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Applying a Health Equity Lens to Program Planning

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Core Theme

This webinar introduces a practical "Health Equity Community Planning Tool" developed by Fraser Health Authority, designed to help public health practitioners integrate a health equity lens into program planning and response, particularly relevant in the context of current public health crises like COVID-19.

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I would like to say hello and welcome to

everybody and thank you so much for

taking the time to virtually be here

with us today I would like to welcome

you to the next installment of our

spotlight on methods and tools webinar

series my name is Kristen Reed and I'm a

research coordinator at the MT CMT and I

along with support from two members of

our our team Ben 9 Leah are here to help

you with any issues that may pop up so

please let us know if you need our help

with anything today we'll be exploring

Frazier health community planning tool

applying a health equity lens to program

planning and given current events

hopefully we'll have a bit of an

opportunity as well to consider how this

type of tool can help us in thinking

about the planning and response to covin

19 so I would like to start by taking

some time to recognize that the MT TMT

which is hosted by big masters

University I situated on the traditional

territories of the Mississauga and

Houghton oceany nations which are

acknowledged in the dish with one spoon

wampum felt this wampum uses the

symbolism of a dish to represent the

territory and one spoon to represent

that the people are to share the

resources of the land and only take what

they need I want to share this with you

it's something that truly resonates with

me and also to encourage everyone

joining us today to take this

opportunity to reflect on these

teachings and with this in mind I would

like to thank you for taking time today

to learn with us in which a very warm

welcome to everybody who has been able

to join us this afternoon so I know we

are all very eager to get to the

presentation so please bear with me as I

share a few housekeeping items you as

you can see there's a chat box on the

right bottom right of your screen

throughout the webinar we will also be

having polling questions to get your

thoughts both of these functions should

be found along the right hand side of

your screen and if not you should be

able to open the panel using the icons

along the bottom also a quick heads-up

that we have a few short evaluation

questions at the end of our webinar it

is very important for us to get your

feedback on the day so please stay tuned

at the end of the webinar and please

please answer the questions if you can

when using the chat please make sure

you're sending to all participants so

that everyone can join in on the

conversation and if you are having or

technical issues we are here to help you

can contact the WebEx helpline or

connect with us in the chat box or

connect to us through email and I will

try to get back to you as soon as possible

possible

so the WebEx number is posted on the

so the slides and recording of this

webinar will be made available shortly

after the presentation we will try to

get them up as soon as possible for

those who are unable to join us today

and so you can access them through the

NP PMT webinars page on our website or

so we do have our first polling a

question of the day and we're just

trying to our hope you get a sense of

who's joining us on the call today

you can answer using the panel on the

right hand side and please try to make

sure to put select submit after choosing

your response we also encourage you to

share and continue to share where you're

from and who you are in the chat box as

well and so we will leave this open for

a bit and I would just like to share a

little bit of information about your

so the webinar today is brought to you

from the National collaborating Center

for methods and tools and the National

collaborating Centre for determinants of

health we are part of the National

collaborating centers for public health

as you can see on the slide here so for

those of you who are unfamiliar the npcs

are funded by the public health agency

of Canada on each hosted in different

academic and non-academic institutions

across the country part of why the NPC's

really exist in the the knowledge

translation field is to reduce

duplication share learnings across

jurisdictions and help identify gaps in

knowledge and practice and that's really

I think a big part about what we're

hoping hoping to do today as you can see

here each NPT works in a different

domain of Public Health and we are

located across across the country the

NCCM tea specifically champions the use

of different types of evidence and

Public Health decision-making and offers

methods and tools for using evidence

when making these types of decisions

until we use the models displayed here

to guide our thinking around evidence

informed decision-making Public Health

and we encourage you to check out our

website for more information our other

co-host for today is the national

collaboration center for different

versions of health and they focus on the

social determinants of health and in

particularly how we can help public

health practitioners address health

inequities and so you can check out

their website access the tool we'll be

discussing today as well as the wealth

of information on health equity and

public health i'm so with that i would

like to jump back so hey just for one

second to officially welcome everyone to

this installment of the spotlight on

methods and tools webinar series

featuring a wonderful planning tool from

fraser health and with that i'll

introduce our facilitator for the day

Kristin it's Diane hi Dan hi hi is that

I'll and acknowledgement slide still neck

neck

I guess absolutely okay no I just wanted

to make sure we were getting no that's

all yeah I think it's just your own on

that side yeah um but yeah so I think

that hello hello Diane thank you for

