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Circles Initiative: Final report – Fall 2020 full report

Fall 2020 full report PDF version (PDF, 2 MB)

Executive summary PDF version (PDF, 328 KB)

Executive summary

Overview

The Circles Initiative final report provides an overview and results from the introduction and pilot of the Circles Initiative to the City of Greater Sudbury between 2017 and 2020. The Circles Initiative was launched in 2017 following receipt of one of Ontario’s Local Poverty Reduction Fund grants totalling $217,000 in late 2016. The Bridges out of Poverty training program, licensed through aha! Process is also connected with the Circles Initiative but was not directly funded through the grant. Public Health Sudbury & Districts implemented the Bridges out of Poverty training initiative through in-kind dollars to ensure all three programs that make up the Circles Initiative were introduced into the community for the pilot. The pilot lasted between January 2017 to September 2020. The Circles Initiative includes three linked programs:

Together, the three programs work to reduce poverty by building relationships across all economic groups and community partners to help individuals and families get out of poverty and build communities where everyone can thrive. These programs offer a novel approach to poverty reduction based on principles of social mobility, social inclusion, and social capital. This approach differs from other community efforts with the focus on multiple sectors working collaboratively to alleviate poverty, and members from all economic groups in the community mobilized to support low-income participants.

The planning, implementation, and sustainability of these programs was supported by an inter-sectoral partnership of 16 agencies in Greater Sudbury that form the Partners to End Poverty Steering Committee. The Steering Committee is represented by agencies across Greater Sudbury who are passionate about and committed to reducing poverty. All partners recognize the need for poverty reduction in the community, with the understanding that everyone has the right to meet their needs and live with dignity.

The Steering Committee met monthly throughout the pilot and worked collaboratively to examine the impact of poverty on individuals and families, identify ways to improve relationships, develop effective poverty reduction strategies, and become agents of change for our community. The Circles Initiative provides a platform for community agencies and providers to work together for the common goal of ending poverty in our community.

During the COVID-19 pandemic, the Steering Committee transitioned to virtual meetings and met more frequently to share timely information and resources with the goal of supporting the increased community needs resulting from the pandemic and negative social and economic impacts on the most vulnerable community members.

The Circles Initiative is strongly aligned with both the provincial public health focus on the social determinants of health and health inequities and the local population health priorities of the City of Greater Sudbury. Locally, Public Health Sudbury & Districts is committed to actions that will reduce health inequities and create opportunities for all members of our communities to achieve their full health potential, including focused efforts on poverty reduction. The City of Greater Sudbury believes in recognizing the specific needs of all citizens and ensuring an inclusive, accessible community for all2 and the Circles Initiative aligns with Greater Sudbury’s current focus on population health.

In keeping with a community-wide approach, each year through the Circles program, Circles Leaders and staff work collaboratively to identify one key issue or community barrier to focus on as a collective, in addition to continuing to work to advance the individual action plans of each Leader. This annual focus for the Circles program is called the Big View. The Big View is intended to benefit Leaders in the program and their families as well as all members within the community currently living in poverty.

Pilot highlights

In less than three years, the Circles Initiative has influenced over 1500 community members. In addition to supporting low income individuals while they work toward economic self-sufficiency, in a new multi-sector approach, this initiative has promoted poverty awareness, increased understanding and compassion, helped reduce poverty-related stigma, and inspired local change. The feedback from partners, training, and program participants has been overwhelmingly positive.

Bridges out of Poverty

Circles Leaders Training

Circles

Due to COVID-19, the face-to-face meetings over a meal together were suspended. Instead of meeting for meals three times a month, the Circles program continues with a shift to virtual meetings on the same schedule. Circles Leaders, Allies, and Coaches meet virtually for group discussions, sharing lived experiences during the pandemic, navigating community barriers, and identifying resources. Circles Coaches also contact Leaders through regular phone calls and virtual connects for six-month check-ins and working on actions plans to move out of poverty. The program also provided all Leaders with large Good Food Boxes each month over the summer into the fall 2020 in efforts to minimize food insecurity during the pandemic.

Circles Big View – Intersectoral action to tackle community issues

For the Circles Sudbury program, the Big View is intended to benefit Leaders in the program and their families as well as the 21 000 other members across Greater Sudbury currently living in poverty. The Big View focus in 2018 was the need for greater compassion and understanding about the realities of living in poverty, including the challenges of service navigation. Public Health Sudbury & Districts hosted a one-day poverty simulation event on December 14, 2018, called the Greater Sudbury Poverty Challenge. Mental health supports and access to affordable housing were identified as key issues by Circles Leaders in Sudbury as the Big View focus for 2019 and 2020. On March 11, 2020, Public Health Sudbury & District’s Circles Initiative partnered with the Northern Ontario School of Medicine Dean Speaker Series to co-host a public event at Science North titled “Fighting Stigma and Finding Support”. The event featured a talk by mental health advocate Amy Willans and an interactive art exhibit of the photovoice project developed by Circles Leaders featuring their experiences with mental health, stigma, housing, and support.

The overall Circles Initiative would not be possible without the support of the agencies connected to the Partners to End Poverty Steering Committee and other community partnerships as detailed throughout this report. The Circles Sudbury program could also not exist without the commitment, dedication and compassion of the community volunteers who serve as Allies and friends in the program. Their ongoing support, networking and allyship with Circles Leaders have been invaluable. Finally, Circles Sudbury would not be possible without the brave Leaders who are working on their life goals and have trusted program staff and the broader initiative with their future wellbeing and prosperity. It is hoped that through continued partnerships and support from multiple sectors, that the Circles Initiative can continue to be sustained beyond the pilot funding that ended in September 2020.

Circles Initiative: Final report – Fall 2020 Full report

Overview

This report provides an overview and results from the introduction and pilot of the Circles Initiative to the City of Greater Sudbury between 2017 and 2020. The Circles Initiative was launched in 2017 following receipt of one of Ontario’s Local Poverty Reduction Fund grants totaling $217,000 in late 2016. The Circles Initiative includes three linked programs: Bridges Out of Poverty, Circles Leader Training, and Circles. Together, the three programs work to reduce poverty by building relationships across all economic groups and community partners to help individuals and families get out of poverty and build communities where everyone can thrive. The planning, implementation, and sustainability of these programs was supported by an inter-sectoral partnership of 16 agencies in Greater Sudbury that form the Partners to End Poverty Steering Committee. The Steering Committee is represented by agencies across Greater Sudbury who are passionate about and committed to reducing poverty.

Background

Poverty and health

Income alone is the single strongest determinant of health, and health improves at every step up the income ladder.1 2 People living with a lower income are at far greater risk of preventable medical conditions across the lifespan, including cancer, diabetes, heart disease, mental illness, and their associated health care costs, compared with those living with higher incomes.3 In the City of Greater Sudbury nearly 21 000 people or 12.8 per cent of the population live in poverty.4 Local data from Sudbury and districts reveal that:

Poverty has a tremendous human and financial cost to Canadian society. The cost of poverty in Ontario was recently estimated to be between $27.1 and $33 billion each year from costs arising from health care, the justice system, lower employment levels, and resulting loss of tax revenue.6 Efforts to reduce poverty therefore offer a clear return on investment by reducing taxpayers’ dollars that go directly into resource-intensive emergency support services that treat the consequences of poverty, like emergency medical services, shelters, social and public services and supports, and the justice system.

