Features
To Our Good Health
New OVC prof hopes research, teaching will help improve public health in Ontario
BY ANDREW VOWLES
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| Prof. Andrew Papadopoulos says public health services are chronically underfunded. Photo by Martin Schwalbe |
Eat right, exercise, don't smoke and drink in moderation. Population medicine pro- fessor Andrew Papadopoulos knows the mantra for preventive health care. He should — he's spent 18 years preaching the gospel as an expert in public health policy and administration, including heading the Association of Local Public Health Agencies (alPHa).
These days, he confesses he's finding it more of a challenge to practise what he preaches. Since being appointed a faculty member this summer in the Ontario Veterinary College — where he's also completing a PhD — he's been busy learning and commuting from his home in Mississauga. That's put a dent in his exercise time. For the same reason, he finds it's sometimes easier to grab something to eat on the fly — and not necessarily the best thing.
Still, the former public health inspector plans to get back on track. Why study health policy and governance intended to improve the province's well-being if he can't ensure his own?
He arrived at Guelph in July. By mid-October, he had packed his boxes again, preparing to move from the main OVC building to the adjoining MacNabb House. That's now home to researchers with Guelph's Centre for Public Health and Zoonoses, directed by Prof. Jan Sargeant, Population Medicine.
Midway through his doctorate under Prof. Jeff Wilson, Papadopoulos hopes to help refine the province's public health system, including making a more effective system that better incorporates ideas from various stakeholders.
Public health boards are intended to protect and improve community health through education, promotion of healthful lifestyles and research on disease and injury prevention. A local board can also become the community focal point during health crises, including threats to drinking water or food safety and disease outbreaks.
He points to the late Dr. Sheela Basrur, who was Toronto's public health commissioner during the 2003 SARS outbreak. She's credited with steering the city through that crisis, which caused 44 deaths and threatened an epidemic. She subsequently became Ontario's chief medical officer of health. Papadopoulos was her colleague during his stints as alPHa executive director and, more recently, as director of Ryerson University's School of Occupational and Public Health.
Ontario's 36 boards of health operate in one of three ways. Some autonomous boards work apart from local municipal councils, such as Wellington-Dufferin-Guelph Public Health. In nine areas, including Waterloo, Hamilton and Halton, the municipal council serves as the public health board. There's also a hybrid system, used only in Toronto, which blends municipal and community members.
Papadopoulos favours a model resembling the autonomous or separate board. He also advocates clarifying funding relationships so people can see who's paying what. And he says the board should allow for community input.
An autonomous health board can also provide independent opinions, he says. Witness the crisis with tainted drinking water in Walkerton, where the local medical officer of health acted to control the E. coli outbreak.
Currently, he explains, autonomous boards are better able to set budgets and allocate funding than their municipally run counterparts. Hamilton, for instance, has some of the greatest needs but consistently struggles to find the resources for public health programs.
Papadopoulos would like to see a higher priority placed on public health, both in policy statements and funding. Many policy documents include financial and environmental impact statements, he says.
“My ideal would be that every policy in Ontario has a public health impact statement attached.”
He says public health services are chronically underfunded. In Ontario, about $500 million is spent each year on public health, a relatively small proportion of the Ministry of Health's more than $30-billion budget.
Although Ontario's health measures are favourable compared with other jurisdictions, the province can do better, says Papadopoulos.
“A whole town with contaminated drinking water is unacceptable,” he says, referring to Walkerton. “A system ill-prepared to combat West Nile virus in my opinion is unacceptable.”
And consider how SARS nearly crippled the health-care system in the provincial capital. “We really shouldn't have these kinds of calamities given our resources.”
He saw many of these issues close up as executive director of alPHa between 1998 and 2004, representing all those agencies across Ontario.
Earlier he was a public health inspector for the City of Toronto, following studies at Ryerson. That occupation came naturally, he says. He'd grown up in Toronto and then Mississauga, where his parents ran a restaurant.
“My name's Papadopoulos — what do you expect,” he quips.
His interests in policy and program development led him to an MBA at York University. “I believed I could effect change more by developing and implementing policy than on a one-to-one basis.”
At Ryerson, he looked after budgeting, staffing and student recruitment while continuing to teach. Those experiences will likely be useful here at the University, where he's helping to lead the introduction of a master's program in public health.
Being at Guelph will allow Papadopoulos to continue to influence public health policy and tap into the University's strengths in food and water safety, environmental and public health, zoonoses and infectious disease. Commenting on his post in OVC, he points out that many communicable diseases from West Nile virus to SARS are zoonotic, crossing from animals to people.
Papadopoulos and his wife, Trudi, an instructor in his former department at Ryerson, have two children.