joining us today civilians and knowledge

translation specialist with MCC D H and

she'll be helping helping to share these

these resources and helping to

facilitate a discussion that we can we

can have around them today so I will

welcome you to the stage Diane and and

pass it off to you to introduce our

presenters as well sure so I think and

thank you I see the lands management now

I was I was thrown off guard I just

didn't want that important piece to get

lost so hello everyone it is finally

aligned in Nova Scotia in Antigonish

Nova Scotia and the NPC D H is located

in Miyazaki which is the ancestral and

unceded territory of Mi'kmaq people this

is a very important piece for us to do

for the land acknowledge Fenton and

every time that I do this I like to

reflect on on why it's important and you

know I grew up in Nova Scotia and I went

to undergrad University here and you

know back in the day we I knew very

little about indigenous culture and Nova

Scotia and the big mouth people in

general and the more communities that

were around me and I think it's you know

it's very important to reflect on how

little that we knew and you know what

what our own role is in that and how

grateful I am to know more now and to

learn and really want to genuinely

extend my thanks and gratefulness for

and with that I'll welcome our

presenters so we have two presenters

with us today both from the Fraser

Health Authority we have Megan Martin

who is our the regional immunization

leader and also some at the tongue who

is the team lead for health equity and

population health unit what I want to

say with these two ladies is that

they're coming to us to share their

health equity in program planning tool

but I really want to acknowledge how

flexible and amazing that they have been

to put this webinar together today and

bring the knot and expertise to us

especially in light of all the increased

demands that everyone's feeling of the

situation and they've also been very

flexible to to incorporate the

discussion of coded and our current

public health crisis in with the use and

application of this tool so I really

want to thank them for being really

great partners on this and I have no

doubt there they've got very valuable

knowledge for us all today so with that

thank you so much for welcoming us and

happy to be here taking with everyone

seems from across Canada and even around

the world

this is Meagan Martin speaking right now

in Batangas whisky now we're coming to

you from the opposite coast from British

Columbia so we want to acknowledge the

territory that we're on as well the

Fraser health provides services within

the unseeded and traditional lands of

the Coast Salish and Inlet optimization

we're really grateful to the care that's

in providing limbs over millennia and

for the opportunity that we have today

to live work and play in this beautiful

part of the world and you can see from

the slide the many diverse nations that

are within this territory in our

presentation today will do a quick

background on health equity and health

equity impact assessments which form the

basis of this tool and then we'll go

into an overview of Atul what's actually

in it and we thought that it would be

helpful then to go into some case

studies to find examples of how this has

been used in practice we'll start off

with what else health equity equity

isn't necessarily a term we hear every

day more often we talk about equality

and equality means treating everyone's

the same and this seems fair on the

surface but as the picture shows

sometimes treating everyone equally

still leave someone out so this is where

equity comes in and equity means

providing everyone with what they need

to succeed equity may actually mean that

we treat differently but we do this so

we can all be able cause oh come well

this kind of redistribution can have a

positive impact on our community we

always want to remember that the goal

should be continuous outpatient and

accommodation but ultimately we want

remove the barriers that are causing the

inequities in the first place so this

requires significant social change but

we can start those conversations just by

acknowledging where barriers exist and

the impact they have the people I'm

seeing a couple of comments that the

audio is choppy I'm going to try and

move closer the mic here hopefully that

so if we're taking health equity lens

how is it that we apply this in practice

so in order to identify who maybe be

thinking of errors and what kind of

supports would be most helpful to

overcome those barriers we can use

health equity impact assessment so AJ

help us to analyze the potential impact

of services programs or policies on

health disadvantaged populations in 2008

the World Health Organisation's

Commission on social determinants of

health all for the use of a chi is a

considered practice can all major

policymaking raise our health develop to

health equity assessment tool or own

internal use and this tool is used to

look at what barrier clinic might face

when trying to access our programs and

services and it was well this school was

being rolled out what their community

health list began to ask whether similar

tool was available to apply equity loans

and any program planning so we met with

some of our community partners looked at

some of the tools that already existed

and again the mark a morally complicated

well other student how quite enough

information the first books that weren't

familiar with health equity and applying

it in practice so they needed something

in between and this went to the health

equity committee planning tool so maybe

open up a polling question here and I'm

wondering how many of you are currently

using health equity impact assessments

in your work you'll see the poll

question appear in the front there and

you can choose from yes no don't no not

currently but maybe you have in the past

or perhaps you're not currently but have

plans to use in the future I'll leave

that up for a minute and remember to hit

meet hopefully we have some responses

rolling in

