A few days ago, the Saskatoon Poverty Reduction Partnership, an intersectoral approach to poverty spearheaded by the Saskatoon Health Region, released an update of its progress over the past three years on health equity among its residents, and its plan for the next five years. The approach taken by the Saskatoon Health Region serves as an example of how collaborative efforts can work to solve some of the harder social problems we face.At a recent Health Equity Forum hosted by Wellesley Institute, Dr. Cory Neudorf, Chief Medical Health Officer for Saskatoon Health Region, described the lessons learned over the past five years in his city.
Saskatoonians were appalled to find some of the highest levels of urban inequality in Canada were within their own neighbourhoods.Under Dr. Neudorf, the Health Region set about building a stronger evidence base. The result was the 2008 report, Health Disparity in Saskatoon: Analysis to Intervention, co-authored with Dr. Mark Lemstra. The report scanned over 10,000 articles for evidence-based policy solutions to the inequities identified. With further consultation, they were able to identify some concrete options for Saskatoon.Dr. Neudorf also worked with the Canadian Population Health Initiative and colleagues like Dr. David McKeown, Toronto’s Medical Officer of Health, and epidemiologist Dianne Patychuck to produce a cross-Canadian examination in the Reducing Gaps in Health: A focus on Socio-Economic Status in Urban Canada report. It was the first time the issue had been looked at nationally at such a small geographic level. (Around the same time, the Public Health Department in the City of Toronto produced a parallel report, The Unequal City, showing similar levels of disparity.)Three strategic directions emerged: a housing strategy, an employment strategy for Aboriginals, and a poverty-reduction strategy.
2. Build political will.
3. Work across sectors.
Because health disparities have roots in many other fields, they are “wicked problems,” as Wellesley’s Director of Policy Bob Gardner calls them, with no agreed solution and requiring multiple players. Dr. Neudorf explained this work has to be done in coalitions and partnerships – as evidenced by the 63 letters of support which lead off the 2008 report.Dr. Neudorf worked with the already-established Saskatoon Regional Intersectoral Committee to develop a community action plan on the range of social determinants of health. More focused community action groups emerged out of this plan.The City of Saskatoon, local school boards, and other regional agencies also launched a common data portal, CommunityView, to make data sharing among human service organizations easier and to improve community planning.As Saskatoon’s Medical Officer of Health, Dr. Neudorf also began to re-shape the delivery of public health services, building health equity audit tools. Low-income schools also became one of the new areas of intervention, despite some pushback from parents. Immunizations were also enhanced. Health programs underwent equity audits, identifying barriers to quality health care at both the patient and the service level.
Finally, the Region of Saskatoon formed the Poverty Reduction Partnership to develop a common plan, which has just been launched. Stakeholders are also exploring innovative ideas such as an idea incubator, with seed money from local philanthropists, to respond to some of the proposals coming forward. The work of the Saskatoon Poverty Reduction Partnership can be found at www.saskatoonpoverty2possibility.ca.