Recent health equity developments in Manitoba
With contributions from Karen Serwonka, Caroline Krebs, Sande Harlos, and Lissa Donner.
Now available: Executive summary and full report of the June 2013 Manitoba health equity forum A knowledge translation forum on health equity and social determinants of health.
A lot has happened in Manitoba since last June, when a diverse group of more than 100 people—from health, First Nations, housing, social planning, education and more—came together to learn and share about health equity ideas and provincial developments. It was an exciting day of new ideas (e.g., ethical space) and recommendations for action that added energy to the substantial work Manitobans were already doing. Download the executive summary of this report here. For the full report, contact NCCDH at [email protected].
We collected some news highlights, and asked our partners to tell us about recent developments in their work to improve the health of all Manitobans.
Manitoba’s 2014 Budget
Manitoba’s 2014 budget has been applauded for addressing poverty. The government raised income-based shelter subsidies, re-committed to completing or starting 4,000 more social and affordable housing units, significantly increased child care spaces, created new apprenticeship programs, and provided support for social enterprises. For the past year, about 150 community organizations campaigned to raise the shelter rates for people on income assistance to 75 per cent of the median market rent; the government has made that recommendation policy.
Manitoba Health, Healthy Living & Seniors, Public Health Branch
A special unit within this branch is dedicated to Population Health and Health Equity. The unit finds systemic ways to incorporate social determinants of health and health equity considerations into policy and program developments across government. It collaborates with partners on strategic initiatives that promote equal opportunity for all Manitobans to be healthy. The inspiring ideas generated by Manitoba forum participants continue to inform the development of a strategic plan for this unit, and for the Chief Provincial Public Health Officer’s (CPPHO) 2015 report on the health status of Manitobans [both of which are works in progress]. A Health in All Policies approach—taking account of health and equity considerations in all key policy directions—is a priority for the CPPHO and the Unit, which is beginning conversations with senior officials on what this might look like in Manitoba.
Since the June 2013 Forum the Public Health Branch has also
- explored synchronicity and future opportunities with the ALL Aboard Poverty Reduction & Social Inclusion Strategy;
- drafted a Guide to Integrating a Health Equity Analysis into our Community Health Assessments that will inform the five Regional Health Authorities’ preparation of their 5th round of community health assessments due by year’s end;
- along with regional, provincial, and federal partners, reviewed health equity tools used in other jurisdictions – in addition to the comprehensive equity-focused health impact assessment piloted and presented at the forum – to apply to our future work;
- continued to support and promote the Manitoba Health community water fluoridation program, a population-based public health measure that has the most impact on those who do not have access to dental care;
- worked with Public Health Inspectors to underline concerns about high risk housing;
- investigated ways to improve the delivery of extreme heat messages to people with lower literacy or who do not speak English or French; and
- along with multiple stakeholders, developed a strategy to help all stakeholders reduce the barriers to immunization. Equity has been embedded throughout the strategy, and a health equity impact assessment is being undertaken to proactively identify possible negative consequences that can be addressed through strategy adjustments. In addition, unintended benefits, from a health equity perspective, could be identified and given more emphasis.
Since the forum, the concept of health equity is much more a part of the Public Health Branch’s environmental health policy and operational discussions.
Public Health Agency of Canada, Manitoba & Saskatchewan Region
The federal public health office is participating on the new Manitoba Health-led intersectoral health equity tools working group. As part of the Canadian government’s Rio Declaration responsibilities, and to inform its own work, PHAC is contributing to a pan-Canadian scan of where and how public health is helping to integrate health equity principles into social programs and policies. The regional office continues to work with government funded social agencies to address health inequities (e.g., Aboriginal Head Start, Community Action Committee for Children), support school readiness for Aboriginal children in Winnipeg, and help improve child well-being and food security for First Nations people.
Winnipeg Regional Health Authority (WRHA): Health For All
Since posting its ‘conversation starter’ report Health for All: Building Winnipeg’s Health Equity Action Plan in June 2013, along with other health equity resources, a number of discussions have taken place and are continuing within the WRHA and with other partners. Several regional action priorities for 2014—identified in the health services recommendations— were identified and have been approved by WRHA leadership, with implementation plans underway. The public health practice implications are being explored through a newly created working group and consultation process. The document has also been used in discussion with partners in other sectors as a way to recognize common ground and amplify collaboration.
Manitoba’s All Aboard poverty reduction initiative
In August 2013, the All Aboard Committee (which began in 2009) published the results (What we Heard) of a consultation process held in March/April 2013. This public input informed the following action plans:
- sustainable employment and a stronger labour market;
- targeted supports for those most in need which highlights landmark legislation passed in December, 2013— The Accessibility for Manitobans Act;
- food security, grounded in the notion that food insecurity is a symptom of low income housing;
- closing the gap for Aboriginal Manitobans;
- creating opportunities for youth; and
- early childhood development and parenting supports.
In January 2014, the Minister of Family Services’ Roundtable on Community Action against Child Hunger proposed twelve actions to reduce child hunger in Manitoba. A few months later, the government’s 2014 budget added $450,000 for school nutrition programs in economically disadvantaged neighbourhoods, and a pilot project to help make healthy foods more accessible to northern Manitobans.
The All Aboard Annual Report (2012/13) outlines gains for Aboriginal peoples since 2009, including ‘potential years of life lost’ and teen birth rates.