Community Conversations
Spring 2010
Guysborough County
Antigonish Town and County
Strait Richmond
Community Health Boards
Presentation Staying Healthy Together, April 7, 2011
Planning Process
• Gathering information through community engagement
• Workshops to develop the plan
• Identify Strategic Directions and Recommendations
• Develop CHB Operational Plans
How did we engage the community?
• Community Conversations
• Understanding Our Health Survey
• Presentations from GASHA Departments and Community
• Direct links to community organizations and coalitions
• Reviewed other information and relevant reports
Community Conversations - Purpose
• Provide information and discussion on important health issues
• Identify factors affecting health
• Identify and prioritize the serious health issues
• Identify some ways to address health issues
• Identify effective communication strategies
Community Conversations
• 40 Focus Groups held across the district – 36 reports
• 344 participants
• Included geographic communities as well as specific
populations: youth, young families, seniors, African Nova
Scotians, Acadian/francophone and First Nation communities,
the business sector, and community agencies.
Lack of Physical Activity - 50% (18/36)
For Youth, Seniors and Young Families
• Access to motivational fitness and wellness leaders (ATC; SR)
• Organized recreational activity in local communities (SR; ATC;
• Leadership by those responsible for recreational activities (ATC);
• Young people need more physical activity (ATC; SR);
• Safe walking routes for seniors (ATC);
• Accessible, affordable, local, and age appropriate programs and
facilities, including attention to the needs of seniors (SR);
• Equipment, education, and some organized fitness programs
Introduce equipment better and at younger age (GC).
Poor Nutrition – Obesity: 78% (28/36)
Poor nutrition, unhealthy eating, poor eating habits (ATC; SR;
Lack of awareness of healthy food choices (GC.);
Need good reliable information and knowledge of community
gardens (ATC; GC);
Easy access to junk food and convenience foods (ATC; SR);
Use of technology encourages inactivity and bad eating habits
(ATC; SR);
Lack of access to healthy food choices (GC).
Need for Prevention & Wellness: 39% (14/36)
Need prevention and wellness activities in our communities
(SR; ATC);
Need for awareness and education about benefits of changing
lifestyles (GC);
Need more focus on relationship between physical activity and
wellness (ATC).
Need for Supportive Environments: 39% (14/36)
• Need support systems and motivation to facilitate understanding
that change is required (GC);
• Need support from friends, family, and extended family; for
example, not giving kids unhealthy food. (GC.);
• Need to support and motivate youth (GC.);
• Need increased workplace wellness, physical activity
opportunities at work, and support for employees and employers;
for example a tool kit for employers (SR).
Addictions & Substance Abuse: 56% (20/36)
Drugs, alcohol and gambling, both youth and adults (SR);
Drugs, smoking, alcohol concerning to youth (ATC);
Many adults are smoking and using drugs and alcohol (GC);
Access is easy for youth. Adults help youth get drugs, alcohol
and cigarettes (GC);
People have multiple addictions (GC);
High percentage of youth in school smoke (GC);
Smoking an issue, especially with young families (ATC);
Peer Pressure – youth want to fit in (GC);
Starting younger in usage (GC);
Lack of enforcement by police for smoking underage (GC).
Chronic Disease: 50% (18/36)
• In all three CHB areas, diabetes identified as a health issue;
including, African Nova Scotians and First Nations communities.
• In the Guysborough County CHB area, cancer, and heart
disease were also identified as priority health issues.
• In Antigonish County, cancer was identified as the top priority
health issue by one focus group.
Factors Affecting Chronic Conditions
• Lack of physical activity
• Obesity, poor diet and lack of
awareness of healthy food
• Mental health issues, such
as stress
• Drugs, drinking and smoking
• Lack of education and
• Access to services and
• Lack of supports, programs
and isolation
• Lack of motivation; people
have difficulty making
• Economic issues, low and
fixed income; high cost of
healthy food and drugs
• Pollution
Mental Health – 58% (20/36)
Factors Contributing to Mental Health
• Isolation and loneliness, particularly for elderly in rural
• Stress and time management for students and young families;
• Relationship between mental health and having a chronic
• Other factors such as economic stress, relationship issues,
racism, stereotypes/stigma, low literacy, lack of physical activity,
and family history.
Mental Health – 58% (21/36)
Access to Services
• Lack of self awareness about mental health status and
conditions, hence the need for “mental health literacy;”
• Lack of awareness about services available;
• Stigma remains a barrier to accessing mental health services;
• Need for more community-based programs, support and self
help groups;
First Nations Communities
• Report mental health as a major health issue. Discharge
planning is of particular concern.
• Memorandum of Understanding (MOU) - mental health one area
outlined for action
What We Heard from our Consultation - Access
Key challenges:
• Growing seniors population requiring supportive environments
• Homecare requires improvements
• Public transportation
• Better access to health information and services & programs
• Community-based services & programs closer to home
• Continue to improve services to communities that have been
historically excluded and marginalized
• Implementation of Dr. John Ross report will require full
community consultation and attention to recruitment and
retention of staff.
