Evidence of meeting #16 for Official Languages in the 39th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was research.
A recording is available from Parliament.
Conservative
The Chair Conservative Guy Lauzon
Good morning, ladies and gentlemen. I would like to welcome all members as well as our guests. This morning we're pleased to welcome Ms. Louise Bouchard, Ms. Nicole Robert and Mr. Marc Laflamme.
We will proceed in the following order: Ms. Robert, Mr. Laflamme and then Ms. Bouchard. We will then have a question period.
Ms. Robert.
Nicole Robert Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
Good morning, Mr. Chairman, members of the committee.
My name is Nicole Robert. I am the chair of the board of directors of the Réseau des services de santé en français de l'Est de l'Ontario. Allow me to introduce Mr. Marc Laflamme, from the University of Ottawa Heart Institute, who will speak to you in a few minutes about a wonderful project called FrancoForme.
The Eastern Ontario health system includes 20 hospitals, 66 community support services organizations, 26 mental health community organizations, 8 community health centres, 1,240 family physicians and 1,450 specialists. Of this number, 66 agencies are said to be designated or identified, meaning that they are compelled by the province to offer health services in French.
My intention in presenting these figures is not to draw easy inferences. Rather, I'm trying to show you the dynamic environment in which the Réseau de l'Est operates, in order to give you a better picture of the issues facing French language health care services, the impact of our network on access, and the relevance of an ongoing commitment to health care for official language minority communities.
The mandate of the Réseau de l'Est is to ensure access to the entire range of high-quality health care services, in French, to the 226,000 francophones in Eastern Ontario. Overall, the francophone population represents 20 per cent of the total population of the region, but our representatives in the House of Commons will quickly point out that this proportion goes up to 40 per cent in certain communities of Stormont, Dundas and Glengarry and up to 70 per cent in the counties of Prescott and Russell.
What this means is that access is particularly important for the francophone clientele and for the institutions that are members of the network and which provide service delivery in French. The network ensures that its mandate is fulfilled in cooperation with its partners through planning, development and evaluation of French-language services throughout its territory.
The network was established following a decision of the Ontario Health Services Restructuring Commission in August 1997. It was recognized as an independent advisory body in 2002 pursuant to a memorandum of understanding signed by Mr. Tony Clement when he was Minister of Health and Long-Term Care for Ontario.
The network is made up of 61 health care institutions and organizations as well as post-secondary educational institutions that offer health care services in French in Eastern Ontario.
In order to fulfil its mandate, the network put in place a cooperative structure bringing together various stakeholders in the field of health care, forming sectoral committees and working groups. The participants are mainly representatives of health care agencies, members of the francophone community and representatives of other sectors such as social services.
Moreover, the network is linked to three other French language health care networks in Ontario as well as 13 networks that operate in other provinces and territories through the Société Santé en français.
A significant portion of the network's mandate consists in supporting the development of French language health care services in the Champlain territory. For eight years now, the network has provided assistance and custom advice to hospitals and community health care organizations that are involved in the designation process pursuant to the Ontario French Language Services Act. To varying degrees, these agencies are working to ensure that French-language services are provided through activities such as recruitment and staffing of human resources capable of working in French; the organization of intake and direct delivery services; French-language communication; continuity of French-language services within the agency and with regard to other agencies throughout the system.
In concrete terms for the population of Eastern Ontario, these actions translate into the proactive provision of health care services for a francophone clientele, who can thus identify French-language services and make use of them.
The network has also piloted a public awareness project on health care careers among students in French-language schools, in order to facilitate the future recruitment of health care professionals. The network also supports health care organizations and francophone community in the development of initiatives and health care programs that involve primary health care among other things, in the county of Renfrew as well as in the region of Kingston and the Thousand Islands.
In 2003, the network managed a total of $1.4 million granted by the Primary Health Care Transition Fund, Health Canada and the Société Santé en français. Twenty-three projects were submitted in the region of which nine were approved.
In order to illustrate the tangible impact of the PHCTF's project initiatives and the enthusiasm it aroused among its partners, I would mention the example of the University of Ottawa Heart Institute, under the leadership of Dr. Wilbert Keon, who is also a senator.
I will now invite Mr. Marc Laflamme, Coordinator of FrancoForme to present the results of the chosen project.
Marc Laflamme Coordinator, Francoforme Project, French Language Health Services Network of Eastern Ontario
Thank you, Nicole.
Mr. Lauzon and members of the committee, thank you for having given us the opportunity to appear before you today.