you have a couple more seconds and then

we can the show the results looks like a

small number are currently using twenty

three folks said that a lot of people

have plans in the future though forty

four chose that option so that's very

clean and hopefully after this webinar

folks will have some ideas of how they

can use them in their own practice so as

I said we developed this tool in

response to a perceived need in the

community the question of folks needed

to ask themselves when would you

actually use this tool so communities

come to this tool because they've

identified a health issue that they want

to address for example your community

may be concerned about mental health

among high school students physical

activity levels in the population or

healthy eating habits in your

communities the key the health issue

that you've identified it could be

physical emotional or social but the key

is that it's an important health issue

community wants to take action to change

the situation so the next question then

is well do you need to apply a health

equity lens to this any applying to

health equity Olympians taking a hard

look at the health issue we want to

address and considering whether certain

groups of people in our community are

great facing greater barriers so point

will help us see opportunities to

deliver our programs and distribute

program resources in a ways equitable

rather than equal so that everyone in

our community can achieve positive

so as we heard from our community and

our own staff there are sometimes

barriers to using this kind of lenss and

community program planning so I'm

wondering at this point what you

perceive as barriers to using an equity

lens in your planning another poll

question is coming up on your right hand

side is it hard to identify the

inequities possibly due to a lack of

data trouble finding the partners or

engaging the community the actual

planning of the program's how it's in a

roll out or is it implementation

sometimes assessment is the challenge or

the maintaining momentum I can get

things started with a group but hard to

keep them going so it's one of those

responses and then hit submit we'll take

a look and see where folks are running

I'll give a couple more seconds to get

your responses in then we can see to me

so a bit of a that across again some

folks saying it's hard to identify the

majority noting that assessing what

difference were making can be a real

challenge a lot around engaging

community planning and implementing as

well so there are a lot of pieces that

go into planning with an equity lens and

within each of these barriers or

challenges there's a step in the tools

that's assigned to address these so

we'll go into that now so we the health

equity and population health in it at

Frazer health worker through the public

health student as well as community

partners to develop the community

planning tool and the tool is intended

to be used in a community context to

apply a health equity lens to program

plan the tool is free to use in download

there's a link at the bottom of the

screen there but it can be found on the

healthier communities pH other reader

Health's website so it's important to

note that this amendment a comprehensive

program planning tool we heard from

several different nurse is that everyone

uses a different approach in their

community and it would be difficult to

find one process that works for everyone

so instead as the title suggests this

tool is actually about applying a health

equity lens to whichever program

planning process works best for your

community and the tools divided into

seven steps seem to be common across

several different models of urban

planning so they're defining the scope

of your program identifying stakeholders

engaging the community and assessing

community capacity selecting the

approach for change and planning for

actions implementing the program

assessing the progress and filing to

gain momentum that's been created by

when you open up this tool you'll see

that each step is laid out like a

workbook so on the left is a simple

visual reminder of the key steps in this

key activities in this step and on the

right of the worksheet which will work

through as a planning team clipper q is

divided into these three sections the

first section of each worksheet gives a

description of what's happening at this

stage of program planning and this will

help you determine which T your planning

group is in then following a projected a

checklist to demonstrate what you will

have accomplished after applying to help

equity-linked stage of your planning and

this can be a useful guide to check your

progress when using the tool then the

third section of the worksheet is a

table and each one have four five

questions which you'll use in the

planning group to apply a health equity

lens to program planning so some of

these questions

nice seem easy for your planning group

to answer for example people who work on

health issue for a long time may have to

consent populations are more or less

advantaged in relation to a health issue

but if you're less familiar with the

issue or if you're starting work on an

emerging issue some of these questions

may be more challenging to answer then

finally I just want to note that if

folks are needing more background on how

to answer these questions there's

actually an appendix for each staff in

school the appendices give more

information on what the questions asking

and provide some guidance on how you

might answer the question by direct

resources or suggesting processes that

your plan and group could use to answer

this question and these were really

developed based on feedback from our

community partners particularly planning

departments or Parks and Recreation who

said that they want to apply this lens

they knew it was important but they did

apparently have a lot of experience in

doing that so they appreciated having a

little bit more direction so these three

pages the visual summary the worksheet

and the appendix are consistent for

every step in the tool and by working

through worksheets reached up planning