Addressing poverty is possible through the decisions and commitments that we make as a society. Reducing poverty and its harm to health is not possible by any one sector but instead requires collective efforts across sectors that focus on individual, community, and system level change. Studies show that poverty elimination interventions that focus only on changing individuals and their circumstances are much less likely to be successful than multi-targeted efforts that include a focus on changing the way systems and communities work together to address poverty.7 8 The Circles Initiative represents the first inter-sectoral and multi-level community approach to poverty reduction in Greater Sudbury.

The Circles Initiative: A comprehensive intersectoral approach to poverty reduction

Public Health Sudbury & Districts, in partnership with agencies across Greater Sudbury, was successful in obtaining one of Ontario’s Local Poverty Reduction Fund grants in late 2016 totalling $217,000. The grant was awarded to support the implementation and evaluation of two programs connected with the Circles Initiative into Greater Sudbury: Circles Leader Training and Circles, both licensed through Circles Canada. The Bridges out of Poverty training program, licensed through aha! Process is also connected with the Circles Initiative but was not directly funded through the grant. Public Health Sudbury & Districts implemented the Bridges out of Poverty training initiative through in-kind dollars to ensure all three programs that make up the Circles Initiative were introduced into the community for the pilot. The pilot lasted between January 2017 to September 2020. The overarching goals of the three programs that make up the Circles Initiative are to:

These programs offer a novel approach to poverty reduction based on principles of social mobility, social inclusion, and social capital. This approach differs from other community efforts with the focus on multiple sectors working collaboratively to alleviate poverty, and members from all economic groups in the community mobilized to support low-income participants. The three linked programs are:

Although new to Greater Sudbury, evaluations of the Circles Initiative in other Ontario municipalities show promising results towards poverty reduction and high program completion rates. Below includes a snapshot of outcomes including increased earnings, education, and program success from the Circles Initiative in Lambton County.

Lambton County Circles Initiative outcomes

Lambton Circles® 10 years of impactful data outcomes:

Through the Circles Canada data base system since inception in 2009 to May 2020:

  • 80% of Circle Leaders increased earnings
  • 61% of Circle Leaders increased their education
  • 58% graduated from post-secondary education
    • careers include nursing, information technology, developmental services worker, social services worker, child and youth counsellor, personal support worker, office administration, apprenticeships and trades
  • 81 Lambton Leaders have met their goals and reached full economic self-sufficiency
  • 21% voluntary withdrawals, the remainder are still active in Circles on their plans of change
  • $2,243,575.00 projected cost saving to the Ontario Works Social Assistance Services system of the Lambton Circles Graduates to date
  • 260 children have participated—breaking the cycle of poverty for the next generation
  • More than 165 Allies, 50+ community volunteers and community partners assist with meals, childcare, advocacy, and educational programming

Source: Lambton Circles. Circles Canada overview. 2020

How the Circles Initiative works

Circles Leader Training and Circles programming are built around the principles of social capital and social inclusion to support individuals and families while they move forward with their plans to exit poverty and achieve economic stability.

The Circles Initiative focuses on increasing the social capital and enhancing the social inclusion of participants by connecting them with significant resources, supports, and relationships. By increasing social capital, participants engage in the process of social inclusion which aims to improve dignity, ability, and opportunity for individuals regardless of their social identity.16 Circles focuses on three types of social capital to support individuals: linking, bonding, and bridging.

Circles focuses on three types of social capital

 

Linking: Connecting individuals and families to community resources

 

Bonding: Fostering relationships and bonds with peers

 

Bridging: Building relationships with people from different economic backgrounds

Intersectoral collective action

The planning, implementation, and sustainability of these programs has been supported by an intersectoral partnership of agencies in Greater Sudbury that form the Partners to End Poverty Steering Committee. The Partners to End Poverty Steering Committee was established to advise and support Public Health Sudbury & Districts and other partner agencies with the implementation and evaluation of the Circles Initiative within the City of Greater Sudbury. Oversight and support from an intersectoral guiding coalition is a requirement of the Circles Initiative. The Steering Committee formed in late 2016 with six participating agencies and has now grown to a total membership of 16 agencies. The Steering Committee is represented by agencies across Greater Sudbury who are passionate about and committed to reducing poverty. The agencies represent many sectors of the community including education, mental health and addiction, employment services, health and housing, social services, Indigenous social services, early childhood education, community and social development, worker’s rights and advocacy services, and public health. All partners recognize the need for poverty reduction in the community, with the understanding that everyone has the right to meet their needs and live with dignity.

The Steering Committee met monthly throughout the pilot and worked collaboratively to examine the impact of poverty on individuals and families, identify ways to improve relationships, develop effective poverty reduction strategies, and become agents of change for our community. The Circles Initiative provides a platform for community agencies and providers to work together for the common goal of ending poverty in our community.

Partners to End Poverty Steering Committee

Given that the programs and associated materials that form the Circles Initiative were not developed locally, an Indigenous Advisory Committee and a Francophone Advisory Committee were established with the goals of identifying if and how each program should be customized or adapted to ensure their relevance in our Northern Ontario context. The Indigenous Advisory Committee is chaired by Rachael George, Apatisiwin Employment Coordinator with the N’Swakamok Native Friendship Centre and the Francophone Advisory Committee is chaired by Raymond Landry, Homelessness Network Coordinator with the Centre de santé communautaire du Grand Sudbury.

COVID-19 adaptations

During the COVID-19 pandemic, the Steering Committee transitioned to virtual meetings and met more frequently to share timely information and resources with the goal of supporting the increased community needs resulting from the pandemic and negative social and economic impacts on the most vulnerable community members.

Alignment with public health

The Ontario Public Health Standards, 2018, indicate that local boards of health shall modify and orient public health programs and services in ways that decrease health inequities. This includes designing strategies that work to improve the health of entire populations while decreasing health inequities experienced by vulnerable community members.17 “Health is influenced by a broad range of factors, including social determinants that affect the conditions in which individuals and communities live, learn, work, and play”.18 Locally, Public Health Sudbury & Districts is committed to actions that will reduce health inequities and create opportunities for all members of our communities to achieve their full health potential, including focused efforts on poverty reduction.

