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Community Calling Volume 3

Editor-in-Chief Dr. Farhan M. Asrar Dr. Farhan M. Asrar Dr. Farhan M. Asrar Dr. Farhan M. Asrar

Editorial Board Dr. Suhail Asrar, Dr. Suhail Asrar, Dr. Suhail Asrar, Dr. Suhail Asrar, Dr. Silvina MDr. Silvina MDr. Silvina MDr. Silvina Memaemaemaema Dr. Khosro ShirpakDr. Khosro ShirpakDr. Khosro ShirpakDr. Khosro Shirpak

French Translation Dr.Dr.Dr.Dr. Colleen Fuller Colleen Fuller Colleen Fuller Colleen Fuller Mr. Mr. Mr. Mr. Émile KhordocÉmile KhordocÉmile KhordocÉmile Khordoc

In conjunction with Public Health Physicians of

Canada (PHPC)

Founder Dr. Farhan M. AsrarDr. Farhan M. AsrarDr. Farhan M. AsrarDr. Farhan M. Asrar

All rights reserved Community Calling © 2013

Contents

Letter from the Editor……………………………..………....Page 3 Update from the Public Health Physicians of Canada....………..Page 4 Canadian Public Health Association…….……....…..….…......Page 5 Pandemics, Policy and the Public Health Agency of Canada....…Page 7 Public Health in Nova Scotia…...………………......….……Page 9 Public Health in the Northwest Territories ………………....Page 11 Publications and Presentations .……………………..……...Page 12 Conversation with Alberta’s Chief Medical Officer of Health.....Page 13 Crowdsourcing-Influenza Data in Canada………..……….....Page 14 Announcements…………………………………….……....Page 15 Award and Scholarship Recipients…….……….…….…....…Page 15 Residents’ Corner……………………...……...…………….Page 16 Acknowledgements.………………….…..…...…………….Page 17 Next Issue……………………………..…...…………...…Page 17

Disclaimer: Community Calling, all rights are reserved. This publication is not to be reproduced, stored in a retrieved system or transmitted in any form or by any means, electronic, mechanical, photocopying or otherwise, without the permission of the Community Calling editor and staff. Views expressed by the contributors are their own and does not reflect the views of Community Calling, the editor and staff, individual PHPM residency programs and also of the Public Health Physicians of Canada (PHPC). Community Calling does not accept any responsibility of the information printed. While all possible and reasonable care has been taken to ensure that the information provided is fair, accurate and up-to-date, Community Calling, its staff and writers shall not in any way be responsible for any errors and consequences of any action taken on the basis of reliance upon the contents of this magazine.

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Individual

Highlights:

Inside Story 2

Inside Story 3

Inside Story 4

Inside Story 5

Last Story 6

Dear Readers, Welcome to another issue of Community Calling, Canada’s premier national Public Health Physician magazine. Public Health continues to be in the news, some of it due to the usual public health practices and planning such as the current flu season. Other news focus on the continuing debates that rage on; water fluoridation continues to be the hot-button issue as always; and another growing debate making the news involves the mandatory flu vaccine/face mask use for healthcare workers during flu season. This season also brings another challenge which public health professionals have to continuously face, I am not referring to deadly bugs and other illnesses one has to prevent, but the budget! Yes, it is that time of the year when one has to ensure budgets are balanced; there is the need to advocate for additional funding for new initiatives and/or enhancing existing initiatives; deal with budget cuts; and also continue to promote the overarching message of the need to invest in preventive care.

Another noteworthy news item involves the transformation of University of Toronto’s (UofT) Dalla Lana School of Public Health (DLSPH) into UofT’s latest faculty (becoming UofT’s newest faculty in the last 15 years). Such a historic achievement was due to the leadership and marvelous work by Dr. Howard Hu who started his role as Director of DLSPH only last year and is now the Dean of the new faculty, Congratulations!. Community Calling would also like to congratulate Dr. Joel Kettner on becoming the President of the Public Health Physicians of Canada (PHPC)

We hope you continue to enjoy reading Community Calling and we look forward to continuing to receive your articles and feedback, thank you.

