Peel Public Health (ON)

  • Gayle Bursey, Director, Chronic Disease and Injury Prevention, Peel Public Health, Mississauga, Ontario
  • Eileen de Villa, Associate Medical Officer of Health, Peel Public Health, Mississauga, Ontario

Evidence-Informed Public Policy Development for Public Health Practitioners Serving a Diverse Population

Rates of diabetes have increased rapidly in Peel exceeding the provincial average. A significant proportion of Peel’s population is of South Asian descent, a group which is at higher risk of diabetes, and experiences higher, and earlier, mortality from heart disease than the general population. Without intervention, projected rates of diabetes pose a major risk to the health and well-being of the public, the sustainability of the healthcare system, and the productivity of the workforce.

Major changes in physical and social environments in recent decades are the underlying causes of widespread physical inactivity, unhealthy eating, and sedentary behaviour, all of which are key risk factors in the development of diabetes. Influencing the environment through public policy is a necessary action for population-level prevention of diabetes. This report addresses our work to seek policy change throughout Peel Region, as well as specifically within the South Asian community. 

The extent of the problem and a vision for change was articulated in our 2012 report, ‘Changing Course: Creating Supportive Environments for Healthy Living in Peel’. We engaged local politicians through a symposium that highlighted the success that New York City (NYC) has had in achieving change through healthy public policy and provided participants a chance to identify opportunities for creating a healthier Peel. Having secured multiple Resolutions from Peel Regional Council providing policy direction, we established inter-departmental workgroups to pursue operational policy implementation, starting within our own and key community organizations. Workgroups are focused on building design, land use, food policy, and parks and schools.

Engagement work and discussions with the South Asian community culminated in a jointly-hosted session by Peel Public Health (PPH) and a South Asian association of health-related organizations. A noticeable shift in interest towards population-level approaches to diabetes prevention was observed with prominent community leaders committing to policy change within their organizations. In addition, some community organizations have adopted healthy food and activity policies.

We have improved writing and policy analysis skills in our public health workforce, and identified the need for improved documentation of our policy work. For example, staff have employed the Advocacy Coalition Framework to create consensus among opposing forces on a food policy. A commitment to institutionalizing these improvements has been made by the PPH Management Team.

Moving forward, the intent is to leverage our early successful policy changes within our organization, to more settings and to implement more complex longer-term changes (e.g., health-informed land-use planning). Reversing trends in diabetes will require a long-term effort involving environmental changes in many settings.

Our experience is readily transferable to other communities. However, our ability to foster change in Peel Region has required executive leadership and support within our organization, investment of financial and human resources including establishment of dedicated positions and external supports, as well as the relentless pursuit of our strategy. We are actively disseminating our experience through conference presentations, fulfilling speaker requests and publications.

Significant progress has occurred in achieving public policy change through partnership and engagement. Political support and media coverage will be critical to sustaining momentum for successful policy implementation.