The Circles Initiative has the capacity to positively influence Leaders’ (participants) and their families’ access and experiences with the social determinants of health. Below is a list of the 16 key social determinants identified by the Ontario Public Health Standards. The social determinants of health underlined below are the ones that the Circles program has focused on in supporting our Leaders to date:

Studies have shown that bridging social capital has a particularly strong effect on the social mobility of individuals who face social and health inequities. Building relationships and community connections can have far-reaching benefits. The Circles Initiative and focus on social inclusion and social support networks also aligns with the recommendations listed in the most recent annual report of the Chief Medical Officer of Health of Ontario, Connected Communities: Healthier Together. The report emphasizes the notion that being connected to other people is essential to our well-being, that strong resilient communities reduce isolation, and that individuals, organizations, communities, and governments must work together to create a society that values and invests in social connection and community.19

Alignment with City of Greater Sudbury priorities

The City of Greater Sudbury believes in recognizing the specific needs of all citizens and ensuring an inclusive, accessible community for all.20 Greater Sudbury provides programs and services to support individuals and families, including those struggling with poverty, with programs such as the Ontario Works.21 The Circles Initiative aligns, builds on, and works with the programs to support individuals and families to exit poverty through education and employment pathways. The Circles Initiative also aligns with Greater Sudbury’s current focus on population health, including the identified ten key priority areas below. The priorities underlined below are ones that the Circles Initiative has supported to date through Bridges out of Poverty, Circles Leader Training, and the Circles program:

Circles Initiative pilot results

Bridges out of Poverty

Bridges out of Poverty is a training opportunity that aims to start a conversation about poverty. Workshops are offered by trained facilitators at no cost by Public Health Sudbury & Districts in three and six-hour interactive formats. Workshops invite participants to look at poverty differently by exploring the experiences and realities of people living in poverty. The training initiative is designed to help participants understand the causes and impacts of poverty on families, the challenges and strengths of people living in poverty, the hidden rules of economic groups, barriers low-income individuals face to moving out of poverty, and the importance of building relationships across economic groups.

Community partnerships

Bridges out of Poverty workshops in French have also been co-facilitated with support from Centre de santé communautaire du Grand Sudbury.

Pilot highlights

Fifty-nine Bridges out of Poverty Workshops were delivered between June 2017 and February 2020 (35 half day workshops and 24 full day workshops) for a total of 971 participants from 134 community agencies. Workshops were evaluated by surveys, completed by participants at the end of the workshop, and were based on three main categories: Program access and delivery, program context, and poverty in the community. Overall 806 of the 971 participants completed workshop surveys.

The majority of respondents indicated high levels of satisfaction in all three areas of the survey including access and program delivery (Table 1), program context (Table 2), and poverty in the community (Table 3).

Table 1: Access and program delivery—percentage of participants who agree and strongly agree

Access and program delivery3-hour workshop6-hour workshop
PHSD staff were helpful and knowledgeable about this workshop98%100%
Like that workshops are offered during business hours90%96%
The location of the workshop was convenient92%94%
The facilitators were well prepared for the workshop97%99%
The facilitators were knowledgeable about the workshop material99%100%

Table 2: Program context—percentage of participants who agree and strongly agree

Program context3-hour workshop6-hour workshop
Enjoyed this workshop96%98%
Have a better understanding of poverty because of the workshop89%93%
Satisfied with the amount of content presented91%97%
Remained engaged throughout the workshop91%95%
The workshop length is appropriate for content80%94%

Table 3: Poverty in the community—percentage of participants who agree and strongly agree

Poverty in the community3-hour workshop6-hour workshop
Happy that poverty reduction programs are being offered in the City 97%91%
Learning about Poverty Reduction Strategies will help me do a better job at work91%96%
Learning about Poverty Reduction Strategies are relevant to me on a personal level 83%88%
Understanding poverty is important for all members of our community.99%100%
Reducing poverty is a priority for our community leaders84%76%

Feedback from Bridges out of Poverty workshop attendees

“As I am not involved professionally in social services, this course won’t help me in everyday life, but as a decision maker and volunteer in the community I feel it was valuable in understanding and hopefully supporting initiatives locally if the opportunity arises. It helped me to see a different side to people living in poverty.” (2017, 6-hour workshop)

 

“Loved the content in this workshop. I felt like it has helped me identify some of the assumptions I was making while in my position.” (2018, 6-hour workshop)

 

“I truly appreciate the information and it will allow me to approach my individuals in a way that is more with their needs in mind when it has to do with poverty. Using empathy to reach out to individuals. Also, being aware of my own biases as to not offend the individual that are accessing our services.” (2019, 6-hour workshop)

 

“I have stepchildren that live and have always lived in poverty. The hidden rules, which I did not know about, were very eye opening to explain some behaviours or norms that I see/find frustrating on a regular basis.” (2019, 6-hour workshop)

Leader Training

Circles Leader Training is a program designed to provide individuals living in poverty with tools to transition into economic self-sufficiency through education and employment pathways. Circles Leader Training is designed to support participants while they assess their current resources, learn how to build on their resources, and create a personal action plan based on their hopes for a prosperous future out of poverty. Circles Leader Training is designed for individuals who are currently experiencing poverty and who are ready and able to develop a plan of change with concrete steps to move out of poverty.

Circles Leader Training is a program that includes facilitated group discussions, interactive activities, and individual self-reflection exercises. Circles Leader Training covers materials on the following:

During Circles Leader Training, participants complete a Life Assessment Tool on a range of categories to measure their overall well-being. Categories include but are not limited to food, housing, transportation, support system, well-being, and mental health. The Life Assessment Tool asks participants to rank themselves along a 5-point scale to indicate where they see themselves along a continuum of surviving (1) to thriving (5). Participants are supported throughout the training while they work to develop their own personal action plans to achieve economic self-sufficiency.

Community partnerships

Circles Leader Training program sessions have been offered at different host partner sites including YMCA of Northeastern Ontario, Barrydowne College, St. Albert Adult Learning Centre, the N’Swakamok Native Alternative School, and Sudbury Vocational Resource Centre (recently renamed Spark Employment Services). Barrydowne College, St. Albert’s Adult Learning Centre, and the N’Swakamok Native Alternative School have provided food to support participants during Leader Training programming.

The Circles Leader Training program has evolved from being facilitated exclusively by Public Health Sudbury & Districts staff to a co-facilitation model and a full facilitation model with St. Albert Adult Learning Centre, thus greatly improving the sustainability of the program and aligning well with the adult learner curriculum. Further, in addition to receiving a certificate of completion upon graduating from the training, a local adaptation of Circles Leader Training in partnership with the local school board partners made it possible for participants to also receive one credit towards their Ontario Secondary School Diploma through Barrydowne College, St. Albert Adult Learning Centre, and N’Swakamok Native Alternative School.

Pilot highlights

Between September 2017 and December 2019 participants were recruited into Circles Leader Training through referrals from agencies in the Partners to End Poverty Steering Committee, postings on social media, self-referrals, and through word-of-mouth. All participants were living below the poverty line as determined by the Low-income Measure23 and most were receiving financial support either through Ontario Works or the Ontario Disability Support Program.

Table 4: Low income measure thresholds by income source and household size

Household size2017 After-tax income
1 person23,513
2 persons33,252
3 persons40,726
4 persons47,026
5 persons52,577
6 persons57,595
Source: Statistics Canada. Table 11-10-0232-01   Low income measure (LIM) thresholds by income source and household size

Between November 2017 and December 2019, nine Circles Leader Training series have been offered with over 70 community members. Of the 73 Circles Leader Training participants, 29 became involved with Circles program to continue their journey.

