Results at a glance - Evaluation of Health Canada’s First Nations and Inuit Health Branch Environmental Public Health Program 2010-11 to 2014-15

The Environmental Public Health Program

• The Environmental Public Health Program (EPHP) provides services in First Nations communities (south of the 60^th parallel) to help them identify, address, and/or prevent environmental public health (EPH) risks that could adversely affect the health of community residents.
• Programming focusses on: Drinking Water; Wastewater; Solid Waste Disposal; Food Safety; Housing; Facilities Inspections; and, Emergency Preparedness and Response. Activities include environmental public health assessments; training; and public awareness activities.

What the evaluation found

• Health Canada's role in Environmental Public Health (EPH) services is to provide advice and guidance. Indigenous and Northern Affairs Canada (INAC) provides funding to communities to reduce EPH risks.
• Many of the current and anticipated environmental health risks facing First Nations communities are similar to the EPH risks observed five years ago during the previous departmental evaluation.
• That said, over the past five years the EPHP has shown progress in a number of areas. These include more timely data collection; increased research to guide EPH activities and address EPH priorities; and, increased awareness of EPH risks among First Nations communities. This progress has resulted in greater demand for EPHP services in communities.
• There has been less progress in addressing some EPH risks. For risks where short-term actions are needed such as drinking water advisories and food safety precautions, progress is good. Progress has been less visible in areas where longer-term actions are needed, such as housing, drinking water, and wastewater
• A key component of the EPHP successes is the work of Environmental Health Officers (EHOs). Nevertheless, there is a concern that EHOs may become less effective in future because of increasing workload in many of the regions, and the greater expected demands placed on the EPHP.
• The EPHP has improved in measuring its performance in the past five years, but still needs to move towards assessing outcomes instead of counting outputs.

Recommendations and responses

1. Enhance collaboration with stakeholders to support First Nations in reducing environmental health risks that may take longer and cost more to address.
   Response: The EPHP has a long history of collaboration with partners to work towards the reduction of complex EPH risks. In the context of Budget 2016, new infrastructure funds and INAC's efforts to address Drinking Water Advisories (DWA) on reserves, EPHP will focus on working with INAC to promote putting greater priority on investments that reduce high environmental health risks. Public health advice and analysis in this area is already being shared between the two departments.
2. Review the current allocation and workload of EHOs to determine what level of service to community is sustainable, given the additional demands on the EPHP.
   Response: Health Canada (HC) is making efforts to improve the availability of, and access to, high quality data to promote better decision-making and planning. As a result, HC will assess how sustainable the current situation is and to determine future requirements for EHOs.
3. Assess the impact of the recommendations made by EHOs to Chiefs and Councils in the area of food, water, and housing.
   Response: A representative sample of recommendations in the areas of food, housing, and drinking water will be reviewed to assess their impacts and determine if the recommended follow-up actions are taken.

About the evaluation

The evaluation reviewed EPHP activities for the period from April 2010 to March 2015. The evaluation was performed by the Office of Audit and Evaluation, and included key informant interviews, surveys, comparative analysis, document and literature reviews, and financial data and performance data reviews.

December 2016