There are profound and systemic differences in how healthy people are and how long they live in all rich countries. The fundamental roots of these health disparities lie in social and economic inequality – the effects of inadequate housing, poverty, employment barriers, social exclusion and other broader social determinants of health. Another key factor is inequitable access to health care.
Many countries have developed comprehensive policies and programs to tackle health inequality, and community-based providers across Canada and around the world are working hard to address health disparities on the ground. This page sets out the kinds of policy changes needed to address health disparities and links to innovative policy, research and other resources on health equity from many jurisdictions.
- Ontario doctors call for an end to three-month wait for OHIP
In earlier posts, I argued that the province should not implement policies that directly – and knowingly – make health disparities worse. Requiring new immigrants and others to wait three months for OHIP coverage is just such a policy. [...]
- Implementing Mental Health Equity in Hospitals
Mental health is a crucial part of health and health equity. I presented to Grand Rounds Psychiatry at a Toronto academic hospital on how to build equity into planning and delivering high-quality psychiatric treatment. [...]
- Driving health equity into action: Bob Gardner at Ryerson Conference
Policy makers, community partners, scholars, and students explored the challenges and issues surrounding a more equitable Canada last Saturday. The Wellesley Institute’s Bob Gardner gave a keynote speech arguing that health equity can be realized, and outlined a roadmap with the strategies, tools, policy changes and community mobilization needed to make it happen. [...]
- Building Equity Into Health Reform: Innovative Primary Care
Two success conditions for equitable reform of the healthcare system are to increase access to high-quality primary care, especially for the most health disadvantaged populations, and to build on the potential of the many effective front-line and community-based innovations addressing the impact of health disparities across the country. A very interesting recent report from the Canadian Health Services Research Foundation entitled Picking Up the Pace: How to Accelerate Change in Primary Healthcare speaks to both vital directions. It is a Casebook of Primary Healthcare Innovations with concrete and insightful examples of enhancing access; addressing the needs of specific populations such as Aboriginal, isolated and hard-to-reach communities; mental health care; meeting complex needs; multi-disciplinary care; and organizational reform. The project looked for cases that enhanced primary care, were showing promise or evidence of immediate and population health impact, could be successfully scaled up, could be sustainable and would be relevant in many regions. Their theme was to share success and learn from challenges. Wellesley has published earlier papers on the equity impact of enhanced primary care. This report helps to show how this potential can be achieved.
- Rising Physician and Drug Costs Through an Equity Lens
The latest Canadian Institute for Health Information report on health care expenditures highlighted that hospitals, drugs and doctors are the largest components of overall spending. Spending has been increasing fastest in physician services and drugs. Some media discussion has correctly highlighted how the incentives built into fee-for-service payment – to see as many patients as quickly as possible — and drug manufacturing and prescription patterns have huge quality implications. At the same time, these funding patterns have equally critical adverse effects on equity. [...]
- Building Equity In: Hospital Planning and Service Delivery
Hospitals are a vital part of the health care system. Some hospitals have developed equity plans and made strong commitments to meeting the needs of health disadvantaged populations, and ensuring equitable access and quality in their services and within their organizations; others less so. This is a short briefing note on pressures hospitals will be facing to incorporate equity within quality improvement and other priorities, and some tools and mechanisms hospitals can adapt to effectively build equity in. [...]
- Health Equity Impact Assessment Into Action: Home Care
Equity-focussed planning is an essential ingredient of comprehensive health equity strategies. Ontario has been developing and implementing a Health Equity Impact Assessment model and Wellesley has presented a number of workshops on how to realize the potential of HEIA. Each of these workshops uses different case studies to work through the model, geared to the particular audience. [...]
- Health as an Equity Issue – and as a Union Issue
I was really pleased to speak at an OPSEU symposium on equity over the weekend. Unions have long played a central role in the broad community coalitions that are so vital to addressing the underlying social determinants of health inequalities. And OPSEU and other union members work on the front-lines of health and are vital players in the innovative solutions needed to build equity into all service delivery and planning. [...]
- Advancing Health Equity in Tough Times
There is a serious chill within governments at all levels as the economy has declined and public finances have become constrained. This policy briefing sets out how to keep equity high on the agenda in the current fiscal climate.
- One Lever To Drive Health Equity Into Practice: Hospital Equity Plans
I’ve been working on pulling together various tools and resources to help policy makers and planners put health equity into practice — stay tuned here. One lever several LHINs have used is to have their partner hospitals do health equity plans. I looked again at this really useful analysis led by Sanjeev Sridharan of the hospital plans done within Toronto Central LHIN. This process proved very successful at mobilizing discussion and coordination within their organizations, and sharing experience across the system. The hospitals are now developing their second generation plans.
- Health Policy ‘Zombies’: One More Time
UBC health economist Bob Evans famously called arguments that Medicare is unsustainable or that we therefore need privatization zombies: meaning that these ideas are constantly refuted by all the evidence, yet they keep being raised again and again. Of course, that is because there are powerful interests driving these ideas. Economist Hugh Mackenzie and health policy consultant Dr Michael Rachlis have done an excellent analysis of how Medicare and a universal health system is sustainable and how the real answers to the pressures facing the system are better policy and management. They highlight that this debate is essentially political; that the fiscal pressures on health and other sectors come from government decisions to cut taxes and services, as opposed to inherent trends within the health system. They point the way forward: improved planning and management of care will control costs; service and organizational reforms can drive better quality care; enhanced primary care, health promotion and prevention can keep people well; and seeing all this as part of a comprehensive and integrated Second Stage of Medicare will underlie a vision of good health and well-being for all.
- Health Equity: Pushing the Boundaries
The theme of the Association of Ontario Health Centre’s annual conference was building equity and diversity into the core of community-based primary care and health promotion. I set out a broad framework on how to drive health equity into action through comprehensive strategies and clear priorities, putting these goals into practice through good planning and resource allocation, [...]
- Health Equity Strategy Into Action for Public Health
The Ontario Agency for Health Protection and Promotion has a vital role in supporting an innovative and effective public health system. The Agency has highlighted equity in its strategic priorities. I presented a workshop there on how to build equity into practice through planning, priority setting, resource allocation and performance management, and how health promotion can be approached through an equity lens. [...]
- Why Hospitals Need to Build Health Equity In
I was speaking to a hospital board member about the challenges of hospitals building health equity into their planning and service delivery. Some hospitals have shown significant leadership in prioritizing health equity and identifying ways their services can address health disparities and access barriers; others less so. I think there are five key arguments to hospital boards that have not sufficiently prioritized equity on why they need to act. [...]
- Health Equity Roadmap: Community Health Days
Equity is being emphasized in many Community Health Days organized across the province by Community Health Centres and other local partners. I spoke at the Kitchener day whose focus was on mobilizing for health equity for immigrant and refugees. I set out an overview of how to build health equity strategy, priorities and tools into action. [...]