Key socio-demographics of participants
Circles Leader Training evaluation results

Circles Leader Training is evaluated through pre and post program surveys with participants which capture information on key areas including socio-demographic data, statistics on living conditions of participants, physical and mental health status of participants, and delivery of the Circles Leader Training program. The evaluation also compares the perceived stress and self-esteem scores for participants before and after participating in Circles Leader Training using the Rosenberg Self-Esteem Survey24 and the Perceived Stress Scale25. A total of 52 respondents completed both pre and post surveys.

The majority or 69% of participants reported lower levels of perceived stress after completing the Circles Leader Training program (Figure 2).

Figure 2: Reduced stress scores after participating in Circles Leader Training

This bar graph depicts reduced stress scores after participating in Circles Leader Training. The majority or 69% of participants reported lower levels of perceived stress after completing the Circles Leader Training program.

The majority or 67% of participants reported increased levels of self-esteem after completing the Circles Leader Training program (Figure 3).

Figure 3: Increased self-esteem scores after participating in Circles Leader Training

This bar graph depicts increased self-esteem scores after participating in Circles Leader Training. The majority or 67% of participants reported increased levels of self-esteem after completing the Circles Leader Training program.

Circles Leader Training participants were asked to identify new skills gained through the program. Top ranked skills identified by participants were: knowing the difference between surviving & thriving, making SMART goals, budgeting, and making a personal action plan to exit poverty (Figure 4).

Figure 4: Participants’ new skills after completing Circles Leader Training

This bar graph depicts participants’ new skills after completing Circles Leader Training. Circles Leader Training participants were asked to identify new skills gained through the program. Top ranked skills identified by participants were: knowing the difference between surviving & thriving, making SMART goals, budgeting, and making a personal action plan to exit poverty.

Feedback from Circles Leader Training participants

“I’m glad that I was involved in this program. It really helped me and it gave me a chance to meet new people.” (2018, Cohort 2)

 

“Please keep Circles going. It is a great experience for people who want to be true leaders. There is a lot to gain from this program.” (2018, Cohort 2)

 

“Leader Training should be broadcasted through media and made more accessible. This is life changing, let’s make this known.” (2019, Cohort 7)

 

“This was a helpful and informative program. Great support for people who need it.” (2019, Cohort 6)

Circles

Circles is a program developed to support individuals living in poverty while they work on their personal action plans to transition into economic self-sufficiency through education and employment pathways. Circles offers support with service navigation, added layers of social support, and community connections. Graduates of the Circles Leader Training program who are ready to move forward with their personal action plan to exit poverty are invited to join the Circles program. Participants are called Leaders since they are leading their own journey out of poverty through their personalized life plans. Each Leader is matched with one to two volunteers who serve as Allies throughout the program. Allies provide intentional relationships that include friendship, coaching, and practical and emotional support. Circles Allies are community members that are often recruited from the Bridges Out of Poverty workshops. Other volunteers recruited in the community are referred to attend a workshop upon expressing interest in becoming a Circles Ally.

Leaders also receive support from Circles Coaches (staff) who support them while they create their action plan which includes education and employment strategies. Action plans include short and long-term SMART goals (specific, measurable, attainable, relevant, time-bound). Circles Coaches review each Leader’s action plan upon entering the Circles program and every six months thereafter until the Leader achieves economic self-sufficiency and graduates from the program. Self-sufficiency is achieved when the individual is earning an income above the Low-income Measure26 for family size. The goal for Circles Leaders is to achieve economic self-sufficiency within 18 to 48 months of joining the program.

Participants, volunteers, and staff attend Circles Sudbury meetings three times per month for a shared meal (dinner) and programming. Transportation is provided for participants as needed and children of Leaders and Allies are welcome. Programming for participants (Leaders) and volunteers (Allies) is tailored to meet the interests and needs of the Leaders to support them in moving forward with their action plans. Programming also focuses on supporting volunteers build their capacity to serve as Allies to program participants. Examples of topics covered in the programming include relationship building, financial literacy, emotional and physical literacy, nutrition, respect, trust and vulnerability, mindfulness, volunteerism, community resources, and job preparedness. Child programming is a key element of the Circles program and includes strengths-based sessions to foster resiliency, develop interpersonal skills, and build relationships. Child programming, which focuses on themes such as respect, compassion, volunteerism, and financial literacy, is designed to give children the opportunity to move forward in parallel to their parent through the adult programming.

In keeping with a community-wide approach, each year through the Circles program, Circles Leaders and staff work collaboratively to identify one key issue or community barrier to focus on as a collective, in addition to continuing to work to advance the individual action plans of each Leader. This annual focus for the Circles program is called the Big View. For the Circles program, the Big View is intended to benefit Leaders in the program and their families as well as all members within the community currently living in poverty.

Public Health Sudbury & Districts released a video in 2018 to provide a snapshot about the Circles Initiative in Sudbury, and can be watched on Public Health’s YouTube channel at https://www.youtube.com/PublicHealthSD.

First Circles Sudbury video – Helping people exit poverty: the power of the Circles program: http://bit.ly/30AyNb7

The video launched in October 2018 features experiences of a Leader and an Ally in the program.

“In my case, I really needed the encouragement and support. The Circles program brings together Leaders, Allies, and Coaches to come up with solutions to help participants get out of poverty. This experience has impacted me in so many ways. I would definitely recommend the Circles program to anyone.” – Hughie, Leader in Circles Sudbury

 

“I think Circles is trying to reach out to folks that are living in poverty and in generational poverty and … It’s showing them that there is a way out, not just that there is a way out of this, but also that there are connections with people. That we are all the same. And building relationships and trust, I think is the first step to moving that piece forward.” – Dan, Ally in Circles Sudbury

Community partnerships

Three community partners graciously agreed to serve as host sites for Circles programming at no cost over the last three years including: N’Swakamok Native Friendship Centre, Jubilee Heritage Family Resources, and Montessori School of Sudbury. Staffing support has also been provided through funded training opportunities through the N’Swakamok Native Friendship Centre’s Apatisiwin On-the-Job-Training Program. Other in-kind supports have been provided to support Circles programming including the provision of meals Ontario Works at Greater Sudbury through partnerships with the Collège Boréal culinary program as well as transportation vouchers to support attendance of participants on Ontario Works to attend Circles Leader Training and Circles.

As Public Health Sudbury and Districts is a learning facility for college and university students, many opportunities have also arisen for 18 post-secondary students to fulfil their clinical placement objectives while supporting Circles Leader Training and Circles. Student placement agreements between Public Health Sudbury & Districts, Cambrian College, and Laurentian University to support Circles Leader Training and Circles programming and promote student applied and experiential learning opportunities. Programs involved include Cambrian Nursing, Cambrian Child and Youth Worker, Laurentian Nursing, Social Work, Masters of Social Work, Indigenous Social Work, and Concurrent Education. Two high school students were also recruited to volunteer during Circles meetings to help with attendance tracking and meal clean up. They have collected high school volunteer hours for their valuable efforts.

