Health Equity

 

The Grey Bruce Health Unit is committed to actions that work towards reducing health inequities, removing barriers and creating equitable opportunities that support health and well-being for all members of our community. We work towards health equity in many ways including;

  • Strengthening meaningful partnerships with Indigenous and non-Indigenous community members and various organizations to support action;
  • Monitoring and reporting on the relationship between social factors, like income, and health outcomes in Grey Bruce; and
  • Participating in policy development to address the social determinants of health.

 

What is Health Equity?

Health Equity means that ALL members of the community have opportunities to be healthy and receive quality care that is fair and appropriate to their needs, no matter where they live, what they have or who they are (Health Quality Ontario, 2018).

 

Equity doesn’t mean Equality

Equality means that everyone is treated the same regardless of their needs or circumstances. However, treating everyone equally doesn’t mean that every person has the same opportunities to maintain optimal health.

 

Equity takes into consideration that some groups in our community face additional obstacles and barriers and require more supports to achieve the same level of health as others. Barriers may include low income, low literacy skills, limited access to healthy food, unsafe housing or limited access to reliable transportation.

 

In order to improve health and well-being for all people, we must first ensure everyone has the basics to be healthy. Thinking that the same approach will work universally to improve health is assuming everyone has those basics. Equity involves trying to understand and give people what they need – so that people are able to reach higher levels of health and live full, healthy lives. Equality in contrast, aims to ensure that everyone gets the same things. 

 

If we compare both equality and equity side-by-side, you will notice on the right side of the graphic that the people haven’t changed. Instead, what has changed are the resources, approaches, policies, or practices that have an impact on the conditions in which community members live.

 

Equality visual

Equity Visual

 

 

What Things Influence Health?

We know that health is influenced by much more than just the healthcare system. The Determinants of Health Model lists many of the factors that affect health. We refer to these factors as the Social Determinants of Health. Social determinants affect the conditions and circumstances in which individuals and communities live, learn, work, and play. It is also important to note that the Social Determinants of Health interact across the life span, and can affect families over the life course and across generations.

Determinants of Health Model

Source: Dahlgreen, G. and Whitehead, M. (1991). Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute for Future Studies.

 

The Grey Bruce Health Equity Tool!

Using a health equity lens is foundational to providing quality care and improving the health of residents in Grey and Bruce. To support the application of a health equity lens at the individual and systems level, a health equity resource tool was developed. The tool was developed collaboratively with system leaders, service providers and community stakeholders across sectors and agencies within Grey Bruce.

 

Click on each section of the wheel to learn more about the social determinants of health that contribute to the health of individuals and communities. The Health Equity tool guides you in planning and implementing your programs, services, and activities to be more equitable by considering the specific needs of populations. 

Need more information or support, but aren’t sure where to start? Visit https://211ontario.ca or call 211 to learn more about programs and services available in the County of Bruce, Grey County and across the province.

 

Health Equity Wheel

People with Disabilities Health Equity Tool People With Low Literacy First Nations Inuit and Metis Youth Refugees Older Adults Ethno-Cultural Groups Residents of Rural Areas People with Low Income Immigrants and Newcomers Lesbian/Gay Bisexual Transgender Women Education Money Language Food Housing Affordability Social Justice Availability Community Behaviour Transportation

Welcome to the Health Equity for All: Grey & Bruce tool

The Health Equity tool is here to guide you in making your programs, services, and activities better for all who access them. Hover over each population name for resources to help you understand and serve that group better, as well as find local agencies focused on doing the same.

Need support but aren’t sure where to start? Visit https://211ontario.ca/ or call 211 to learn more about programs and services available in Bruce County, Grey County, and across the province.

People with Disabilities & Health Equity

Learn More:

Create Health Equity for People with Disability

Resources in Grey County & Bruce County:

Community Living: Owen Sound and District

Canadian Mental Health Association Grey Bruce

First Nations, Inuit, and Métis Peoples & Health Equity

Indigenous Equity (IND-Equity) and inequities are distinct from those experienced by non-Indigenous peoples. Factors such as colonization and the decimation of culture underlie health experiences of many Indigenous peoples.

