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J Am Board Fam Med. 2018 May-Jun;31(3):479-483. doi: 10.3122/jabfm.2018.03.170299.

Proactive Strategies to Address Health Equity and Disparities: Recommendations from a Bi-National Symposium.

Author information

1
From the Department of Family Medicine, McGill University, Montreal, Canada (JH); Richard Parrillo Family Professor of Healthcare Ethics, Section of General Internal Medicine, University of Chicago, Chicago, IL (MHC); Manitoba Centre for Health Policy & Professor, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Canada (AK); School of Public Health, University of Alberta, Edmonton, Canada (KY); Westcott Partners, LLC, Silver Spring, MD (JF); Health Services and University Medicine, Ministère de la Santé et des Services Sociaux, Quebec, Canada (AG); National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (EJP-S); The Ottawa Hospital, Ottawa, Canada (JT); Department of Family Medicine, Oregon Health & Science University, Portland, OR (JED); United States Department of Veterans Affairs, Washingtone D.C. (UU). jeannie.haggerty@mcgill.ca.
2
From the Department of Family Medicine, McGill University, Montreal, Canada (JH); Richard Parrillo Family Professor of Healthcare Ethics, Section of General Internal Medicine, University of Chicago, Chicago, IL (MHC); Manitoba Centre for Health Policy & Professor, Departments of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Canada (AK); School of Public Health, University of Alberta, Edmonton, Canada (KY); Westcott Partners, LLC, Silver Spring, MD (JF); Health Services and University Medicine, Ministère de la Santé et des Services Sociaux, Quebec, Canada (AG); National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD (EJP-S); The Ottawa Hospital, Ottawa, Canada (JT); Department of Family Medicine, Oregon Health & Science University, Portland, OR (JED); United States Department of Veterans Affairs, Washingtone D.C. (UU).

Abstract

INTRODUCTION:

Health inequities persist in Canada and the United States. Both countries show differential health status and health care quality by social characteristics, making zip or postal code a greater predictor of health than genetics. Many social determinants of health overlap in the same individuals or communities, exacerbating their vulnerability. Many of the contributing factors and problems are structural and evade simple solutions.

METHODS:

In March 2017 a binational Canada-US symposium was held in Washington DC involving 150 primary care thought leaders, including clinicians, researchers, patients, and policy makers to address transformation in integrated primary care. This commentary summarizes the session's principal insights and solutions of the session tackling health inequities at policy and delivery levels.

DISCUSSION:

The solution lies in intervening proactively to reduce disparities-developing risk-adjustment measures that integrate social factors; increasing the socioeconomic, racial, and ethnic diversity of health providers; teaching cultural humility; supporting community-oriented primary care; and integrating equity considerations into health system funding. We propose moving from retrospective analysis to proactive measures; from equality to equity; from needs-based to strength-based approaches; and from an individual to a population focus.

KEYWORDS:

Administrative Personnel; Canada; Health Status; Primary Health Care; Retrospective Studies; Risk Adjustment

PMID:
29743230
DOI:
10.3122/jabfm.2018.03.170299
[Indexed for MEDLINE]
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