Pilot highlights

The Circles Sudbury program was launched in February 2018. Since the beginning of Circles Sudbury, 29 Circles Leaders with their 34 children and 57 Circles Allies were recruited into the program. There are currently 12 Leaders, 21 Allies, and 25 children (18 children of Leaders and 7 children of Allies) in the Circles Sudbury program. Child programming for children of Leaders and Allies was facilitated by Public Health Sudbury & Districts students and Early Childhood Educators.

Due to COVID-19, the face-to-face meetings over a meal together were suspended. Instead of meeting for meals three times a month, the Circles program continues with a shift to virtual meetings on the same schedule. Circles Leaders, Allies, and Coaches meet virtually for group discussions, sharing lived experiences during the pandemic, navigating community barriers, and identifying resources. Circles Coaches also contact Leaders through regular phone calls and virtual connects for six-month check-ins and working on actions plans to move out of poverty. The program also provided all Leaders with large Good Food Boxes each month over the summer into the fall 2020 in efforts to minimize food insecurity during the pandemic.

Examples of topics covered during Circles meetings include relationship building, job preparation, networking, reviewing and updating individual action plans and SMART goals, empowerment and self-advocacy, motivational interviewing, theory of change, and allyship. Circles programming also engaged with partners across the community to build connections and raise awareness about services and agencies. The table below is a summary of agencies and topics covered during Circles sessions.

Table 6: Guest speakers at Circles Sudbury

AgencyTopics
Canada Revenue AgencyBenefits, credits, income tax, filing and more
Homelessness Network
Centre de santé communautaire du Grand Sudbury
Housing and services offered by the Homelessness Network
Monarch Recovery ServicesBuilding Connections
NORCATPrograms, services and online training
Northern Initiative for Social ActionMental Health Awareness and Resources
N'Swakamok Native Friendship CentreSession on National Indigenous Peoples’ Day;
Other traditional cultural teachings including drumming and a round dance
Our Children Our FuturePrograms and services
Ontario Works
City of Greater Sudbury – Employment Support Services
Overview of local industries & occupations and other topics
Public Health Sudbury & DistrictsBuilding our resiliency through our strengths
Re-defining Allyship
Photovoice Project
Relationship building activities
Gear up for food safety
Circles cooking club (cooking on a budget)
Mental health during COVID and community resources
Sudbury Workers Education & Advocacy Centre Services offered by Sudbury Workers Education & Advocacy Centre
St. Albert Adult Learning CentrePrograms and services
United WayCommunity Conversations (focus groups)
YMCA of Northeastern OntarioSMART goals
Interview skills
Progress of Leaders

As mentioned previously, Circles Leaders strive to attain self-sufficiently within an 18 to 48 month timeline. Self-sufficiency is achieved when the individual is earning an income above the Low-income Measure27 for family size. Circles staff support Circles Leaders while they explore and develop short and long-term goals that are primarily linked to education or employment pathways.

Long-term goals

Examples of long-term goals set by Circles Leaders:

As of September 2020, 64 per cent of the long-term goals that were identified by the Circles Leaders are currently in progress. Given that they are long-term goals and that the duration of the program itself spans between 18 and 48 months, it is reasonable to expect the majority of long-term goals to be in progress among participants at any given time during programming.

Table 7: Circles long-term goals identified and achieved

Long-term goals identifiedNumber of goalsTotal goal %Long-term goals met
YesIn progressNo
Education3947%12234
Employment3441%9241
Financial22%020
Transportation45%400
Volunteering11%010
Housing11%010
Health11%010
Retirement11%010
Total 8399%*25535
Percentage100100%30%64%6%

*Totals less than 100% due to rounding

Education

Through this program, Circles Leaders have acquired the skills to set realistic long-term goals and develop plans to pursue post-secondary education. In fact, 47 per cent of goals identified by the Circles Leaders were related to education. A total of ten Leaders have increased their education level by working towards their high school diploma, by obtaining their Ontario Secondary School Diploma, or by entering a post-secondary education institution such as college or university.

Circles Leader’s story: Immeasurable outcomes

 

Dealing with mental health issues, children with developmental issues, and suffering from low-self-esteem from an unhealthy relationship, a Circles Leader was convinced that they would never be able to pursue post-secondary education. However, an influential person recommended the Circles program. Circles staff and Allies supported the Circles Leader to push through their fears, obtain their high school transcripts, and apply to college. Within two months of completing Circles Leader Training and joining the Circles program, the Circles Leader started their studies at college and is now working towards a diploma in the social work field

Circles Leader’s story: “I want a better life for my family”

 

After completing Circles Leader Training, joining the Circles program, and graduating from high-school, a Circles Leader was uncertain of where to go next. They were motivated by the goal of improving their family situation, but they weren’t sure which post-secondary program would allow them to accomplish their goal. Circles staff and Allies supported research into different post secondary programs and pros and cons of each. Support with self-advocacy also helped waive sitting fees of a local college. Currently, the Circles Leader has completed pre-trades at college and is now enrolled in the Electrical Engineering program at Cambrian College. They wish to become an electrician and to be the first in their family to go to college.

Employment

A total of 41 per cent of long-term goals identified by Circles Leaders were linked to exiting poverty through full-time employment. Several of the Circles Leaders’ plans included post-secondary studies leading into full-time employment. Some Circles Leaders were recipients of Ontario Disability Support Program and their goals were to obtain part-time work suited to their needs. Several Circles Leaders were able to obtain employment (e.g. personal support worker, superintendent of building, furniture sales associate, automobile sales associate, cleaning services associate, social media channel creator, customer service representative in the gaming industry, team member at a restaurant, and Circles Program Intern with the Circles Sudbury program).

Circles Leader’s story: Leader turned entrepreneur

 

A Circles Leader was unable to obtain employment after a tragic death in the family that left them with mental health challenges. Due to these challenges, the Circle Leader had to leave their full-time employment and apply for Ontario Disability Support Program. The Circles Leader decided to join Circles and attended every Circles session though they had difficulty leaving their home due to their mental health challenges. With time and help from their supportive Allies, the Circles Leader gained the confidence to pursue their employment goals. Being a creative individual, they turned their hobbies and passion for working with youth into the foundation for a small business. They contacted the Regional Business Centre for help developing a business plan and they are continuing to work with an employee at the Business Centre. They are also moving forward as an online entrepreneur and pursuing part-time employment working with youth.

Circles Leader’s story: Graduating into self-sufficiency

 

In a short timeframe, a Circles Leader graduated from the Circles program and attained financial self-sufficiency. Starting the Circles program in February 2018, the Circles Leader was able to gain the confidence to obtain their G license, buy a car, and secure full-time employment before August 2018. The Circles Leader originally had difficulty pursuing employment as they always struggled with developing job resumes and undergoing job interviews. Thanks to the knowledge gained in Circles Leader Training and the support from Circles staff and a supportive Ally, the Circles Leader successfully completed the interview and gained full-time employment. The Leader states their self-esteem has greatly improved, and they are still currently working.

