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Dr. Jeffrey Turnbull

Health Equity in Northern Ontario: Thinking Locally

Think globally, act locally: As a slogan for advocacy this phrase has much to recommend it but it is especially relevant to the task of helping to build a health equity strategy for Northern Ontario.

Health equity should be a priority for all health systems no matter what their funding or governance model. It is identified as one of the six main drivers for a quality health care system and is a stated priority for Health Quality Ontario.

You can’t have a quality health care system unless you have equitable health for all.

The need for a strategy to specifically address health equity in Northern Ontario has been clearly identified by Health Quality Ontario in its recent report: Health in the North: A report on geography and the health of people in Ontario’s two northern regions.

That report documents how the 800,000 people living in northern Ontario are more likely to have worse health, poorer access to health care and die earlier than people in other parts of Ontario.

Even before this report’s publication, work had begun to craft a strategy to specifically address the underlying causes for these inequities. As Dr. Jennifer Walker, Canada Research Chair in Indigenous Health at Laurentian University noted so eloquently, “Solutions cannot simply be imported from the southern part of the province. The landscape – social and cultural as well as geographic – is totally different.”

Hence the need to act locally in the north and the genesis of a health equity strategy crafted by decision makers, health care providers, patients and caregivers living and working in Northern Ontario, with the support of Health Quality Ontario.

The vision for this strategy is clear: That all northerners have equal opportunities for health, including access to appropriate, timely, high-quality health care, regardless of where they live, what they have or who they are.

Coming directly from this vision is the goal of developing a strategy that reflects the unique needs and abilities of northerners and outlines a set of recommended actions necessary to improve overall health and wellbeing.

A major step in this process was taken on May 25th when a Health Equity Summit was held in Sudbury and Thunder Bay to discuss and build on more than 30 meetings held throughout Northern Ontario this spring. Participants were invited from urban, rural, remote and First Nation communities, francophone communities and other larger northern communities facing inequities.

Priority areas of focus identified during this engagement process were:

  • Acting upon the social determinants of health.
  • Equitable access to high-quality and appropriate health services.
  • Indigenous healing, health and wellbeing.
  • Data availability for equity decision making.

Developing a health care system that is equitable is rarely an easy task given how the roots of these inequities are often buried deep in social determinants of health, such as income and education, and are not amenable to easy fixes.

During the engagement process in developing the equity strategy, the following themes related to the social determinants of health were identified: Awareness of the Social Determinants of Health, Organizational Structures and Workforce Development, Income Security, Food Security, Housing, Education, Early Childhood Development and Social Inclusion.

With a clear vision and goal, development of a robust strategy will certainly provide the impetus to address these challenges in a manner that will have an impact. Work will proceed to engage groups in the north that have not yet participated in the process, a final report is anticipated to be submitted in the fall and the strategy will then be disseminated for implementation.

The profile of this initiative will continue to be raised in the short term as Health Quality Ontario will host a Quality Rounds from Thunder Bay Regional Hospital on June 15th, focused specifically on the Northern Health Equity Strategy.

Health equity for Northern Ontario residents – thinking globally and acting locally.

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