Pervasive and systemic differences in health by income, race, neighbourhood and other social determinants of health are increasingly well documented across the province. The need to reduce these disparities and enhance overall health equity is high on the agenda of the provincial government and many LHINs. Wellesley initiated a series of forums with community-based health and social service providers, researchers and others and commissioned research to flesh out what a community-based framework for health equity would look like.
The first roundtables were held over two days in December 2007. A backgrounder by Dr Michael Rachlis was sent out to all participants beforehand, he also made a presentation to facilitate discussion on the day, and Bob Gardner discussed provincial and LHIN interest in equity created significant windows of opportunity for community-based polity input.
A wide range of experience and expertise was represented and an equally wide range of tremendously valuable innovations and ideas were identified. The main theme was that there is a great deal of innovative and responsive service planning and delivery underway on the ground, and one key task of provincial and LHIN policy is to enable and build on this front-line innovation. A summary of these rich discussions was prepared by Margot Lettner, who facilitated the sessions.
Two directions arose out of these first roundtables, and a number of follow-up meetings and working sessions were held through the winter and spring of 2008. One was to sharpen the focus of the community-based innovation and initiatives that were identified in the first round. The goal was to identify some key directions that the Ministry and LHINs could pursue that would make a significant difference in enhancing health equity. Several more backgrounders were prepared to facilitate this ‘sharpening’ exercise; one on operationalizing health equity within the health system and a second on how to identify the most promising of the ideas generated at the December roundtables.
A further paper synthesizing key lines of action recommended by the roundtable participants was then developed and used to facilitate further sessions of the roundtable in June 2008. These ideas were worked up into briefing notes and presented to Ministry and LHIN policy makers.
The Roundtable further refined these issues in 2009 and a further more specific presentation was made to MOHLTC.
The second issue that arose during these roundtable was funding.