Short-term goals

Circles Leaders break down long-term SMART goals into short-term concrete steps and tasks. These steps and tasks are short-term goals that can be accomplished within a six-month timeframe. The short-term goals identified by the Circles Leaders can vary from financial tasks (e.g. creating a budget with their Ally) to tasks related to transportation (e.g. obtaining their G driver’s license). As of September 2020, a total of 42 per cent of short-term goals identified were completed and 49 per cent of them are still in progress.

Examples of completed short term goals include:

Table 8: Circles short-term goals identified and achieved

Short-term Goals identifiedNumber of goalsTotal goal %Goals met
YesIn progressNo
Education10238%394914
Employment5721%33222
Other124%651
Financial 239%8150
Transportation104%640
Service navigation52%320
Housing104%370
Mental-well being93%360
Brainstorming62%222
Health114%461
Family/ Social support93%351
Volunteer41%031
Criminal Background Check52%131
Self-advocacy41%031
Total26798%*11113224
Percentage100%100%42%49%9%

*Totals less than 100% due to rounding

Circles Leader’s story: Moving forward from precarious housing

 

For years, one Leader struggled to find affordable housing. Several factors limited them from obtaining “urgent status” for subsidized housing despite a history of mistreatment by their landlord. Accessing other shelters was a challenge due to conflicts between their volunteering hours and set housing curfews. This left the Leader stuck renting their current room with the $550 that was allocated by Ontario Works. Circles staff advocated for the Leader, checked listings, found housing opportunities, and encouraged the Leader to reconnect with the Canadian Mental Health Association (CMHA). A transitional housing worker from CMHA was able to help them receive a rent supplement of $850 a month and also assisted in paying first and last month payments of rent. With these extra supports the Circles Leader was able to secure safe and affordable housing. The Leader stated that for the first time in a long time, they finally felt hope.

Financial Status

Financial data are tracked for Circles Leaders’ at initial program entry and every six months thereafter. Data from the Circles Leaders who joined in 2018 indicate steady increases in the average annual income or earnings from 2018 at $25,900 to present at $39,500. Unfortunately, the average yearly income has decreased for the participants who joined the Circles program in 2019 from $16,600 at entry to $15,600 at present. The decrease in income is due to different factors that impacted the Leader’s life, for example, a change in the family status and no hours during the COVID-19 pandemic for their part-time employment. The average yearly income has increased for the participants who joined the Circles program in 2020 from $14,600 at entry to $15,100 at present (See Table 9)

Table 9: Circles Leaders’ yearly average income

 Initial income (year)Current income (year)% Increase/Decrease
Average yearly income of participants who joined Circles in 2018$25,900 (2018)$39,500 (2020)34.4% (increase)
Average yearly income of participants who joined Circles in 2019$16,600 (2019)$15,600 (2020)6.4% (decrease)
Average yearly income of participants who joined Circles in 2020$14,600 (2020)$15,100 (2020)3.3% (increase)

Circles Leader’s story: Exciting news — a Circles Leader on CBC

 

A Leader from Circles Sudbury volunteered to share their story at the provincial public election forum hosted by CBC radio in the spring of 2018 in downtown Sudbury. The story included one of childhood poverty, substance use, poor housing conditions, and partner suicide. The Circles Leader opened the public debate with their story which led to the candidates sharing how their platforms would address poverty in the community and related social and community supports. The Circles Leader joined Circles in search for a better life for their children and to receive support while working on goals to become the first in their family to go to university. Circles programming supported the Circles Leader by enhancing their negotiations skills to enable them to engage in self-advocacy. Further, the program empowered the Circles Leader by identifying an authentic and powerful opportunity for a Circles Leader to share their story through this public forum.

Circles Leader’s story: Exciting news — a Circles Leader speaks to City Council

 

A Circles Leader and a staff member supporting the Circles program from Public Health Sudbury and Districts were invited to present at community delegation about the Circles Initiative to the Greater Sudbury City Council. The Public Health Sudbury and Districts staff member provided an overview and highlights and outcomes to date of the Circles Initiative including each of the three components: Bridges out of Poverty, Circles Leader Training, and Circles. This also included the funding that was coming to an end for the initiative and need for supports from the community to support the sustainability beyond the granting period. The Circles Leader shared their personal history and experiences with the Circles program in support of his own journey towards financial self-sufficiency. The Circles Leader’s presentation was moving and compelling and brought tears to the eyes of many Council members as well as those from the public who attended the meeting. The Circles program session was also held at the site of the City Council meeting (at Tom Davies Square) that evening and the entire program, including staff, Leaders, Allies, and other supporters also attended the meeting to provide emotional support in presenting in such a daunting venue, and to celebrate in the Leader’s personal successes and demonstrate their support of the Circles Initiative. The Council responded positively by passing a motion to prepare a business case to ensure the ongoing sustainability of the Circles program in collaboration with sector partners in Greater Sudbury for consideration during the 2021 deliberations.

Circles Big View – Intersectoral action to tackle community issues

Each year through the Circles program, Circles Leaders and staff work collaboratively to identify one key issue or community barrier to focus on as a collective, in addition to continuing to work to advance individual plans of each Leader. For the Circles Sudbury program, the Big View is intended to benefit Leaders in the program and their families as well as the 21 000 other members across Greater Sudbury currently living in poverty. The Big View focus in 2018 was the need for greater compassion and understanding about the realities of living in poverty, including the challenges of service navigation. Mental health supports and access to affordable housing were identified as key issues by Circles Leaders in Sudbury as the Big View focus for 2019 and 2020.

Table 5: Circles Big View topics by year

YearIssue identified by Circles Sudbury for
Big View focus
Corresponding projects
2018Lack of compassion and understanding about the realities of living in poverty, including the challenges of service navigation Second Circles Sudbury video – A thriving community begins with compassion: stories from the Circles Initiatives

Greater Sudbury Poverty Challenge

Third Circles Sudbury video – Greater Sudbury Poverty Challenge
2019/
2020
Mental health supports and stigma of mental illness

Affordable housing
Keynote lecture by mental health advocate and educator Amy Willans

Interactive art exhibit highlighting local experiences of mental health, housing and support

Third Circles Sudbury video – Fighting Stigma, Finding Support

Big View 2018: Greater Sudbury Poverty Challenge

Public Health Sudbury & Districts hosted a one-day poverty simulation event on December 14, 2018, called the Greater Sudbury Poverty Challenge. The event was held in partnership with the Partners to End Poverty Steering Committee. The Greater Sudbury Poverty Challenge brought civic leaders together to experience poverty and its challenges based on real-life profiles. Civic leaders were offered a glimpse into the life of struggling local families as they try to meet their basic needs and navigate community resources.

This authentic experience helped increase understanding about the realities of living in poverty. They were asked to experience several real-life scenarios. Profiles included some of the following instructions: “You are unemployed. Jobs are scarce. You live in subsidized housing. You need help finding temporary housing. You are couch surfing and cannot afford an apartment. You are dealing with your addiction and have no social support”.