Dr. Farhan M. Asrar, Editor-in-Chief communitycalling@yahoo.ca

Chers lecteurs, Bienvenue à cette nouvelle édition de Community Calling, le principal périodique pour les médecins en santé communautaire au Canada. La santé publique demeure en un lieu de prééminence dans l’actualité - en partie à cause de l’effet saisonnier de l’influenza. D’autres sujets ciblés dans les médias sont le débat en cours de la fluoration de l’eau (un sujet brûlant, comme d’habitude), et le discours grandissant sur la question de la vaccination obligatoire contre l’influenza (ou l’utilisation d’un masque pendant le saison) pour les travailleurs médicaux. Et bien sûr, cette période de l’année amène l’autre enjeu permanent pour les professionnels en santé communautaire - non, pas les micro-organismes mortels ou les maladies a prévenir - le budget! Oui, il est encore l’heure de vérifier qu’on a un budget équilibré, quand il y a un besoin de solliciter du financement additionnel pour améliorer les initiatives actuelles, ou pour en commencer des nouvelles. C’est le temps de l’année où on doit faire face à les compressions budgétaires mais continuer à faire la promotion du message global de la nécessité d'investir en soins préventifs. D’un autre coté, Community Calling voudrait noter la transformation récente de l'École Dalla Lana de Santé Communautaire (Dalla Lana School of Public Health, DLSPH) en nouvelle faculté de l’Université de Toronto, la seule nouvelle faculté de l’université depuis 15 ans. Cet accomplissement formidable s’est fait grâce à la direction et le travail merveilleux du Dr. Howard Hu, qui a commencé son rôle comme directeur du DLSPH il y a un an, et qui est maintenant doyen de la nouvelle faculté. Félicitations! Community Calling voudrait aussi féliciter le Dr. Joel Kettner, qui est devenu Président des Médecins de Santé Publique du Canada (MSPC). Nous espérons que vous continuerez à profiter de la lecture de Community Calling, et nous attendons avec plaisir la réception de vos commentaires et articles! Merci!

Dr. Farhan M. Asrar, Editor-in-Chief communitycalling@yahoo.ca

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The PHPC is our voice as a specialty, working to advocate for the importance of the role of the public health and preventive medicine specialist, the public health physician, and for public health more broadly. Our founding purpose was to support PH specialists achieve their aims for continuing professional development. Here’s what we’ve been doing:

• CPD event at our 2013 Annual Symposium: sharing the latest and most effective developments with speakers from across Canada. It was a great event!

• Survey of members to determine how the PHPC can best meet the learning needs of the members: the survey found that you want more presentations, shorter with time for Q&A, that the topics should be, well, topical! Use local speakers and invite MOHs or members to talk about something that they’ve had to deal with in the past year.

• We were successful in our application for funding from the Public Health Agency of Canada (PHAC). The project began in April and will last for three years. Funds will support the provision of on-line CPD offerings and Medical Officer of Health core competency development. We’ll also look at potential employers to understand how (if) they use the core criteria for MOH for their hiring decisions, and to show some of them that they ought to consider a PH specialist when they are staffing.

• We’ve always worked closely with the Canadian Public Health Association (CPHA), but we’ll also partner with CPHA to establish a framework for the implementation of a Certified Public Health Professional in a project funded by PHAC.

We’ve been developing a strategic plan for membership growth for the organization because while our membership has increased annually, only about 45% of specialists are members. Last year at the Annual General Meeting, the membership agreed to increase our fees in order to more effective on behalf of members. Now we need to be sure that members are getting more of what they want.

6. We contracted basic secretariat support to assist in communication, advocacy and CPD activities

7. Volunteer members on our Committees are working to make PHPC more visible. We are better able to partner with other organizations to get out message out because our secretariat supports logistics and follow-up. Last year we supported new hypertension guidelines, restrictions on food advertising to children, and regulation to reduce sodium in food in Canada;

8. CPHA, the College of Family Physicians of Canada, the Canadian Medical Association and PHPC are entering the 3rd year of an initiative we call “Collaborations in Advocacy”. CiA advocated in writing, through the press and with others about the dangers of asbestos and on the gaps in pandemic response. We’ve exercised important positive influence upon government as a result of this collaboration.

9. We’re working on the website. It isn’t a great reflection of our profession quite yet, but it can be. We’ve got new software that simplifies membership renewal, we’ve got Council members donating their time (three cheers to the Resident Representatives who’ve been spectacular!), and we’re going to be able to improve our on-line CPD offerings and webinars. Very importantly, we need to make it accessible in both official languages. Which brings me to the next point

10. Do you want to help translate? We’ve used e-mail appeals to look for members to represent the Society on committees or at meetings to which PHPC is invited. There hasn’t been a lot of response. This is something that we need to improve – any ideas? Perhaps you’d like to join the Membership Working Group? Volunteering will improve your team and leadership skills, introduce you to experienced MOHs and PH officers, and widen your understanding of the profession. It looks good in your CV, too!

