Health equity concerns itself with all the social determinants of health: income, employment status, ethnicity, gender, immigration status and location. All of these factors have an impact on individual and population health.
The Feature Post by co-authors Dr. Adalsteinn Brown and Dr. Jeffrey Turnbull highlights one of the largest urban initiatives for measuring health equity in Ontario by Sinai Health System. This is an effort to mandate the standardized collection of demographic data from patients and caregivers in the Toronto Central Local Health Integration Network (TC LHIN). Toronto is one of the most multicultural cities in North America, with a rich history of immigration and a wealth of ethnicities. This amazing feature of Ontario’s capital also presents a challenge for many when entering the health care system – language.
In Toronto, almost half (49%) of people have a mother tongue other than English, which may affect their comprehension of complicated and important information about their health. A recent study by Dowbor et al. from the Li Ka Shing Knowledge Institute, Centre for Research on Inner City Health, considers shrinking the language accessibility gap by using over-the phone interpretation. This study evaluated relevant services and makes recommendations for improving equity in language and comprehension in health care.
When interfacing with the health care system, many factors are at play, including income and education. Having a low personal or household income, having less than a high school education and living in a high-dependency neighbourhood greatly increases the odds of being a high-cost health care user. Such users tend to bounce in and out of the system with difficulty maintaining a care plan and a dedicated provider. Read more about Looking Beyond Income and Education: Socioeconomic Status Gradients Among Future High-Cost Users of Health Care by Fitzpatrick et al. in the American Journal of Preventive Medicine.
For an international perspective from the Institute for Health Policy at Massachusetts General Hospital in Boston, Green et al. have been looking into Leveraging Quality Improvement (QI) to Achieve Equity in Health Care. They found three ways that QI interventions can reduce disparities in health and discuss the creation of culturally competent guidelines for QI.
Have you ever encountered any issues with equity? Share your thoughts and comments below on this pressing issue.