LHINs do have considerable powers and they have the potential to develop effective partnerships with providers to operationalize equity. One lever that has proven effective in several LHINs is having hospitals and/or community service providers develop health equity plans to guide their organizations.
The 18 hospitals in Toronto Central developed comprehensive health equity plans in 2008. See the extremely useful analysis led by Sanjeev Sridharan of the Centre for Research in Inner-City health. These plans were refreshed in 2010. In both cases, templates were developed that other LHINs could adapt.
Central LHIN also had their hospitals do equity plans; priorities identified in the plans were then reported on quarterly. Central went on in 2009-10 to have all other providers undertake plans. Bob Gardner conducted a workshop on health equity for community providers in Central LHIN who were developing their equity plans.
An interesting variant came up in recent conversations with another LHIN: enabling provider coordinating or planning networks or committees to do equity plans for the cluster of services or sector as a whole.
This links to notes on the potential of requiring provider equity plans and other levers LHINs can use to build equity into the system.