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PHO in Action is Public Health Ontario’s blog. Here we tell stories of the work we do day in and day out, with our partners, to keep Ontarians safe and create a healthier tomorrow.

February 14
​Join us for a special series of PHO Rounds on substance use


Substance use has been thrust into the spotlight in the past year, with the rapid increase of opioid-related deaths and the Health Minister calling the opioid crisis a “public health emergency”. Coupled with the impending cannabis legalization fast approaching in July 2018, it’s becoming more important to establish public health approaches to mitigate the burden of substance use. In such a quickly changing environment, public health professionals are asking, “Can we keep up”?​
This series provides a much needed forum for us to discuss recent developments, explore opportunities, and advance practice related to substance use.” 

 Pamela Leece, Public Health Physician, Public Health Ontario​

In response to this evolving environment, Public Health Ontario is introducing a PHO Rounds series that will focus on substance use to provide up-to-date and relevant information that will help you and your team feel more prepared. Our series will focus on surveillance data, local responses, and evaluation approaches – all presented by the foremost experts in each of these areas. Please join us for the following three sessions:


Upcoming presentations

Tuesday, March 13:  Municipal Drug Strategies – An Evaluation Framework, 12:00 p.m. to 1:00 p.m.

Michael Parkinson, Drug strategy specialist, Waterloo Region Crime Prevention Council      
Rob Schwartz, Executive Director, of Ontario Tobacco Research Unit

Tuesday, April 17:  Legalization of Cannabis, 12:00 p.m. to 1:00 p.m.

Elena Hasheminejad, Public Health Nurse and member of the Ontario Public Health Association Cannabis Task Force
Dr. Lawrence Loh, Associate Medical Officer of Health, Region of Peel

Thursday, May 24:  Opioid Surveillance Panel, 12:00 p.m. to 1:00 p.m.

Presenters to be announced.

How can I register?

Visit our Events page for more information on each session, including registration links. If you have any questions, please contact the PHO Events Team at

Past presentations

Tuesday, February 13:  Opioid Early Warning Systems, 12:00 p.m. to 1:00 p.m

Dr. David Williams, Chief Medical Officer of Health
Dr. Kieran Moore, Medical Officer of Health, Kingston, Frontenac and Lennox & Addington Public Health Unit.


Missed a presentation? Visit our presentations page to check it out at a later time. 

January 23
Profile: Justin Thielman​

In school, Justin Thielman pursued an undergraduate degree in biology with a minor in psychology. While he was drawn to the exactness of biology, after some years studying, he realized he didn’t want to work in a traditional wet lab. Since he couldn’t decide what his next move was, he moved overseas to Taiwan to teach English for a year.

<iframe width="300" height="169" src="" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen></iframe>​​
​See Justin discuss his walkability research.

After his travels, he returned to Ontario, where he started taking courses in Public Health,  including some epidemiology courses. He knew right away that he had found the right field – it was the perfect mix of the social science concepts he loved, and quantitative measurement and analysis. He applied to M.Sc. programs in Epidemiology.

That’s when he started to become enamoured with research. In his undergrad, he felt he never learned what research was – in biology, they largely focused on memorization. When he was in his Master’s program, Justin realized that research has a major creative component –  a unique way of thinking and looking at problems, and this type of analysis fit with his personality and interests.

He was interested in tackling what seemed to him the biggest health problems – ones that affected the most people: chronic disease and obesity. He ended up doing his master’s thesis on neighbourhood walkability and physical activity.

Walkability can be defined by four categories:

  •         well-connected streets (meaning a direct route to destinations)
  •         high population and residential density
  •         high density of nearby amenities (banks, grocery stores)
  •         good aesthetics (sidewalks that aren’t all cracked, good street lighting)

Focusing on the built environment and physical activity also allowed him to look at a broader population perspective when it comes to chronic disease and obesity:

“Many people tend to focus on obesity and chronic disease as an individual level problem – as in, individuals need to change their behaviours to become healthier. I thought it was just as important to consider these issues from a context point-of-view – certain environments are more conducive to living a healthier lifestyle. It’s overly simplistic to chalk it up to individual choices – to get the full picture you have to look at contextual factors like neighbourhoods”.