Whenever my children ask me if they can purchase something, I always ask if the purchase meets our criteria. In other words, the item in question must be good, beautiful, inexpensive, and it must be necessary.
In 2005, the Heart Institute received funding for the implementation of a new program as part of the PHCTF projects. Here is a summary of it.
The problem is the following: cardiovascular disease is the main cause of disability and premature deaths in Ontario. The prevalence of cardiovascular disease, as well as its related risk factors, is much more widespread among francophone residents of the province than among anglophones. The FrancoForme project is intended to reduce the disparity between francophones and anglophones in the Champlain region as far as cardiovascular health is concerned. It targets francophones living in both urban and rural areas and aspire to improve their access to individualized prevention and cardiac rehabilitation services, which will result in their improved cardiovascular health. A need exists.
Let us now talk about the solution. The FrancoForme project is managed and directed by the University of Ottawa Heart Institute, in collaboration with community partners, including the Eastern Ontario Health Unit and the Eastern Townships Community Centre. The program promotes healthy living habits by encouraging physical activity, a healthy and balanced diet, stress management, quitting smoking and adequate control of cholesterol and glycemia. A counsellor calls each participant once a week over a three-month period. A person's cardiovascular disease risk is assessed both at the beginning and at the end of the program. In short, the FrancoForme project offers its participants an empowering opportunity that will guide them towards a healthier life style and will reduce their risk of cardiovascular disease. This is good.
Let us look at the results to date. An advisory committee was created to offer support and advice throughout the project. Furthermore, our community partners offered us considerable and permanent support throughout. The program is now set up and in operation at the University of Ottawa Heart Institute and at the Eastern Ontario Health Unit in Alexandria. Several participants have already completed the program. As expected, we have seen an improvement in the risk factors such as their cholesterol level, their blood pressure, their weight, their level of physical activity and their sense of well-being. These participants say they are very satisfied with their experience. That is beautiful.
Moreover, an appropriate assessment of our project has shown that not only is the initiative effective from a clinical point of view, but that this service delivery model is less costly than a traditional cardiac rehabilitation program. It is not expensive.
I would now like to make some recommendations to the committee. We care deeply about the health of francophones. Within the scope of the PHCTF project, we have identified the problem, we have targeted the population at risk and we have had a significant and sustainable impact on its state of health. We strongly believe that the FrancoForme program, developed within the framework of this project, could be implemented not only in the Champlain region, but that it has the potential to become a service delivery model for preventive and cardiac rehabilitation services for other francophone communities in Ontario, and in time, across Canada. The broadening of the program, through the addition of one or more access points, such as the one planned for Cornwall under the foundation project, will take place over the next few months.
Once the program is well established in the Champlain region, we recommend the establishment of other satellite sites in Northern Ontario as well as in other francophone regions of Canada. The viability of these satellites will depend on the available financial resources and an association with various local health care stakeholders interested in establishing and maintaining the program. In short, we propose to create an infrastructure in order to establish the service in other regions of Ontario and of Canada where there is a large population of francophones at risk. Initiatives like this are good, beautiful, inexpensive, and francophones need them.
Thank you.
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
Thank you, Marc.
I will move on to the subject of the importance of service planning in the region.
Over the years, the network has carried out many studies on French services and has taken on the planning of these services through its working groups and through activities such as community forums.
Furthermore, the network set about developing the 2005-2006 regional plan for health services in French, a responsibility it was given by the Minister of Health and Long-Term Care. It was in this context that the "Préparer le terrain" project, whose goal was to establish a plan to develop French language primary health care in Eastern Ontario, was managed by the network and integrated into the regional plan.
This important exercise generated a list of recommendations and priorities for French language health services, which were presented to the local integration of services for health care network for the region of Champlain in the fall of 2006. They are as follows: human resources, the organization of services, primary health care, accountability within the system and support of health care agencies in supplying French-language services.
The continuation of the regional plan deals with the development and implementation of courses of action, a stage we intend to tackle soon.
The Government of Canada has been a partner of the Réseau de l'Est from the outset. Through Heritage Canada as well as Health Canada and the Société Santé en français, it has directly contributed to our role as an advocate of French language health care services in the region, and has been from the beginning of our network.
As far as cooperation with provincial authorities is concerned, we have been following the development of the restructuring of the health care system launched by the Minister of Health with great interest for the last two years.
The province's regionalization of health care services, through the creation of local integration of service networks, has a very special impact on French-language services.
