Minutes To be Confirmed

This meeting of the Board of Health was conducted with members participating in person and remotely.

The Board of Health:

1. Recommended the Medical Officer of Health to include in the 2027 annual progress report a summary of progress made, including advancing health equity, and key implementation risks.

2. Requested the Medical Officer of Health to identify through the 2027 budget process any Strategic Plan actions whose implementation may be at risk without additional funding or resources.

Dr. Michelle Murti, Medical Officer of Health gave a presentation on Toronto Public Health's Strategic Plan 2024-2028: 2026 Annual Progress Report.

On July 8, 2024, the Board of Health adopted the Toronto Public Health (TPH) Strategic Plan 2024-2028, which serves as the guiding blueprint to navigate Toronto Public Health’s key priorities, ensuring continued delivery of high-quality programs and services over a four-year period. The strategic plan identifies five priorities:

1. Strengthen health protection, disease prevention and emergency preparedness

2. Promote health and well-being across the lifespan

3. Promote the conditions to support positive mental health and reduce the harms of substance use

4. Advocate to advance health equity

5. Nurture a positive workplace culture

These priorities are being operationalized through 22 key actions, all of which contribute to Toronto Public Health’s vision of a city where all people can be healthy and thrive.

This second annual progress report provides an update on Toronto Public Health’s progress over the past year in implementing the strategic plan. It highlights initiatives from the past year that demonstrate the strategic plan in action. These initiatives include developing and implementing a climate change surveillance framework, promoting physical activity and reducing sedentary behaviour across the lifespan, offering training to front-line staff on trauma-informed approaches to service delivery, implementing sociodemographic data collection, and actioning an employee engagement plan.

The Board of Health:

1. Received the report (June 25, 2026) from the Medical Officer of Health for information.

The Ontario Public Health Standards: Requirements for Programs, Services and Accountability require that local Boards of Health review and revise their by-laws, policies and procedures regularly. The Board of Health Procedures By-law was last updated in May 2023. Earlier this year, the Board of Health directed the Medical Officer of Health, in consultation with the City Clerk, the City Solicitor, and the Board of Health to review the Board of Health Procedures By-law and report back with the outcomes of this work.

This report presents the process and findings of the review. No changes to the Procedures By-law are recommended at this time.

The Board of Health:  

1. Shared the report (June 24, 2026) from the Medical Officer of Health with the Ministry of Health to fulfill its duty in responding to the request for action from Boards of Health by the Office of the Chief Coroner.

This report summarizes Toronto Public Health's response to the Office of the Chief Coroner recommendations and affirms its commitment to work that contributes to the implementation of these recommendations in Toronto, including programming to advance Indigenous data sovereignty and health outcomes via Toronto Public Health's Indigenous Health Strategy.

Early this year, the Ontario Ministry of Health received recommendations from a coroner's inquest in response to deaths due to a blastomycosis outbreak in the Constance Lake First Nation (CLFN) community. On January 23, 2026, the Office of the Chief Coroner wrote to all Ontario Boards of Health (Attachment 1) requesting they respond to the five verdict recommendations that were specifically directed at local boards of health.

Blastomycosis is an infection caused by a fungus that grows most commonly in moist soil and decaying wood and leaves. The infection cannot be spread from one person to another. Some people, such as those with weakened immune systems and underlying health conditions, may develop severe illness requiring hospitalization and, in some cases, the infection can lead to death. The risk of Blastomycosis infection in Toronto is low.

The Board of Health recommends that:

1. City Council request the Chief People Officer to work with the Occupational Health and Safety Coordinating Committee to update the Indoor Air Quality Guidance (2016) policy with any relevant changes to reflect learnings from COVID and other technological improvements that may have happened since this policy was last published.
 

2. City Council request the Chief People Officer to consider establishing a public Indoor Air Quality dashboard for City-owned buildings bringing visibility to indoor air quality.

