POWER, Data and Planning for Health Equity

Bob Gardner Panel on Releasing Power Report: Access Chapter March 30, 2010 © The Wellesley Institute www.wellesleyinstitute.com

• 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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 2

• 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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 3

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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 4

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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 5

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? © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 6

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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 7

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 © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 8

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) © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 9

• 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 © The Wellesley Institute www.wellesleyinstitute.com 10

The Wellesley Institute advances urban health through rigorous research, pragmatic policy solutions, social innovation, and community action. © The Wellesley Institute April 12, 2010 www.wellesleyinstitute.com 11

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POWER, Data and Planning for Health Equity

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