Seniors – Supportive Environments 39% (14/36)
• Growing Aging Population
• Adequate, affordable housing
• Homecare
• Rural transportation
• Elder abuse
• Safe places for walking &
physical activity
• Poverty
• Cost barriers to programs &
• Lack of communication &
awareness about services &
• Housing supports for snow
removal, lawn mowing, etc.
• Isolation: support systems for
elderly and caregivers;
smaller families and people
moving away.
Access to Homecare
• Gap in supportive care upon leaving hospital and returning to
home (ATC);
• Cost of and access to adequate caregivers which would allow
seniors to stay in own home (ATC);
• Need support systems for elderly and their caregivers (SR; ATC);
• Home care services received are very limited and need to be
expanded (SR);
• Housing supports for seniors and individuals living by
themselves for snow removal, lawn mowing etc. (SR).
Transportation – 58% (21/36)
Antigonish Town & County CHB area:
• Affordable and accessible transportation - over ½ of focus
groups. Lack of rural transportation, especially for seniors.
Strait Richmond CHB area,
• Affordable transportation – in particular lack of access to services
Guysborough County CHB area - one of priority health issues
• Lack of transportation to appointments, clinics and education
programs as well as lack of access to programs and facilities.
• African Nova Scotian community of Lincolnville - lack of public
transportation major issue in accessing services and programs
as many residents do not have cars.
Communication and Engagement 47% (17/36)
• More information about community programs & services in local
communities (GC; SR; ATC);
• Access to health information (AC; SR; GC)
• More promotion on what to do to improve health (SR).
• Suggestions to promote programs and services: brochures in
communities; information on internet and website; CAP sites to
have safe health links; pamphlets available on reliable health
links; promotion of the 811 service. (GC; SR; ATC);
Supportive Environments for Young Families:
28% (10/36)
• Child and parenting supports
• Child care in order to access programs
• Locally organized recreational activities
• Isolation and stress - many young mom’s are on their own –
‘single moms’ while partners are working away
• Need to keep young families in our communities through support
for economic sustainability
Community-based Services/Programs 83% (30/36)
• Chronic disease programs/self help groups, support programs
• Health education (ATC, GC, SR)
• Screening programs - monthly clinics (ATC, GC, SR)
• Outreach health and wellness programs (ATC, GC, SR)
• Expanded hours at existing walk-in clinic; more walk-in clinics
and clinical services, youth health centres (ATC, GC, SR)
• Community gardens; good nutrition, meal preparation, healthy
meal planning (ATC, GC, SR)
Health Inequities
Physical & Built Environments: 22% (8/36)
Strait Richmond CHB area:
• Safe drinking water; particularly well water; education about
water testing; cost for well water test can be a barrier to testing.
Guysborough County CHB:
• Education and better information about well water testing and
how the test works.
• Lincolnville identified insufficient water supply as one of their
priority health issues.
Strait Richmond and Antigonish Town & County CHB areas
• Safe areas for walking, particularly those living in rural areas.
Health Inequities – Poverty/Income 39% (14/36)
In all three CHB areas, poverty identified as a factor affecting health
and linked to a number of other factors as follows:
• Food security and ability to buy nutritious food;
• Ability to access to services due to lack of transportation,
especially in rural areas;
• Adequate and affordable housing;
• Ability to access recreation opportunities;
• Ability to participate in programs due to cost barriers;
• Access to prescriptions due to costs.
What We Heard from Consultation: Youth (7 gps)
• Most common health issues: (1) mental health (2) drugs,
smoking and alcohol; and (3) obesity.
• Need places for youth to gather – youth health centres & after
school recreational and social activities
• Affordability & transportation in rural areas critical to engaging
• Need to improve physical activity levels
• Healthy eating/obesity need to be addressed
• Readiness for change to improve health and wellbeing identified factors to help increase physical activity levels
• Reseau Sante – Nouvelle Ecosse youth focus groups similar
Strategic Directions
1. Strengthening & Supporting Mental Health in Our Communities
2. Implementing a Comprehensive Community-based Chronic
Disease Strategy
3. Promoting & Supporting Healthy Living
4. Building Bridges to Youth Health
5. Facilitating Access to Services & Programs
6. Addressing Inequities to Improve Health
7. Promoting Communication with Communities & with GASHA
8. Enabling Health Planning & Coordination
CHB Focus Group Conclusions
• Results reinforced issues from Understanding Our Health Survey
• Multiple factors contribute to health of populations (seniors, youth,
those living in poverty)
• Access and health inequities critical to address in rural areas
• Need to consider determinants of health and health inequities in
delivery of all services
• Need to focus on youth as our most critical health promotion and
prevention strategy.
• Recommendations: community-based and collaborative services
will ensure more wholistic approach to improving health
Thank you!