Bob Gardner's blog http://wellesleyinstitute.com/blog/2837/atom/feed 2007-08-01T09:11:33-07:00 Indicators to Measure the Health of a Community http://wellesleyinstitute.com/indicators-measure-health-community 2008-07-09T13:57:46-07:00 2008-07-09T13:57:46-07:00 Bob Gardner In June 2008 the Canadian Policy Research Network and Ontario Trillium Foundation held a roundtable of government and business leaders on indicators to measure and help guide planning for healthy and vibrant communities. A useful primer and range of presentations have been published.

]]> In June 2008 the Canadian Policy Research Network and Ontario Trillium Foundation held a roundtable of government and business leaders on indicators to measure and help guide planning for healthy and vibrant communities. A useful primer and range of presentations have been published.

It is certainly vital that there is widespread community discussion of the kinds of indicators needed to adequately reflect the incredible diversity and challenges of current populations, and help shape planning and monitor progress on reducing health disparities, reducing poverty, enhancing the social resilience of communities, enhancing health opportunities and outcomes for particular disadvantaged populations and other key objectives. Experience has not always been productive: community service providers have to report an enormous amount of data to government and other funders, and the data has seldom been used to actually monitor progress and guide planning. In policy development terms, the search for perfect data and indicators can delay actually moving on key areas where there is clear consensus. Nonetheless, this is a vital issue: communities, service providers and funders all want to be able to assess what kinds of interventions work most effectively and to know that their activities are making a difference. This roundtable provides useful material for this key challenge.

]]> OMA on Health and Poverty http://wellesleyinstitute.com/oma-health-and-poverty 2008-07-02T05:16:05-07:00 2008-07-02T05:16:05-07:00 Bob Gardner The Ontario Physicians Poverty Work Group are publishing a very useful series of three articles on the links between poverty and health on the Ontario Medical Association web site. The articles are by local physicians and members of Health Providers Against Poverty, public health leaders and Wellesley Associate Michael Rachlis, and provide excellent overviews of the adverse impact of poverty on health and what physicians can do to mitigate the worst health effects of poverty.

Further information on Health Providers Against Poverty’s research, advocacy and education activities can be found on its web site.

]]> The Ontario Physicians Poverty Work Group are publishing a very useful series of three articles on the links between poverty and health on the Ontario Medical Association web site. The articles are by local physicians and members of Health Providers Against Poverty, public health leaders and Wellesley Associate Michael Rachlis, and provide excellent overviews of the adverse impact of poverty on health and what physicians can do to mitigate the worst health effects of poverty.

Further information on Health Providers Against Poverty’s research, advocacy and education activities can be found on its web site.

]]> Public Health Consultation on the Social Determinants of Health http://wellesleyinstitute.com/public-health-consultation-social-determinants-health 2008-06-11T06:32:26-07:00 2008-06-11T06:32:26-07:00 Bob Gardner In March 2007, the Public Health Agency of Canada, supporting Canadian involvement in the World Health Organization Commission on Social Determinants of Health, held a consultation with civil society organizations on how to move a social determinants of health agenda forward. I participated on behalf of the Wellesley Institute. Key challenges were identified:

]]> In March 2007, the Public Health Agency of Canada, supporting Canadian involvement in the World Health Organization Commission on Social Determinants of Health, held a consultation with civil society organizations on how to move a social determinants of health agenda forward. I participated on behalf of the Wellesley Institute. Key challenges were identified:

  • public policy discourse that focuses only on economic growth and efficiency is too restricted to accommodate SDoH approaches
  • limited public awareness of the impact of social determinants, and
  • how to build a case for investment in SDoH

Prevailing themes in the discussions were the importance of comprehensive coordinated polices across social, economic, education, health and other key spheres that address SDoH, the need for governments to develop far better cross-sectoral collaboration and to get beyond departmental and jurisdictional silos, simpler clearer language to promote SDoH, and building on the many community-based initiatives that take broad SDoH approaches.

Download the full consultation report, or for more information on the Social Determinants of Health visit our collection of the WHO's SDoH Knowledge Networks.

