Blog

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.

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.

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:

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

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

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, 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 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:

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.

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.