Yours sincerely, Dr. Maura Ricketts Past President, PHPC Contact the PHPC at phpc@cpha.ca

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As a Public Health and Preventive Medicine specialist, it is a true privilege to assume the Chair position of the Canadian Public Health Association (CPHA). The volunteer leadership of CPHA over the past 102 years has included the giants of public health in Canada. It is a humbling experience to join them. For those of you who are members of CPHA—and I would stress that you should all be members--see later for why (PS for the US readers, I am also a member of the American Public Health Association and am VP Canada of APHA so please join your association, or both, wherever you live), you will know that the last few years has seen the Association strive for sustainability in a new fiscal environment where government is no longer a paying partner in projects and where, in particular, global health assistance, which was a major CPHA revenue line, is funded more bilaterally than as part of a lively competition among non-governmental organizations. There is an accompanying sociopolitical environment as well that considers, as foundational, that government has no business supporting civil society organizations (except for maybe as part of good governance aid elsewhere). Despite ‘the troubles’ to borrow a Northern Ireland term, CPHA continues to grow its policy capacity and influence, with of course two great victories—the success of the InSite safe injection site Supreme Court decision, and the change of government policy on chrysotile asbestos, both files that utilized considerable volunteer and staff resources of CPHA over the past few years. The quality and relevance of the Canadian Journal of Public Health under the superb editorial guidance of Gilles Paradis and the broad range of expertise represented by his Editorial Board, has also been considerably strengthened. Residents in Public Health and Preventive Medicine should consider it a rite of passage to have your first, if not one of your first, articles published in CJPH. The CPHA annual conference is the platinum event for the public health community and annual attendance is great for networking, as a forum for presenting your work, and to hear from Canada’s public health leaders on issues of topical interest to the public health community. The Public Health Physicians of Canada pre-conference session is also a must-attend event of the conference period. CPHA’s student activities are ably led by Student Board Member, and include many volunteer and leadership-building opportunities. Over the next two years as Chair of CPHA, I look forward to working with CPHA Executive Director, Ian Culbert, our impressive Board members, and the CPHA membership and key partners, to ensure not only that CPHA is sustainable as the independent voice for public health across Canada but also that we are policy- and practice-relevant to Public Health, broadly defined. Ian has the commitment, vision, skills and the team to achieve this goal but tired as the mantra might be, we cannot do it alone. We need membership revenue. We need charitable donations. We need to make a profit from the CPHA conference. We need to develop new business lines. We need to engage expertise from volunteers for our policy work. As Chair, while honouring CPHA’s eminent past, my goal is to complete the work of transforming CPHA into an innovative, vibrant, and sustainable organization whose presence matters in a new sociopolitical environment.

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We know that many of the issues facing CPHA also face our partner organization, of which I am a founding member, Public Health Physicians of Canada. PHPC recently announced a substantial membership fee increase as it works to sustain itself after facing similar difficulties to CPHA. I have many identities and many loyalties and loyalties draw upon one’s personal and financial resources. I am also crazy busy like everyone reading this article is, so why do I suggest that you be steadfastly loyal to CPHA? Because CPHA is your collective and it matters that a pan-Canadian association dedicated to public health is invited to policy tables, convenes the public health community, and publishes cutting edge studies about public health. I began my public health volunteer career in 1987 as Board member and later President of the Public Health Association of Nova Scotia. I was later vice-chair of the Family Health division of CPHA and led the Royal Commission on New Reproductive Technologies file for CPHA in the area of prevention of infertility. I was first elected to the Board of CPHA six years ago so it is a long road to Chair. In the interim, I served on several civil society boards including as Co-Chair of the Canadian Society for International Health, another CPHA partner organization, and board member for the Canadian Council of Food and Nutrition and National Cancer Institute of Canada, plus an array of governmental boards. In each instance I have been a public health physician—that is my identity and because I truly believe in the interdisciplinary that is public health, CPHA is my collective. So as you as residents in Public Health and Preventive Medicine solidify your identity in our transformative medical specialty, consider that you will have many draws on your loyalties but that they will likely all be subsumed under the collective good that is the goal of Public Health. I believe the CPHA embodies that collective.