Learn More:

Health Inequalities and Social Determinants of Aboriginal People’s Health

Aboriginal Relationship and Cultural Competency Courses

Resources in Grey County & Bruce County:

M’Wikwedong Native Cultural Resource Centre

Southwest Ontario Aboriginal Health Access Centre

Chippewas of Nawash Unceded First Nation

Great Lakes Metis Council

Saugeen First Nation

Youth & Health Equity

Learn More:

Diversity Snapshot: Youth

Resources in Grey County & Bruce County:

Keystone Child, Youth & Family Services

WES for Youth Online

The Grey Bruce We C.A.R.E Project

People with Low Literacy & Health Equity

One’s proficiency in reading, writing, and solving problems has a significant impact on capacity to make decisions related to health. Use plain language written at an appropriate literacy level to make client and public resources more accessible.

Learn More:

The Office of Literacy and Essential Skills

Resources in Grey County & Bruce County:

Connect through The HealthLine

Literacy and Basic Skills at Georgian College

Adult Learning Centres

Refugees & Health Equity

Learn More:

Health Equity for Immigrants and Refugees: Driving Policy Action

Resources in Grey County & Bruce County:

Grey Bruce Newcomers Network

Older Adults & Health Equity

Learn More:

Diversity Snapshot: Seniors

Resources in Grey County & Bruce County:

Council on Aging Grey Bruce Owen Sound

Ethno-Racial/Racialized Groups & Health Equity

Learn More:

Racial Equity Tools

Health Equity and Racialized Groups: A Literature Review, 2011

Residents of Rural Areas & Health Equity

Learn More:

The Huron County Healthy Rural Policy Lens

Pierre’s Story: The Many Costs of Rural Living (video)

Resources in Grey County & Bruce County:

Bruce & Grey Community Information

People Living with Low Income & Health Equity

Learn More:

Equity and Inclusion for People Living in Poverty

Income and Health

Income and Health in Grey Bruce

Resources in Grey County & Bruce County:

Bruce Grey Poverty Task Force

United Way of Bruce Grey

Immigrants, Newcomers & Health Equity

Learn More:

Health Equity for Immigrants and Refugees: Driving Policy Action

Resources in Grey County & Bruce County:

Connect through 211

Newcomer Support Hub is an online portal, through which vulnerable newcomers, sponsors, service providers, volunteers, and the public can access up-to-date information and resources to support social and economic integration of newcomers. It provides information in 25 of the most common languages in the Region.

Education & Health Equity

“… length and quality of education is crosscutting — it predicts employment and income, which influences where someone can live and if they can afford health care. Education is not just about what is learned in the classroom; it is also about the doors it unlocks to future well-being.”
The Nation's Health - Education attainment linked to health throughout lifespan

Housing & Health Equity

Safe and affordable housing is an absolute necessity for living a healthy life.  The presence of mould, poor heating, inadequate ventilation, pests and overcrowding are all determinants of adverse health outcomes.  Children who live in low quality housing condition have a greater likelihood of poor health outcomes as children and also later in adulthood. The Canadian Facts

 

Housing is unaffordable when it costs more than 30% of your income.  As a result, it is difficult to purchase other necessities such as food, transit, clothing and essentials.  CMHC - About Affordable Housing in Canada

 

Resources in Grey County & Bruce County:

RentSafe

Money & Health Equity

… none of these compares to the way that poverty makes us sick. Prescribing medications and lifestyle changes for our patients who suffer from income deficiency isn’t enough; we need to start prescribing healthy incomes. The Star - Basic Income, Just What the Doctor Ordered

 

A living wage is the hourly wage a worker needs to earn to cover their family's basic everyday needs: food, housing, utilities, childcare and transportation. A living wage is not the same as the minimum wage, which is the lowest wage rate an employer can pay an employee. The calculation of a living wage for Bruce Grey has been determined to be $18.39. Income and deductions from government taxes and transfers are included in the living wage calculation.

 

Poverty is a risk factor for many health conditions. Poverty: A Clinical Tool for Primary Care Providers directs providers to use key questions to find out more about their patients, their employment, living situation, social supports and the benefits they receive. The tool includes links to key government and community resources to support positive interventions.