Why the neighbourhood? What’s significant about this context?

“Neighbourhood is important – because policy has the potential to influence a neighbourhood [layout], you can change community design, or change the street network. You can’t influence someone’s individual home or workplace as much. Each workplace is different and probably managed by different organizations.” Justin emphasizes the importance of rising above the individual point of view – to have a positive impact on as many people as possible using an upstream approach.

How do these concepts – walkability, the built environment – link with the social determinants of health, for example?

 “The social determinants of health and built environment interact a lot. Someone’s socioeconomic status will majorly impact the neighbourhood that they choose to live in. In cities like Toronto, the most walkable neighbourhoods tend to be the most expensive neighbourhoods. The reverse is true as well – Let’s say you’re living in an unwalkable built environment that is far from your workplace. Your commute may add to your stress level, it can take away from time with your family, and ultimately it negatively affects your health.”

Why is PHO important to your work?

Justin’s thesis work on walkability led him right into PHO’s doors – he became the lead epidemiologist on a project looking at Neighbourhood walkability.

“All of the walkability work that I’ve done at PHO has been interesting – the thing that makes it interesting at PHO is that we have a strong connection with policy-makers and local public health units, so you have that connection to the people who are using the information. Sometimes you don’t get this connection at academic institutions, so you can tailor your work to what is useful to those stakeholders. You can hear input from different groups, hear what they think is important and let it inform your research.”​

January 16
Public Health 101: Food Insecurity


Food Insecurity.png

From: Health Equity Indicators

January 12
Profile: Alex Marchand-Austin

Have you ever required laboratory data for a research paper or report? It seems simple enough to generate this information, but it actually requires a lot of coordination and expertise.

<iframe width="300" height="169" src=";showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen></iframe>​

​Watch Alex talk about lab surveillance and data management at PHO's laboratory.
Let’s go behind the scenes with Alex Marchand-Austin, manager of lab surveillance and data management at Public Health Ontario, and see how it all works.

How does one become a manager of lab surveillance and data management?​

Not many children dream of becoming something as specific as a lab manager in surveillance and data management – so how did Alex get here? Alex has a Bachelor’s of Science  in cell and molecular biology, and started his career working at the Public Health Agency of Canada as a liaison officer with PHO not long after graduation. It was in this position that Alex first worked closely with PHO lab data and was later recruited to lead the new lab surveillance and data management department. This wasn’t, however, the end of his educational path.

It’s Alex’s job to manage a team that helps process data requests from the wealth of data available from Public Health Ontario’s laboratory. As an intermediary between those who make requests (anyone from Public Health Units to researchers and academics) and the laboratory, Alex has to work with his team to interpret and tailor highly technical data to support each request.

This work helps make data that is already valuable from a clinical perspective even more valuable by extending its use for public health initiatives. It’s the best of both worlds: when people are already sick, lab test results help them understand how and start them on the road to treatment. Going forward, those results can be looked at from a population perspective to develop public health interventions that prevent them from getting sick in the first place.

The importance of teamwork

People might not know how much knowledge and expertise goes into generating the data that Alex’s team works with: “Although lab tests may seem to be a simple “answer” to a diagnostic question, there is a lot of work that goes on behind the scenes to generate it. Designing and validating tests, skilled lab techniques, complex interpretation of multiple results,patient factors, quality control, lab computer system design and maintenance, to name just a few. All of these factors can influence data quality and need to be considered to various degrees when building a data set for another purpose like surveillance or research.”

All of this wouldn’t be possible without Alex’s team and colleagues, a particular point of pride for him: “The amazing people at the lab put a lot of work into generating great results and are your greatest resource. We have come together from a variety of backgrounds to form a super knowledgeable, fun, and helpful group. Their enthusiasm for learning and problem solving makes me immensely proud to have them as colleagues.”

