A Population Health Approach: Addressing equity and social determinants of health in Canadian healthcare

Introduction: Currently, there is limited knowledge about operationally feasible strategies that help link the provision of integrated care with the population health approach1,2. The scope of integrated care needs to be expanded to bridge the gaps not only within the health system, but also between public health, health care and social care1,3. This broader focus for integrated health care would enable health systems to address the social determinants of health SDOH of populations4. Using results from an ongoing multi-case study investigating implementation of population health approach in Canada and abroad, we will present an analysis of strategies used by select Canadian primary care and speciality care organizations that have taken on the population health approach and link the provision of integrated care, and successfully tackle issues of inequity and the SDOHs.

Methods: In this multi-case study we use field visits, interviews, document analysis and other resources to identify key strategies, barriers and enablers to implementation of the population health approach. Population health experts and health planners nominated potential cases that were then assessed against the criteria that identify population health systems. Integrated knowledge translation has been incorporated to link knowledge users and academic researchers throughout the study. The study draws on the expanded chronic care model, socio-ecological model and equity lenses.

Expected results: The study will identify and provide evidence about the effectiveness of specific strategies, including creative approaches and innovations that help routinely screen for the SDOHs and integrate social supports into delivery of care. We will map out strategic partnerships and inter-sectoral collaborations designed to support integrated delivery of health promotion and disease prevention, health care services and social care.

Discussion/conclusion: This study will contribute to the knowledge about the planning and implementation of population-based integrated systems of care that successfully address a range of SDOH. Findings may help inform relevant policy and strategy and are directly relevant to ICIC 2018 theme "Population Health Management", sub-themes: Tackling inequalities and the social determinants of health, Improving population health outcomes and Strategy development, partnerships & leadership.

Potential suggestions for future research: As the population health approach is adopted across the continuum of care, future research needs to facilitate the spread and scale up of integrated care in the context of population health.

References:

1- Struijs JN, Drewes HW, Stein KV. Beyond integrated care: challenges on the way towards population health management. Int J Integr Care. 2015;15December:7-9.

2- Groene O. Kicking off the Special Interest Group Population Health Management – how can the scaling up of innovative success stories be supported ? In: 16th International Conference on Integrated Care, ed. International Journal of Integrated Care IJIC. Vol 16. Barcelona, 23-25 May 2016; 2016:1-8.

3- Trinity M, Dyer MB. Integrating Health Care and Social Services : Moving from Concept to Practice.; 2016.

4- Vaida B. For Super-Utilizers, Integrated Care Offers A New Path. Health Aff. 2017;363:394-397. doi:10.1377/hlthaff.2017.0112.