--Submitted by Gobinaa Manoharan, Product Development Advisor, Health Promotion Capacity Building, Public Health Ontario and Jason LeMar, Health Promotion Consultant – Alcohol Policy, Health Promotion Capacity Building, Public Health Ontario
A municipal alcohol policy (MAP) is a civic policy that aligns with provincial liquor laws and outlines the appropriate use of alcohol on local government owned or managed property.  The goal of a MAP is to encourage moderate, responsible alcohol consumption by changing the social norm and value placed on alcohol in a community. [2,3] The Ontario Public Health Standards outline the need to develop and implement healthy public policies that address issues such as alcohol.  In addition, the Prevention of Substance Misuse 2010 guidance document released by the Ministry of Health and Long-Term Care suggests that boards of health increase awareness of MAPs and improve or initiate the creation and implementation of a MAP.  The Framework for a Canadian National Alcohol Strategy (NAS) also provides recommendations to create safer communities using local alcohol policies. 
An environmental scan was conducted to gather information about the implementation of MAPs throughout the province of Ontario. The purpose of this article is to highlight some of the results received from this survey, specifically the status of MAPs across Ontario, the successes and challenges of implementing MAPs, and the community’s reaction to MAP development.
An on-line survey was developed and distributed to each public health unit in October 2014. It was requested that staff associated with the Low-Risk Alcohol Drinking Guidelines (LRADG) programming complete the survey, with one coordinated response submitted per public health unit. The survey was divided into three sections. The first section gathered information on the respondent; the number of years of experience the respondent had in public health; the department that best represented their work; and the number of people on their team. The second section captured the status of the MAPs in each municipality. Finally, the survey included a qualitative component to understand the various successes and challenges public health units have experienced in MAP development and the reaction from communities regarding MAPs.
A total of 32 of 36 public health units completed the survey, a response rate of 88.89%, with all regions of Ontario represented well.
According to the Ministry of Municipal Affairs and Housing there are 444 municipalities in Ontario.  Based on the survey results 236/444 (53.1%) municipalities had a MAP. Of the 236 MAPs, 41 (17.4%) MAPs were evaluated and 122 (51.7%) MAPs were developed with public health unit involvement.
For qualitative feedback the survey collected information about the respondents’ perspectives on the successes in MAP development, specifically what worked well, unintended effects and/or benefits, and new opportunities. The common themes around success in MAP development included:
- Public health unit involvement and collaboration with municipalities; various internal departments; other public health units; enforcement agencies; businesses; and credible partners.
- The use of MAP templates and resources.
- Conducting workshops and information sessions.
The second qualitative question investigated the respondents’ perspectives on the challenges in MAP development, specifically the barriers, unanticipated issues and implementation hurdles. The common themes around challenges in MAP development included:
- Lack of training/knowledge by public health unit and municipal staff and staff turnover.
- Collaborating with municipalities.
- Loss of revenue.
Finally the survey asked respondents to describe the types of community reaction and feedback to date on MAPs through media and community partners. The common themes around reaction to MAPs included:
- No reaction or lack of awareness on MAPs from the community.
- Mixed reaction: both positive and negative reactions within and/or between communities in public health units.
Positive reaction/feedback on MAPs: municipalities and communities were receptive to MAPs.
Based on the survey results, over half of Ontario municipalities have MAPs, however, only a small portion (17%) have been evaluated. Without evaluation data, it can be a challenge to provide positive case studies and models for implementing MAPs in the rest of Ontario.
A number of themes emerged from the qualitative responses. In terms of successes of MAP development, respondents identified that public health unit involvement and collaboration with other stakeholders was useful. Additionally, public health unit-led workshops and information sessions with municipalities were effective in introducing and revising MAPs. Workshops were also relevant to businesses that serve alcohol, such as golf courses. The use of existing MAP templates and resources from other organizations as well as resources created by public health units were also helpful in MAP development.
