A Health Equity Lens Contributes to an Effective Pandemic Response: A Canadian Regional Perspective.

As cases of COVID-19 began to increase in Ontario, Canada, throughout 2020, early evidence from surveillance and media highlighted disproportionately higher rates of COVID-19 infection, hospitalization and mortality among racialized and low-income populations. This disproportionate impact on underserved populations calls for a shift in approach away from what has traditionally occurred in health protection, that is the use of a universal approach which assumes everyone is affected and benefits equally from the same type and intensity of interventions. In this article, public health agencies are, therefore, being called to consider moving away from using a purely universal approach, often used in the control of communicable diseases, and apply a more tailored approach and use principles of health equity and proportionate universalism to reduce COVID-19 cases and their impacts among underserved groups and address health inequities exacerbated by the pandemic. We highlight examples from York Region Public Health, one of the largest health units in Ontario, to demonstrate areas of possible impact of this paradigm shift. It is clear that with a health equity lens applied to the pandemic response, the impact of COVID-19 can be further reduced and health inequities that predated the global pandemic can improve.

Walking the Walk: The Case for Internal Equity, Diversity, and Inclusion Work Within the Canadian Public Health Sector.

Equity is fundamental to public health practice. However, limited work has evaluated public health units, as employers, in ensuring equitable workplaces. Public health units must examine their policies for promoting equity, diversity, and inclusiveness. We suggest strategies that these organizations may adopt to establish a diverse workforce, including programs of responsibility, broader advertisement of employment opportunities, and standardized application processes. These practices are site dependent and are more effective when supported by senior management. By considering these strategies, institutions of public health can improve equity, diversity, and inclusion in their workplaces while addressing health equity in the communities they serve.

A systematic review of randomized controlled trials of interventions to improve the health of persons during imprisonment and in the year after release.

We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases in 2014, and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender was specified); only 16 studies focused on adolescents. Most studies were conducted in the United States (n = 57). The risk of bias for outcomes in almost all studies was unclear or high (n = 91). In 59 studies, interventions led to improved mental health, substance use, infectious diseases, or health service utilization outcomes; in 42 of these studies, outcomes were measured in the community after release. Improving the health of people who experience imprisonment requires knowledge generation and knowledge translation, including implementation of effective interventions.