]]> Health Promotion with Policy Impact http://wellesleyinstitute.com/health-promotion-policy-impact-0 2008-05-27T12:42:01-07:00 2008-05-27T12:43:32-07:00 Bob Gardner I developed and presented a workshop on health promotion with policy impact to the annual Health Promotion Ontario conference. It was designed to help people in various health promotion positions and sectors make a strong case for needed programmes, research and innovation to policy makers. The workshop focussed on how to identify the policy implications of the projects they were working on, translate these initiatives into ‘policy speak’ with cost-benefit, risk assessment, options and concrete recommendations and ‘asks’, and effectively present and promote their cases to decision makers.

Health Promotion with Policy Impact by Bob Gardner

]]> I developed and presented a workshop on health promotion with policy impact to the annual Health Promotion Ontario conference. It was designed to help people in various health promotion positions and sectors make a strong case for needed programmes, research and innovation to policy makers. The workshop focussed on how to identify the policy implications of the projects they were working on, translate these initiatives into ‘policy speak’ with cost-benefit, risk assessment, options and concrete recommendations and ‘asks’, and effectively present and promote their cases to decision makers.

Health Promotion with Policy Impact by Bob Gardner

]]> Diabetes Planning Through an Equity Lens http://wellesleyinstitute.com/diabetes-planning-through-equity-lens 2008-05-26T04:26:24-07:00 2008-07-02T09:53:16-07:00 Bob Gardner Wellesley Board member Jan Campbell, in her capacity as a consultant to the Greater Toronto CHC Network, and Bob Gardner, Director of Policy and Research, along with Lynne Raskin, ED of South Riverdale CHC, and Laura Cowan, ED of Street Health, facilitated a workshop on applying the urban health framework developed by the GT CHCs to planning diabetes. It was part of a daylong conference sponsored by the Ontario Hospital Health Promotion Network and St Joseph’s Health Centre on Working Together to Prevent and Manage Chronic Disease held May 23, 2008 in Toronto. The goal of the workshop was to demonstrate and refine the urban health framework as a tool to better plan and coordinate community-based initiatives and innovation addressing chronic conditions, especially for disadvantaged populations. Bob’s notes on Diabetes Planning Through an Equity Lens were part of setting the context for the workshop, which worked through planning for diabetes and vulnerable populations such as homeless people and newcomers.

Diabetes Planning Through an Equity Lens

]]> Wellesley Board member Jan Campbell, in her capacity as a consultant to the Greater Toronto CHC Network, and Bob Gardner, Director of Policy and Research, along with Lynne Raskin, ED of South Riverdale CHC, and Laura Cowan, ED of Street Health, facilitated a workshop on applying the urban health framework developed by the GT CHCs to planning diabetes. It was part of a daylong conference sponsored by the Ontario Hospital Health Promotion Network and St Joseph’s Health Centre on Working Together to Prevent and Manage Chronic Disease held May 23, 2008 in Toronto. The goal of the workshop was to demonstrate and refine the urban health framework as a tool to better plan and coordinate community-based initiatives and innovation addressing chronic conditions, especially for disadvantaged populations. Bob’s notes on Diabetes Planning Through an Equity Lens were part of setting the context for the workshop, which worked through planning for diabetes and vulnerable populations such as homeless people and newcomers.

Diabetes Planning Through an Equity Lens

]]> Blueprint for Action on the Social Determinants of Health and Health Equity http://wellesleyinstitute.com/blueprint-action-social-determinants-health-and-health-equity-0 2008-05-14T14:26:42-07:00 2008-05-14T14:26:42-07:00 Bob Gardner I recently presented to a Portuguese-Canadian National Congress action meeting on health. They were discussing the Viva! Health Project, really interesting research on the health situation and challenges of the Portuguese communities. My role was to set the context for this discussion by outlining the social determinants of health that underlie health disparities. But I also wanted to set out some lines of policy and community action that can be taken to address these determinants and disparities.

Blueprint for Action on the Social Determinants of Health and Health Equity

]]> I recently presented to a Portuguese-Canadian National Congress action meeting on health. They were discussing the Viva! Health Project, really interesting research on the health situation and challenges of the Portuguese communities. My role was to set the context for this discussion by outlining the social determinants of health that underlie health disparities. But I also wanted to set out some lines of policy and community action that can be taken to address these determinants and disparities.