3. City Council direct the Executive Director, Municipal Licensing and Standards, in consultation with the Medical Officer of Health and the Executive Director, Housing Secretariat to identify options within the City’s authority to strengthen indoor-air-quality protections in rental housing, including ventilation and filtration maintenance, public guidance, tenant notification and complaint-response pathways, and report back to the Board of Health in Q3 2027.

The Board of Health:

1. Requested the Medical Officer of Health continue to review emerging indoor air quality guidance and incorporate into local public health communication where appropriate, including strengthening information on practical, evidence-informed actions that people can take at home to reduce the risks from exposure to indoor air contaminants.

2. Requested the Medical Officer of Health to continue collaborating with Toronto school boards and other relevant community partners to support the distribution of public health guidance on preventing transmission of respiratory viruses.

3. Requested the Medical Officer of Health to continue participating in knowledge exchange and academic partnerships that support local understanding of effective indoor air quality risk-reduction measures.

4.  Requested the Medical Officer of Health, in consultation with other relevant City divisions, to promote and share the City of Toronto's Indoor Air Quality Guidance as a resource for employers, building owners, operators, and organizations seeking to improve indoor air quality and support healthier indoor environments.

5.  Requested that the Province of Ontario take steps to improve indoor air quality by:

a.  Enhancing provincial programs and financial supports to reduce exposure to wildfire smoke among vulnerable populations, including improving access to effective indoor air quality measures like filtration and cleaner air spaces;

b.  Implementing, where feasible, interventions based on Health Canada guidance and other evidence-informed practices to reduce exposure to indoor air contaminants in publicly funded schools and child care centres;

c.  Increasing access to portable air cleaners and replacement filters for people who have low-income and are medically vulnerable; and

d.  Updating the Ontario Building Code to incorporate ASHRAE Standard 241 and ASHRAE Guideline 44-2024.

Dr. Shovita Padhi, Associate Medical Officer of Health and Dr. Michelle Murti, Medical Officer of Health gave a presentation on Public Health Role in Indoor Air Quality.

Urban Canadians spend almost 90 percent of their time indoors, meaning that most daily air exposure occurs in homes, schools, workplaces and other indoor environments. Poor indoor air quality can contribute to respiratory and cardiovascular health risks, worsen exposure during wildfire smoke and extreme heat events, and affect transmission risk for some respiratory infections in shared indoor spaces.

Indoor air quality oversight in Canada is distributed across multiple orders of government and sector-specific frameworks, including housing, workplaces, schools, public facilities, and health settings. In Ontario, many of the primary levers for improving indoor air quality sit with the Province, building owners and operators, employers, and school boards.

Toronto Public Health (TPH) also plays a role in indoor air quality. Toronto Public Health helps protect indoor air quality by monitoring health risks and emerging evidence, responding to complaints and investigating health hazards, supporting outbreak prevention in indoor settings and working with other organizations to share information and coordinate action.

Recommendations in this report focus on strengthening Toronto Public Health's public communication on indoor air quality in accordance with provincial and federal guidance; continuing collaboration with partners, including school boards; and requesting provincial measures to improve indoor air quality, including supports to reduce wildfire smoke exposure and targeted actions in schools, child care settings and for vulnerable populations.

The Board of Health:

1. Requested the Government of Canada and Province of Ontario to ensure that any proposal to expand operations at Billy Bishop Toronto City Airport be subject to a comprehensive assessment on the potential health impacts, including introducing jets in close proximity to residential communities, potentially increased noise, increased traffic, and air quality impacts, including ultrafine particles, resulting from the expansion.

2. Requested the Medical Officer of Health to offer support for the federal and provincial governments assessment of the potential health impacts of an expanded Billy Bishop airport, when sufficient information regarding proposed changes to Billy Bishop becomes available.

3. Requested the Medical Officer of Health to assess the potential health impacts of the proposed expansion plans for operations at Billy Bishop Toronto City Airport including introducing jets in close proximity to residential communities, potentially increased noise, increased traffic, and air quality impacts, including ultrafine particles, resulting from the expansion, when expansion plan proposals are available for review and assessment, and report back to the Board of Health with the outcomes of this assessment.