team is prompted to in their

understanding of the health issue that

you're trying to address and how it

affects population groups differently

the information you're planning

team gather to check the tool will help

adjust your program so that it's focused

on serving those who face greatest

barriers to good health in your

community so that is a quick overview of

what the tool looks like and how its

structured and then I wanted to give you

a bit of a better sense of the content

tool and we thought that we would share

an example for one of our local

communities the city of Delta so we'll

talk to the first few steps the tool to

give you a sense what kinds of questions

were asked as worksheet and how they

so when the social planner that we spoke

with arrived in Delta there was the

sense that poverty and homelessness was

not a sixteen issue in their community

and she felt that the issue was

underrepresented and wanted to make a

case that more action was needed

she started with step one of the tools

assessing inequities and defining the

scope of the problem she dug into the

data and she spoke with people with

lived experience to get a fuller picture

of the issue in her community and the

social practices they were preventing

those living homelessness from accessing

the services they needed and his sister

makes a case to key decision-makers that

this was an issue that needed to be addressed

the step two of the tool recognizes that

health inequities are complex and the

structures that hold them in place are

interconnected and they can't be tackled

in isolation so identifying and

assembling partnerships becomes a

critical step in addressing health

issues with an equity lens so in Delta

what's the scope of the issue of

homelessness was established the social

planner set up to find partners that

could help and in step two she

identified who those people could be how

they approached the issue and what they

could contribute this led to

collaboration between the city plan

garden police and viola officers base

communities and not-for-profits had

now step three reinforces the importance

of data engaging the community in your

planning or to put it another way

nothing above without us and it also

encourages the user to take a

strengths-based approach to assessing

community capacity in Delta step three

gave the newly formed partnership an

opportunity to take stock of all of the

skills and resources that we're already

available in the community in some cases

biologically officers weren't aware of

social services that could help the

people they encountered and social

service agencies didn't appreciate the

extent to which law enforcement were

engaging with the homeless population

and how they could help to identify

those services and where they could be found

found

so the social planner identified

question two as particularly impactful

and this asks which social structures or

practices the community believe are

leading to the health inequity and it

gave all of the partners the opportunity

to question what structures or processes

we're contributing to homelessness in a

community and explore how those

processes can be altered to break down barriers

now I'm step four this is where all of

this preparation and assessment comes

together as you select your approach to

change and plan for action when Delta

they recognized that a lack of trust

between agencies and the siloed approach

to practice were major contributor to

why people experiment weren't getting

the services they needed the partners

needed to build relationship with one

another and establish better

communication so some of the approaches

to change that they combined we're

raising awareness of the issue building

capacity and changing some

organizational policies or practices to

implement this a regular weekly phone

call was established which can be

facilitated by the social planner and

this helped ease communication between

the different agencies and over time to

build trust directly between the

agencies so that they could share

information and set up systems for

referral in their community this

relationship building had the potential

to fundamentally shift patterns in the

community that were contributing to

homelessness and an important component

of this stage of planning with question

five considering the potential

unintended negative consequences of

their actions so is increased

collaboration between partners there

were potential consequences the agencies

themselves as well as the people they

were trying to serve so it's helpful to

identify these potentially defenses up

so finally is in steps five this is the

step that felt is currently at

implementing and monitoring this

initiative so one of the most important

measures for them with the annual

homeless count and with improvements in

engagement in monitoring homeless

numbers went up for the years because

the count was now more effective they

were connecting with more of a people in

their community whether the numbers

started to turn around and at the last

count Delta achieved an important

milestone while there were still folks

that were experiencing homelessness none

were found to be functionally homeless

there were still people living in RVs

and transient populations that needed

support but the regular street

intrenched population was now being

engaged in connecting with services more

quickly the social planner also shared

the Durbin positive spillover effects by

changing the structures and relationship

in the community by addressing those

fundamental barriers the agencies

involved are now communicating more

quickly on versatile issues and a wide

scope of their partnerships beyond

meeting the needs of people experiencing

homelessness so I have the social

planner why her key takeaways which key

for folks that are looking at using this

tool and one she highlighted was this

tool really helps them to check their

assumptions they thought they understood

the issue they had some beliefs about

the issue but it forced them to see if

the data and the reality actually

aligned with don she noted that it also