Despite the benefits of having public health unit involvement in MAP development, the results demonstrate that only about 50% of MAPs had public health unit involvement. Increasing public health unit involvement across Ontario may increase the number of MAPs implemented and evaluated.
Some challenges faced during the MAP development and implementation process include concerns from communities that MAPs lead to a loss of revenue. Other challenges that need to be addressed within public health include the lack of knowledge on MAPs by health unit staff, staff turnover and competing priorities with other public health topics.
The challenge of working with municipalities to develop and/or amend MAPs may be overcome by conducting information sessions, which was highlighted as a success to MAP development. Another opportunity that was mentioned was to raise awareness on the legal and liability issues which were important concerns for municipalities.
Many respondents were not aware of any community reaction or feedback regarding MAPs. Some respondents reported a mix of both positive and negative reactions to MAPs. For example one community was pleased with their MAP as the community experienced tragedy from alcohol misuse, whereas other communities were concerned they would lose tourist dollars. Thus more awareness of the benefits of MAPs is needed for communities to realize its purpose and worth.
This Provincial MAP Scan survey has provided high level data on the status of MAPs across municipalities in Ontario. The qualitative responses have highlighted a number of key areas of successes and challenges in MAP development. The results from this survey will be used to shape programming and future initiatives by relevant working groups and interested stakeholders.
To learn more about municipal alcohol policies, visit The Eight Steps for Developing a Municipal Alcohol Policy. http://www.publichealthontario.ca/en/eRepository/AtAGlance_Eight_Steps_A...
Making the Case: Tools for Supporting Local Alcohol Policy in Ontario was produced by the Centre for Addiction and Mental Health and Pubic Health Ontario. It aims to foster awareness about, and underscore the need for local action on alcohol-related harms, and support the development and implementation of local alcohol policies within communities across Ontario. http://www.publichealthontario.ca/en/eRepository/Making_the_Case_2013.pdf
The Municipal Alcohol Policy Guide is a practical resource for successfully managing drinking in recreational settings from the Centre for Addiction and Mental Health. http://www.camh.ca/en/education/about/services/camh_library/Documents/Re...
A Local Government Guide to Creating Municipal Alcohol Policy from the BC Ministry of Health in collaboration with BC Healthy Communities serves as a guide for local governments/First Nations in the planning of a municipal alcohol policy (MAP). A MAP helps local governments/First Nations manage alcohol facilities they own and manage, and reduces liability for alcohol-related problems. http://www.health.gov.bc.ca/library/publications/year/2012/creating-muni....
Framework for a Canadian National Alcohol Strategy is available at http://www.ccsa.ca/Resource%20Library/SecondForumReport_en.pdf.
B.C. Healthy Communities. A Local Government Guide to Creating Municipal Alcohol Policy - British Columbia. 2012 [cited 2014 August 5]. Available from: http://www.health.gov.bc.ca/library/publications/year/2012/creating-muni...
Douglas, R.R., Rylett, M., Narbonne-Fortin, C., & Gliksman, L. (1999). The evolution of municipal alcohol policy: Ontario 1980-1998. Municipal World, 109(7), 21-23.
DePape, D., Leonard, M., Pollet, G. Health Benefits of Municipal Alcohol Policy: A Role for Public Health. Public Health Branch, Ontario Ministry of Health. September 1995.
Government of Ontario. Ontario Public Health Standards 2008. Toronto, ON: MOHLTC.
Government of Ontario. Prevention of Substance Misuse Guidance Document 2010. Toronto, ON: MOHLTC.
National Alcohol Strategy Working Group. Reducing Alcohol Related Harm in Canada: Toward a Culture of Moderation – Recommendations for a National Alcohol Strategy. 2007.
List of Ontario Municipalities [Internet]. Queen's Printer for Ontario; 2014 [updated 2014 Oct 21; cited 2015 Jan 19]. Available from: http://www.mah.gov.on.ca/Page1591.aspx