4. Requested the Toronto Port Authority to fund Toronto Public Health for the assessment of health impacts related to the proposed expansion of the Billy Bishop City Airport.

City Council on May 20 and 21, 2026, adopted Item MM41.19 as amended and, in so doing, has requested the Board of Health to request the Medical Officer of Health to:

a. collect all available data from studies related to the potential health impacts of transportation emissions, including ultrafine particles, and noise, including the presence, expansion, and introducing jets in close proximity to residential communities, in the context of Billy Bishop Airport, specifically, Pearson International Airport, and in other jurisdictions internationally; and

b. work with Health Canada to conduct a comprehensive study of the potential health impacts of jets in proximity to Billy Bishop Airport including an assessment of the related costs and burdens to our public healthcare system, and a comparison to Pearson International Airport.

The Board of Health recommends that:

1. City Council request the General Manager, Children’s Services, the Executive Director, Social Development and the General Manager, Parks and Recreation to consider the Council of Chief Medical Officers of Health Position Statement on digital culture and child and youth well-being in the development of policies and programs, in particular, the following recommendations for mitigating the harms associated with digital culture:

a. Build digital literacy and digital "checks" into training curriculums for professionals who educate and care for children and youth; and

b. Increase inclusive and accessible options for people to connect and engage offline across a range of interests and activities.

The Board of Health:

1. Endorsed the position statement by the Council of Chief Medical Officers of Health on digital culture and child and youth well-being, that:

a. States the evidence of potential harm to children and youth from social media and smartphones warrants public health action;

b. Acknowledges the risk of early exposure to exploitative marketing, including online gambling; and

c. Frames digital technology not only as a parenting or educational issue but as an emerging population health concern that requires coordinated action across sectors.

2. Requested the Medical Officer of Health to share the Council of Chief Medical Officers of Health Position Statement with school boards for consideration in the development of the next Toronto Healthy Schools Strategy, with respect to improving mental health and well-being of students, including the impacts of screen time.

The Council of Chief Medical Officers of Health (CCMOH) recently released a position statement on digital culture and child and youth well-being. The statement highlights growing evidence that social media, smartphones and other online platforms can affect the health and well-being of children and youth. It concludes that the potential harms warrant a precautionary public health approach and coordinated action across sectors.

The statement was developed and endorsed by Chief Medical Officers of Health from across Canada. It recognizes that supporting healthy digital environments is a shared responsibility among families, schools, health systems, communities, industry and governments. It encourages consideration of digital culture through a public health lens and highlights the importance of coordinated action to support children and youth.

The Board of Health has consistently supported initiatives that promote the health and well-being of children and youth. On October 22, 2025, the Board of Health adopted Item HL28.1 - Working with Schools to Improve the Health and Well-being of Children and Youth, which directed the Medical Officer of Health to work with school board partners on the development of the next Toronto Healthy Schools Strategy and to include a focus on student mental health and well-being, including the impacts of screen time. The principles outlined in the Chief Medical Officers of Health position statement align with this direction and with ongoing work with school board partners to support student mental health and well-being and promote healthy school environments. The position statement also advances the goals of Our Health, Our City by supporting a coordinated approach to promoting child and youth health and well-being. By endorsing the Chief Medical Officers of Health position statement and sharing it with school boards, the Board of Health can support an evidence-informed approach to addressing the impacts of digital culture on children and youth.

