This presentation highlights the factors driving and influencing a health equity agenda. Bob Gardner, Director of Policy www.wellesleyinstitute.com Follow us on twitter @wellesleyWI

1. Bob Gardner
Panel on Releasing Power Report:
Access Chapter
March 30, 2010
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2. • goal is to ensure equitable access to high quality healthcare
regardless of social position
• can do this through a two pronged strategy:
1. building health equity into all health planning and delivery
• doesn’t mean all programs are all about equity
• but all take equity into account in planning their services and
outreach
2. targeting some resources or programs specifically to addressing
disadvantaged populations or key access barriers
• looking for investments and interventions that will have the highest
impact on reducing health disparities or enhancing the
opportunities for good health of the most vulnerable
all of which needs good data = POWER
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3. • many speeches outlining health equity
frameworks:
• to define and show problem to be solved
• to LHINs, agencies and other stakeholders
• conferences, etc. e.g. speech last week to public
health professors and other leaders in Berlin
• community planning and other forums
• also to highlight complexity and inter-
dependence of SDoH
• e.g. food insecurity and chronic conditions data
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4. Success condition POWER provides
1. addressing health disparities in 2. and that requires solid actionable
service delivery and planning data
requires a solid understanding of:
• key barriers to equitable access to high
quality care
• the specific needs of health-
disadvantaged populations
4. which then highlights need for 3. e.g. data on how access to care varies
sophisticated analyses of the bases
of disparities: by:
• i.e. is the main problem language • length of time in Canada for
barriers, lack of coordination among
providers, sheer lack of services in immigrants
particular neighbourhoods, etc. • language group
• which requires good local research and
detailed information as well
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5. 1. Toronto Central and other
LHINs are implementing 2. POWER provides
• as key means of • solid actionable data
encouraging/enabling • by LHIN
equity-focused planning of • to support devel of best
specific programs HEIA process
• part of template is asking
for data and evidence to
support planned service
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6. 1. TC LHIN (and others) 2. POWER provides
• required Hospital Equity Plans • baseline data on inequitable
• major theme of our analysis outcomes and access – i.e.
the problem to be solved
of plans was to identify how
to build system where equity • can allow realistic targets to
be set, and locally relevant
is integrated into targets, indicators to be developed
requirements and incentives
• POWER will provide data on
of performance mgmt system progress on these indicators
• e.g. how does hospital • which can be incorporated
utilization match catchment
needs?
into SAAs
• is interpretation available to
• which can drive ongoing
match languages of monitoring
communities?
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7. identify key barriers POWER provides
2. can then drill down to see 1. data on inequitable access
what problem is: to care by:
• is it language barriers → • ethno-cultural background
inability to communicate with
and language
provider and understand
treatment • by income and SES
3. and then develop solutions:
• TC LHIN project to analyze
how to streamline
interpretation
• Sick Kids project to translate
key docs into many languages
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8. Diabetes for Prov and LHINs POWER provides
1. can’t succeed without 2. data on incidence by SDoH in
understanding where each LHIN → can identify
diabetes is concentrated most vulnerable populations
and which 4. allows development of equity
populations/communities targets and indicators:
are most at risk • not just overall reduction in
incidence
3. once identified, then need • reducing differences in
to develop programs that incidence and impact by
take SDoH/particular social neighbourhood
conditions into account 5. then can monitor progress
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9. Healthy behaviour POWER provides
1. major provincial and LHIN 2. differences in healthy
behaviour and risk factors by:
priority – esp. implications • income
for CDPM • ethno-cultural
3. up-stream health 4. need to customize health
promotion programs to take
promotion, empowering underlying SDoH inequalities
people to life well, chronic into account
disease prevention and • universal programs will make
inequities worse unless they
maintenance are crucial take unequal SDoH into
account (better off take up
health promotion program at a
higher rate – benefit more)
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10. • these speaking notes and further resources on
policy directions to enhance health equity, health
reform and the social determinants of health are
available on our site at
http://wellesleyinstitute.com
• my email is bob@wellesleyinstitute.com
• I would be interested in any comments on the ideas
in this presentation and any information or analysis
on initiatives or experience that address health
equity
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11. The Wellesley Institute advances urban health through rigorous research,
pragmatic policy solutions, social innovation, and community action.
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