Health unit post-merger check-up: Lakelands Public Health delves into priorities
By editor/reporter Sarah Hyatt
Eighteen months after the official voluntary merger that created Lakelands Public Health, the region’s top public health doc says the priorities and challenges ahead are still many as several crises continue to intersect and public health has a major role to play.
Back in August 2023, the Ministry of Health announced its proposal “to strengthen the public health sector” and plans to offer one-time funding, resources and supports to public health agencies that decided to voluntarily merge by January 2025. Discussions started between the former local Haliburton, Kawartha, Pine Ridge District Health Unit and Peterborough Public Health shortly thereafter, with formal board of health votes shifting the needle towards provincial approvals in early 2024.
By Jan. 1, 2025, Lakelands Public Health officially became a reality and merged, but integration work is still ongoing, Dr. Thomas Piggott, the health unit’s medical officer of health (MOH) and CEO, told the Independent.
On a provincewide scale, these voluntary mergers ended reducing the grant total of public health units from 34 to 29.
“I made the joke to staff that we, you know, like an 18-month-old baby, we’re still learning some, you know, new words and how to walk consistently, but we’ve fortunately got some great parents, (with) the health unit background (being) HKPR and Peterborough Public Health.”
In addition to maintaining services, Piggott said staff also continue to work towards adding and bolstering service delivery in the region.
“That is all underway right now. And in the background of that as well is obviously the need for more work in public health.”
The climate today is difficult – the issues are more complex – and priorities and crises are often colliding and/or intertwined. And this isn’t unique to just public health.
Take the healthcare system that is in crisis and its challenges around access to care, noted Piggott.
“Public health really has a critical role to play into helping to support communities and prevention at a population level.”
In terms of learnings amid merger work and top priorities to tackle for the merged health unit, this is just one area.
Lakelands Public Health has a much larger geographical area to serve now, and of course, one of the most important actions is to get on the ground and chat and spend time with folks and get to know more partners and communities, explained Piggott.
“It’s important for me as a leader, but I think important for all of our staff.”
To this end, back in May and June, the health unit hosted a series of town-hall style events throughout its coverage area, including locally, to hear directly from residents about their priorities.
“We’re pulling all of that information together and it’s coming together in what will be our strategic plan that we plan on launching early next year from the board of health,” said Piggott, noting this plan will serve as a blueprint for key priorities for the next five years.
Piggott acknowledged the need for a lot of work under public health and the team will continue to try and figure out the best path forward in all its communities as Northumberland’s individual needs are likely to vary to say in comparison to Haliburton or Curve Lake First Nation.
The team will of course then be challenged with responding to those individual needs while also balancing efficiencies within the health unit and better ways of delivering more for residents throughout the region.
As for what public health heard at these town halls, the issues identified were many and some are broader.
“I think one of the prominent things we’ve heard throughout the whole region is mental health and addictions-related challenges,” said Piggott, acknowledging the plethora of stressors and factors contributing to these crises today.
Meanwhile, there’s also inequality and poverty, which has increased, and those have an impact on health, too, he noted.
“We’re seeing more people experience the visible impacts of homelessness … and that’s a concern in many of our communities, big and small, as well as the substance-use crisis and challenge, which involves not only the need to get access to treatment, but to support people with where they’re at and to help to prevent those harms from happening in the first place.”
Then, there’s tackling misinformation, especially around vaccines from a public health standpoint, which is increasingly becoming a challenge to get out good evidence and science so people can make informed decisions for themselves, their families and kids, which is critical, continued Piggott.
“We’ve seen a decrease in uptake of some vaccines following the COVID-19 pandemic. And that leads to challenges like what we’ve seen with measles transmissions and even measles death in the province, which a generation ago, we would have thought would never happen again. So those challenges are very much real here.”
Another area of concern the health unit has heard loud-and-clear is around environmental health challenges and how the changing climate is impacting health.
And that’s not all.
“We’ve probably seen the most significant Lyme disease season on record this past year – and the tick that carries Lyme disease is spreading, (and) is much more prominent … and more people are getting sick from Lyme disease and a whole litany of other illnesses associated with the environment,” explained Piggott.
Then there has been the wildfire smoke, along with increasing extreme heat events, which are also impacting health, especially for older adults, vulnerable populations and those without access to cooling, he added.
Simply put, “there’s a lot going on” and to work on.
What’s more, Lakelands Public Health, as a whole, now has the oldest population of any public health unit in the province.
And with this comes an opportunity to age healthier and prevent diseases but also a whole host of challenges from an access to care standpoint, a hospital strain standpoint, and more, he explained.
Piggott believes public health has a key role to play to help keep people healthier, at home longer and aging in healthier ways in local communities – and these are just a few of the priorities that have come up and that public health will be working on as part of its developing five-year blueprint.
After the COVID-19 pandemic, readiness for emergencies is another prominent ask.
“We learned from the COVID pandemic, but there’s also been extreme weather events and storms that have really strained our ability to be ready and respond. We need to do that better,” said the MOH. “So really, there’s a lot of challenges and priorities.
“What we’re trying to do now is to continue to strengthen the health unit following the merger to make sure that our staff and our communities are ready for what’s to come in the future.”
He also noted he believes one critical element to this puzzle is size. Both previous health units were “a little bit small before the merger.” Now, Piggott feels they’ve found “that Goldilocks zone in size,” meaning it’s not too big and not too small.
“We’re not so big that we lose touch with our communities and residents throughout the region, but we’re bigger and we have a bit more capacity and ability to have specialized staff (who) can support our region and to have some improvements in the services that we deliver and our readiness for future events and emergencies.”
But finding and maintaining that “sweet spot” “takes a lot of work” and “change is hard,” he noted.
Continuity under relationships, deep agency connections and partnerships with community organizations will also remain a focus moving forward, he said.
“For me, as a leader in public health, I’m also mindful that I need to get out and be part of conversations in the region.”
Just one local example he pointed to included attending the recent Tattoos4Trauma Walk to End Suicide in Cobourg, where he spoke with residents, community agencies and others.
“I’m trying to do everything that I can to get in and around Northumberland County and all through our region to make sure that folks know who I am, know (what) the health unit is, and know that we’re there and here to support them.”
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