Perspectives is the quarterly newsletter of the New Brunswick Health Council

In this issue...

Stéphane Robichaud
CEO of the NBHC

Message from the CEO

As we begin a new calendar year, we are also entering the final quarter of the 2015-2016 fiscal year.  Taking stock of the work accomplished to date, we consider what remains to be done for this fiscal year but also undertake the planning of the coming year.  For the NBHC, this has become a normal annual cycle of work.  Nevertheless, each passing year offers many lessons to be learned and challenges and opportunities to be considered.  These are valuable elements as we continuously seek to clarify our vison of success for the years ahead.

As we release our latest report on youth health, we are appreciating how successive reports are improving our understanding of not only health and health service quality trends but also variations within the province.  With each report, there is a stronger message regarding the importance of health promotion and the prevention and management of illnesses.  Provincial numbers also suggest that injuries are higher than national average and this builds on the case for improved preventative efforts.  We have numbers to help identify provincial priorities and also how these may vary within the province.

When we look at deaths before the age of 75, New Brunswick performs well when it comes to avoidable mortality due to treatable causes (rank 2 out of 10 provinces).  Meanwhile, it does not perform well when it comes to mortalities due to preventable causes (ranks 7 out of 10).  These numbers further illustrate the need to prioritize health promotion and illness or injury prevention, in addition to shifting priorities from the current hospital focus towards primary health services.  It appears the main challenge is not in convincing various health system stakeholders of the need to change.  The main challenge seems to be in having an effective collective description of what is expected so that decisions can be taken accordingly.

In order to see positive improvements in population health and health service quality indicators, it can take some time.  Similarly, in order to have a significant shift in how health system resources are allocated, it will require a number of coordinated steps.  The two RHAs are the biggest health system players. But regardless of their size, their plans must first be part of a provincial approach.  By law, they share responsibility for defining this provincial approach.  For 2016-2017, if there isn’t a defined provincial approach that facilitates the development of multi-year plans for all health system stakeholders, defining this approach is the starting point.

The challenges related to effective planning are well known by health system leaders, it is far easier to have plans approved than implemented.  These challenges are obstacles for individual organizations but these challenges are also shared by all, whether in government or at the front line service level.  New Brunswick is a small province, even though its rural nature represents some challenges.  Accordingly, an effective provincial approach would require a sustained commitment by very few people.  Hopefully, 2016 will be conducive to a strengthened collective approach.

 On behalf of the New Brunswick Health Council members and staff, I convey our best wishes for 2016.

Youth mental health in New Brunwick 

The New Brunswick Health Council (NBHC) has identified four priorities to focus on when it comes to youth in our province:
  • achieving healthy weights
  • achieving tobacco-free living
  • preventing injuries
  • improving mental health
In its most recent brief titled Protective factors as a path to better youth mental health, the NBHC focuses on youth mental health, under the wider umbrella of disease prevention and health promotion.  This is related to the NBHC’s third recommendation to the Minister of Health in 2011, when the NBHC recommended that the Government of New Brunswick, through the Department of Health, “ensures that a concerted strategy is developed to improve health promotion and disease prevention in the province”, including for mental health.

Many initiatives in the province already recognize the need for improvements, but, as is the case in other areas of health, greater coordination is required, along with clear and common performance targets.  The brief describes potential avenues that could lead to improvement in youth mental health, namely to focus more on improving protective factors (as opposed to only targeting risk factors) and on the concept of resilience.

What are protective factors and risk factors?
Protective factors help prevent the development or worsening of an undesirable health condition. Risk factors are the opposite; they contribute to the development or worsening of an undesirable health condition. For example, physical activity is a protective factor for obesity (and other conditions), while smoking is a risk factor for lung cancer (and other conditions).

What is resilience?
Resilience can be broadly defined as the ability to bounce back from adversity. It is also in part the capacity of individuals to find the right supports, programs and services for their needs. Although resilience is not limited to mental health (nor does it cover the complexity of all health issues), it is a concept that helps look at the adoption of key protective factors that contribute to better mental health.
The brief is available on the NBHC website, or by clicking here, along with its supporting document titled Fostering Resilience in New Brunswick Schools and Community.
Did you know?

