A consistent lesson from all those countries that have developed comprehensive strategies to tackle health disparities is that macro-level social and economic policies to reduce the pervasive inequality that underpins health disparities must be combined with local and community-based action. It is through well coordinated local initiatives that the roots and impact of health disparities can be addressed on the ground and that crucial services and resources can be targeted to those communities most badly affected. Regional Health Authorities across this country – and their equivalents in other countries – are a main way in which health care is planned and delivered at the local and regional level.
This means that building equity into regional health authority strategic priorities, resource allocation and service planning is a critical direction for acting on health equity. Here in Ontario, it is the Local Health Integration Networks (LHINs) that will need to develop effective local strategies to address health disparities.
Bob Gardner, Director of Policy , was appointed Special Advisor on Health Equity to the Toronto Central LHIN and seconded for a three-month period to develop a comprehensive equity strategy for them. He developed a broad 12-point action plan and many specific recommendations designed to address and reduce inequitable access to healthcare, effectively target programs and resources to disadvantaged communities, support cross-sectoral action and collaboration, and encourage system change and innovation to reduce health disparities in Toronto. The 2008 health equity strategic framework is availble at:
Health Equity Discussion Paper
Health Equity Discussion Paper – Executive Summary
To ground and inform this work, we commissioned research by prominent health analyst Denise Kouri on equity strategies and initiatives in leading RHAs across Canada.
- Building Equity Into Health Impact Assessment
The American-based Prevention Institute made a presentation to recent National Research Council deliberations on HIA. They argued that HIA aligns well with primary prevention or upstream action on the roots of ill health and health disparities, and with healthy community planning approaches to addressing the underlying determinants of health. [...]
- Comprehensive Community Initiatives: Lessons Learned, Potential and Opportunities Moving Forward
Do comprehensive, collaborative place-based initiatives to reduce poverty “work”? This was the question posed by the Tamarack Institute, Vibrant Communities Canada, and The J.W. McConnell Family Foundation at a very productive Strategic Dialogue held May 10-11, 2010. The Wellesley Institute was commissioned to review research and experience in this field. Our backgrounder Comprehensive Community Initiatives: Lessons Learned, Potential and Opportunities Moving Forward, was distributed to participants beforehand and discussed at the sessions. [...]
- Central LHIN Leaders’ Briefings: Building Health Equity into Action
One critical way to drive health equity is by building expectations and requirements into system and performance management. Several LHINs have required their partner service providers to develop health equity plans which identify vulnerable populations and access barriers, detail plans to address those challenges, outline initiatives underway addressing equity in service delivery, and set out priorities for the future. [...]
- Environmental Scan of research by community-based organizations within the Toronto Central LHIN
The Toronto Central LHIN commissioned an Environmental Scan from the Toronto Community-Based Research Network. This environmental scan: [...]
- Addressing Health Disparities in Regional Health Authorities
Commissioned by the Wellesley Institute, this research report examines equity strategies of regional health authorities (RHAs) across Canada. [...]
- Health Equity Roundtables Dialogue Highlights
The Health Equity Roundtables were held on December 5 and 6, 2007, hosted by The Wellesley Institute, Toronto, Ontario. Thirty five participants, bringing together service providers, policymakers, researchers and [...]
- Community Engagement and Regional Planning
Presentation by Bob Gardner, Director of Public Policy at the International Union for Health Promotion and Education in Vancouver. June 2007. [...]
