Evidence-based public health interventions to reduce social inequalities in health

Dr. Louise Potvin

Marie-France Raynault

Institution

  • Direction de la santé publique de Montréal

Nominated Principal Investigator

  • Louise Potvin

Principal Co-Investigator

  • Marie-France Raynault
  • Program team

    Co-investigators

    • Lise Gauvin
    • Angèle Bilodeau

    Principal decision-maker partner

    • Richard Massé, Direction de la santé publique de Montréal

Research objectives

The proposed objective of this research program is to conduct intervention research in collaboration with Montreal’s public health agency, the Direction de la santé publique de Montréal (DSPM), which has made reducing social inequalities in health a priority. More specifically, the research team will produce evidence and moderate a space for sharing and using knowledge about the processes and effects of public health interventions designed to reduce social inequalities in health by applying the four population-based strategies of the Ottawa Charter for Health Promotion: building healthy public policy, strengthening community actions, creating supportive environments and reorienting health services.

Approach

This research program comprises four interrelated components, each of which examines one of the following four public health interventions:

  • the policy establishing reduced-contribution day care centres;
  • the Montreal initiative to support local social development;
  • the urban-planning intervention to encourage active, safe transportation;
  • the integration of the DSPM’s community-based interventions with those of other actors in the Montreal region.

A combination of quantitative and qualitative methods will be used, including case studies based on geographic entities

Project update: How can partnerships help to reduce social inequalities in health?

Drs. Louise Potvin, Marie-France Raynault, Lise Gauvin and Angèle Bilodeau, and the Centre de Recherche Léa-Roback (CLR) team, work closely with the Direction de santé publique de Montréal (DSPM) to reduce the city's health-related social inequalities.

The CLR is an important partner of the DSPM as it helps analyze the city's context and identify actions to improve the health of Montrealers. For example, Dr. Marie-France Raynault, principal co-investigator on the programmatic grant and researcher at the CLR, led the development of the Rapport du directeur de santé publique 2011 – Les inégalités sociales de santé à Montréal : le chemin parcouru [ PDF (25.9 MB) - external link (in French only) ]. This report continues to direct the DSPM in its work to reduce social inequalities. Dr. Raynault also recently assumed the scientific leadership for a report on housing, Pour des logements salubres et abordables [ PDF (6.0 MB) - external link (in French only) ], in response to a key recommendation of a 2011 report by the Director of Public Health that called for concerted action on this fundamental determinant of health. The team has also provided expertise for the preparation of briefs and public health advisories for Montréal.

Playing a key role within the organization, the CLR supports different sectors of the DSPM, notably with prevention-promotion, the urban environment, infectious diseases and occupational health, using the approaches they have developed to address the problems related to social health inequalities. Below are some of the projects that resulted in beneficial exchanges between public health professionals and researchers:

  • Production of a monograph and conduct of a study on the health impacts of housing among 1,600 Montréal households that serves as the basis for new housing programs;
  • Literature review on barriers to access to quality services for disadvantaged children and the development of better policies to overcome them;
  • Collaboration with the DSPM evaluation and monitoring team to establish indicators of social inequalities in health and production of knowledge transfer tools (e.g., Inégaux – Le film (in French only));
  • Long-term study of health inequalities and reportable diseases;
  • Discussion of research findings with stakeholders to realign primary care programs to address inequalities in access to services;
  • Literature review and qualitative research on health problems of precarious migrants, and recently an emphasis on temporary personnel agencies employing them (in collaboration with Prof. Katherine Lippel, University of Ottawa and Prof. Sylvie Gravel, UQAM);
  • Photographic monitoring of projects being implemented as part of the Quartiers 21 program, conducted jointly by the DSPM and the City of Montréal to transform environments to make them more conducive to active transport and sustainable development;
  • Analysis of intersectoral action and its effects.

The partnership between the CLR and the DSPM has resulted in strong relationships, funding, joint assignments and sharing between researchers and practitioners, in addition to significantly improving the uptake of research results. The CLR also contributes to the DSPM's research culture by guiding and supporting its research priorities. In addition, working closely with the DSPM has enabled the team to reach all of its partners outside the health system, who are also key players in the fight against social inequalities in health.

Selected publications

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