History

Public health units have been an integral part of the health care delivery system of this province for over 50 years. While 1945 is often thought of as the year of the inception of health units in Ontario, this was simply an important milestone.

The pattern of local public health services administration for Ontario was established in 1833 when the Legislature of Upper Canada passed an Act allowing local municipalities "to establish Boards of Health to guard against the introduction of malignant, contagious and infectious disease in this province." This delegation of public health responsibility to the local level, established 150 years ago has persisted to the present day.

Important Milestones
Year	Event
1873
1882	The first board health was established
1884	A more comprehensive Public Health Act, was prepared by Dr. Peter B. Bryce. This Act established the position of the medical officer of health and the relationship with the board of health. Within two years of passage, 400 boards of health were in operation.
1912	Public Health Act was amended so that health units could be established on a county-basis.
1934	The first county-wide health unit was established with a grant from the Rockefeller Foundation. It included the four eastern counties of Stormont, Dundas, Glengarry, and Prescott. At this time, Ontario had 800 local boards of health and 700 medical officers of health, most of whom were part-time.
1945	The Public Health Act was amended so that provincial grants could be provided to municipalities for the establishment of health units. Six health units were in place by the end of 1945.
1950	25 county and 12 municipal health units were in place which served two thirds of the population of Ontario.
1965	54 boards of health were in place, which served 95% of the population.
1967	The Public Health Act was amended so that organized municipalities were required to provide full-time public health services. The District health unit concept was introduced based on the collective experience of operating health units in Ontario. Economies of scale concepts were introduced which suggested optimum population sizes for health unit catchment areas. The province encouraged health units to regroup on a multi-county basis to become more efficient.
1983	The Health Protection and Promotion Act was proclaimed.
1997	The Health Protection and Promotion Act was revised as part of Bill 152, the Services Improvement Act.
1998	Municipalities in Ontario assume 100% funding of public health services as a result of the province’s decision to transfer funding responsibility to the local level.
1999	Public health once again becomes a shared responsibility and is funded 50% by municipalities and 50% by the province. Presently there are 37 health units in place: 27 county-district health units; 9 regional health departments; and 1 amalgamated city (Toronto).