provides a structure to apply an equity

lens even if conceptually you understand

it sometimes it's hard to integrate into

an existing planning process so what is

that it's systems and structures that

are contributing to you and it actually

empowers decision makers to see the

tangible changes that they can make in

their own systems rather than seeing an

issue as too big for them to handle or

outside of their control so this is just

one example of how the tool can be used

in a community starting with step one

and moving sequentially through now to

hand it over to some this song is going

to share an example internally of how

that could be used by Health Authority program

thanks Megan so nice to meet you all

joining and so the example that I'm

going to be sharing with you is

regarding the elevation Institute and

just to give you some context around it

I'm just going to call it soggy for

short sake with Impreza Health was

created to a fancy understanding of key

health adjudication population and to

support the development of culturally

appropriate strategies for improving the

health of the diverse South Asian

community with interest of health so for

the last five years the team has focused

efforts upon promotion activities to

prevent lung disease in the South Asian

communities in settings where they post

for example the places of worship

schools and salvation businesses the

currently currently the program is I'm

going to do some of their work and so

expenditure planning tool was used to

reflect a high level Houska work

applied health equity consideration the

team was asked to complete six one three

and four with a good consideration to

their desired level of engagement with

so in step 1 this tool hydrated for the team

team

during the early stages of program

development the focus of the work for

sake was on the Scylla patient rady

project now that the program has

developed further there was opportunity

to look at whether the stuff like their

specific efforts within the South Asian

community broadly fed experience greater

inequities and through this step they

actually identified new salvation

immigrants as the population that they

could actually further work on having

some additional inequities that they've

compared to people who emigrated to

Canada or to BC and have lived here for

longer so however when they do this that

they also recognized that they needed to

find more information about the new

immigrant journey what services programs

already existed for these clients and as

the intent of this tool list for the

team to use is such a reflection at a

high level the team didn't complete

question number 5 which is to look at

the but that this would be done later so

for step 3 here in terms of assessing

community capacity engaging communities

this step help team to consider the

social determinants of health as well as

how they did the importance of community

inputs in influencing the success of

their work the questions also help them

to identify further opportunities for

the team to engage with the news

salvation new immigrants or under-strength

under-strength

their needs and we'll explore how could

they shift the current level of

engagement which they're saying right

now is or from the inform consult level

to their desired level which is

collaborative power they also recognize

that while on average the lead level

engagement was more informed and consult

but there are instances where they

actually had empowerment for

collaborations so I just wanted to note

here too with this step it actually

kinda what Megan mentioned earlier in

the summary from the city of Delta

example is a way to check assumptions so

the asahi team is comprised mostly of

members from the South Asian community

that reinforced to them

point is important of checking their own

assumptions even though they may already

be from the respective community

themselves and not safe for step 4 which

is that they completed they searched

identify strategies to build on and

partner with existing programs and

services there's a South Asian new

immigrant and also to explore how to

engage the soviet-german

within the existing teams planning

process so for example from idea

generation prioritization the ideas and

feedback the team was recognized that

not not all South Asian new immigrants

would be reached by community agencies

serving new immigrants and so starts to

discuss how could they reach them when

these women are dooming we reach by the

community services the question about

removing barriers that is question

number to further reinforce to the team

at the current approach of bringing

their work into the community and

descending to where the community is at

with a key strategy that the con be

using and will continue to use to remove

some of the barriers and question number

four highlighted the importance for the

team on evaluation that it you still

need to have it at the beginning is

important at the beginning the start of

planning and that formal evaluation

isn't always faster is the approach that

could be used or needs to be used so

just end for this step here as you see

the team completed steps 1 3 & 4 that

there will be intent or plants or

authority to fully complete the tool

later on in the spring with the support

of an mph practicum students so listen

take key takeaways for sahi it's a good

way to check in with how we have a

matter of whether we have done something

or not the tool was framework of steps

and considerations at the start of

planning and before any strategies and

interventions are developed and I

mentioned this earlier having a better

understanding of where they were at with

their desired level of engagement with

existing partners helps them to plan for

where they want to be with the plans and

lastly with community input ends

find where gaps maybe would help them to

focus their efforts and resources to

help meet the needs of identified

population so um you'll see that through

the tool there's some overarching themes

take up the core or make up the core and

help the health equity lens and so these

