Population health indicators across Ontario’s Public Health Units: a cross-sectional analysis of the Canadian Community Health Survey

Background Currently, 34 public health units (PHUs) in Ontario deliver public health programs and services to reduce preventable diseases, promote and protect health of their communities, and reduce persistent health inequities. Changes to the structure of Ontario PHUs have been proposed. This analysis compares the current 34 Ontario PHUs based on key health indicators for the purpose of determining local health needs in delivering public health programs and as a baseline for measuring the effect of any future changes to PHU structure.Methods We used data from the 2015–2016 Canadian Community Health Survey (CCHS), a voluntary cross-sectional survey about health status of Canadians. Twenty-one health indicators measured by the CCHS and particularly relevant to PHU responsibilities were identified and compared across units. In this descriptive, cross-sectional analyses we used survey-weighted frequency calculations of the selected indicator variables by PHU and χ 2 analyses to test differences in indicator distribution across PHU.Results All indicators except for sex were distributed unevenly by PHU. We particularly highlight differences across units in modifiable indicators and risk factors such as obesity, fruit and vegetable consumption, physical inactivity, smoking, and access to primary care physicians.Impact of the study While all PHUs strive towards the same mandated responsibilities, considerable variations in health indicators exist between health units. This underscores the necessity for PHUs to tailor programs and deliver services based on local needs. Future changes to PHU structure must be tested against baseline to determine if they ameliorate or exacerbate health inequities in Ontario.