During his time at PHO, Alex pursued his Master’s of Science, using his thesis to focus on whole genome sequencing of Bordetella pertussis, the bacteria that causes whooping cough. He looked at how that technology could be used to describe changes in the bacteria over time and how monitoring those changes might be important to public health organizations. The topics explored in those studies are becoming increasingly relevant to his job, since data from whole genome sequencing is increasingly being used to enhance public health surveillance and research initiatives.

HIV datamart

A major project that Alex has worked on is the HIV data mart. This is a repository that provides timely, robust HIV data, contributing to:

  • surveillance
  • epidemiology
  • clinical care
  • research
  • priority-setting
  • planning and evaluation

At local (e.g. clinic, public health unit), regional (e.g. LHIN) or provincial levels.

The HIV laboratory data mart can help PHO support the delivery of better clinical and public health services in Ontario, by providing a better understanding of how many people are affected by HIV in Ontario.

The data mart helps automate a laborious data cleaning and transformation process that used to be performed manually. This frees up the time for epidemiologists and analysts to work with high quality data for analysis and reporting instead of spending the majority of their time cleaning and formatting. This has already allowed PHO to report on Ontario’s progress in achieving the 90-90-90 goals set forth by the WHO for the reduction of HIV – and would have been near impossible without the data mart.

Ultimately, Alex is glad to be a part of the work that happens at PHO: “PHO brings together experts from a variety of fields to tackle public health issues from all angles. We have laboratory experts, epidemiologists, analysts, scientists, physicians, nurses, and all the supporting staff under one organizational umbrella to support our various partner’s public health needs. This critical mass of expertise helps anchor a sometimes seemingly fractured public health system. “​

December 27
Vaccine Sciences Symposium 2017: A profile on our student prize winners


PHO hosted its 4th Vaccine Sciences Symposium (VSS) on November 15, 2017. The Symposium brought together over 165 researchers, health care practitioners, public health professionals and students to share diverse perspectives and critically examine immunization issues.
This year, students had the opportunity to showcase their immunization projects through a series of short, three-minute presentations. The top student prize went to Lauren Ramsay a PhD candidate in Health Services Research at the Institute of Health Policy, Management and Evaluation, University of Toronto. Lauren presented on her research project “Measles Control during Elimination: Is current public health action worth the efforts?”
We caught up with Lauren to learn more about her experience at VSS 2017.

What is your research project about?

“Early in 2015 there was a measles outbreak in Ontario that resulted in 18 cases of measles, 16 of which occurred in Toronto and the Niagara region. Measles cases in Ontario prompt public health action, including case and contact follow up and vaccine administration. The resource-intense outbreak response in 2015 raised the question of whether or not it was good value for money. This research project sought to answer that question using economic evidence from the healthcare payer perspective. It was a particularly interesting context in which to explore the cost-effectiveness of the measles outbreak response due to Ontario’s high vaccine coverage and measles elimination status, which play a role in measles transmission in Ontario.”

What interested you in presenting at VSS 2017?

“The diversity of the attendees is what got me most interested in presenting at VSS 2017. It seems rare, coming from an academic setting, to have the opportunity to present to front-line public health professionals, people involved in policy, and researchers all at once. The intersection of these groups is where things have the potential to get really interesting and impactful. As a student, I knew that having the opportunity to stand in front of these people (even for just 3 minutes!) was an important development opportunity for me.”

How was your experience presenting at VSS 2017?

“Like many others, I get major jitters when it comes to public speaking, and the impressive turnout at the symposium didn’t help my nerves. However, it turned out to be a really positive experience presenting to such an engaged and friendly audience. It was clear that everyone was there to support you and that they were genuinely interested in what the presenters were speaking about.”

What are a couple things you learned while attending VSS 2017?