Blueprint for Action on the Social Determinants of Health and Health Equity

]]> The Last Straw! A Board Game on the Social Determinants of Health http://wellesleyinstitute.com/last-straw-board-game-social-determinants-health 2008-04-30T06:32:36-07:00 2008-05-14T13:23:13-07:00 Bob Gardner The Last Straw! A Board Game on the Social Determinants of Health, co-funded by the Wellesley Institute, is a fun way for players to learn how the daily life cycles and social conditions of individuals and communities can affect health and illness – think ‘Monopoly’ with social conscience and analysis. The Last Straw! shows how "macro" issues such as political climate, economic structure and environmental change, and "micro" issues, such as individual finances, education, and family dynamics, shape the health of both individuals and communities. It’s a tremendous health promotion tool and has been successfully used to facilitate learning on social determinants of health in practice in many settings.

Visit the Last Straw! for more information.

]]> The Last Straw! A Board Game on the Social Determinants of Health, co-funded by the Wellesley Institute, is a fun way for players to learn how the daily life cycles and social conditions of individuals and communities can affect health and illness – think ‘Monopoly’ with social conscience and analysis. The Last Straw! shows how "macro" issues such as political climate, economic structure and environmental change, and "micro" issues, such as individual finances, education, and family dynamics, shape the health of both individuals and communities. It’s a tremendous health promotion tool and has been successfully used to facilitate learning on social determinants of health in practice in many settings.

Visit the Last Straw! for more information.

]]> Planning Resources on Community Health and Development http://wellesleyinstitute.com/planning-resources-community-health-and-development 2008-04-23T08:56:26-07:00 2008-04-23T08:56:26-07:00 Bob Gardner The KU Work Group on Community Health and Development provides a range of useful planning resources on community development as one crucial direction for improving population health and addressing health inequities. Established in 1975, it was designated by the World Health Organization as a WHO Collaborating Centre in 2004 Its core values and assumptions are:

]]> The KU Work Group on Community Health and Development provides a range of useful planning resources on community development as one crucial direction for improving population health and addressing health inequities. Established in 1975, it was designated by the World Health Organization as a WHO Collaborating Centre in 2004 Its core values and assumptions are:

  1. Building healthy communities involves improving conditions and outcomes for the health and well-being of the population as a whole.
  2. This requires changing conditions, including environmental and policy conditions, that affect behaviors and related outcomes.
  3. Since health and human development outcomes are caused by multiple and interconnected factors, single interventions are likely to be insufficient.
  4. Since environmental influences occur in different contexts, collaborative efforts must bring about changes in multiple sectors and systems.
  5. Local people, including those most affected, should be active participants in changing local conditions.
  6. Justice requires health and well being for all, including for marginalized groups that have different exposures, vulnerabilities, and consequences related to their situations.
  7. To improve health for all requires addressing broader social determinants, such as social inclusion, income equality, and efficacy or the ability to have influence on conditions.
  8. Collaborative partnerships act as catalysts for change; they convene key parties, broker relationships, and leverage needed resources.
  9. The aim of support organizations is to build capacity to address what matters to people over time and across concerns.
  10. Community health and development involves interdependent relationships among multiple parties in which none can function fully without collaboration with others.

The Work Group's Community Tool Box (CTB) is the world's largest resource (over 7,000 pages of content) for building capacity for community health and development. They also publish many guidelines and tool kits for health planning and community development, and provide links to a range of articles and reports.

]]> Addressing Health Disparities through Community Engagement http://wellesleyinstitute.com/addressing-health-disparities-through-community-engagement 2008-04-22T05:41:27-07:00 2008-04-22T05:41:27-07:00 Bob Gardner One precondition for successfully addressing health disparities is to build on local community-based initiatives and on the needs and perspectives of local residents. Incorporating the views, experience and priorities of residents, especially from the most disadvantaged and marginalized communities, into planning and resource allocation processes is vital to regional health planning and delivery that can effectively focus on health disparities. Diversity and equity-driven community engagement is one vital enabler of successful local and regional action on health equity.

Here are two interesting resources. The first is a recent handbook from CPRN (the Canadian Policy Research Network) on citizen engagement. It reviews several health examples, including the extensive community engagement strategy developed by Vancouver Coastal Health.

