Unit 4 Resources - Multilevel Approaches to Understanding Health-Beyond the Individual

Unit 4 : Week 7 and 8 consisted of discussing more deeply how various health determinants may influence health from various perspectives both upstream and downstream: social structures, policies, individual behaviours and more.

Advancing equity in mental health: An action framework. (n.d.). Retrieved February 28, 2022, from https://ontario.cmha.ca/wp-content/uploads/2016/07/PPE-0001-Advancing-Equity-in-Mental-Health-2.pdf

This report summarizes why mental health matters for equity and why equity matters for mental health. It breaks down what can be done at the service delivery level, organizational level, and the regional planning and provincial policy level.

Advancing equity in ontario: Understanding key concepts. (n.d.). Retrieved March 1, 2022, from https://ontario.cmha.ca/wp-content/uploads/2016/07/Advancing-Equity-In-Mental-Health-Final1.pdf

This is a report to help understand the importance of health equity within mental health. It is also a report to help Canadian Mental Health Association (CMHA) lay the foundation for the next steps in trying to gain health equity within mental health. The social determinants of health are used to show inequities that people living with mental health illness are experiencing.

DeCamp, M., DeSalvo, K., & Dzeng, E. (2020). Ethics and spheres of influence in addressing social determinants of health. Journal of General Internal Medicine, 35(9), 2743–2745. https://doi.org/10.1007/s11606-020-05973-1

This article focuses on the importance of the social determinants of health and whether or not they should be screened universally or targetted. The authors described spheres of influence and how it originated from a military and political standpoint and how it is now being utilized within the social determinants of health.

Dover, D. C., & Belon, A. P. (2019). The health equity measurement framework: A comprehensive model to measure social inequities in health. International Journal for Equity in Health 18(36). https://doi.org/10.1186/s12939-019-0935-0

The authors discuss the health equity model framework and how it was specifically designed to measure the direct and indirect effects of the social determinants of health to measure health equity. The authors highlight areas that should be influenced by public policy including non health (education and labour) in recognizing how their policies influence population health and and what their role is in health equity.

Government of Canada. (n.d.). Achieving health for all: A framework for health promotion. Retrieved February 27, 2022, from https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/achieving-health-framework-health-promotion.html

This website is used to describe the goal of the Canadian healthcare system. Reducing inequities is one of the challenges listed but the article does acknowledge the importance of eliminating the difference of inequities.

Health Quality Ontario’s health equity plan. (n.d.). Retrieved February 27, 2022, from https://www.hqontario.ca/Portals/0/documents/health-quality/Health_Equity_Plan_Report_En.pdf

This plan discusses Ontario’s recognition of health inequity and creating a framework to deal this inequity. Focuses on the important areas of quality : Access, experience and health outcomes. The plan goes through research, strategies, hopeful outcomes and lists 5 priorities for Health Quality Ontario to focus on moving forward.

Krisberg, K. (2020). Equity at center of revised 10 essential public health services. The Nation’s Health, 50(9), 1-10.

In this article the author brings forward the framework used within Public Health with Equity at the core. There are 10 essential public health services that are used within this framework and it focuses on the individual as a whole but also community factors around them. The framework changed the center of the framework from “research” to “equity” promoting the evolution of public health and the importance of looking at the individual as a whole.

Levi Gahman Lecturer: Radical Geography and Critical Development Studies, & Gabrielle Thongs Assistant Lecturer. (2021, April 28). In the Caribbean, colonialism and inequality mean hurricanes hit harder. The Conversation. Retrieved February 22, 2022, from https://theconversation.com/in-the-caribbean-colonialism-and-inequality- mean-hurricanes-hit-harder-84106?utm

This article discusses the social determinants of health and how Caribbean areas are affected on different socioeconomic levels. Those living in a lower class area do not have the radios to hear about the storms coming and therefore aren't always as prepared.

Peterson, A., Charles, V., Yeung, D., & Coyle, K. (2021). The health equity framework: A science- and justice-based model for public health researchers and practitioners. Health Promotion Practice, 22(6), 741–746. https://doi.org/10.1177/1524839920950730

This article describes the Health Equity Framework. The authors focus on how health outcomes are influenced by complex interactions between people and their environments. This framework centers on three foundational concepts: Equity at the core of health outcomes, multiple, interacting spheres of influence, and historical and life course perspective. The framework intentionally focuses on health outcomes at a population level, rather than the individual in order to elevate and shift our understanding of health equity.

Planning and Evaluation Framework. Middlesex-London Health Unit. (n.d.). Retrieved March 2, 2022, from https://www.healthunit.com/planning-and-evaluation-framework

This is a concept guide of how the Middlesex London Health Unit is looking at health equities and planning and implementing the use of them upstream, midstream and downstream.

Shah, U. A., Hadayia, J. M., & Forys, L. E. (2017). From principles to practice: One local health department’s journey toward health equity. Health Equity, 1(1), 23-27. https://doi.org/10.1089/heq.2016.0004

This article focuses on how Harris County Public Health in Texas used the health equity framework and put it into practice. They recognized that working on upstream factors (like the Social Determinants of Health) would actually benefit downstream inequities. They created a model to help them identify risk factors for those at risk to inequities in healthcare. Within 6 months they began to see a shift in their infrastructure and how their patients were being treated.

Sherman, R. (2017). Knowing your sphere of influence. Emerging RN leader. Retrieved February 23, 2022 from https://www.emergingrnleader.com/knowing-your-sphere-of-influence/

This article focuses on RN leadership and having the ability to decipher between your sphere of control and sphere of influence. This can be used towards any change formation as it is showing how change is coming from a systems approach and the sphere of influence may not be as prominent as before. This article can help decipher between sphere of control (directly can control, team, budget, projects) and sphere of influence (influencing behaviours and reactions of a person so that the outcomes mirror the leader).

https://youtu.be/tZd4no4gZnc

This short clip from YouTube briefly describes the difference between equality and equity.

Social Determinants of health - world health organization. (n.d.). Retrieved March 2, 2022, from https://www.who.int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf

This is a large report but one section focuses on identifying health equity and the importance of the social determinants of health in regards to health equity.

Woodward, E. N., Singh, R. S., Ndebele-Ngwenya, P., Castillo, A. M., Dickson, K. S., & Kirchner J. E. (2021). A more practical guide to incorporating health equity domains in implementation determinant frameworks. Implement Sci Commun 2(61). doi: 10.1186/s43058-021-00146-5

The authors provide research and findings in why it is important to provide health equities when creating programs in health care. Findings show that the reasons it is hard to include lower marginalized people in research is due to lack of accessibility and lack of engagement. The article defines micro, meso or macro levels of outer context and how one affects the other.