Of all age groups, young people are the most likely to experience mental health challenges. Left unadressed, youth mental health issues also persist through adulthood.

It is a priority to improve the state of mental health in New Brunswick youth.

Brief on health service quality released

A brief focusing on the quality of health services with respect to the health system sustainability challenge was published in the fall and is now available on our website. The brief addresses the variability in health service quality within the province and the need for an effective provincial accountability framework to improve performance.
The quality of health services varies greatly throughout New Brunswick. This variability between geographic areas can be observed in measures across the system, thus in all sectors, all quality dimensions as well as in all programs and services.
Analyzing and understanding this variability is extremely important. To address the variability issue in health service quality and ensure that more and more geographic areas in the province can perform as well as the higher performers, benchmarking must be done and performance targets must be set. In addition to putting forth that the health system should prioritize the primary health sector as well as mental health and addiction services, this brief also explains that the system must focus its efforts on two of the six dimensions of quality, namely accessibility and appropriateness, since the improvement of these two will have a ripple effect on the other dimensions of quality.
To read this report in its entirety, please visit our website at, or to see more data related to health service quality, see our Data section at and our Health System Report Card at
Did you know?

Only 29% of youth in New Brunswick get the recommended 8 hours or more of sleep. This number varies among communities from 15% to 54%.

Evidence shows that lack of sleep significantly and negatively affects learning, emotion and behaviour.

Update on our surveys

The NBHC will soon be releasing the results of the 2015 edition of its Home Care Survey.  The objective of this report is to provide data at the provincial, regional and community level in order to measure, monitor and evaluate the quality and experience of home care services.

This report will also make comparisons possible between the 2012 and 2015 survey results.
This survey provides a voice to citizens in evaluating the quality and experience of home care services in New Brunswick and is an important piece of the quality improvement process, as citizens generally believe that:
(1) sharing their experiences will lead to improvements in services,
(2) publicly funded services are designed to meet their needs, and
(3) government leaders plan and make decisions based on the information or evidence that is available.
Home care is a range of health and support services received at home that help citizens achieve and maintain optimal health, well-being and functional ability through a process of assessment, case coordination, and/or the provision of services, and can help people stay in their own home and function as independently as possible in the context of their daily lives. The results will be published soon on
Also, the NBHC, in partnership with the Horizon Health Network and the Vitalité Health Network, has begun a hospital patient care experience survey. Between the months of December and March, all eligible medical and surgical patients discharged from an acute care hospital will be invited to participate and will receive the paper mail-out survey at home after being discharged.

Participation is voluntary, but very important; it’s the opportunity for citizens to share their views on their recent hospital stay.  The survey will ask questions about the care that was received from the nurses and doctors while in hospital, about the patient personally and about their experiences while in hospital.

The responses from the survey will be analyzed to learn more about the experiences of hospital patients and will be compared to the responses from the two previous surveys (2010 and 2013). 
Did you know?

The NBHC's analysis on resilience shows that the protective factor that youth least identify with is about knowing where to go in the community to get help.

It is important to help young people learn about and access all supportive services available.

Your feedback on our community profiles

In 2014, the NBHC published a series of 33 community profiles. These portraits of New Brunswick communities have been the result of long and tedious work done by the team of the NBHC. In the fall, we began a review exercise to determine what improvements need to be made for the 2017 edition.  People using the profiles regularly were asked about their impressions regarding the profiles and about the improvements they would like to see.

Today we invite you to consult the community profiles and to give us your feedback.  Your comments will enable us to improve the content, the presentation, and the information available in the documents.

Thank you for taking a few minutes to complete this questionnaire so that we can produce a document that better matches your needs as a citizen of New Brunswick:
The NBHC has been established as an independent organization that measures, monitors and evaluates New Brunswick’s health care system performance and population health, and that engages citizens in the improvement of health service quality.
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