A consistent lesson from all those countries that have developed comprehensive strategies to tackle health disparities is that macro-level social and economic policies to reduce the pervasive inequality that underpins health disparities must be combined with local and community-based action. It is through well coordinated local initiatives that the roots and impact of health disparities can be addressed on the ground and that crucial services and resources can be targeted to those communities most badly affected. Regional Health Authorities across this country – and their equivalents in other countries – are a main way in which health care is planned and delivered at the local and regional level.
This means that building equity into regional health authority strategic priorities, resource allocation and service planning is a critical direction for acting on health equity. Here in Ontario, it is the Local Health Integration Networks (LHINs) that will need to develop effective local strategies to address health disparities.
Bob Gardner, Director of Policy, was appointed Special Advisor on Health Equity to the Toronto Central LHIN to develop a comprehensive equity strategy. He produced a broad 12-point action plan and many specific recommendations designed to address and reduce inequitable access to healthcare, effectively target programs and resources to disadvantaged communities, support cross-sectoral action and collaboration, and encourage system change and innovation to reduce health disparities in Toronto. The 2008 health equity strategic framework is availble at:
To ground and inform this work, we commissioned research by prominent health analyst Denise Kouri on equity strategies and initiatives in leading RHAs across Canada.