The Board of Health:

1. Declared the drug toxicity crisis an epidemic in the City of Toronto.

2. Requested the Medical Officer of Health, in consultation with the Deputy City Manager, Community and Emergency Services and the Deputy City Manager, Community Development and Social Services, to continue the work of the interdivisional coordination table which is comprised of representatives from relevant City divisions and agencies for the purpose of developing a strategy with clear deliverables and timelines to present to the Board of Health by Q1 2027, including consideration for the following:

a. Recognizing staff burnout at remaining Supervised Consumption Service sites, shelters, and drop-in centres and supporting as appropriate;

b. Coordinating City services and anti-stigma communication campaigns to increase community safety for all community members, including people who use substances, in residential, educational, and commercial areas;

c. Expand access to overdose response in priority locations through support to impacted service providers and increased access to overdose response tools, including naloxone, overdose detection technology and training in basic life support, first aid care and airway management;

d. Expand access to low-barrier testing for HIV and Hepatitis C;

e. Advocate for drug checking services to remain available across the City; and

f. Engage with key community organizations and people who use drugs through the Our Health Our City, Supervised Consumption Site Closures working group.

3. Requested the Province to fund a healthcare focused response to the drug toxicity epidemic in Toronto through increased funding for:

a. A broader range and increased availability of evidence-based opioid use disorder treatment options, withdrawal management services, and ongoing stabilization supports;

b. Low-barrier community-based health care supports for those who are underhoused (e.g. increased community paramedicine, health-care providers at drop-ins) and people who use drugs; and

c. Additional street outreach and drop-in staff supporting increased needs in the community stemming from the sudden closure of supervised consumption services.

4. Requested the Clerk to forward the Board's decision to the Association of Municipalities of Ontario (AMO), Federation of Canadian Municipalities (FCM), and Ontario's Big City Mayors (OBCM).

Between January and April of this year, the prevalence of calls to Paramedic Services for non-fatal suspected opioid overdoses has been significantly higher compared to 2025. In the month of April there were 485 non-fatal suspected opioid overdoses attended by Paramedic Services, the highest monthly prevalence since 2021. On Friday, June 19th, Toronto Public Health issued a drug alert related to an increased number of overdoses in the downtown core -just one of four alerts that have already been issued this year, compared to just one alert issued in 2025. These alarming figures are the combined result of an unregulated toxic drug supply and the forced closure of nearly all of the safe consumption sites in Toronto.

The remaining supervised consumption sites have experienced a radical increase in the number of clients trying to access their services. With each site only being able to provide a handful of supervised use booths, many people who use drugs have instead been using at other venues where they hope they could be found in the case of an overdose. These locations include shelters, drop-in centres, community health centres, public libraries, the sidewalks outside of these spaces, and public parks.

In my capacity as Chair of the Our Health, Our City Implementation Panel under the Board of Health, I have heard from frontline workers who are experiencing extreme burnout as they respond to several overdoses every day. Responding to these events, in addition to being both emotionally and physically taxing, takes community service workers away from their core job responsibilities.

The serious harm that has already been inflicted both on people who use drugs and the people who support them over the past year and a half is the result of the Provincial enactment of the Community Care and Recovery Act.

When you consider the increased burden on our emergency services, the scope of the harm only grows. The data we have been dutifully collecting and monitoring at the City clearly shows that this is a crisis.

This issue is urgent because indicators are showing that the prevalence of suspected non-fatal overdoses is significantly higher this year compared to 2025. The lives and wellbeing of people who use drugs and frontline workers are at stake. Immediate action is required to prevent further harm.

Announcements

The Chair acknowledged that the Board of Health was meeting on the traditional territory of many nations including the Mississaugas of the Credit, the Anishnabeg, the Chippewa, the Haudenosaunee and the Wendat peoples and is now home to many diverse First Nations, Inuit and Métis peoples. The Chair also acknowledged that Toronto is covered by Treaty 13 with the Mississaugas of the Credit.

The Chair further acknowledged that not all people came to these lands as migrants and settlers, and specifically acknowledged those who came here involuntarily, particularly those brought to these lands as a result of the Trans-Atlantic Slave Trade and Slavery. In support of the City of Toronto's ongoing efforts to confront anti-Black racism, the Chair paid tribute to those ancestors of African, Caribbean and Black origin and descent.

Where the Directors of the Board of Health listed in the attendance for this meeting participated remotely, they were counted for quorum as permitted by Section 189(4.2) of the City of Toronto Act, 2006, and the Board's Procedures, as amended.