“I learned a lot from all of the presentations, but the presentations from Dr. Nicole Le Saux and Dr. Jeff Pernica on vaccine safety were particularly informative for me. It was really interesting to learn about the different work being done by the The Canadian Immunization Monitoring Program, ACTive (IMPACT) and the Special Immunization Clinics Network (SIC).”
Congratulations to Lauren and our other student prize winners at VSS 2017:
1st prize — Lauren Ramsay
“Measles Control during Elimination: Is Current Public Health Action Worth the Effort?”
Health Services Research
Institute of Health Policy, Management and Evaluation, University of Toronto

2nd prize — Jingqian Liu
“Mycobacterium tuberculosis mutant with Isr2 gene deletion is attenuated in animal models of infection”
Master of Public Health, Epidemiology
Dalla Lana School of Public Health, University of Toronto

3rd prize — Raina Loxley
“Sero-epidemiology of Varicella in Ontario, 2013-2014”
Master of Public Health, Epidemiology
Dalla Lana School of Public Health, University of Toronto

4th prize — Hadia Hussain
“Determinants of influenza vaccine uptake among health care workers in acute care hospitals in Canada”
Master of Public Health, Epidemiology
Dalla Lana School of Public Health, University of Toronto
December 11
Public Health Professional Exchange: Pilot and working group


Are you a public health professional that’s interested in increasing your skills, strengthening your understanding of approaches used in other organizations and building your networks?

You’re in luck. alPHa and Public Health Ontario have collaborated to create a public health professional pilot program that will commence in Spring 2018. We are accepting applications until January 8, 2018.

We are seeking volunteers who currently work in public health to be a part of this pilot. If you’re not ready to be part of a formal exchange, but want to learn more, consider joining our working group, which is also seeking volunteers. To be considered for either the working group or the pilot project, you should have identified specific goals and interests, a host organization in mind and a supportive home organization.

To learn more, visit the alPHa website.


November 07
PHO Talks Videos are available now!



On October 26th, audiences tuned in for PHO Talks, a brand new series of short, compelling talks by our diverse experts.

In one hour, we heard three short talks from PHO experts Dr. Natasha Crowcroft, Rhonda Pollard and Stacie Carey. These talks helped us to re-think how we can work together to address health issues and challenges and ultimately move knowledge to action. ​

To see what you missed, or to re-live the experience, watch the recordings of the talks below!

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October 30
Antibiotic Awareness Week 2017 – stewards needed!


Antibiotic resistance has been identified as one of the biggest public health threats of our time. With mounting numbers of infections caused by antibiotic resistant bacteria and a lack of new antimicrobial agents in development, a crisis is slowly emerging.

Antibiotic stewardship (in other words, using antibiotics wisely) is an important way we can help thwart this crisis; but a concerted effort is required, from hospitals to the community, from human use to agriculture, from clinicians to the general public. We all need to be antibiotic stewards!

From November 13th to 19th, 2017, countries all over the world recognize Antibiotic Awareness Week. The aim of this week is to raise awareness about antibiotic resistance and how we can better use antibiotics to prevent this growing problem.

This year, Public Health Ontario (PHO) has partnered with Choosing Wisely Canada (CWC) to create an exciting antibiotic awareness campaign to help spread the message! Of more than 200 Choosing Wisely Canada recommendations, over 20 encourage antibiotic stewardship. Check out key recommendations here:

Join in the conversation on social media by following our Twitter – don’t forget to use the hashtag #SaveABX!​

Already a steward in your healthcare setting? Check out our ASP resources.

Are you a clinician interested in learning more? Join us for our November 14 webinar.

Management of community-acquired infections: A case-based approach to improve antibiotic use

During this webinar, Dr. Kevin Schwartz will discuss commonly encountered infections in community practice. This case-based presentation will provide practical tips to help improve the management of these infections and use antibiotics more appropriately to preserve their effectiveness into the future.

