Longwoods Blog

Equity – a blog

Ontario’s Ministry of Health and Long-Term Care (MOHLTC) has identified equity as a key component of quality care. The Ministry has developed a Health Equity Impact Assessment (HEIA) to support improved health equity, including the reduction of avoidable health disparities between population groups. HEIA also supports improved targeting of healthcare investments—the right care, at the right place, at the right time. And that is what this blog covers. Join us in the conversation.

The “For All” in Ontario’s Excellent Care for All legislation is a deliberate recognition that we can only improve the health of the population if everyone receives the recommended standard of care.

Though we have made strides in providing more equitable health care, the Toronto Central LHIN and its partners continue to improve access.

Today, more than ever, equity needs to be integrated into every single health care decision; every single health planning exercise.

Equitable care simply cannot be left as an afterthought or add-on to health care planning.

Equity is integral to sustainable and cost effective health care.

The reasons – from social justice and population health grounds – are obvious.

But there is also an economic argument for taking on health equity.  In fact, there is a strong business case.

Think about it for a moment…

Among the 1% of the population that accounts for 34% of health costs, there is a strong correlation with poverty and marginalization.

Looking at specific communities, like St. James Town for example  – a densely populated area with high rates of recent immigration and higher rates of people living alone – the percentage of ED users with no primary care provider is 18%, compared to 12% for the city of Toronto.

The inequities can be found even within a more confined geography.  In one apartment building in St. James Town, ED visits increased 38% over three years, while buildings just blocks away had little or no increase at all.

And it is no secret: people with limited access to appropriate, timely service end up accessing the system in a more acute stage – like in an ER – where services are most expensive.

In 2011, the Toronto Central LHIN initiated Access St. James Town – a collaborative effort among St. James Town residents, health care organizations, the City of Toronto and the United Way to develop an integrated model for delivering services to the community.

Through Access St. James Town, we are uncovering the root causes and finding new ways to assist people who have “fallen through the cracks.”

For many people, the term “Equity” typically conjures up many emotions and we tend to equate this term with the immigrant, refugee or visible minority experience.

But “equity” is not restricted to class, background or gender. There are many layers of equity.

For example, according to the POWER study, while men overall had a higher prevalence of diabetes than women, woman had worst health and functional outcomes than men, including higher rates of co-morbidity and depression.

Other studies indicate that twice as many woman report having unmet health care needs compared to men.

It is clear: we must all do more to improve access to health care for all women.

Ontario’s embrace of the quality agenda is extremely important and even transformational.  Many, including me, view the Excellent Care for All Act as one of the most significant pieces of health legislation.

I am extremely proud our local health care system, but I know as a system we must do better to improve health care for all people. Addressing health equity is not only the “right thing to do”.  Health system sustainability depends on it.

About the Author:

Camille Orridge – Chief Executive Officer

Camille Orridge is a recognized and respected senior executive with comprehensive knowledge of and experience in the health care and community sectors. As Chief Executive Officer of the Toronto Central LHIN, Camille is responsible for an organization that plans, coordinates and funds 174 health care service providers in central Toronto which provide key services to a local community of 1.14 million people as well as to a to large number of Ontarians who live in other LHINs.

Camille has led the development of a Code of Ethics for Care in the Community, working as a member of the Joint Centre for Bioethics. She has participated in think tanks on such topics as Health System Integration, ethics within the context of decision-making for Local Health Integrated Networks, the development of performance measurement activities for health care in Ontario and The Change Foundation’s Vision 2020, exploring strategic directions for Ontario Health Human Resources. She has been a member of the provincial ER/ALC Expert Panel, the business lead for the Resource Matching and Referral project,  and the Co-Chair of both the Aging at Home Council and the Integrated Care for Complex Populations Task Force at the Toronto Central LHIN.

Camille is also very active in community development activities.

She holds a Masters Degree in Health Administration from the University of Toronto and is a long-standing member of the Canadian College of Health Service Executives.

This entry was posted on Wednesday, June 6th, 2012 at 2:37 pm and is filed under Longwoods Online.