The British health research and knowledge exchange foundation NICE conducted a systematic review of the impact of community engagement on addressing social determinants of health in 2007.

]]> One precondition for successfully addressing health disparities is to build on local community-based initiatives and on the needs and perspectives of local residents. Incorporating the views, experience and priorities of residents, especially from the most disadvantaged and marginalized communities, into planning and resource allocation processes is vital to regional health planning and delivery that can effectively focus on health disparities. Diversity and equity-driven community engagement is one vital enabler of successful local and regional action on health equity.

Here are two interesting resources. The first is a recent handbook from CPRN (the Canadian Policy Research Network) on citizen engagement. It reviews several health examples, including the extensive community engagement strategy developed by Vancouver Coastal Health.

The British health research and knowledge exchange foundation NICE conducted a systematic review of the impact of community engagement on addressing social determinants of health in 2007.

]]> Reducing Health Inequities through Better Health Promotion http://wellesleyinstitute.com/reducing-health-inequalities-through-better-health-promotion 2008-04-18T08:46:40-07:00 2008-04-18T12:58:12-07:00 Bob Gardner The Victorian Health Promotion Foundation in the state of Victoria, Australia has recently released an outline on reducing health inequities through better health promotion. People, Places, Processes: Reducing Health Inequalities Through Balanced Health Promotion Approaches provides a a good overview of the health equity lens, and elements of a strategic framework, analytical review and workbook / planning tool for health promotion approaches.

VicHealth is close to an Agency, Board or Commission in Ontario terms, was originally established as part of anti-smoking initiatives and is governed by a board appointed by the Minister of Health that also includes Members of Parliament. Reducing health inequalities is one of their program priorities.

]]> The Victorian Health Promotion Foundation in the state of Victoria, Australia has recently released an outline on reducing health inequities through better health promotion. People, Places, Processes: Reducing Health Inequalities Through Balanced Health Promotion Approaches provides a a good overview of the health equity lens, and elements of a strategic framework, analytical review and workbook / planning tool for health promotion approaches.

VicHealth is close to an Agency, Board or Commission in Ontario terms, was originally established as part of anti-smoking initiatives and is governed by a board appointed by the Minister of Health that also includes Members of Parliament. Reducing health inequalities is one of their program priorities.

]]> Health Disparities, Neighbourhoods, and the UK Experience http://wellesleyinstitute.com/health-disparities-neighbourhoods-and-uk-experience 2008-02-15T13:10:40-08:00 2008-02-15T14:26:50-08:00 Bob Gardner In even the wealthiest countries there are pervasive and stark differences in health by neighbourhood and region, race, socio-economic conditions and opportunities, and other liens of social and economic inequality. Many governments are trying to develop comprehensive policy and programme action to address these health disparities. One at the municipal level is the Greater London Authority in England: it issued a report identifying key issues and priorities for action in August 2007. As foundations for its action plan, the GLA had published a comprehensive review of the evidence base and an overview paper mapping the policy context for strategies and activities to address health inequality.

]]> In even the wealthiest countries there are pervasive and stark differences in health by neighbourhood and region, race, socio-economic conditions and opportunities, and other liens of social and economic inequality. Many governments are trying to develop comprehensive policy and programme action to address these health disparities. One at the municipal level is the Greater London Authority in England: it issued a report identifying key issues and priorities for action in August 2007. As foundations for its action plan, the GLA had published a comprehensive review of the evidence base and an overview paper mapping the policy context for strategies and activities to address health inequality.

]]> European reports on policy action to address health inequalities http://wellesleyinstitute.com/european-reports-policy-action-address-health-inequalities 2007-08-31T09:40:37-07:00 2007-09-12T11:55:21-07:00 Bob Gardner Two recent reports survey policy action on health inequalities in

Europe. The first is a summary of the situation in 21 countries, examples of best practices for local interventions and overall conclusions derived from the European Union’s Closing the Gap project. The report stresses that “it is however at the local level where measures to address health inequalities take direct effect.” The project’s European Health Inequalities portal collects over 90 case studies of good practices.

The second report is a massive comparative analysis of health inequalities and polices to address them, prepared as part of the Eurothine Tackling Health Inequalities in Europe project.