Dr. Lynn McIntyre

Professor and CIHR Chair in

Gender and Health,

Associate Scientific Director,

Institute for Public Health,

University of Calgary

Chair, CPHA

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Are you keen to chair a daily intelligence meeting to consider important events affecting Canada, represent Canada at an international public health consensus conference, work with Provincial and Territorial public health departments to develop national surveillance standards, manage the national Tuberculosis surveillance system or develop content for online public health professional development programs? Variety, broad scope, national and international interactions and the opportunity to participate in urgent national public health responses are just some of the reasons why physicians choose to work at the Public Health Agency of Canada (PHAC). The Agency is the main Government of Canada body responsible for public health in Canada. It was established in 2004 in part as a response to the SARS outbreak in 2003, and was confirmed as a

legal entity in December 2006. The Agency is the focal point for the federal government's work on promoting health, preventing chronic disease and injury, combating infectious diseases, and preparing for and responding to public health emergencies. The Agency engages in activities that range from research on antivirals and vaccines to pandemic planning, and from building national public health networks to

engaging in international health security exercises. Because public health is a shared responsibility, PHAC collaborates with all levels of government, although primarily at the Provincial and Territorial level. The Agency also works closely with non-government organizations, including civil society and business, other countries and international organizations like the World Health Organization. The Agency has a staff of over 2,000 employees in a wide range of operational, scientific, technical and administrative positions in Ottawa, Winnipeg and regional offices. As well as tackling the obvious public health issues in Canada, PHAC is building public health capacity and infrastructure though the Public Health Network – a formal Federal, Provincial, Territorial collaborative structure. Examples include the Multi Lateral Information Sharing Agreement – a formalized intergovernmental data sharing agreement that will be submitted for approval by Ministers of Health – and a systems approach to surveillance for the country. Physicians at PHAC As the Deputy Chief Public Health Officer, I am playing a lead role in physician talent management in the organization. Although doctors are one of several public health professionals working at PHAC, we are focusing on the unique skill sets they bring and how we can nurture and take full advantage of their competencies.

“I have been operations Chief at our Emergency Operations

Centre during pandemic H1N1, the Olympics, G8/G20 and the Fukushima nuclear

reactor incident” Dr Ken Scott,

“I direct national surveillance programs for HIV, TB, hepatitis

and sexually transmitted infections”

Dr Chris Archibald

“After residency I completed the Canadian Field Epidemiology

Program and subsequently was hired as a medical specialist.”

Dr Robert Gervais

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Physicians at the agency have the opportunity to work in many different areas and roles during their careers. They act as public health experts and consultants, as policy advisors and in direct management and leadership roles. There are opportunities to collaborate on international initiatives, work closely with Provincial and Territorial governments, combine public health and clinical responsibilities and contribute to shaping national public health policy.

The diverse backgrounds, training and experience of the physicians working at the agency contribute to a challenging and enriching professional atmosphere.

Working at PHAC We welcome resident placements at the Agency, not only in the standard areas of surveillance and epidemiology, but can craft unique learning experiences in areas such as policy development. In addition to placements, residents may choose to apply to the two year Canadian Field Epidemiology Program or to participate as affiliate field epidemiologist. As an affiliate PHPM residents participate in the three-week “Epidemiology in Action” training course and are eligible to get direct hands-on experience participating with a field epidemiologist in the investigation of local, provincial/territorial or national public health issues. The Agency is piloting an“ MD Experience” program for newly graduated PHPM fellows. This is a one year term position at the Agency which gives the graduate a working opportunity to experience Federal Public Health first hand. For more information about opportunities for residents at the Agency please contact Dr Hilary Robinson, hilary.robinson@phac-aspc.gc.ca; or myself: gregory.taylor@phac-aspc.gc.ca Dr. Gregory Taylor Dr. Hilary Robinson Deputy Chief Public Health Officer of Canada Senior Medical Consultant Director General of the Office of Public Health Practice Office of Public Health Practice Public Health Agency of Canada Public Health Agency of Canada

“My academic education includes two engineering

degrees in addition to being a licensed physician.”