In fact, it is a matter of a real integration of French language health care services, within the provincial and local health care system. The same is true for the improvement of access to services and of accountability through legislation and its regulations.
Briefly, we welcome the provincial government's leadership with pleasure as far as health care in French and the francophone population are concerned, as well as the prospect of an even closer cooperation on the issue of French language health care services at the regional level.
In this context, the complementarity of jurisdictions between the provincial and federal governments in health care is something that could be considered. The French Languages Health Services Network of Eastern Ontario is in a position to play a decisive role through cooperation between the partners.
In this regard, we keenly wish to continue our activities toward only one goal, that being to improve access to health care services in our community and to contribute to the improvement of the francophone population's state of health.
I thank you for the invitation to appear before you today.
Thank you.
Conservative
The Chair Conservative Guy Lauzon
Thank you, Ms. Robert.
Ms. Bouchard, I believe you have some comments to make.
Louise Bouchard Professor, Director of PhD Program - Population Health, University of Ottawa
Thank you, Mr. Chairman, Madam Clerk and members of the committee.
I also thank you for the invitation to appear before you today. I am speaking today as a professor-researcher, and mainly on the issues relating to my research.
First of all, I will tackle the state of our acknowledge: what do we know about health, about health issues in a minority environment? How do we find that knowledge? What issues are connected to the production of knowledge on these issues? And finally, what are the best means or why is it necessary to develop a research infrastructure that will allow the continuous documentation of the needs connected to this problem?
What do we currently know about the health of francophone communities living in a minority situation? We know that these communities are spread across the entire country, with a more significant concentration in Ontario and in New Brunswick. We also know that they present a diversified profile, according to their demographic or socioeconomic context. The data will reveal that members of francophone communities are generally older, have less formal education and are fewer in number on the labour market. Francophones living in a minority situation are more concentrated in regions where the economy is more unstable, making it more difficult to develop and access social resources.
The revision of the Official Languages Act in 1988 committed the federal government to support the development of English and French minority communities in Canada, and to promote the full recognition and use of French and English. The importance of language takes on a particularly significant dimension when it is a matter of health. The ability to understand and be understood is critical to the effective relationship between health care professionals and users of the system, and access to health care services in one's language is an essential component to the improvement of people's health conditions and quest for healthy living.
Several recent articles and reports have described the challenges and problems that the francophone population outside Quebec faces in terms of health. One Health Canada publication describes the negative effects of the language barrier on access to health care services, on the quality of the care and on health itself.
Despite universal access, users of the health care system who cannot communicate in their language do not have the same access or the same quality of care as their fellow citizens. The language barrier limits the use of preventive services, limits access to all services that require communication, particularly mental health, rehabilitation and social services, as well as adequate follow-up of patients, which in turn contributes to the increase in emergency services and the use of supplementary medical examinations to compensate for difficulties in communication.
For example, a study coordinated by the FCFA, the Fédération des communautés francophones et acadienne, showed that French language health care services are three to seven times less accessible to francophones living in 71 regions of Canada where they live in minority situations.
The few analyses undertaken on the group of Ontario francophones who participated in the National Population Health Survey in 1996-1997 support the hypothesis that there is a different state of health for francophones and that for this group, certain health care determinants play a bigger role. Even though the differences are not major, francophones in Ontario would be in fewer numbers to state that they are in very good health, but in larger numbers to state that their activities are restricted, that they have chronic health problems, to score higher on the stress scale and are apt to be taking more medication. Also, a significant percentage of users say that they cannot get the services they need.
Therefore, these disparities are poorly documented and have not yet been the focus of rigorous assessments of health care policies and programs.
In an effort to better understand—and you will see a few of the results I will be talking about on the slide show that will be presented—our team, which comes from a partnership between Statistics Canada and researchers at the University of Ottawa of which I am one, tried to establish if the fact of living in a minority situation can be considered a determinant of health. I am sorry, I did not say where I am from. I am also with the Institute of Population Health Research at the University of Ottawa.
We tried to establish whether living in a minority situation could be considered a determinant of health. With the cooperation of the Statistics Canada Health Analysis and Modelling Group, we combined the Canadian Community Health Surveys of 2001 and 2003, in order to have the largest sample possible, which often poses a problem when conducting secondary analyses.