Date: November 14, 2017
Time: 1:00 pm - 2:00 pm
Registration: No registration required! Simply join in on our webinar -

Call in details:

  • 1-416-850-2050
  • Participant Code: 14596671

Keep exploring Antibiotic Awareness Week! Here’s a list of some of the participating organizations in Canada and around the world and links to their resources:

October 23
How to get the most out of PHO Talks


PHO Talks is coming up this week! Here’s how to get the most out of this event:

Get ready to watch:

  • Register now for the live-stream on October 26th and book the hour in your calendar to watch. You won’t want to miss the talks (but there will be videos of them posted later if you do!)
  • Be open to new ideas. This isn’t your regular lunch and learn session. These talks will introduce new ideas and challenge you to re-think health topics.

Share the experience with others:

  • Organize a viewing with your colleagues, peers, or classmates. Book a space and encourage everyone to bring their lunch.
  • Facilitate a short group discussion to talk about what you just heard. You can use the questions below, or come up with your own.

Reflect on what you learned:

  • Did you agree with the ideas? Why or why not?
  • How could you apply what you learned in your personal life, work or community? What action could you take right away to address this? One month from now? One year?              

Start a conversation:

  • Share the talks with others. We’ll post the talks on Youtube after the event. Whether you agreed, disagreed or just learned something new, sharing the talks is the first step in starting a conversation.
  • Tell us what you think! We’d love your feedback on the topics, the talks and the event format to help us plan the next event.


October 12
PHO Talks Speaker Profile: Rhonda Pollard


PHO Talks is a brand new series of short, compelling talks by our diverse experts. In one hour, you’ll hear three talks from our speakers. Register now for the live stream on Thursday, October 26, 2017.

Meet one of our speakers, Rhonda Pollard.

Rhonda is a Senior Advisor in leadership development and organizational development.  Most of her 17 year career has been spent leading strategic facilitation, management coaching, succession planning, change management, leadership and team development to provincial health care agencies. At Public Health Ontario, Rhonda has created a leadership framework and development strategy for PHO, facilitated staff engagement sessions during the strategic planning process and lead team development and change management sessions for various departments.

Watch the teaser video below to learn more about Rhonda and her talk! Learn more about our other two speakers, Stacie Carey and Natasha Crowcroft. ​ 

rhonda twitter blog.jpg

October 11
PHO Talks Speaker Profile: Stacie Carey


PHO Talks is a brand new series of short, compelling talks by our diverse experts. In one hour, you’ll hear three talks from our speakers. Register now for the live stream on Thursday, October 26, 2017. 

Meet one of our speakers, Stacie Carey.

Stacie Carey is a knowledge exchange specialist at PHO, where she is working to build knowledge exchange capacity, processes and tools across the organization. Her experience spans multiple public health priority areas including physical activity promotion, mental health and injury prevention. She has worked with local, provincial and national organizations to design and evaluate creative knowledge exchange strategies.

Watch the teaser video below to learn more about Stacie and her talk! Learn more about our other two speakers, Natasha Crowcroft and Rhonda Pollard​.  

stacie twitter blog.jpg

October 10
PHO Talks Speaker Profile: Dr. Natasha Crowcroft


PHO Talks is a brand new series of short, compelling talks by our diverse experts. In one hour, you’ll hear three talks from our speakers. Register now for the live stream on Thursday, October 26, 2017. 

Meet one of our speakers, Natasha Crowcroft.

Dr. Natasha Crowcroft leads Applied Immunization Research​ at Public Health Ontario, developing strategy, direction and partnerships, providing training and mentorship and leading the research program. Natasha has published over 150 articles and has international experience working at the World Health Organization (WHO), the Pan-American Health Organization (PAHO) and the United Kingdom’s Health Protection Agency. She has also been a member of the Canadian National Advisory Committee on Immunization (NACI).

