November 2008

 

Alcohol and the Ontario Public Health Standards

For those working in public health and, in particular, one of the 36 Ontario Public Health Units, the month of November will offer a lot of excitement. On the 12th of November the new Ontario Public Health Standards (OPHS) [PDF] will be officially announced. These standards have been a joint initiative of three ministries: the Ministry of Health Promotion (MHP), the Ministry of Children and Youth Services (MCYS), and the Ministry of Health and Long-Term Care (MOHLTC).

The purpose of the OPHS is to set out the minimum requirements for fundamental public health programs and services targeted at prevention of disease, health promotion and health protection.

The Ministry of Health and Long-Term Care have outlined the following directions served as a foundation for the review:

1. Move from guidelines to program standards that are linked with specific performance measures for increased accountability;
2. Renew the program standards based on current science, evidence, and best practices;
3. Integrate renewed standards into an overall performance management system for public health;
4. Adopt a logic model approach to clearly identify and illustrate short- and long-term outcomes;
5. Establish ongoing review, enhancement and support processes so that standards are continually evolving.

For more information on the process of the Ontario Public Health Standards, you can read about it on the Ministry of Health and Long-Term Care website. The site includes how the OPHS was developed, the committee members, the terms of reference, the 56-page OPHS document, and updates.

The standards cover seven areas of public health:

1. Health Promotion and Wellness
2. Chronic Disease
3. Family Health
4. Prevention of Injury and Substance Misuse
5. Emergency Preparedness
6. Infectious Diseases
7. Environmental Health

For those who are new to public health the new OPHS are replacing the Mandatory Health Programs and Services Guidelines of 1997. These new standards are different in many areas and are worth reviewing. The most significant changes that impact the alcohol field is a clear move to ensure health units are identifying alcohol within their assessment and surveillance activities, and health promotion and policy development as it relates to chronic disease prevention and substance misuse and injury prevention.

It has been shown that alcohol is no ordinary commodity. It impacts the health of Ontarians socially, physically, and financially. Sadly, alcohol plays a lead role in numerous injuries and preventable deaths along with a variety of chronic diseases.

The Alcohol Policy Network and the Association to Reduce Alcohol Promotion in Ontario are two programs that are key in supporting health units in these mentioned areas. Due to this unique position both programs have been mapped to reflect how they can assist in the deliverables for health units under chronic disease and/or injury prevention and substance misuse programming. You can download the entire document [PDF] from our website. The document outlines which requirement alcohol pertains to, the programs and/or resources that APN and ARAPO deliver that relates to each requirement, and an explanation of why the programs or resources are relevant.

Alcohol and Older Adults - Teleconference

In 2004, over three quarters (77%) of adults in Canada aged 65 to 74 consumed alcohol in the past year, as did about two thirds of adults aged 75 and over. In fact, as Canada’s population increases it will have to address the impact alcohol will have on it’s ageing population.

This information is emerging in the United States as researchers at Brandeis University recently published Unhealthy Drinking Patterns in Older Adults: Prevalence and Associated Characteristics in the Journal of the American Geriatrics Society. The article explained that 9% of elderly Medicare beneficiaries — 16% of the men and 4% of the women — engaged in unhealthy drinking. Researchers said those numbers could be conservative because they are based on self-reporting.

The study was funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The NIAAA and the American Geriatric Society determined that risky drinking for someone 65 or older involves consuming more than seven drinks weekly or more than three drinks on a single day. Other guidelines have suggested that single-occasion drinking should be limited to no more than two drinks. It should be noted that an October 2008 article in the Journal of the American Dietetic Association, "Alcohol and Consumption by Ageing adults in the United States: Health Benefits and Determinates", reviewed alcohol guidelines as they relate to older adults.

Though these guidelines are different from those of the Centre for Addiction and Mental Health, the co-author in this research, Dr. Elizabeth Merrick, a senior scientist at Brandeis University's Heller School for Social Policy and Management, stressed the importance of education and awareness by saying, "It's important for health-care providers and others who work with this population to be aware of this issue so they can screen for it and talk to people about the maximum amount of drinking that is healthy"".

Due to the fact that a large proportion of Canada’s population is ageing, research, awareness, and education are important components to address. CAMH has recently published a document, Improving our Response to Older Adults with Substance Use, Mental Health and Gambling Problems. This five-chapter document is meant for supervisors, managers, and clinical staff who work with older adults. Chapter one outlines key messages, and introduces various terms readers may want to know. Chapter two talks about "Improving our response." The third chapter identifies substance use, mental health, and gambling in older adults, while Chapter four is a brief overview of treatment and services, and finally, strategies for challenging situations are captured in Chapter five.

For more CAMH publications that examine older adults and substance use/misuse you may be interested in the following:

• Choosing to Change: A Client-Centred Approach to Alcohol and Medication Use by Older Adults
• Responding to Older Adults with Substance Use, Mental Health and Gambling Challenges

Additionally, you may be interested in a free teleconference that the Alcohol Policy Network is hosting to review current resources on substance use/misuse and older adults, Seniors and Alcohol: Understanding current trends; making the most of public health opportunities. The teleconference will be held on Tuesday, December 2, 2008 from 1:00 p.m. to 2:00 p.m. eastern standard time. The teleconference will be moderated by Charmaine Spencer, Research Associate, Gerontology Research Centre and Adjunct Professor, Gerontology Department, Simon Fraser University, Vancouver, BC.

To register for the teleconference, please access our online registration page. Space is limited, so register early to ensure a place.