Dr Peter Uthoff

“I worked for Health Canada as a medical officer for First Nations’ Health and MOH in the Yukon before returning to work in national public health

surveillance.” Dr Hilary Robinson

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Following two decades of crumbling public health infrastructure across Canada1,2severe acute respiratory syndrome (SARS) shocked the collective public health community in Canada by exposing the fragility of the public health system. Building on Learning from SARS (the Naylor Report)3and multiple inquiries, royal commissions and reports, Nova Scotia undertook an external review of public health to assess its strengths and limitations and to ensure a system that is responsive, integrated, coordinated, efficient, effective and prepared for new, existing and re-emerging public health threats. The review – The Renewal of Public Health in Nova Scotia- Building a Public Health System to Meet the Needs of Nova Scotians (the Renewal Report)4 was released in 2006 and identified 21 actions for system renewal. The five major categories of the actions were: improve the structure and function of the provincial level of the system, improve the structure and function of the local level of the system, improve how those to levels worked together, improve how the public health system worked with the broader health care system and build infrastructure – people, information and financial supports. Action for system renewal #1 was to ‘articulate and be guided by a collective vision for the public health system.’ Knowing that public health was facing major public health issues such as an epidemic in chronic disease as well as requiring a robust system to continue deal with communicable disease, we chose an approach that would expose us to new ways of understanding our internal and external environments while also addressing social innovation and system change. We also knew that doing the typical strategic planning processes and expecting a different result was, as attributed to Albert Einstein – his definition of insanity. Working with external consultants, we used Theory U – a change management method targeting leadership as a process of inner knowing and social innovation developed by Otto Scharmer from MIT5 - as our framework. We embarked on a year journey of ‘sensing’ – learning about ourselves as leaders and as a system, we spoke to people we serve, to partners, to groups and organizations whose mandates touched ours, to people we had not worked with in the past and with those who interfaced with public health. Through an appreciative inquiry approach – we were able to transcend what we heard – the good, the bad and the ugly – to identify our way forward with clarity on our purpose, how we needed to change to meet the changing needs of our province and its people and how we worked together within public health as well as our partners.6 Through this very deliberate and intense process of ’presencing’ the path forward for our public health work became clearer. We have clarity on our purpose (Nova Scotia Public Health purpose statement: public health works with others to understand the health of our communities and acts together to improve health), our call to work much more in primordial prevention, the unique contribution that public health brings to understanding and exposing health inequities, as well as public health’s role in facilitating changes in the physical, social and political environments where people live, work and play. Through the

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commitment to participatory leadership and the methodologies used in Theory U – for example, world café, open space, deep democracy – to bring the collective wisdom of people forward, we are on a new and innovative trajectory in public health.7 Re-aligning public health work will take time and will require building capacity within our system, our staff and in others. Nova Scotia has developed public health standards8 that embed the commitments to understanding and social justice and our vision to shift our focus much more to the determinants of health and populations. Shifting our work in public health will fundamentally contribute to improving the health of our population as well as contribute to the sustainability of our health care system. Shifting the work of public health to be better positioned to effectively impact 21st century issues has a number of implications. Shifting towards primordial prevention will require greater focus on collaborative partnerships outside the health system, more emphasis on community engagement and increased attention to influencing government and organizational policies. This has implications for PH educational and workforce development programs as well as the type and mix of professions that we recruit and hire into public health. There are also significant implications for the interface between public health and primary care, a topic of ongoing research and discussion. The ongoing shift towards multi-disciplinary primary care and the need to increase the up-stream focus of public health work creates the opportunity to discuss where the individual-level work (e.g. supporting infants and parents, vaccination of infants and pre-school children) currently done by public health is best located and who is best to do that work. There is no right or wrong answer, the discussions need to happen locally to factor in local context’s but public health needs to be open to thinking, and working, differently than we are today. The road ahead is not straight nor easy. It will require us, with partners, to understand together what roles we all play in improving and protecting health as well as ensuring quality care to the public we serve. It will require transitioning work among, across and with partners. It will require development, maintenance and enhancement of public health and leadership competencies. It will require leadership, tenacity and a long term commitment to a renewed public health system.

References: 1 Federal Provincial and Territorial Advisory Committee on Population Health (Can). Survey of public health capacity in Canada: highlights. Ottawa: The Advisory Committee, 2002. 2 Frank J, DiRuggiero E, Moloughney B. The future of public health in Canada: developing a public health system for the 21st century: CIHR, 2003. 3 National Advisory Committee on SARS and Public Health. Learning from SARS: renewal of public health in Canada. Ottawa: Health Canada, 2003. 4 Province of Nova Scotia. The renewal of public health in Nova Scotia: building a public health system to meet the needs of Nova Scotians. Halifax: 2006. 5 http://www.presencing.com/ 6 http://www.gov.ns.ca/hpp/yourmove/Journey-Towards-Renewal.pdf 7 http://www.gov.ns.ca/hpp/yourmove/yourmove-movingforward.pdf 8 http://www.gov.ns.ca/hpp/yourmove/Public_Health_Standards_EN.pdf