Our objective was to assess the link between living in a minority situation and self assessed health satisfaction, a variable of perception that is closely linked with the objective situation. In research, this variable has a widely accepted scientific validity. Therefore, we can use it without concern about overly influencing the results. We introduced four blocks of variables related to lifestyle, socio-demographic data, in context to life and inabilities. We hypothesized that living in a linguistic minority situation, despite the principles of universality and accessibility of Canada’s health care system, would negatively influence the perceived state of health. The results show that based on age, Francophones living in a minority situation were more inclined to declare poorer health than Anglophones in a majority situation, both for men and women.
These results raise an important point that has never been explored in the Canadian context of official languages. Health publications have amply demonstrated that age, sex and income are the main determinants of health, but living in a minority situation has never, until now, been documented. These results, in addition to observations and initial studies on the matter, which confirm a different health situation negatively affecting francophone minority communities, underscore the importance of probing deeper and better understanding all the determinants of health.
The results also reveal the increased importance of conducting contextual or environmental analyses of health, allowing a better understanding between contexts, local settings and health.
The rapport between minority and majority seems to translate into a social inequality and unequal access to resources which, combined with other social determinants of health—socioeconomic status, education, literacy, age, sex and immigration—contribute, in fact, to the disparities in health.
This again poses a fundamental question that has been raised a number of times by lobby groups, that of linguistic duality and the inclusion of a sixth principle in the Canada Health Act, in terms of access to health care in both official languages as another requirement for federal funding.
Currently, the reforms are particularly favourable for reflecting on the organization of the services, as indicated by colleagues active in the field. But it is also important to document these realities and, in that sense, research is a necessary tool for doing so. Currently a number of obstacles are preventing research in this area. The marginalisation of this field of study, the difficulty in obtaining meaningful information, dispersal of researchers across Canada, and their affiliation with small universities that are often less competitive and offer few programs of study, make it even more difficult for professors to conduct research.
For two years, the joint research commission at the CNFS, the Consortium national de formation en santé, and the Société Santé en français, have been working hard on creating an environment conducive to the development of research, the promotion of networking and the support of thematic teams, to correct the inadequacies in the information on health, social determinants of health and access to services. To do so, the commission undertook to raise awareness among subsidized agencies such as the CIHR, the Canadian Institutes of Health Research, or the SSHRC, the Social Sciences and Humanities Research Council, about the importance of strategic research on official language minority communities.
This initiative was successful and resulted in the development of strategic competitions over the past year. I receive a subsidy, along with my colleague, Ann Leis, from Saskatchewan. Not only should these initiatives be maintained, but they also need to be enhanced because they give researchers the true means to produce the top notch research needed for a reliable analysis of the determinants and needs in health in a minority situation. It is through research that knowledge becomes useful to the decision makers and planners; it is through research that students are taught about realities and truly learn the job they will perform, we hope, with as much clarity as possible.
It is crucial for subsidized agencies and their partners to acquire lasting funding for an issue as important as the challenges of official languages in our Canadian context, in order to ensure continued production of top notch knowledge; to support the teams, research networks, and the succession; to implement broader studies that are representative of Francophones in a number of provinces. In that vein, I must point out the major limitations of the administrative data on health, which do not provide insight into the official language communities because the linguistic variable is never entered into health records. This is a problem that can be easily resolved; this information is essential in research for understanding where the inadequacies lie. The same is true for the national health studies that, without provincial oversampling, do not allow for very good studies in the different provinces. For example, in the Community Health Survey, only Ontario was oversampled. Studies may be done in Ontario, but is extremely difficult to get out of the Ontario context. Provinces should ensure that minority communities can be studied in national studies.
In fact, these shortcomings could be overcome if research in this area were taken seriously and given the means to make progress. The development of research infrastructure is, in my opinion, the best way to truly develop the ability to research sociolinguistic minorities and health, and a real network of teams of researchers with increasingly greater ramifications. This network will, thanks to the recruitment of young researchers and students benefiting from the mentorship of experienced researchers, consist in the experience of centres of research, and support from the network as well as the trust gained from initial successes and the results achieved.
A research network will also help mitigate the disparities in the ability to even conduct research; bring together researchers from different disciplines and different institutions; develop research programming; provide convincing results for developing policies; and ensure and support the succession. Connections between academic institutions, the health care environments and community partners could thereby be enhanced. This infrastructure will also help transform the environment of research on the health of francophone minorities, to allow the research teams to be competitive and obtain funding during subsidy competitions.
The synergy created by the team of researchers and partners involved in health in Canada will contribute to creating a corpus of scientific knowledge that is extremely useful for understanding the disparities in health and implementing structured interventions to better serve the francophone populations living in a minority situation, particularly the most vulnerable among them.