 

Poorer people in cities with more equal sharing of income, are healthier and live longer than richer people in cities with less sharing of income (p16). Are Widening Income Inequalities Making Canada Less Healthy? How much are resources shared in the community you live in?

Language & Health Equity

Improving Health Equity through Language Access: A Model for Integrated Language Services throughout the Toronto Central LHIN

 

Just like in legal settings, a patient’s ability to understand and participate in their own health care is critical. Yet, many Ontarians do not have access to care in a language that they understand. >The Right to Language Accessibility in Ontario’s Health Care System

Food & Health Equity

Currently, diet related factors represent the top risks for morbidity and mortality in Canada. Research has shown that not meeting dietary recommendations cost Canadians $13.8 billion/year in 2014 (direct health care: $5.1 billion, indirect: $8.7 billion).

The Grey Bruce Food Charter expresses the values of the Grey Bruce community to support a healthy, just, and economically and environmentally sustainable food system. The Charter can be used to guide the development of policies and programs.“ The Charter acknowledges the right of all to food.” The Charter is a commitment to work together to build a vibrant, sustainable, food secure community. With community participation, a sustainable local food system will prioritize health, social justice, education, economic development, the environment, and culture.

The 2014 Canadian Community Health Survey demonstrated that 11% of households in Grey Bruce experience household food insecurity. Household food insecurity occurs when there is inadequate or insecure access to food due to financial constraints. This is a serious public health problem in Canada that impacts mental, social, and physical health. PROOF Food Insecurity Policy Research.

Because household food insecurity results from financial constraints, it cannot be solved through charitable food provision. After rent and other expenses, many households do not have enough money to buy food and they become ‘Food Insecure’.” GBHU News Release – The Cost of Eating Well

Many food literacy programs and emergency food supports exist in Grey Bruce including twenty-two food banks, nineteen Good Food Box sites, and Student Nutrition Programs in local schools. These programs do not address the root cause of the issue, poverty, but are able to provide valuable social and food skills programming.

Affordability & Health Equity

Affordability can be another barrier for some individuals and families living on low incomes. As an example, an individual might go to their local emergency department because they can’t afford health care insurance or the cost of services such as oral health and dental care.

Social Justice & Health Equity

Understanding the fair distribution of resources and responsibilities helps us to recognize the root causes of inequities, the advantages that some groups or individuals have relative to others, and the need to eliminate inequities through collaborative action.

Behaviour & Health Equity

The social determinants of health can influence lifestyle choices and behaviours. Coping with conditions such as low income, food insecurity, unsafe housing, insecure employment and discrimination can lead to high levels of stress. Individuals may adopt unhealthy coping behaviours such as smoking, overeating, alcohol and/or substance use in attempt to relieve such stress having an immediate impact on health. Your Health

Transportation & Health Equity

Lack of transportation and limited public transportation can be a barrier limiting access to health services, jobs, social services, recreation and programming. It affects the health of many individuals including women, children and youth, disabled persons, low-income groups, and the elderly.

Resources in Grey County & Bruce County:

Movin’ Grey Bruce

Community & Health Equity

Health is influenced by the way that communities are planned and built, as well as by the services and resources available within them. Building relationships with and engaging priority populations is an important aspect of community engagement in order to understand their unique needs, assets, histories, and cultures.

Availability & Health Equity

Governments at all levels can influence the availability of social determinants such as housing, employment, recreational opportunities, family benefits or social assistance through policies, laws, and regulations. Healthy Public Policies

The Health Equity Tool and training video was developed by the Moving Health Equity Forward Committee, an action group of the Bruce Grey Poverty Task Force.

 

How Can the Tool be Used?

When designing or making changes to policies and programs, or when working with your clients, consider these 5 key questions to ensure that you are using a health equity perspective.

If you are making changes for a group or organization, consider the system perspective. If you are making changes in the work you do directly with clients, patients, or other individuals, consider the individual perspective.

 

System Perspective
a) Are all who may be impacted engaged in the planning process?
b) What are the roles of each stakeholder?
c) Have we used a broad lens to ensure perspectives cross sectors/silos?
d) Have we engaged patients, clients, or others who will experience the impact?