are some of the themes here focus is

just sort of those facing the greatest

barriers rather than designing a program

for general population engaging the

spirited population as a partner rather

than a meta target and the tool starts

to help start some place of strengths so

acknowledging and building on the

strengths of the identified population

and recognizing that they have

resiliency and they're not just needed

the tool also or the health equity lens

is not just building programs for

communities but also building capacity

within the community to meet their own

needs and ultimately the goal is to

eliminate barriers so some closing

thoughts this tool is to supplement

current program planning processes you

can use all our parts present as needed

and just as demonstrated by the patient

IDs and actually as we're seeing the

tool being used more this is not while

the intent of the tool was created for

community planning purposes actually

this tool is applicable and can be used

in any setting as you see in 3d in you

know health 30 program so it's quite

flexible that way used tool when

addressing a health issue in your

community well that's the intent of the

tool well if you're addressing using to

address a non health issue may not be as

a sum of questions and if I deal to fill

out the worksheets of the planning team

as much as possible

it's having a team to come come together

generates that dialogue and identifies

areas where the person may not be able

to given maybe their experience or the perspectives

perspectives

and the tool is flexible so you can use

the tools to do the stuff that you need

but as you are able to give yourself

enough time to consider all the

questions and gather the information

needed and obviously this is a learning

process the more use the tool the kid

Europe it is to apply the health equity

less I'm going to just pass it over to

Diana I think we're going to open up for

some discussion now Oh Diane take it away

away

oh wait I was needed sorry about that um thanks

thanks

thank you very much Megan and Samantha I

I was writing notes madly here in the

background and I think he says oh I

hadn't opened this polling question as I

as I talk of it and I really wanted to

comment I I what I appreciate about this

tool is it are the points about building

on community strength which really

reinforces that you know the importance

of engaging with the community and you

know recognizing a community has

inherent strengths that public health

practitioners can really draw on as a

source of knowledge and you know I also

really appreciate the the reinforcing

that it's a team approach to filling out

an assessment like this because we all

bring different you know all members of

the team bring different perspectives

and then then really you come up with a

collaborative type of solution as well

and so I I really appreciate how

practical everything was and and then

the transferability and that Becca sort

of leads into this question you know

that the transferability of what you how

we use this tool and how you've used

this tool and that is not it's not just

for one topic or one setting it's it can

be across settings or across topics so

so when we think about something like

kovat which is which is you know the

thing one of the things that that that

is on public health mind maybe the

biggest thing on public health mind

right now

you know I we really wanted to

from our audience how a tool like this

could be used in Cova 19 planning and

response so as people are typing in

responses what what do you guys think

Megan and Samantha what and Kristen I

know you're there what do you all think

about how this tool could be applied to

this college planning response and

mitigation and then maybe in the long

term so this is Samantha and all using

Apple say for the sake Ching um I think

I think that coded is is an evolving

institution and multiple numbers of

levels are involved so we can imagine

kind of like a bit of the craziness the

chaos that can ensue and with the

vocation in helping you we've been

getting a number of questions from

members rightfully so that they had

concerns and questions we're hearing

from them that they were good a lot of

different information and they didn't

know what that miss base and what was

not so they're requesting information

from us and so we looked into this

further we also recognize that not all

South Asian community members are litter

literate in English we trying to

understand English with that was very

translated into the languages that were

used by the South Asian community

recognized that there weren't a lot out

there to go through the nature of the

amount of information and communications

needed to be shared so we identified

through just quickly you can get a need

was to also look at for example the

places of worship a lot of the seniors

go that are social venue to connect with

other community members but a lot of

them that attend the place of worship

are also illiterate so their knowledge

and understanding of coded what they

need to do to take self precautionary

measures was limited and so what we

ended up doing was to take the key

messages that have been shared and

promoted by the provincial level and

help to translate them

our Shino we did I'll give you a good

example of that we are treated to

clutches met with the leadership of

various places abortion give them like

here is some key points that your priest

could speak to at the end of sermon

during prayer to the congregation who

are there and just as reminders as a

because it you know the leave there they

are champions within their community and

so they could share that message and we

created a package to share with the

leadership and help them was that they

felt empowered my team members was

saying that they could see the

difference once they were getting I felt

like once I got evidence-informed a

different informed information from for

the health they were able to measure

broadly with their community and so they

- took on the initiative and did they

translate the English text into what

