Agenda

Membership:

Councillor Chris Moise (Chair), Abinaya Chandrabalan (Vice Chair), Councillor Alejandra Bravo, Councillor Lily Cheng, Councillor Rachel Chernos Lin, Charna Gord, Ida Li Preti, Rebecca Mador, Charles Ozzoude, Councillor Anthony Perruzza, Ramanjeet Singh, Councillor Michael Thompson, Stephanie Zhou

Members of the public are invited to submit written comments or register to speak on any item listed on the agenda. For detailed information on how to participate in the Board of Health meeting, including procedures for submitting comments or requesting to speak, please visit: Have Your Say at Council & Committee Meetings (https://www.toronto.ca/city-government/council/council-committee-meetings/have-your-say/)

 toronto.ca/council

The Medical Officer of Health recommends that:

1. The Board of Health recognize the importance of preventing adverse childhood experiences and promoting protective experiences, and endorse the Ontario Early Adversity and Resilience Framework, as outlined in this report, which seeks to build resilience for children and youth, families, and communities.

2. The Board of Health request the Medical Officer of Health, in collaboration with the relevant City divisions, agencies and corporations to advance a coordinated trauma- and violence-informed approach to City services that recognize the impacts of trauma, adversity, racism and violence to foster trust and safety with clients and prevent re-traumatization.

3. The Board of Health request the Medical Officer of Health to build on Toronto Public Health’s initiatives to mitigate early adversity in alignment with the Ontario Early Adversity and Resilience Framework through continued collaboration with City and external partners.

Early experiences have a powerful influence on lifelong health, making it essential to strengthen the conditions that support children and families across Toronto. Adverse childhood experiences are stressful or potentially traumatic events that occur before age 18, including physical, sexual, and emotional abuse, neglect, and household dysfunction such as parental substance use, mental health concerns, incarceration, or witnessing intimate partner violence. Community level experiences such as consistent exposure to community violence including gun violence, and structural forms of trauma including colonialism, racism, poverty, and unstable housing are also significant sources of adversity.

Adverse childhood experiences are common in Toronto, with nearly one-third of adults reporting at least one adverse childhood experience. Due to structural and systemic inequities, certain populations experience a greater burden of early adversity, including Indigenous, Black, racialized, 2SLGBTQIA+ individuals, women, immigrant communities, and people living in low-income households. Exposure to early adversity is associated with negative long-term health and social outcomes, including chronic disease, mental health challenges, substance use, lower levels of physical activity, increased sexual health risk, and housing instability or homelessness.

While there is an association with negative outcomes later in life, adverse childhood experiences do not necessarily lead to negative outcomes. Protective factors, such as safe, stable, nurturing relationships, social-emotional skills for children and families, equitable environments, and social connectedness, can reduce the impacts of early adversity by building resilience. The Ontario Early Adversity and Resilience Framework provides structured approaches for upstream prevention, resilience-building, and equity-informed action across individual, family, community, and structural levels.

Toronto Public Health delivers programs and services across the preconception, prenatal, early parenting, and child development stages to prevent adverse childhood experiences, foster positive experiences, and strengthen resilience. Toronto Public Health also tracks related data to guide programs and inform policy development. Collaboration with City divisions, agencies, and community organizations contribute to the improvement of social, economic, and relational conditions that support safe, stable, and nurturing environments. Preventing adverse childhood experiences and fostering protective experiences improves outcomes for individuals, families, and communities, reduces long-term impact on health and well-being, and advances equity for communities disproportionately affected. As a result, preventing early adversity and strengthening positive childhood experiences through upstream, equity‑informed public health action is a critical strategy to improve health outcomes across the lifespan. The recommendations in this report ask the Board of Health to recognize the importance of early intervention to prevent adverse childhood experiences, endorse the Ontario Early Adversity and Resilience Framework, and collaborate with relevant City and external partners to advance a coordinated trauma- and violence-informed approach to City Services and explore opportunities to prevent early adversity, promote protective experiences, and build resilience for children, families and communities across Toronto.

Any financial impacts resulting from the adoption of this report can be accommodated within approved operating or capital budgets.

The Medical Officer of Health recommends that:

1. City Council receive this report for information.

Toronto Public Health currently has service contracts with partner agencies that support service delivery in the community for the Healthy Babies Healthy Children program, Food Security initiatives, Sexual Health services and clinics, the Dental Care to Youth Experiencing Homelessness and Low-Income Adults program, and the Ontario Seniors Dental Care program.

Purchasing services from community agencies is an effective and efficient way to provide essential public health services. This approach builds on existing service infrastructure in the community, facilitates community partnerships, supports continuity of service to clients, and can increase service efficiencies.

The purpose of this report is to provide information on the $7.250 million in purchase of service contracts awarded and executed by the Medical Officer of Health for 2026, according to the delegation of authority by City Council.

This report has no financial impact beyond what has already been approved by City Council in the 2026 Operating Budget for Toronto Public Health. Attachment 1 outlines $7.250 million in service contracts awarded and executed by program to support delivery for 2026.

The Chief Financial Officer and Treasurer has reviewed the report and agrees with the information as presented in the Financial Impact Section.