Individual Perspective
a) Were you included in the discussion?
b) Is everyone included that you want (e.g., personally, professionally)

System Perspective
a) What do the organization and community consider the critical factors for success?
b) Have we completed the Health Equity Impact Assessment to identify possible negative impacts and plan for mitigation?

Individual Perspective
a) Have you asked the stories of people with lived experience? Do you understand what is important to those you serve?
b) What is the goal that you want to achieve? What is most important to individuals you serve?
c) What steps are important to getting to that goal?
d) What is important to providers? Is it the same as what the individual(s) wants to achieve?
e) What screening tools can be used to better understand someone’s current situation?

System Perspective
a) What is the immediate impact to core agencies and system users?
b) What are the ripple effects to other agencies and the community?
c) Have we clearly identified the positive and negative impacts? Do we have a plan to mitigate negative impacts?

Individual Perspective
a) How will this affect you?
b) How will this impact those immediately around you?
c) What are the positive impacts that we can leverage to help you drive the change?
d) What are the negative impacts and how can we reduce them?

System Perspective
a) Are all the players willing to move this ahead?
b) What are the barriers?
c) Are there funding or other systems (political, social) that need to be overcome to make this achievable?

Individual Perspective
a) Is it a realistic goal or set of goals?
b) Do you have what you need to achieve it?
c) What things or people do you need to support you to achieve it?
d) How confident are you that you can achieve your goal?

System Perspective
a) What other key players do we have to engage before we can move ahead (political, funders, etc.)?
b) Are there data or supportive information that we need before moving ahead?
C) What does implementation look like?

Individual Perspective
a) What actions do you need to take to move toward your change goal(s)?
b) What do you need to help you move ahead with your change goal(s)?
c) Do you feel ready to work toward your change goal(s)?

 

Additional Health Equity Resources

When working with individuals, small steps toward health equity can be achieved. Consider the factors displayed on the tool (above) as a starting point for learning about barriers that community members may face, as well as how to reduce those barriers. The following resources can be used as tools for equity-informed practice at the individual level:  

Measuring Health Equity: Demographic Data Collection in Health Care

From the Margins to the Middle: D.I.Y. Health Equity Kit

“Let’s Talk” Health Equity

Health Equity Impact Assessment (Ministry of Health & Long Term Care)

Health Equity Impact Assessment (Wellesley Institute)

“While leadership at the top of an organization is needed to support health equity action, champions in other parts of the organization need to be supported when they assume leadership in their management of health equity projects and programs” Public Health Speaks: Leadership for Health Equity [video]

Awareness of the Social Determinants of Health in Grey Bruce

 

Health Equity Impact Assessment (HEIA)

Using the Health Equity Impact Assessment (HEIA) by the Ministry of Health and Long Term Care is an excellent tool to support health equity. HEIA is a tool that helps identify and address any unintended health impacts that a plan, policy or program might have on vulnerable or marginalized groups within a general population. The overall goal of HEIA is to achieve health equity and eliminate disparities. 

 

Examples of the Health Equity Impact Assessment Tool

CMHA Grey Bruce Mental Health and Addiction Services Integration

HEIA CMHA Detailed Final

HEIA CMHA Summary Final

CMHA HEIA Monitoring Activities

 

Tools & Training

Would you like a hard copy of the Health Equity Tool?

Send us an e-mail and a member of the Moving Health Equity Forward Action Group will be in touch.

 

Grey Bruce Health Equity Tool: Training Videos

The following three video modules are intended to increase awareness of health equity and build capacity for health equity-focused decision-making at all levels of health, social and community service organizations.
Please Note: For optimal quality, please download the videos prior to projecting to an external device.
 

Video 1: Provides an introduction to health equity and the determinants of health.

Video 2: Explains the Grey Bruce Health Equity Tool and components of the tool.

 

Video 3: Demonstrates how to use the tool online.

 

The Health Equity Tool and Training Videos were developed with support from Health Link Grey Bruce through a collaborative of the Bruce Grey Poverty Task Force.

 

 

References

Health LinkBruce Grey Poverty Task Force

 

Share this page