Chronic disease prevention and management is a key health priority for the Ontario government, as evidenced by a chronic disease framework and disease-specific strategies. And as the government looks to reign in health spending, we can expect an even greater focus on health promotion initiatives that reduce health care costs.
A new report released yesterday by Cancer Care Ontario and Public Health Ontario provides a blueprint for the government to take the next step in chronic disease prevention and management. The report argues that chronic diseases are the leading causes of death in Ontario and that many of these diseases are preventable with the right interventions and public policy. The report presents a range of options to prevent chronic diseases, including reducing tobacco use and alcohol consumption, improving physical activity and health eating opportunities, and building whole-of-government capacity to deal with chronic diseases.
None of this is new, but what is particularly encouraging is that the report includes an entire chapter on health equity. They note that people in less-advantaged situations – whether measured by income, education, socio-economic status, gender, race, or other forms of social inequality and exclusion – have poorer health outcomes and that this is avoidable. The report argues for improved data collection to adequately identify and assess disparities in exposure to risk factors and the burden of disease and for increased targeting of resources for health promotion initiatives for disadvantaged populations. (For more information on measuring equity, check out the MAgIC project in which the Wellesley Institute is participating).
The report also calls for Health Equity Impact Assessments (HEIA) to be conducted prior to program and policy implementation to identify the differential impacts of interventions on sub-populations. Moreover, the report applies the existing Ontario HEIA tool, which was developed in partnership with the Wellesley Institute, to its own recommendations to ensure an equitable impact on chronic disease prevention for disadvantaged populations.
HEIAs are proven to help make equitable program and policy decisions, and the Wellesley Institute advocates for the application of HEIAs to decision-making where inequities may exist , from health reform to social assistance reform to municipal budget decisions. We are very encouraged that Cancer Care Ontario and Public Health Ontario have challenged the government to use the Ontario tool to build equity into chronic disease prevention and management.
The Wellesley Institute has a range of tools and resources the guide users through conducting Health Equity Impact Assessments.