they needed their congregation and then

they started to do other things within

the House are their place of worship to

set it up so that it would be enable

people to practice precautionary

measures that they would need you yeah

yeah that's a really good point

Meghan did you want to add before we

take a look at the responses we're

sharing responses now did you know I

think that's great I think it is as Sam

has said things need to quickly and

change so quickly then it can make it

difficult to connect with all of the

players that are serving diverse

populations and we're going to keep that

in mind as we move but I'd love to hear

what other people are thinking well some

of it the responses up here are really

interesting and also just the folks know

we will be sharing a summary and

overview of the responses that we get

with with attendees sometime in the next

couple of weeks in case that would be

useful and you want to refer to that

later you know I see some responses here

about distributing resources equitably

I'm just looking down the list here

determining areas of communities where

more resources need to be deployed you

know it's there may also be that

and when I think of one of the first

step with the with the assessing

inequities and defining the scope you

know what are so the areas that might be

at highest risk great where what are the

geographical areas where more of our

seniors live or where other populations

that may be a particular risk lives to

help deploy those responses so yeah

there's some really interesting things

here thank you very much everyone for

your responses I really we don't

necessarily have all the answers with

this Kovach piece then where we're

trying to draw on the knowledge us out

there so so thank you for that let's go

to the next polling question this is

where we're really hoping to pull on the

expertise set out there so we'll wait

for it to come up in the screen but I

think the question is who are the most

advantaged or disadvantaged in relation

to this issue of kovat 19 who are who

are those groups that are most at risk

we know seniors are right in terms of

infection and and poor health outcomes

but but who are some of the other groups

and communities in the population that

may be at a higher risk either of

infection or of worse the longer term

consequences so you know I think about

mitigating the circumstances of an

infection but what about you know in

terms of the the isolation poor outcomes

related to the isolation or outcomes

long term after things lift a little bit

and people are able to you know that the

normal routines of life return who you

know who might be in equitably more

vulnerable but also then have a have a

more severe impact I have some thoughts

but Megan and Sam Kristin what do you

guys think yeah this is Megan here I

think this is been a Philly fascinating

the the dialogue that's happening like realm

realm

I think about we have to move good

quickly we have to take action but I've

been impressed with how quickly people

are moving - and what are the unintended

negative consequences of that and taking

actions to try and mitigate that knowing

so many bars restaurants and people in

the service industry are being affected

by the loss of work and income never

appreciated that recognized as a really

fundamental me that you met and I

appreciate the government servicing

action to address that so it's kind of

helpful to have these questions to

prompt us to plan around those issues

even when we have to take really bold

action that it's not left as an

afterthought but it's right in the

middle of the planning that we think

about who's going to be negatively

impacted and can we do as a community

right now to address that oh yeah Sam

what do you think um I mean you Diana

mentioned as years and I would even look

at different ethnic groups of seniors

and I would say homeless homeless

population I mean we've been getting

another part of my portfolio I also had

deals with housing and health and with

getting questions from the shelters that

we have partnerships with around what

can they do so as you can see this whole

bit is just touching every single part

of our world and it's so complicated so

how do we meet that need and I hope even

say not in terms of populations I would

even say terms of settings or businesses

right if you're looking at from a

context preview like so our shelters you

know they have their nonprofit they I

mean yes they're funded partly by our BC

housing provincial agencies at the same

time they have limited resources so

compared to large corporations they may

not have that ability to say such staff

need to be off like they need to have

all those considerations to mind as well

as their ability to this came up

recently their ability to source and get

protective equipment and clean a bike so

you're not able to get cleaning supplies

so how can they in the setting with

shelters up

accommodating those who are not about

housing themselves that you know to kind

of promote and share and keep people

safe right it's a it's a challenge though

though

I think this human thinking about this

is like wow this the number of

populations that could be disadvantaged

and obviously the people who rely on

working to have the first opinion on our

diamond you're looking at now families

right if you can take as far reaching I

think family to the school nurse her

schools are closed but if you adapt with

the compounded by someone needs to work

but they can't another good to have a

child at home so it's just grow

exponentially yeah yeah yeah no you're

right Jen job and I think Leah if you

can maybe put they put the polling

results up now I would just add to that

you know all that you said I think you

know we think about groups that have

greater risk of a long-term negative

consequence and you know I think about

people who work in place of employment

where there aren't paid sick days where

they don't have the ability and capacity

to work at home and I think you know one

of the things that I've been thinking

about with this coded responses or with

a co-ed situation I mean is is you know