There seems to be no hesitation when it comes to funding research in genetics or genomics and creating centres of excellence without much benefit or results in terms of improving public health. Why should social research have to prove its relevance and importance in crucial matters and problems inherent to the Canadian situation in order to get such a small share of the funding?
Thank you for your attention.
Conservative
The Chair Conservative Guy Lauzon
Thank you to our three guests. We will now begin our round of questioning. The first round is seven minutes.
We will start with Mr. Simard.
Liberal
Raymond Simard Liberal Saint Boniface, MB
Thank you very much, Mr. Chairman, and welcome to our guests.
As you know, in Saint-Boniface, we have a French health care centre. I would like to gain a better understanding of your structure. My question is for Ms. Robert. First of all, I would like to know if you have more than one centre? Do you have centres in rural regions? Are they independent, or located in hospitals? Are they funded by the federal government, the provincial government or both?
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
The network itself, for which I chair the board of directors, includes all francophone organizations from several districts in Eastern Ontario, where 226,000 francophones live. The network is primarily responsible for planning and needs assessment. It is made up of 66 organizations.
We have various structures. We have hospitals, naturally, that receive their funding solely from the Ontario Ministry of Health. Then we have community organizations. We have community health care centres which also receive their funding from the Ontario Ministry of Health and Long-Term Care. These community health care centres are primary health care centres where we deal with mental health and where doctors meet patients. As members of the network, we also have mental health organizations that also members of community health care centres. They are funded in different ways, but generally, many of them are funded by the Ministry of Health and Long-Term Care. They are all under provincial jurisdiction since we are talking about health care.
However, the network is fortunate to receive funding from both the federal and provincial levels. We were lucky enough to maintain our network until it was officially recognized by the provincial government, as I stated in my presentation. So we are funded by the provincial government and by the federal government, in the latter case, through Société Santé en français and the Department of Canadian Heritage. The network does not provide services directly to the general public. Instead, it is an organization that brings together other health care organizations that offer services in French and that help hospitals in our region obtain designation under the French Language Services Act. Members of the network can then help others, thanks to their expertise, to meet the conditions for designation established by the Ministry of Health and Long-Term Care.
Liberal
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
The organizations in the network use French.
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
We offer services in both languages. Many organizations are bilingual, but they also have a structure that is very francophone. Look at the example of Salus, which is an organization to help people with mental health problems find housing. The organization is bilingual in that it has a completely francophone parallel structure. The people in charge have applied for designation as a francophone organization, in other words, interaction, reception and service provision is all in French.
Liberal
Raymond Simard Liberal Saint Boniface, MB
The farther we go from the centre of the country, the more trouble we have providing training for professionals: doctors, nurses, and others.
Do you encounter the same problems, or do you have enough training facilities here in Ottawa, for example, to serve your centres?
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
The answer is yes. Fortunately, we have the Montfort Hospital which has been recognized as a university training centre for our health care professionals, especially in the field of medicine. We also have the Cité collégiale, which trains our health care professionals, and the University of Ottawa, which is the university in the region that serves all of Eastern Ontario. So we are very lucky in that regard.
The problem, like everywhere else, is attracting people in the health care field and training them. All regions of Canada, be it in English or French, are facing a shortage of health care professionals in all disciplines: doctors, nurses, physiotherapists, occupational therapists, and so on.
Liberal
Raymond Simard Liberal Saint Boniface, MB
When you talk about the links you have with the Société Santé en français, do you discuss such things as sharing staff?
We have a great deal of difficulty attracting young doctors back home, especially in rural communities. Are those the kinds of things you discuss?
Director, French Language Health Services Network of Eastern Ontario, French Language Health Services Network of Eastern Ontario
The networks and the Société Santé en français do, of course, discuss possibilities, especially with telemedicine and all of the distance care that is created. As Ms. Bouchard indicated, we also promote exchanges so that research is done in this area. Research projects are currently under way in Alberta, Manitoba, and New Brunswick to explore possibilities for distance education.
I think that with the new technology, it will be much more advantageous, especially in rural regions. Our organizations in Eastern Ontario are in both urban and rural communities. Access is more difficult in rural regions, that is for sure, but we succeeded in establishing services in Renfrew, which is a completely anglophone centre.
Liberal
Raymond Simard Liberal Saint Boniface, MB
My question is for Mr. Laflamme.