Each profile came with challenging scenarios for civic leaders to navigate. They were given a limited amount of time and set of resources and they were asked to manage several common community agency encounters. Representatives from seventeen community agencies were present to interact with participants, adding greater depth to the event.

The Greater Sudbury Poverty Challenge event was designed to raise awareness about the realities of living in poverty and to inspire and sustain commitment to local poverty reduction efforts. The second Circles Sudbury video was released during the event and features the stories and hopes of participants connected with the Circles Initiative.

Second Circles Sudbury video—A thriving community begins with compassion, stories from the Circles Initiative: http://bit.ly/2PeXrND

The video launched on December 14, 2018 features the stories and hopes of participants connected with the Circles Initiative in Sudbury.

I have this amazing mentor. She’s been my mentor for just over a year now… She has helped me formalize our tenant group. She has helped me write grants for the garden.” –  Lynn

When we made this video, we really wanted to make people think about how they treat people trying to access the services they are providing. We wanted to remind them that we are all human beings, and that we all deserve the same type of compassion.” – Raven

A video was released on May 22, 2019, to provide a snap shot of the 2018 Greater Sudbury Poverty Challenge event. 

Third Circles Sudbury video—Greater Sudbury Poverty Challenge: http://bit.ly/3426WTx

“It was something new to me, the poverty simulation, where you actually place yourselves in the situation of what I would call people living in absolute poverty. We were asked to navigate: Where can I find a place to sleep tonight? Where can I get food? How can I get longer term housing? How can I get connected to a job? And for the most part it was a nightmare. It is still plagued by bureaucracy, by a rationing and by an inability of what is available now, to meet the needs that are out there.” – Dennis Raphael, Professor, York University, Faculty of Health – School of Health Policy & Management

“We have to just think of what is possible. I think we need to continue to advocate. I think we need to continue to have these dialogues with our family, with our friends, with our students so that we bring these issues to light, so that if we don’t agree with something that the government is handing down, or we really feel strongly about something that we don’t just sit back and complain about it. What are you, individually and collectively going to do about it? And that’s where the hope is. Bringing people together to fight, for each other. So there is hope in that because I don’t think that is lost yet.” –  Karla Ghartey, Professor of Nursing, Cambrian College

“It was a great experience in the sense that we took the role of somebody who actually experienced this through their life. When they say the system is broken, it is not because the services is not there, but the process to it is probably what’s broken.” – René Lapierre, Greater Sudbury Councillor, Ward 6, Chair, Board of Health, Public Health Sudbury & Districts

To learn more about the Greater Sudbury Poverty Challenge event, please visit: https://www.phsd.ca/health-topics-programs/health-equity/a-community-approach-to-poverty-reduction/greater-sudbury-poverty-challenge/

Big View 2019-2020: Fighting Stigma, Finding Support— Photovoice exhibit and public lecture

In discussions leading up to identifying a focus for 2019’s Big View, it became very apparent that the key issues that were identified by Circles Leaders were equally important as well as interconnected. It was decided collectively to focus on how poverty is underscored by mental health challenges and a lack of affordable housing and how stigma is a further barrier to seeking services and supports. The complexity and scope of these interconnected issues resulted in this focus being extended across 2019 and 2020.

The idea of photovoice project was selected by Circles Leaders to begin to unpack these issues and amplify their lived and living experiences. Photovoice is a research method where participants take photographs to identify personal concerns, depict struggles, and increase awareness of community barriers. Photovoice intends to empower its participants, helping those who often are unheard gain a voice on issues that affect their lives.

Circles Leaders were asked to take photos that represent their own personal experience of how mental health challenges and the lack of affordable housing are barriers in their own journey to exit poverty. The goal was to create awareness and compassion and advocate for social action. This project provided Circles Leaders an opportunity to creatively record and reflect on their own experiences with mental health challenges, stigma, a lack of affordable housing, and the importance of support as they relate to larger community issues.

Included below are a few samples of photovoice pieces that were developed through this project.

“The connections I made in Circles helped me flourish, share my interests, and give back to my community.”

The connections I made in Circles helped me flourish, share my interests, and give back to my community.

“Circles has shown me that you don’t have to face things alone as long as you have the right people supporting you!”

Circles has shown me that you don’t have to face things alone as long as you have the right people supporting you!

“When you move into poverty you move into filth. When you live in poverty finding housing with $500.00 isn’t about the perfect location or the right amount of space. It’s about choosing whether you want to live with bed bugs and roaches, or unsanitary shared spaces. These aren’t choices people living in poverty should have to make.”

When you move into poverty you move into filth. When you live in poverty finding housing with $500.00 isn’t about the perfect location or the right amount of space. It’s about choosing whether you want to live with bed bugs and roaches, or unsanitary shared spaces. These aren’t choices people living in poverty should have to make.

The lack of affordable housing means I have to make difficult choices. I have to choose between buying my children a new pair of shoes or paying my rent. Nobody should have to choose between basic necessities of life.

The lack of affordable housing means I have to make difficult choices. I have to choose between buying my children a new pair of shoes or paying my rent. Nobody should have to choose between basic necessities of life.

My mental illness caused me to question my own strength. I believe I am not strong enough. There is a constant lack of confidence. It gets to the point that I want to rip my own hair out in frustration.

My mental illness caused me to question my own strength. I believe I am not strong enough. There is a constant lack of confidence. It gets to the point that I want to rip my own hair out in frustration.

Depression and anxiety not only affects the person experiencing it but their whole family. For me, it has gotten to the point where it took over my whole life. Mental health stigma prevents people from seeking the support they need. If these medications were for a physical illness nobody would give it a second thought but when they are used for mental illness everyone has something to say.

Depression and anxiety not only affects the person experiencing it but their whole family. For me, it has gotten to the point where it took over my whole life. Mental health stigma prevents people from seeking the support they need. If these medications were for a physical illness nobody would give it a second thought but when they are used for mental illness everyone has something to say.

On March 11, 2020, Public Health Sudbury & District’s Circles Initiative partnered with the Northern Ontario School of Medicine Dean Speaker Series to co-host a public event at Science North titled “Fighting Stigma and Finding Support”. The event featured a talk by mental health advocate Amy Willans and an interactive art exhibit of the photovoice project developed by Circles Leaders featuring their experiences with mental health, stigma, housing, and support.

A video was released on November 10, 2020 to provide a snapshot of the Fighting Stigma Finding Support event.

