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Building Health Equity:  The Role of Public Health  Dr. Cory Neudorf CMHO, Saskatoon Health Region A. Prof., University of Saskatchewan
Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Inequity Reporting
Introduction ,[object Object],[object Object],[object Object],[object Object]
The Saskatoon Health Region timeline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
1.02 (no difference) n/s 0.89 ( no difference) n/s Cancer 1.82 (82%) n/s 1.33 (33%) n/s Stroke 1.70 (70%) 1.34 (34%) Coronary Heart Disease 1.53 (53%) n/s 1.38 (38%) n/s COPD 12.86 (1186%) 3.98 (298%) Diabetes 2.46 (146%) 1.54 (54%) Injuries and Poisonings 4.27 (327%) 1.85 (85%) Mental Disorders 15.58 (1458%) 3.75 (275%) Suicide Attempts Hospitalizations Rate Ratio Core : Affluent  Rate Ratio Core : Total Saskatoon Health Issue
Income and Health, selected results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Survey Data Summary ,[object Object],[object Object],[object Object]
Survey Data Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Public Release of Initial study ,[object Object],[object Object],[object Object]
Public Health Follow up and Research grants  ,[object Object],[object Object],[object Object],[object Object]
School based intervention research ,[object Object],[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Evidence – Based Policy Options
Credits Research Team Ushasri Nannapaneni,   Christina Scott, Tanis Kershaw, Wendy Sharpe, Norman Bennett, Josh Marko, Lynne Warren, Terry Dunlop and Gary Beaudin Funding The Canadian Institutes for Health Research for their grant titled: “Reducing Health Disparity in Saskatoon”
 
Saskatoon Health Region Life expectancy in years, 1998-2004
Reducing Gaps in Health: A Focus on Socio-Economic Status  in Urban Canada Nov. 2008 A collaboration between the  Canadian Population Health Initiative and the Urban Public Health Network
Saskatoon Analysis of Dissemination Areas by Deprivation Index Quintiles
Pan-Canadian, Regina,  Saskatoon and  Winnipeg Comparison
Ratio of Age Standardized Hospitalization Rates Between Low and High SES Groups, Pan-Canadian, Regina, Saskatoon and Winnipeg  Source: RQHR presentation on CPHI study
Ratio of Age Standardized Self-Reported Health Percentages Between Low and High SES Groups, Pan-Canadian, Regina, Saskatoon and Winnipeg Source: RQHR presentation on CPHI study
Moving Beyond Reports to Reducing the Gaps ,[object Object],[object Object],[object Object],[object Object],[object Object]
What Can Public Health Do? Advocacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Can Public Health Do? Build Broad-based community support ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What Can Public Health Do? Effect change where we can ,[object Object],[object Object],[object Object],[object Object],[object Object]
Saskatoon Action Plan to Reduce Poverty ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Community Roundtables   Leadership Group Coordinating Group Community Action Plan Action Groups   Measurement & Evaluation Child Care Health Resources Education Housing Income Assistance Welfare to Work  Aboriginal Employment
[object Object],[object Object],[object Object],Community Roundtables
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Action Groups
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Leadership Group
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Coordinating Group
 
Business sector, Faith sector ,[object Object],[object Object],[object Object],[object Object]
The Health System Response Source : Dahlgreen, G. & Whitehead, M. (2006).  European strategies for tackling social inequities in health: Levelling up Part 2.  World Health Organization.
Reorient local Public Health Services ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Work within the rest of the health system ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health care equity program Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Care Equity Audit  Cycle Problem (inequity )  and causes Intervention to  address inequity Measure Impact and  Amend intervention Identify  Evidence Based  Interventions
Health Care Equity audit Immunisation Problem Low Immunisation rates  Core Neighbourhood Implement Phone based  reminder system for parents And other service changes Measure Impact and  Amend intervention Lit Review –  Evidence Based practice  for Improving Rates
Barriers to Quality Healthcare ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Health Care Equity Audit Surgical procedures ( City Residents) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Eg: Cardiovascular Revascularization
Ischemic Heart Disease Mortality
 
