A pan-Canadian dialogue leads the way to improving health equity

Inequity in health care is an increasingly relevant topic across Canada as stakeholders look to improve health care for all Canadians. To explore this further, CIHI led a pan-Canadian dialogue in March 2016, where experts and health system leaders discussed the measurement of inequity in health. A total of 37 participants attended from 12 provinces and territories and the federal government.

Participants identified the core stratifiers (socio-demographic variables) that were the highest priority for measuring equity in health care and discussed how to access and collect them. The highest-priority stratifiers were

  • Age                                                                   
  • Sex
  • Geographic location
  • Income
  • Education
  • Aboriginal identity
  • Ethnicity/racial groups

Additional stratifiers, including housing, disability, language, health insurance, immigrant status, sexual orientation and gender identity, were highly rated by participants. However, those at the dialogue did not unanimously support including them in the core set.

Attendees contributed to an action plan for advancing equity measurement in health care. Short- and long-term goals for knowledge translation and stakeholder engagement were identified, as were goals for stratifier development and implementation.

As suggested by the participants, CIHI has already begun engaging with a broader group of stakeholders to validate the proposed core stratifiers. In an online survey of individuals from health-related organizations, 95% (20 of 21) of respondents agreed or somewhat agreed with the core stratifiers identified. Many indicated that while these stratifiers are important to measure, others do require consideration. As one survey respondent noted, this list represents “a good core set of equity variables that can meet the varied contexts across Canada.”

Ideas for next steps

Participants at the dialogue also suggested establishing working groups to review stratifier definitions and provide an outlet to exchange success stories and lessons learned. A set of resources that will include working definitions for each of the core stratifiers is currently in development. This will help to simplify comparisons of inequity in health care across Canada.

Further details of the dialogue are available in our Pan-Canadian Dialogue to Advance the Measurement of Equity in Health Care: Proceedings Report