Watch the teaser video below to learn more about Natasha and her talk! Stay​ tuned to our blog to learn more about our other two speakers, Stacie Carey​ and Rhonda Pollard​.  ​

​ ​​​natasha twitter blog.jpg

September 20
What you need to know: Emerging Multidrug Resistant Bacteria


PHO expert, Dr. Jennie Johnstone, recently appeared in the Canadian Medical Association Journal’s podcast to talk about emerging multidrug resistant bacteria. These bacteria, including Carbapenemase producing Enterobacteriacaeae, or CPE, are resistant to most or all antibiotics. They are common in hospitals and nursing homes and are difficult to treat, making them extremely deadly. 

Tune in below to hear Dr. Johnstone talk about why CPE is so dangerous, how we can detect and treat it, and what public health and healthcare providers can do to help prevent the spread. 

Dr. Johnstone also recent published an article with Dr. Samir Patel in CMAJ, Five Things to know about an Emerging Multidrug Resistant Bacteria

Want to learn more? See our infographic on Antibiotic overuse in Ontario’s long-term care homes, or the Ontario Health Profile on Antimicrobial Resistance. To find more about Dr. Johnstone’s work, see her scientist video profile

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September 13
Save the Date! PHO Talks: Big ideas, short talks

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New ideas and creative minds help drive innovation in public health. Hear some of the brightest minds at Public Health Ontario share their ideas in this unique event on October 26th. 

This brand new series of short, compelling talks by our diverse experts are appropriate for all audiences. In one hour, you’ll hear three short talks from experts Dr. Natasha Crowcroft, Rhonda Pollard and Stacie Carey. These talks will help you re-think how we can work together to address health issues and challenges, and ultimately move knowledge to action. 

Register now for the live stream and save the date!

We’ll be revealing more information about the speakers and events over the coming weeks. Stay tuned to our blog or follow us on Twitter (@PublicHealthON)!

July 26
Vector-borne diseases in Ontario — annual update


What are vector-borne diseases? 

Vector-borne diseases are infections that are transmitted by a vector such as a mosquito, tick or flea. The most common types of vector-borne diseases in Ontario are:

  • West Nile virus: a virus transmitted through the bite of an infected mosquito. It was first detected in Ontario in birds in 2001, with the first human cases following in 2002. 
  • Lyme disease: an infection transmitted through the bite of an infected tick. In Ontario, the majority of these human cases have occurred in areas associated with the blacklegged tick populations.
  • Eastern equine encephalitis virus​ (EEEV): a virus that circulates between birds and mosquitoes, with bridge vectors (mosquitos) transmitting the virus to humans and horses. EEEV has been reported in Ontario’s horse population since the 1930s; however, the virus has been detected sporadically in the Ontario mosquito population since 2009.

Annual trends in vector-borne diseases

VBD-Square.jpgIt’s important to monitor the trends in vector-borne diseases across the province. That’s why every year, with support and routine surveillance from the local public health units in Ontario, we publish our annual report on vector-borne diseases. We are happy to announce the release of the Vector-Borne Diseases: 2016 Summary Report​, which provides an overview of the 2016 data on the vectors that transmit West Nile virus, EEEV and Lyme disease in Ontario.

Interesting findings from the report:

  • ​There was an increase in West Nile virus positive mosquito pools over the last two years – with 211 positive pools identified in 2016.
  • While human data are not included in this report, it was noted that Ontario had the first ever human case of EEEV reported in Canada.
  • There was an increase in the number of blacklegged ticks submitted to PHO from 1,903 in 2015 to 2,041 in 2016.

Please note that human data are not included in this report. However this information is still available on our website through the Infectious Diseases Query tool and Reportable Disease Trends in Ontario.

Additional resources 

We offer a number of great resources and tools on vector-borne diseases. Check out our interactive West Nile virus surveillance page (updated weekly) or our Lyme disease page for more information.

Stay tuned to our PHO in Action blog for more vector-borne disease posts in the coming weeks.

Questions about the report?

Please feel free to contact us at

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