New Sections Highlights

• Greater congruence and clarity between functions of PHO, MHOs, and EHOs, with clearer mandate for MHOs to advise in an independent manner on public health issues.
• Allow for regulations for health authorities regarding core public health functions.
• Provincial and regional health promotion planning requirements to support prevention the ever-increasing burden of chronic diseases, and address determinants of health. (continued)
• Clarity of role of local government, and relationship to health authorities.
• Updated mandatory disease reporting requirements. (continued)
• Updated provisions on health “registries” e.g. Cancer
• Strengthened measures to deal with health hazards i.e.withholding information about a health hazard can be an offense, allow for cost recoveries
• Allow for regulations to protect people from harmful exposure to ultraviolet radiation.
• Allow for regulations to provide compensation for people affected by actions such as quarantine.
• Updated measures to support planning for and response to public health emergencies, including the ability to investigate potential threats, mobilize resources, and take direct action to protect the health of the public.

Potential Concerns

• Discussion about exercise of public health powers can result in fears that these will be used excessively
• These are necessary powers to have but are only used as last resort and only when health of public is threatened, after careful consideration of all alternatives.
• Proposals regarding “core public health functions” and “population health promotion planning” could result in additional regulatory burden on Health Authorities.
• This is to provide for consistency of public health services across the province, while recognizing the need for local flexibility.
• There will be minimal requirements in legislation, but rather details can be required through performance agreements.

Next Steps

• Feedback on Consultation Public Health Act.
• Continue targeted consultation on policy issues. Main outstanding issues include:
  • Role local government and relationships to Health Authorities
  • Appointments of Medical Health Officers and Environmental Health Officers to First Nations and other federal lands
  • Regulation of “registries” i.e. personal information banks that are used for a variety of health purposes
• Preparation of legislative proposals.