Cross-discipline staff-driven approach to collaborating on food systems
Stephanie Oakes, BA, MPP Raymond Ramdayal, CPHI(C)
Toronto Urban Fellow, Research Associate Public Health Inspector
Toronto Public Health Toronto Public Health
I (Raymond) have been a Public Health Inspector (PHI) for over 15 years and currently fulfill the role of Environmental Health Specialist with Toronto Public Health (TPH) within the Healthy Environments directorate. With over 16,000 food premises in the City of Toronto, PHIs responsibilities include conducting inspections, investigating food-borne illness, providing food handler training, participating in food recalls, and emergency preparedness and response. PHIs collaborate on a daily basis with members of the public, foodservice operators, business owners, government counterparts and community partners.
Our experience with an initiative at TPH shows how PHIs can be part of addressing a broad public health issue in the name of health equity. The way that food is produced, processed, sold, prepared, consumed, and disposed of as part of a “food system” affects the diversity and availability of food. Sustainable local food systems support employment, food security, and economic growth, and complement the social and political processes that support health equity. Food system reform is a strategic priority at TPH. Last year, a working group including representatives from each directorate as well as a variety of disciplines (such as PHIs, dietitians, nurses, researchers, and policy staff) was formed to do a food portfolio analysis. The group met twice a month for 7 months to develop themes that connect diverse public health programs to food systems and to identify cross-directorate opportunities for collaboration. An early exercise was creating a map that outlined the steps in the food system; members of the working group placed themselves on the map to visualize where they fit in the process, which allowed them to identify where their work has an impact on food systems.
A report for senior management with recommendations for next steps included the creation of a “food innovation lab” to provide a dedicated neutral opportunity to come together, brainstorm and share information and strategies to support a food systems approach. “Innovation labs” allow participants to think beyond embedded organizational processes and consider diverse viewpoints of other staff that they might not encounter as part of regular program work. A “lab” like this takes ideas that exist “out in the cloud” and brings them to the table for discussion in search of solutions. People want to collaborate, to have some space to explore options, and need organizational support to do it, but don’t necessarily want to be told exactly what and where and how. A food innovation lab allows a space (virtual or physical) for ideas and new initiatives to be tested.
The food innovation lab is endorsed by the Medical Officer of Health (MOH) and all levels of management, who have agreed that staff will be supported to use work time to participate. An advisory team with representatives from directorates across TPH will meet regularly to plan and develop goals and objectives which will inform next steps and an evaluation strategy. The idea is to be open and accessible to everyone, and include different disciplines, topics and ideas related to food. Any staff can bring an idea or issue forward and get input from the group to help build a new or existing program, policy or strategy they are implementing, and can be on the listserv to be kept updated on progress. The hope is to strengthen current work and also come up with new ways to influence a food systems approach.
The launch of this initiative was at the end of October 2015, with the first lab as a three hour workshop on an “introduction to food systems.” This was an interactive session with small group discussion so people could get a firm foundation in the concept and see themselves as part of the solution. There were about 40 people who voluntarily attended. The response from this session was very positive and most participants expressed interest in doing the other four modules in Food Systems and Policy developed by the Food Strategy Team and Ryerson University. The hope is that interest will spread and build momentum as more people attend, facilitate and champion the lab. Feedback from every session will be used to plan the next sessions and contribute to how this initiative develops. The idea is to build action, evaluate results, and showcase the good work that TPH is doing in this area. The food innovation lab is helping public health staff to see how their work related to food systems and why this is important work in food security. The most recent session was held in January, 2016 focusing on the work of the Healthy Corner Store Project led by the Food Strategy Team. This project aims to improve food accessibility in underserved communities through the sale of healthy, affordable foods in convenience stores. At the session, close to 30 staff from eight different directorates gathered to discuss the model and brainstorm potential solutions to some of the challenges the project faces.
PHIs have influence at various points of the food system. Often PHIs are isolated in the work they do because many of our responsibilities are regulatory in focus and must meet a provincial mandate; the “consistent demand” nature of our work means that we may not see the importance of our role in addressing broader issues. The food innovation labs allow us to break down some of the silos which exist and ensure a culture of collaboration to address broad public health issues. PHIs bring a wealth of knowledge and expertise in the area of food safety and risk assessment, unique in the larger context of food system reform, which contributes to health equity. Innovation labs can leverage this knowledge and ensure PHIs are key players by keeping food healthy, accessible and safe.
We would like to hear from you! What experiences have you had in addressing the SDH and health equity in your environmental health practice? Please send your stories to Dianne Oickle, Knowledge Translation Specialist and help us share your practice stories. Our colleague Karen Rideout at the National Collaborating Centre for Environmental Health (NCCEH) will be continuing to collect stories from health protection or PHIs/EHOs who have taken action on SDH or health equity through their work. She would love to hear from you too!
Please visit the NCCDH Resource Library for related materials, including:
- Public Health Speaks: Where are the resources to “move upstream” in Public Health work?
- Let’s Talk: Health equity
- Let’s Talk: Moving upstream
- Let's Talk: Public health roles for improving health equity
- Public Health Speaks: Public Health Roles for Improving Health Equity