Janet Braunstein Moody RN MPH,

Senior Director, Public Health Renewal

Dr. Robert Strang Chief Public Health

Officer for Nova Scotia

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Up here, you choose your own magical northern adventure. It might be a dramatic explosion of northern lights at a wilderness lodge, or world-class fishing on one of our super-sized lakes during the long days of summer. It might be a drive across the Arctic Circle, a rugged hike at the top of the world, or a long paddle down one of our remote northern rivers. It might be wood bison, moose and bears that are commonly spotted along the road or the rare birds from across the Americas that still nest here each summer. You may be unexpectedly blown away by the fantastic food and hip, fun, and young people in our many communities, our islands of urbanity in a vast wilderness. It is beyond belief, but within your reach, right here in the spectacular Northwest Territories. When it’s time to get to work, you’ll also find more adventure and opportunity in the type of public health practice we do here in the north than practically anywhere else on the planet. The Office of the Chief Public Health Officer provides leadership and guidance in all aspects of public health. Appointed under the Public Health Act and on behalf of the Minister of Health and Social Services, the Chief Public Health Officer (CPHO) is given broad responsibilities and powers with regard to the protection of citizens against

communicable diseases and environmental health hazards, as well as the surveillance of disease conditions and monitoring of program activities. We must ensure that the public and decision-makers at the community, regional and territorial level have access to timely and quality information on the health impacts of their decisions. With support from staff in other divisions of the Department of Health and Social Services, we develop, monitor, and enforce compliance with standards and guidelines for programs and services in the health and social services sector, as well as advocating for healthy public policies. We work closely with the territorial epidemiology team to interpret trends in health status indicators and offer advice and consultative services on a wide range of health and social issues, having opportunities to work on interdepartmental, intersectoral, national and even international (usually circumpolar) initiatives. There are also many opportunities to collaborate with colleagues from the academic sector to Improve Knowledge on public health methods and processes, be involved in research

Sparkle is a tame description of the sky full of shimmering, fiery northern lights reliable on most clear winter nights over Yellowknife, Northwest Territories.

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- Dr. Huy Hao Dao (Resident, Université de Sherbrooke) “Pilot project to support dentists and dental hygienists in smoking cessation counseling in the Montreal’s south shore area, Canada”. Poster presented at the American Public Health Association Annual Meeting (November 2-6 2013) in Boston, MA.

- Dr. Khosro Refaie Shirpak (Resident, McMaster University) "Primary care needs and services in pandemics and other disasters in Canada; developing a research agenda". Poster presented at the annual Family Medicine Forum (November 6th-9th, 2013) in Vancouver, B.C.

- Dr. Farhan Asrar (Resident, McMaster University) “Aboriginal Peoples in Canada and Food Security”. Poster will be presented at The Ontario Public Health Convention – TOPHC (March 31- April 2, 2014) in Toronto, On.

Do you have a recent presentation or publication, email us at communitycalling@yahoo.ca

projects and to build northern capacity to conduct in-depth analytical studies and reviews. For instance, here are some concrete examples:

• Investigation of disease clusters (e.g. syphilis, cancer, HPV seroprevalence);

• Evaluation of program outcomes (e.g. immunization coverage rates, cancer screening rates);

• Preparation of special reports using multiple sources of data (e.g. Health of Elders, Youth, and integrated chronic disease prevention and management strategy);

• Implementation of new surveillance systems or tools. (e.g. congenital anomalies surveillance system);

projects and to build northern capacity to conduct in-depth analytical studies and reviews. For instance, here are some concrete examples:

• Participation in infection control initiatives including the investigation of antibiotic use and the study of antibiotic resistant organisms such as MRSA, and ESBL

• Contributing to government-wide strategies dealing with poverty reduction, early childhood development or injury prevention.

Finally, there is the never-ending task of updating our policies and legislative framework. All said, working in the northern context provides a unique opportunity for an innovative, productive and meaningful public health career. We hope to see some of you very soon, and if you have further questions, don’t hesitate to contact those of us who work in the north!