Circles Sudbury video — Fighting Stigma and Finding Support: https://bit.ly/3nh6gm2

“There was one nurse who pointed to me and said to the student nurse with her, this one is a schizophrenic. And when I turned to her and asked her if she could give me something to help with the terrible anxiety I was experiencing, she turned to the student nurse again and said they’re all drug seekers, don’t give in. And it was in that moment, that I felt the most stigmatized, the most worthless, the most disconnected and the most alone in the world.” – Amy Willans, Mental Health Advocate

“Five years in and out of the hospital, five years where I stood, you know really at the end of the earth where life has nothing to offer me. But thank goodness that I had the people around me because I believe that they kept me alive. They watched me and cared for me, ‘cause I’ll tell you, I had a hundred ways to end my life. A hundred ways to make it stop hurting.” –Amy Willans, Mental Health Advocate

“They [Circles program] helped me find stable housing. Because that’s the first step of even getting a job or anything, is stable housing. If you don’t have stable housing you have nothing, really. And that was my first step, and I was stuck in unstable housing for three and a half years. It’s a steppingstone out of poverty for sure. Helping you build social skills, like I said, they helped me make my resume again, and I’m currently working.” – Alison, Circles Leader

Summary

In less than three years, the Circles Initiative has influenced over 1500 community members. In addition to supporting low income individuals while they work toward economic self-sufficiency, in a new multi-sector approach, this initiative has promoted poverty awareness, increased understanding and compassion, helped reduce poverty-related stigma, and inspired local change. The feedback from partners, training, and program participants has been overwhelmingly positive.

Bridges out of Poverty

Circles Leaders Training

Circles

Community volunteers

The overall Circles Initiative would not be possible without the support of the agencies connected to the Partners to End Poverty Steering Committee and other community partnerships as detailed throughout this report. The Circles Sudbury program could also not exist without the commitment, dedication and compassion of the community volunteers who serve as Allies and friends in the program. Their ongoing support, networking and allyship with Circles Leaders have been invaluable. Finally, Circles Sudbury would not be possible without the brave Leaders who are working on their life goals and have trusted program staff and the broader initiative with their future wellbeing and prosperity. It is hoped that through continued partnerships and support from multiple sectors, that the Circles Initiative can continue to be sustained beyond the pilot funding that ended in September 2020.

Executive summary endnotes

  1. Statistics Canada. (2017). Table  11-10-0232-01   Low income measure (LIM) thresholds by income source and household size
  2. City of Greater Sudbury. (2019). About Greater Sudbury. Retrieved from https://www.greatersudbury.ca/live/about-greater-sudbury/

Full report endnotes

  1.  Public Health Sudbury & Districts. (2019, July 16). Health equity. Retrieved from https://www.phsd.ca/health-topics-programs/health-equity/
  2. Mikkonen, J., Raphael, D. (2010). Social determinants of health: The Canadian facts. Toronto. York University School of Health Policy and Management. Retrieved from https://thecanadianfacts.org/The_Canadian_Facts.pdf
  3. Association of Local Public Health Agencies and Ontario Public Health Association. (2017). Basic Income Consultation [Letter].
  4. Statistics Canada. 2017. Greater Sudbury, CDR [Census division], Ontario and Ontario [Province] (table). Census Profile. 2016 Census. Statistics Canada Catalogue no. 98-316-X2016001. Ottawa. Released November 29, 2017. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/prof/index.cfm?Lang=E  (accessed September 3, 2020).
  5. Public Health Sudbury & Districts. (2020). Opportunities for Health for All: A Focus on Income. Sudbury, ON: Author. Retrieved from, https://www.phsd.ca/wp-content/uploads/2020/02/Impact_of_Income_Report_FINAL.pdf
  6. Lee, C.R. and A. Briggs. (2019). The Cost of Poverty in Ontario: 10 Years Later. Feed Ontario: Toronto, Ontario. Retrieved from https://feedontario.ca/cost-of-poverty-2019/
  7. Rothwell, A. (2014) Promising strategies for the elimination of poverty: A resource guide. Unpublished report, Master of Public Health Program, University of Guelph.
  8. Raphael, D. (2003). Barriers to addressing the societal determinants of health: public health units and poverty in Ontario, Canada. Health Promotion International, 18(4), 397-405.
  9. Statistics Canada. (2017). Table  11-10-0232-01   Low income measure (LIM) thresholds by income source and household size
  10. Mulunga, S. N., & Yazdanifard, R. (2014). Review of social inclusion, social cohesion and social capital in modern organization. Global Journal of Management And Business Research.
  11. Mulunga, S. N., & Yazdanifard, R. (2014). Review of social inclusion, social cohesion and social capital in modern organization. Global Journal of Management And Business Research.
  12. Mulunga, S. N., & Yazdanifard, R. (2014). Review of social inclusion, social cohesion and social capital in modern organization. Global Journal of Management And Business Research.
  13. Burton, L., Welsh, W. (2015).  Inequality and Opportunity: The Role of Exclusion, Social Capital, and Generic Social Processes in Upward Mobility. Duke University. William T. Grant Foundation. Pp. 1-5.
  14. Daly, M., Silver, H. (2008). Social Exclusion and Social Capital: A Comparison and Critique. Theory and Society. 37. Pp 537–566.
  15. Mulunga, S. N., & Yazdanifard, R. (2014). Review of social inclusion, social cohesion and social capital in modern organization. Global Journal of Management And Business Research.
  16. Mulunga, S. N., & Yazdanifard, R. (2014). Review of social inclusion, social cohesion and social capital in modern organization. Global Journal of Management And Business Research.
  17. Ministry of Health and Long-Term Care. (2018). Protecting and Promoting the Health of Ontarians Ontario Public Health Standards: Requirements for Programs, Services, and Accountability 2018. Retrieved from http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/protocols_guidelines/Ontario_Public_Health_Standards_2018_en.pdf
  18. Ministry of Health and Long-Term care. (2018). Health Equity Guideline, 2018. Retrieved from http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/docs/protocols_guidelines/Health_Equity_Guideline_2018_en.pdf
  19. Ministry of Health and Long-Term Care. (2019). Connected Communities: Healthier Together. 2017 Annual Report of the Chief Medical Officer of Health of Ontario to the Legislative Assembly of Ontario. Retrieved from http://www.health.gov.on.ca/en/common/ministry/publications/reports/cmoh_19/cmoh_19.pdf
  20. City of Greater Sudbury. (2019). About Greater Sudbury. Retrieved from https://www.greatersudbury.ca/live/about-greater-sudbury/
  21. City of Greater Sudbury. (2019). Employment Support and Financial Assistance. Retrieved from https://www.greatersudbury.ca/live/employment-support-and-financial-assistance/
  22. City of Greater Sudbury. (2018). Population Health. A Call to Action 2018-2028. Pp.1-24. Retrieved from https://www.greatersudbury.ca/city-hall/reports-studies-policies-and-plans/report-pdfs/population-health-call-to-action/
  23. Statistics Canada. (2017). Table  11-10-0232-01   Low income measure (LIM) thresholds by income source and household size
  24. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press. https://www.docdroid.net/Vt9xpBg/society-and-the-adolescent-self-image-morris-rosenberg-1965.pdf
  25. Cohen, S. and Williamson, G. (1988). Perceived Stress in a Probability Sample of the United States. Spacapan, S. and Oskamp, S. (Eds.) The Social Psychology of Health. Newbury Park, CA: Sage
  26. Statistics Canada. (2017). Table  11-10-0232-01   Low income measure (LIM) thresholds by income source and household size
  27. Statistics Canada. (2017). Table 11-10-0232-01   Low income measure (LIM) thresholds by income source and household size

This item was last modified on December 4, 2020