Earlier on, you talked about satellite projects. I know that back home in the country, in Notre-Dame-de-Lourdes, they want to build a French services centre, but they are also talking about a travelling service for the other small villages in the region.
Is that something that you advocate in your discussions?
Coordinator, Francoforme Project, French Language Health Services Network of Eastern Ontario
Good, beautiful, inexpensive!
In fact, we would like to be in a position to export the highly effective intervention model we designed throughout Canada, to Saint-Boniface or elsewhere. You want a cardiac prevention and rehabilitation service in Saint-Boniface? We provide you with the data base we use, we train your staff, we recruit a bilingual person and then provide support. So if you have a minor problem with the data base software, the Heart Institute will serve as a resource.
Here's how the program works. Let us look at Alexandria, where members of the team are very autonomous: once the staff is trained, they recruit patients themselves, they are in a position to follow them, they promote the program in pharmacies, they meet with doctors to encourage them to send at-risk patients. So, we can reach the at-risk francophone population in the communities.
Conservative
The Chair Conservative Guy Lauzon
Thank you, Mr. Laflamme and Mr. Simard.
Ms. Barbot, you now have the floor for the second round of questions.
Bloc
Vivian Barbot Bloc Papineau, QC
Thank you, Mr. Chairman.
Thank you for being here this morning. Mr. Laflamme, you said that these initiatives are a good deal. I like that expression. That is what I used to say to my children when they were little.
However, when we are dealing with the health of francophones living outside Quebec, according to what we have heard so far, it is not a very good deal for the money. Maybe, and this probably applies to well-defined prevention programs, once they are implemented—and you said so yourself— the expertise can be applied elsewhere and that is how the objectives are met.
However, when we take a look at the entire situation, particularly when it comes to research, it is obvious that the main factor in determining what can be done is money, in other words, how much we are willing to spend. But when the target population is dispersed, there is not enough information to allow for a clear correlation that would lead to concrete action later on.
In my opinion, the funding allocated to these communities is a very important factor. This applies to health care as well as to all other areas. That is why, when it comes to language, this committee is so determined to help people find a way out of these unfavourable situations.
Moreover, Ms. Bouchard, you provided information comparing the health of francophones and anglophones. Francophones, in general, are not as healthy; others have told us the same thing.
Without taking into account these comparisons, can you tell me, objectively, about the health of francophones living in Canada, outside Quebec?
Professor, Director of PhD Program - Population Health, University of Ottawa
I would like to clarify something. Before beginning these surveys, we had to decide how the groups would be divided: French-language respondents, respondents whose preferred language is French or respondents for whom the first official language that they learned is French. This was important because we were dealing with health services where, as I explained, communication is the key. Therefore, when I speak about surveying the francophone population, this also includes immigrants who speak French. That is an important point and I stress the importance of the language category because in the context of Canada's official languages, these infrastructures must reflect our Canadian reality.
It was difficult to find a reliable way to document this survey. First, because data relating to language cannot be found in the administrative data relating to health. Surveys have to be done. There are problems related to access to information and to ethics. The small surveys done by Health Canada do not provide a big enough sample to allow for a reliable study. This situation has to be corrected.
I worked with Jean-Marie Berthelot and his team at Statistics Canada. I thought that by combining a number of age groups I would have an accurate snapshot, but, in my opinion, being part of a minority group means having a different type of access to resources and services, something that must be documented. It is true that socio-economic status is the main health determinant, generally speaking. But this study does not take financial status into account, nor does it consider age, sex, all of the factors where differences apply. Even if you ignore all of those factors, there is still something that has a negative effect on health. It might look simple, but I thought that this finding was significant because of the relationship to a linguistic or sociolinguistic minority. So this is something that must absolutely be explored further.
Obviously, since I am a researcher, I will advocate more research, so that we might be able to document this phenomenon and provide better service to these communities. What the networks have done to provide training in the French language for professionals is of tremendous value. That said, research is still the best way to determine how these services should be provided to this population.
Ontario is currently regionalizing its services. It is an extremely valuable opportunity for sociolinguistic communities to put forward services plans that will meet their needs. These communities must avail themselves of the opportunity to take a closer look at the issue.
I have a student who is working on her Ph.D. on the health of populations and who is examining rural and linguistic aspect of Northern Ontario. She is taking part in the regionalization project. I asked her to write her thesis on the language issue and the organization of services in Northern Ontario's rural communities where there is a need for professionals and where professionals should be sent; but the situation must be documented to ensure that services are provided in both languages.
Conservative