Dr. André Corriveau Chief Public Health Officer for the Northwest Territories Andre_Corriveau@gov.nt.ca Dr. Corriveau previously served as the Chief Medical Officer of Health for the province of Alberta (2009-2012). Dr. Corriveau also sits as the Provincial/Territorial Co-Chair for the Pan-Canadian Public Health Network Council

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“I was honoured to be appointed Alberta’s Chief Medical Officer of Health back in June last year,” said Dr. James Talbot. “I grew up in this province, studied here, and this has been my home for decades. The health of Albertans is important to me. I very much want to continue the fine work done by my friend and colleague, the former Chief Dr. André Corriveau.” Dr. Talbot brings experience to the job. He was the Chief Medical Officer of Health for Nunavut in 2004 to 2005. In the eight years since, he’s done extensive work in epidemiology and biostatistics, and been an Associate Clinical Professor in the School of Public Health at the University of Alberta. His private practice included hospital, lab, business and governmental experience, and he holds a doctorate in biochemistry as well as in medicine. The vision for the Chief Medical Officer of Health is healthy lives for all. To meet it, Dr. Talbot works to protect and promote the health of all Albertans— making recommendations on how to prevent disease and injury, and encouraging Albertans to get vaccines and flu shots, to make healthier choices and have communities and governments that support or encourage them to do so. . “Public health has been called the silent hero, because most of the work is behind the scenes. Often people don’t realize it is there until there’s an emergency, such as an outbreak or pandemic,” said Dr. Talbot. “But public health needs a bigger public voice to promote health and prevention. That means getting in front of people with the message, and expanding the conversation.” Strategies included social marketing, for example to

promote early childhood development; healthy aging and injury prevention. Among Dr. Talbot’s current challenges are increasing access to the Human Papilloma Virus (HPV) vaccine, and improving the lives of vulnerable populations such as refugees, aboriginals and those living in poverty. “Much of our health care actually is illness care; it’s there to treat or cure. The more we can improve people’s health and prevent illness, the more we can direct funding and resources to prevention, including social programs such as housing, income supports and better parks and play grounds.” Dr. Talbot points to polio as an example. “Polio wasn’t eradicated by buying more iron lungs and crutches, but through immunization, improving environmental health, and educating the public on the importance of these strategies.” When he became the Chief, Dr. Talbot called for a different conversation on health in Alberta that goes beyond hospitals and doctors’ visits, and focuses on how social determinants contribute to people’s health. Communication is key. “How can we make Albertans feel that social factors and other issues like early childhood development, healthy aging and injury prevention are important, without overwhelming them with statistics? How do we turn collaboration, innovation and community leadership from cliché and into something practical and real?” For Dr. Talbot, the solution lies in how Albertans, volunteer organizations, industry, academics and government work together as organizations, and also as neighbours and individuals. “We can begin by making the healthy choice the easy choice, and the unhealthy choice the harder choice. We need to ensure that children have safe communities to play in and families have access to affordable nutritious food and access to affordable housing.”

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Crowdsourcing is becoming an increasingly common mechanism for gathering public health data. For example, Google Flu Trends estimates influenza incidence using flu-related search terms, and other groups are mining Twitter for flu-related tweets. Google Flu Trends usually closely mirrors the US Centre for Disease Control and Prevention’s (CDC’s) data, which are based on outpatient surveillance and virology results from laboratories (Butler, 2013; Schmidt, 2012). Last year, however, Google Flu Trend’s results significantly overestimated influenza incidence when compared to traditional surveillance data. Some have suggested this may be due to increased search activity in response to media reports of a particularly severe influenza season (Butler, 2013). Syndromic surveillance data solicited from online volunteers are less vulnerable to media suggestion and are more participatory, but are drawn from smaller populations, than term-based algorithms. Both types of data are available earlier than traditional surveillance data. Flu Near You is one such online syndromic surveillance system and its data closely mirror those from the CDC (Butler, 2013). Flu Near You is a website that collects anonymous, geo-tagged survey data on influenza-like illness (ILI) symptoms from users in order to map influenza activity. Flu Near You is administered by HealthMap, a real-time outbreak monitoring system based out of the Boston Children’s Hospital, in partnership with the American Public Health Association and the Skoll Global Threats Fund. Flu Near You participants are e-mailed a weekly survey to identify if they have had any of 10 ILI symptoms—fever, cough, sore throat, shortness of breath, chills or night sweats, fatigue, nausea or vomiting, diarrhea, or body aches or headache—in the prior week. Participants can also answer the same questions about their family members. Data from Flu Near You are freely available online to anyone accessing the website (Chunara, Aman, Smolinski, & Brownstein, 2012). Flu Near You was launched in 2011 in the United States and now has approximately 46,000 participants (Butler, 2013). In December 2012, it was expanded to Canada. There are now approximately 200 participants in Canada and Flu Near You is hoping to recruit more Canadian volunteers. If you are interested in participating, learning more, or using Flu Near You data, please visit the website at https://flunearyou.org/.