 

]]> Two recent reports survey policy action on health inequalities in
Europe. The first is a summary of the situation in 21 countries, examples of best practices for local interventions and overall conclusions derived from the European Union’s Closing the Gap project. The report stresses that “it is however at the local level where measures to address health inequalities take direct effect.” The project’s European Health Inequalities portal collects over 90 case studies of good practices.

The second report is a massive comparative analysis of health inequalities and polices to address them, prepared as part of the Eurothine Tackling Health Inequalities in Europe project.

 

]]> Inclusive Cities Project http://wellesleyinstitute.com/inclusive-cities-project 2007-08-20T07:25:06-07:00 2007-08-20T07:25:06-07:00 Bob Gardner The Inclusive Cities project is a partnership of community social planning organizations and municipal politicians from across the country that seeks to enhance cities’ ability to enable and sustain social inclusion and to ensure the full diversity of community voices are valued and recognized. They have developed a range of very useful papers, including on:

 

]]> The Inclusive Cities project is a partnership of community social planning organizations and municipal politicians from across the country that seeks to enhance cities’ ability to enable and sustain social inclusion and to ensure the full diversity of community voices are valued and recognized. They have developed a range of very useful papers, including on:

 

]]> Winnipeg Integrated Health and Social Services http://wellesleyinstitute.com/winnipeg-integrated-health-and-social-services 2007-07-30T10:35:20-07:00 2007-07-30T10:35:20-07:00 Bob Gardner While the fundamental social determinants of health will only be fully addressed with major shifts in government policy and action, there are many innovative and effective ways in which their impact on health disparities can be tackled more immediately in front-line service delivery.  One direction is where regional health authorities, community health centres and social service providers are delivering more coordinated community-based primary care, other health care, health promotion, public health and social services, often out of single locations.

An interesting example is underway in Winnipeg.  The Winnipeg Regional Health Authority and Manitoba Family Services and Housing have been partnering on a new model to integrate health and social service delivery called the Winnipeg Integrated Services Initiative:

]]> While the fundamental social determinants of health will only be fully addressed with major shifts in government policy and action, there are many innovative and effective ways in which their impact on health disparities can be tackled more immediately in front-line service delivery.  One direction is where regional health authorities, community health centres and social service providers are delivering more coordinated community-based primary care, other health care, health promotion, public health and social services, often out of single locations.

An interesting example is underway in Winnipeg.  The Winnipeg Regional Health Authority and Manitoba Family Services and Housing have been partnering on a new model to integrate health and social service delivery called the Winnipeg Integrated Services Initiative:

The vision of integrated community-based and social services is to provide efficient, effective and holistic services which are person or family focussed and recognize the principles of population health and primary health care.

Part of the integration of services is the creation of access models. Three of these models have already been announced. One in each of the River East, Transcona and Inkster areas.

An Access model is a provincially funded site that will provide community-based, integrated health and social services. Each model will offer a broad range of services that reflect the needs of the communities they serve. Where services are not available within Access, the public will be referred to related community resources. Access will provide a one-stop source of information to the community and will support community activity and development.

The WRHA, Manitoba Family Services and Housing and Manitoba Health are committed to working with communities to ensure that citizens are involved in decisions that affect their lives. In each community, there will be opportunities for citizens to express their opinions about Access as it is developed in their area. Watch for information about public consultation in your community.

They had earlier developed a comprehensive conceptual framework for how integrated health and social services and the community access model could work.

Appendices set out how this framework is solidly grounded in a determinants of health analysis, in the Alma-Alta declaration on primary care and in a wider commitment to primary care reform within the province.

]]> World Health Organization Knowledge Network Literature Reviews http://wellesleyinstitute.com/world-health-organization-knowledge-network-literature-reviews 2007-07-23T00:00:00-07:00 2007-08-01T09:11:33-07:00 Bob Gardner The WHO Commission on Social Determinants of Health has been active on many fronts. One of the most interesting has been its various knowledge networks. The Health Systems Knowledge Network has recently published a series of literature reviews on key issues. These include papers on:

]]> The WHO Commission on Social Determinants of Health has been active on many fronts. One of the most interesting has been its various knowledge networks. The Health Systems Knowledge Network has recently published a series of literature reviews on key issues. These include papers on:

]]>