Pervasive and systemic differences in health by income, race, neighbourhood and other social determinants of health are increasingly well documented across the province. The need to reduce these disparities and enhance overall health equity is high on the agenda of the provincial government and many LHINs. 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 health equity would look like.
The Roundtables
The first roundtables were held over two days in December 2007, and the following report and presentation were shared with all participants:
- Delivering Equity: Community-Based Models for Access and Integration in Ontario’s Health System by Dr. Michael Rachlis, November 2007.
- Health and Equity: What Can the Health Care System do? Presentation by Dr. Michael Rachlis, with discussion regarding provincial and LHIN interest in equity by Dr. Bob Gardner, December 2007.
A wide range of experience and expertise was represented and an equally wide range of tremendously valuable innovations and ideas were identified. The main theme was that there is a great deal of innovative and responsive service planning and delivery underway on the ground, and one key task of provincial and LHIN policy is to enable and build on this front-line innovation.
For a summary of the roundtable discussions held in December download Health Equity Roundtables Dialogue Highlights – December Sessions by the roundtables facilitator Margot Lettner
Key Directions
Two key directions arose out of these first roundtables, and a number of follow-up meetings and working sessions were held through the winter and spring of 2008.
A) Ministry and LHINs
One of our goals is to identify some key directions that the Ministry and LHINs could pursue that would make a significant difference in enhancing health equity. Several more backgrounders were prepared to facilitate this ‘sharpening’ exercise at the February:
- Operationalizing health equity within the health system
- How to identify the most promising of the ideas generated at the December roundtables, Health Equity Working Session, February 28, 2008 – Backgrounder
- Health Equity Now: A Working Paper on the Best First Steps for Ontario , synthesizing key lines of action recommended by the roundtable participants, has been developed and used to facilitate further sessions of the roundtable in June 2008. These ideas will be worked up into briefing notes and presented to Ministry and LHIN policy makers.
B) Funding
The second issue that arose during these roundtable was funding.
There was considerable concern among community-based providers and researchers that the new HBAM (Health-Based Allocation Model) being developed within MOHLTC to allocate funds to the LHINs would not adequately take account of health disparities, the tremendous diversity of the Ontario population and the challenging and complex health needs of disadvantaged communities.
- Health Equity and Ontario’s Health Based Allocation Model backgrounder prepapred by Dr. Michael Rachlis was prepared to facilitate February Roundtable meetings and was presented at a meeting between Dr. Rachlis , Bob Gardner, and key Ministry officials leading the HBAM work.
- Ontario’s Health-Based Allocation Model through an equity lens is a second updated backgrounder by Dr Rachlis and Bob Gardner on possible changes to HBAM and directions for the future that would build equity into founding formulae more effectively was also produced
