For all of us, health care wears a human face. We think of personal experiences of ill health and of friends or relatives who have chronic conditions, cancers, or have had heart attacks, and can easily picture the physicians, nurses, pharmacists, physiotherapists and others who’ve treated them.
Harder to picture are those whose mission is wellness and prevention of illness. They’re working “upstream” and aren’t as visible.
In our community it’s the Haliburton, Kawartha, Pine Ridge District Health Unit (HKPR) that has the task of preventing illness, protecting us against disease and promoting healthy lifestyles.
To put a human face on this side of our health system and learn more about how it operates, I arrange to sit down with the health unit’s Lisa Kaldeway.
When we meet at Boiling Over’s Coffee Vault, I’m surprised to learn the youthful-looking Lisa has been with the health unit for 18 years.
She came here from Nova Scotia where she’d earned a Bachelor of Science degree in health education from Dalhousie (since then she’s completed a master’s degree and in April will add a Health Services Management Certificate).
The first thing I learn from Lisa is that HKPR covers a huge area (Kawartha Lakes, Haliburton and Northumberland counties) and has a range of responsibilities equally huge — everything from inspecting restaurants to ensure they follow safe practices to providing support to breastfeeding moms.
Some staff members focus on health promotion, some on health protection. Lisa’s in one of the three health promotion sections: healthy communities. (The others are healthy schools — addressing topics such as oral health, vision screening and substance use; and healthy families — public health nurses supporting the health of babies and their parents.) Her job title is “health promoter.”
Over the years Lisa has made presentations on topics ranging from cannabis and healthy living to car seat safety, led healthy workplace and smoking cessation programs and a Ministry of Health and Long Term Care-funded heart health project, and initiated the age-friendly City of Kawartha Lakes project.
She’s passionate about what she does and models healthy living practices. She eats well and has balance in her life, meaning her diet, exercise, and work-life balance. Her most recent vacation with her husband, Dan, involved hiking Newfoundland’s Gros Morne mountain.
Over her 18 years at HKPR Lisa has seen changes. Public policy and education have reshaped attitudes toward tobacco, but new challenges have emerged: Cannabis, opioids and vaping are concerns. Increased levels of inactivity and more time spent sitting, much of that in front of screens (at an earlier and earlier age) pose growing health risks.
Increasingly, public health staff members have shifted their approach to working with community partners to implement healthy changes through policy development, training other professionals (e.g. naloxone distribution) and creating environments that support health for all. Changes in government funding have also necessitated a need for health units to find ways to do their work differently.
The provincial government has initiated a review of the way all public health units are structured and funded, including changing their funding formula. As of January 1, 2020, health units are to receive 70 per cent of their funding from the province and the remaining 30 per cent from the municipalities they serve. Before the change, the province provided 75 per cent of the funding.
“Everything I do in the community is in partnership,” says Lisa. “That is how we are successful — building relationships and working to meet mutual mandates.”
Being strategic is another key to success. “We can determine where there’s a need, where there’ll be more impact and greater uptake. It’s possible to be creative in how we meet our requirements,” says Lisa.
How it Plays Out
So how does this play out in practice? Lisa describes two initiatives.
First, the Kawartha Lakes Sport and Recreation Council. Lisa helped bring together seven agencies and sport and recreation providers, among them the City and the Boys & Girls Club, to apply for a Trillium grant. Since the council’s formation, Lisa has co-chaired the council and overseen the work of the coordinator.
The council recently partnered with the Ontario Early Years Centre to offer a program that gave early childcare providers skills for teaching young children how to move confidently and competently — an efficient train-the-trainer approach. Another, the Active Again program, was for older adults, and provided support for activities such as pickleball, walking rugby and cycling.
The second initiative Lisa points to involves active transportation. Walking and cycling provide healthier alternatives to driving — for individuals and the environment — and for some it’s the only option, given that not everyone owns or can operate a vehicle.
Since 2007 Lisa has worked with trails associations and cycling groups and she contributed to the City’s Integrated Community Sustainability Plan, which included an Active Communities section.
More recently, when the City asked for agency comments on plans for the development north of Wilson Fields along Colborne Street, Lisa pulled together a group who were happy to contribute advice to refine plans for multipurpose walking and cycling pathways.
An important step will be creation of an Active Transportation Master Plan to ensure a future that makes walking or cycling the easier choice. Now that council has committed to funding the plan, she’s sharing models from other communities and looking forward to contributing to our local process.
Back to Work
The hour Lisa’s allotted for our conversation from her demanding schedule is up and she heads back to work.
You won’t see the impact of what she does right away, but, operating upstream, she’s helping shape a healthier community for all of us.