Chronic Disease & Community Health

This year, the pandemic has amplified and widened health inequality gaps, especially among racialized communities and seniors. It has highlighted important issues such as social isolation, lack of access to healthcare, low digital literacy, precarious housing, food insecurity and mental health challenges. Newcomers, immigrant seniors, ethno-racial communities with language barriers and people living with multiple chronic conditions were among those at higher risk of the consequences of these inequalities.

The Community Health and Chronic Disease programs at SRCHC quickly changed gears to phone-based contact, virtual support and groups. Personal protective equipment, public health protocols and enhanced cleaning and infection control allowed us to provide acute care to clients and community members as well as Allied Health and Health Promotion programs. In order to maximize client and staff safety during the year, a hybrid model of both in-person and virtual care was provided. Phone or video assessment and followup were available; additionally, in-person services were offered based upon the complexity of the condition, barriers to access and risk of adverse effects from COVID-19 exposure. The demand for service remained consistent with most people preferring in-person followups along with virtual supports.

The Diabetes Education Community Network of East Toronto (DECNET) remained active in order to maintain the well-being of those impacted by Type 2 diabetes. DECNET provided appointments for urgent foot assessments, foot care and counselling appointments. Via phone or video, education, support and care were provided.

By establishing friendly calls with clients, weekly online support groups, exercise classes, and information sessions throughout the year, Harmony Hall Centre for Seniors and Harmony Community Food Centre checked in on isolated seniors at home. Food security needs were supported by grocery gift cards, delivery and meals. Harmony Community Food Centre, also established a seasonal affordable food market, open to all. Addressing food insecurity, a weekly, freshly-made take-out meal was available. The Community Food Centre offered live, online community kitchens for all ages in which participants received ingredient kits. The seniors’ transportation program continued to provide seniors with rides for medical appointments and expanded to assist with drop-offs and pick-ups of essential items. Enhanced support and more frequent programming for Chinese seniors was provided by our Grand Cafe program, moving from a monthly to weekly schedule.

Community-based programming and environmental health promotion work continued, virtually in most cases, to help those who are socially isolated gather in a safe (virtual) space. Programs included client parenting support, a Muslim womens’ social, a “dental bus” supporting staff and clients, monthly meetings across southern Ontario on climate action, the bike repair clinic, mindfulness tours to the Art Gallery of Toronto and the Royal Ontario Museum, and movie screenings. We recognized that there are many people who are not comfortable or adept with digital usage, or cannot afford its associated costs (computer, cell phone, reliable internet). Through our “Phone Drive” campaign, we have provided some with cell phones, allowing access to services and contact.

One of the lessons provided by the pandemic is that, even if our teams do very different tasks, we are all in this together. It became clear over the year that unity was needed more than ever to support clients facing social, economic, mental, emotional and physical barriers, especially those living in poverty and/or with chronic health conditions. The Community Health and Chronic Disease programs have shone during difficult times; we have learned that support from family, friends and our networks is essential to our well-being. We look forward to identifying even better ways to facilitate access to healthcare by continuing to address the social determinants of health and by utilizing a new, “hybrid normal” of both virtual and in-person care.