 
Health Equity Audit-Next Steps for SHR ,[object Object],[object Object],[object Object]
Health System Response - Summary ,[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]

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Building Health Equity: The Role of Public Health

  • 1. Building Health Equity: The Role of Public Health Dr. Cory Neudorf CMHO, Saskatoon Health Region A. Prof., University of Saskatchewan
  • 2.
  • 4.
  • 5.
  • 6.  
  • 7. 1.02 (no difference) n/s 0.89 ( no difference) n/s Cancer 1.82 (82%) n/s 1.33 (33%) n/s Stroke 1.70 (70%) 1.34 (34%) Coronary Heart Disease 1.53 (53%) n/s 1.38 (38%) n/s COPD 12.86 (1186%) 3.98 (298%) Diabetes 2.46 (146%) 1.54 (54%) Injuries and Poisonings 4.27 (327%) 1.85 (85%) Mental Disorders 15.58 (1458%) 3.75 (275%) Suicide Attempts Hospitalizations Rate Ratio Core : Affluent Rate Ratio Core : Total Saskatoon Health Issue
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.  
  • 15.
  • 16. Credits Research Team Ushasri Nannapaneni, Christina Scott, Tanis Kershaw, Wendy Sharpe, Norman Bennett, Josh Marko, Lynne Warren, Terry Dunlop and Gary Beaudin Funding The Canadian Institutes for Health Research for their grant titled: “Reducing Health Disparity in Saskatoon”
  • 17.  
  • 18. Saskatoon Health Region Life expectancy in years, 1998-2004
  • 19. Reducing Gaps in Health: A Focus on Socio-Economic Status in Urban Canada Nov. 2008 A collaboration between the Canadian Population Health Initiative and the Urban Public Health Network
  • 20. Saskatoon Analysis of Dissemination Areas by Deprivation Index Quintiles
  • 21. Pan-Canadian, Regina, Saskatoon and Winnipeg Comparison
  • 22. Ratio of Age Standardized Hospitalization Rates Between Low and High SES Groups, Pan-Canadian, Regina, Saskatoon and Winnipeg Source: RQHR presentation on CPHI study
  • 23. Ratio of Age Standardized Self-Reported Health Percentages Between Low and High SES Groups, Pan-Canadian, Regina, Saskatoon and Winnipeg Source: RQHR presentation on CPHI study
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29. Community Roundtables Leadership Group Coordinating Group Community Action Plan Action Groups Measurement & Evaluation Child Care Health Resources Education Housing Income Assistance Welfare to Work Aboriginal Employment
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.  
  • 35.
  • 36. The Health System Response Source : Dahlgreen, G. & Whitehead, M. (2006). European strategies for tackling social inequities in health: Levelling up Part 2. World Health Organization.
  • 37.
  • 38.
  • 39.
  • 40. Health Care Equity Audit Cycle Problem (inequity ) and causes Intervention to address inequity Measure Impact and Amend intervention Identify Evidence Based Interventions
  • 41. Health Care Equity audit Immunisation Problem Low Immunisation rates Core Neighbourhood Implement Phone based reminder system for parents And other service changes Measure Impact and Amend intervention Lit Review – Evidence Based practice for Improving Rates
  • 42.
  • 43.
  • 46.  
  • 47.  
  • 48.
  • 49.
  • 50.

Editor's Notes

  1. Thank you for the kind introduction. As was mentioned, in addition to being chair of CPHI, I am also a local Medical Officer of Health in Saskatoon, one of the member cities of the Urban Public Health Network. Therefore, I am doubly pleased to be able to present to you the results of the report being launched today by these two groups entitled “Reducing the gaps in Health: A Focus on Socio-Economic Status in Urban Canada