Scott Wolfe prepared a powerful paper for Wellesley showing how primary care can make a crucial contribution to meeting the needs of vulnerable populations and advancing overall health equity.  He also highlights how improved primary and other health care needs to be supplemented by pharmacare, access to dental services, health promotion and other up-stream investment to keep people well and prevent illness.  This is the Second Stage of Medicare always envisioned by its founders and is crucial to achieving health equity.

The two policy briefs, Access to Health and Social Services and Impacts of the Physical Environment, are based on the findings from our qualitative research work with newcomer immigrants of St. James Town.  The briefs provide suggestions for the government to invest in and enhance immigrant integration and to support better health and wellbeing of newcomer immigrants.

Report: Exploring the Link Between Neighbourhood and Newcomer Immigrant Health

Policy Brief: Availability and Access to Health and Social Services

Policy Brief: Impacts of the Physical Environment on Health and Wellbeing

Tamarack has developed a Strategic Dialogue web page which contains the documents and presentations shared with participants in advance of the Strategic Dialogue.

In addition, Anne Makhoul, Principal Project Officer, Caledon Institute of Social Policy and Eric Leviten-Reid, Coordinator, Evaluation and Learning, Vibrant Communities Canada were tasked with observing and writing about the Strategic Dialogue. They have written two reports – a longer story about the event and a two page overview which can also be found on the web page .

Principal Organizations: Ryerson University

Investigators: Dr. Sepali Guruge, Dr. Parvathy Kanthasamy

Participants: Older Tamil immigrant women

Research Methods: Interviews and focus groups

Participatory Program Evaluation (PPE) is a model that provides an opportunity to build an agency’s capacity to incorporate evaluation into its daily activities, engage a diverse range of stakeholders, and ensure that it is providing the most effective services for its clients.

The Paloma Foundation and Wellesley Institute partnered to produce this Guide on Participatory Program Evaluation to support non-profit service organizations.  It is the result of two years of extensive research into the theory and practice of Participatory Program Evaluation.  It has been tested in small, medium and large organizations.

The process has proven to be flexible, adaptable and evidence-based.  At the same time, it easy to use by both experienced evaluators and beginners to the process.

The prime focus of Working Together: The Paloma– Wellesley Guide to Participatory Program Evaluation is on building program excellence — a key step in creating positive social impact.

If you have questions, suggestions or feedback about this Guide, email info@palomafoundation.ca and write “Participatory Program Evaluation” in the subject line.

Investigators: Nora Jacobson, Deqa Farah and Cultural Diversity Community of Practice

Participants: Mental health service users and family members in the Caribbean, Somali, and Tamil communities in Toronto

Research Methods: Focus groups

In the mental health field, the word “recovery” has gained popular currency but its exact meaning – and relevance – for different people and cultures has not always been clarified.  Equitable and responsive policies and services need to be informed by the diverse communities they serve in order to be effective.  This report describes what recovery means from the perspectives of three cultural groups: Caribbean, Somali and Tamil and, in so doing, suggests how a culturally-responsive model of recovery can help mental health organizations meet the needs of Toronto’s multicultural population.

Key Recommendations

1. Implement the affordable housing strategy component of Vision 2020, a comprehensive provincial social economy strategy, by

   • maintaining existing housing commitments
   • strengthening the operational capacity of the Ontario Ministry of Municipal Affairs and Housing
   • strengthening the technical capacity of Ontario’s affordable housing sector
   • increasing capital funding for new affordable homes

   Estimated cost: $289 million

2. Make the initial investments in a Health Equity Innovation Fund, that will support far-sighted planning and effective service interventions to address the adverse impacts of health disparities through

   • equity driven consumer health services
   • evaluation follow-up
   • knowledge transfer programs

   Estimated cost: $43 million

3. Support innovation and enhance capacity in Ontario’s vital community sector by

   • maintaining existing funding commitments
   • moving forward with a more comprehensive agenda for the third sector (as set out in the province’s Poverty Reduction Strategy of 2008)
   • providing initial capitalization for a social innovation fund for necessary initial seed capital for triple-bottom-line social entrepreneurs.

   Estimated cost: $30 million

To date, community-based researchers have used a range of participatory research methodologies such as photovoice and concept mapping to explore the relationships between neighbourhood characteristics (physical, social, environmental, and economic) and health and wellbeing. However, the use of multiple participatory methodologies to fully involve disadvantaged populations in the process of collecting, organizing, consolidating and interpreting data in meaningful ways has received much less attention.

The results of this study highlight the complementary nature of CBPR approaches, photovoice and concept mapping. The sequential integration of the results from the photovoice project with concept mapping extended the findings by systematically and rigorously building a consensus framework of health impacting factors in the St. James Town neighbourhood.

Download reporthere

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Throughout the course of the St James Town Initiative, residents have expressed several challenges that they face on a daily basis. Many of the neighbourhood’s issues can be solved by innovative and targeted policy interventions at all three levels of government.  The city, provincial, and federal governments all have important roles to play in the improvement of the community and in addressing the social determinants of health.  In a new series of policy briefs, the Wellesley Institute’s Matt Kanter analyzes specific challenges for residents of St James Town – immigrant employment , language training , and the improvement of living conditions – and sets out clear and achievable recommendations for policy action.

Published: November, 2007

Summary: Health equity is high on the agenda of governments and health planning authorities. Wellesley initiated a series of forums with community-based health and social service providers, researchers and others and commissioned research to flesh out what a community-based framework for addressing health disparities would look like.

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