Reducing Health Disparities - Roles of the Health Sector: Recommended Policy Directions and Activities

[back] [Table of Contents]

Recommended Health Sector Policy Directions And Activities To Address Health Disparities

1. Make Health Disparities Reduction a Health Sector Priority

Making health disparities reduction a health sector priority, with coordinated effort on several fronts, will have the greatest impact. Leadership on disparities reduction within the health sector is needed to facilitate the roles of the health sector and to support growing awareness and policy action in other sectors to achieve health gains.

Proposed Activities:

• Ensure that there is national leadership capacity in addressing health disparities. Key leadership roles should include the following:

  • Setting health disparities reduction targets, monitoring trends and producing periodic reports on progress.
  • Developing an integrated strategy to reduce health disparities.
  • Assessing the impact of current and potential health sector policies on health disparities to guide policy and program decisions.

• Facilitate and support all governments to make the reduction of health disparities (i) a public policy priority and (ii) a key measure of overall government performance.

• Collaborate among jurisdictions (provinces/territories and federal government) to consider a health disparities reduction fund to support program innovations and evaluation.
• Develop priority areas on which to focus policies and interventions within the health sector and with other sectors. Initial priorities should include key disadvantaged groups and related determinants of health (e.g. socio-economic status, Aboriginal identity, gender, and geographic location).

2. Integrate Disparities Reduction into Health Programs and Services

The health system is a key determinant of population health. If health care and public health programs and services do not include a focus on the needs of disadvantaged individuals, populations and communities, there is a risk of increasing rather than reducing health disparities. The health sector also has an important role to play in mitigating the causes and effects of other determinants of health through interventions with disadvantaged individuals, populations and communities.

Proposed Activities:

• Ensure that health disparities reduction is considered in the design, implementation and evaluation of all health programs and services so that disadvantaged populations benefit to the maximum extent possible.

• Reduce financial and non-financial barriers to health care and public health, and develop strategies to improve access, comprehensiveness, appropriateness, coordination and follow-up for disadvantaged populations.

• Develop performance indicator frameworks and reporting requirements, which include a range of measures on health disparities, for improved accountability.

• Develop communications and educational strategies to foster public awareness and understanding of the importance of reducing health disparities.

3. Engage with Other Sectors in Health Disparities Reduction

Taking action on a wide spectrum of factors - and their interactions - known to influence health is essential to reducing health disparities. This requires participation from those sectors whose work aligns with key health determinants. As noted in its Global Strategy on Diet, Physical Activity and Health, the World Health Organization (WHO) sees engaging with other sectors as an essential responsibility of the health sector. Such partnerships and promotion of a health disparities perspective are most effective when they extend to the public, private and voluntary sectors.

Proposed Activities:

• Support and facilitate the contributions of the public, private and voluntary sectors in disparities reduction initiatives.

• Collaborate with other sectors in the development of structures and mechanisms for (i) setting policy, (ii) developing, implementing and assessing programs, and (iii) sharing information and resources in a way that is most likely to create the conditions for reducing health disparities, to include:

  • Supporting the development of necessary intersectoral mechanisms at the national, provincial, regional and community levels in order to enhance capacity to address health disparities.
  • Continuing to support current investments in key initiatives that align with priority disadvantaged groups and determinants of health, and where there is evidence of effectiveness in reducing health disparities or the demonstration and evaluation of promising approaches.

4. Strengthen Knowledge Development and Exchange Activities

Comprehensive disparities reduction approaches in other countries originated with a commitment to documenting the extent of disparities, developing evidence-based policies and evaluating interventions. Further development and ongoing expansion of the knowledge base in Canada is key to further advancement of policy development, priority-setting and evaluation efforts.

Proposed Activities:

• Develop indicators to measure the impact of health disparities on the economy, community and individual well-being.

• Continue to support research that (i) advances our understanding of the causal mechanisms that result in health disparities (ii) identifies effective interventions for reducing health disparities and (iii) measures the cost-effectiveness of different types of initiatives over time.

• Enhance and refine information systems for improved surveillance, monitoring and reporting, to include
  • Extending the capacity to link health data to socio-demographic data to support evaluations of access and effectiveness.
• Systematically share knowledge related to addressing health disparities within the health sector and across other sectors whose policies and services play an important role, to include
  • Compiling and maintaining a compendium of best practices in Canada and from around the world in reducing health disparities.

Conclusion

This paper has highlighted the current status of health disparities in Canada and their consequences, and has described how the health sector can take action on reducing health disparities. The recommended policy directions and proposed activities set forth in this paper provide the health sector with opportunities for action in areas within its span of direct control and through influencing partnerships with other sectors.

Evidence and experience have shown that reducing health disparities has many potential benefits - for the improvement of health outcomes and the overall quality of life of Canadians, as well as for the effectiveness and sustainability of the health system.

• The overall health of the community can be improved by reducing disparities.

• Because there is a gradient of health status across the entire range of socio-economic status, addressing health disparities will improve the health of all of society.

• Reducing the health care needs of low SES populations and other disadvantaged groups can decrease cost drivers and result in reduced pressures on the delivery of health services.

• Better health enables more people to participate in the economy, reducing the costs of lost productivity.

The time is opportune for health sector leadership and action to make further advances in realizing these benefits. The transition to new structures, such as the Health Council, the Public Health Agency of Canada, the Pan-Canadian Public Health Network and related Expert Groups, and the National Collaborating Centre for Determinants of Health, provides opportunities to guide and support this effort. There is a sufficient evidence base and a readiness to act on the part of stakeholders both within and outside the health sector.

[back] [Table of Contents]