Dr. Emily Groot, PGY2 Public Health and Preventive Medicine Queen’s University

References

Butler, D. (2013). When Google got flu wrong. Nature, (494), 155–156. Retrieved from http://www.nature.com/news/when-google-got-flu-wrong-1.12413 Chunara, R., Aman, S., Smolinski, M., & Brownstein, J. S. (2012). Flu Near You: An online self-reported influenza surveillance system in the USA. 2012 International Society for Disease Surveillance Conference (p. 40). San Diego, USA. Retrieved from https://s3.amazonaws.com/ISDS/2012-Conference/2012-ISDS-Conference-Abstracts.pdf Schmidt, C. W. (2012). Trending Now: Using social media to predict and track disease outbreaks. Environmental Health Perspectives, 120(1). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261963/

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McMaster University Residents sweep the Public Health Physicians of Canada (PHPC) Awards: Dr. Farhan Asrar was awarded the PHPC President’s Award Dr. Gayane Hovhannisyan received the PHPC Resident Leadership Award Dr. Mustafa Hirji and Dr. Kit Ngan Young Hoon received the PHPC Resident Travel Grant Dr. Khosro Shirpak (Resident, McMaster University) is a co-investigator and member of a research group that was awarded a CIHR grant (~ $25,000) to pursue research on Primary Care's Role in Disaster Medicine. Dr. Farhan Asrar has been awarded the CAIR Dr. Joseph Mikhael CAIR National Award for Medical Education (This award honours those who have taken a leadership role in promoting high-quality medical education and contributed to improving undergraduate and postgraduate medical education in Canada. CAIR is the national representative body of over 8,000 resident physicians across Canada).

New Book: Dr. Anne Andermann (Medical Specialist in Public Health and Preventive Medicine at Health Canada’s Quebec Regional Office and Public Health Physician at the Cree Board of Health and Social Services of James Bay Northern Quebec) is the author of a recent book entitled ‘Evidence for Health: From Patient Choice to Global Policy’ (Cambridge University Press). Sir Michael Marmot praised the book saying “Evidence for Health: From Patient Choice to Global Policy is an innovative and timely book that provides important insight on how to make more transparent and informed decisions that will result in healthier individuals and more equitable societies.' Now available online and at a bookstore near you! Community Calling would also like to congratulate Dr. Andermann for recently being awarded the Canadian Rising Stars in Global Health award from Grand Challenges Canada.

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Early this year, senior residents from across Canada attended the annual Senior Management Course organized by McMaster University’s Public Health & Preventive Medicine Residency Program. The course was developed and led by Dr. Matthew Hodge (Left). Photograph courtesy of Dr. Shovita Padhi

The Public Health Physicians of Canada (PHPC) invites residents to join for free. If you are already a member then get involved in your national association. Contact the PHPC Resident Council

Co-Chairs: Dr Andrew Gray and Dr. Rim Zayed at phpcresidents@gmail.com

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Community Calling would like to thank and acknowledge:

Dr. Maura Ricketts, Dr. Lynn McIntyre, Dr. Gregory Taylor, Dr. André Corriveau, Dr. Robert Strang, Dr. James Talbot, Dr. Hilary Robinson, Ms. Janet Braunstein Moody, Mr. Dan Wong, Ms. Jo-Anne Bacon, Dr. Shovita Padhi, Dr. Emily Groot, Dr. Colleen Fuller and Mr. Émile Khordoc.

And as always, we would like to thank the readers for the continued support.

Community Calling, Canada’s only National public health physician magazine that reaches public health professionals from all provinces and territories, is looking for faculty members, pubic health professionals and residents to volunteer and become the editor/join Community Calling’s Editorial Board. Have an interest/passion for writing/editing and like to interact with PH physicians across

Canada? then contact us at communitycalling@yahoo.ca Send in your submissions for the next issue; - Announcements about awards, pubic health publications and presentations. - Share your experience and impressions of a conference/program you had attended. - ACPM articles, news and updates. - Residency Program News: Send us news about your noteworthy achievements/awards and share your experiences on a national or international rotation you pursued. - Photos of social and professional events pertaining to Public Health physicians.

For further details and deadlines, contact us at: communitycalling@yahoo.ca

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