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Health Disparity: Analysis to Intervention. Dr. Mark Lemstra Senior Epidemiologist Dr. Cory Neudorf Chief Medical Health Officer Saskatoon Health Region. Initial Study: Health Disparity by Neighbourhood Income.
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Health Disparity: Analysis to Intervention Dr. Mark Lemstra Senior Epidemiologist Dr. Cory Neudorf Chief Medical Health Officer Saskatoon Health Region
Initial Study: Health Disparity by Neighbourhood Income • Substantial disparity in all health outcomes between six contiguous low and five high income neighbourhoods • Examples: • Infant mortality – 448% higher • Suicide attempts – 1458% higher • Chlamydia – 1389% higher
200 Knowledge Transfer/Community Consultations • Regional and Provincial Government • Community Groups • Community Agencies • Low Income Residents
Random Survey of 5,000 Saskatoon Residents • Most believe that there should be 0% difference in health outcomes by income status • 83.2% believe health disparity can be reduced • Most support for interventions: • Work earning supplements (84.1%) • Strengthen early intervention (83.8%)
Initial Intervention • Health Region transferred over 1 million dollars of resources to low income neighbourhoods • Paediatricians, public health nurses, mental health workers, etc. • Changes to strategic vision • Government of Saskatchewan • $40 million for low income subsidized housing • City of Saskatoon • Doubled the budget for affordable housing
Initial Intervention (continued) • United Way and Health Region • $80,000 annually for after school programs • Partnerships with Saskatoon Tribal Council • Inner City Immunization Clinic, HIV Clinic, Research
More Research – Examples • CCHS Data Merge (n = 5,948) • Multiple health and behaviour outcomes • Saskatoon School Health Survey (n = 4,093) • Prospective, longitudinal cohort • CCHS Data Linkage with Health Records (n = 3,433) • Systematic Literature Reviews • First Nations Regional (Saskatoon) Longitudinal Health Survey
Main Findings (CCHS & SSHS) • Age and income have the strongest associations with disease/disorder prevalence • Aboriginal cultural status a has more limited association with poor health outcomes and risk behaviours after multivariate adjustment
Literature Review • Reviewed 10,076 published and unpublished articles on effectiveness of interventions to reduce health and social disparity • 42 evidence based policy options to reduce disparity in income, education, housing, employment and access to health care • Review and input from government and community groups • Another 100 knowledge transfer sessions
Support for Health Disparity Reduction Plan • Saskatoon Health Region • Saskatoon Tribal Council • Greater Saskatoon Catholic School Board • Saskatoon Public School Board • United Way • Regional Intersectoral Committee • Various clinical departments, community groups • City of Saskatoon • Province of Saskatchewan