the need for those you know broader

economic policies that help ensure some

level of income security for those who

don't otherwise have it and you know

that what you know often the solutions

to help lie outside of the health system

they may lie in economic policy for

example so other you know other sort of

structural and determinants in

structural systems that have an impact

on health outcomes so that's really

reinforced and there's a really

interesting result here as well you know

in terms of who is most vulnerable

certainly homeless is mentioned people

who have comorbidities so other

illnesses that make them

immunocompromised folks that

our indigenous and live in isolated

communities lower income populations so

there's a whole host people done a

really good job of identifying at-risk

and and those without a vehicle and that

live away from services and may they may

harder to access treatment and

information so so I think we'll go

really quickly and do the next polling

question a little more quickly because

I'm noticing our time so the next

question is what opportunities exist to

work cooperatively with other sectors to

address those inequities around covin 19

so you know we've heard mention of that

a little bit there certainly and we've

heard that in the federal government's

response there you know within the

federal government health and on health

departments are working together we've

got you know but it's certainly

transportation trade income in economics

you know but I lost my words our Pacific

the next one but there's there's all of

what the federal government is doing is

certainly spent clearable to community

organizations as well megamen sandy have

quick thoughts on this on this I would

agree with the level of collaboration

and communication and information and

data sharing we're seeing is hopefully

setting us up well to continue to work

corporately collaboratively after all

the dust settles but it certainly

highlighted the ones one sector can

solve this alone we all getting to pull

together I agree and just quickly I

would even look at like all sectors so

even looking at media how can they help

to promote the messaging and reach the

people who may not be able to get the

messaging either way but providing the

appropriate thing to help support them

but also translating it I think that's

meaningful and resonate

yeah yep Leah can you put up the the

responses for this one and and we'll

have to look at this really really

quickly but again will will share with

with everyone after the fact obviously

here for a second for them to set it

comes there we go

so I think we should all keep thinking

about this and I think you know there's

some thought to be put into how how to

like this and can help in the recovery

phase as well so thanks for that

everyone and thanks to Megan and Sam for

for your thoughts on that and on this

ever evolving situation and so there's a

few thank yous from from our speakers

and I think if we can go then to the

next slide and I think we did have a few

questions come through the the chat box

let's see Leah did you send those to me

by any chance or should I go back up

through hi Dan there should be a summer

English at the bottom of your top off oh okay

okay

ah there we go okay

so um I see that now sorry about that so

how can it be applied to First Nations

communities especially you know those

who are isolated and may have limited

yeah I mean that's where a great

question and I think that the way this

tool was set up we can think of broad

populations within a larger community of

which the indigenous population could be

a sub population but then within an

individual community for the the diverse

populations within First Nations

communities whether

it's elders whether it's younger

children they're people who have been

living away and come back so thinking

about some of those diverse populations

can be helpful but I think where I

appreciate this tool is it keeps

reinforcing that this is about reducing

the barriers not just delivering a

program or a project so it gives

planning groups an opportunity to look

at what are the the structures and the

processes that are in place that that

are holding a health inequity in place

and then it also hopefully as city of

Delta and asahi found inspires people to

see what's within their well control

that they can make tangible changes and

then I think within the broader Canadian

context hopefully it does increase

awareness of how our programs and

policies in the general sense are

impacting populations differently

including the indigenous peoples of Canada

Canada

the question of buy-in from senior

leadership and team members within the organization

organization

what's the how did that happen within

break your help for example how is a

good way to gain buy-in and build that

team approach um if I'm not sure if the

question is related to just health

equity in general or more specifically

tool if it's health equity in general

this is something that we've been

working on and I think it's a common

thing probably cuz no multiple

organizations are setting and it really

you think it depends I mean before we

United and I mean at this point right

now with enforcer Health West we have

going on for us is that we do have

organizational priorities where health

equity is linked and so we've been

working to a little raw organizational

part 30 and sometimes it's also a matter

of filling in evidence to demonstrate

that so this is actually a long story I

can actually be answered in multiple

ways and could take on kinda mindful of

time but if it's specific to them itself

I would say that you know science is not

necessarily its introducing the tool

maybe introducing the tool look at the

questions to see what you think would

resonate at the one point in question

that would kind of spark the dialogue

that's what has been interesting is that

it's sort of a I see a value of the tool

is these Byrne conversation once you

start the conversation you can start to

build that momentum and gain that

insight and buy-in and then even it may

be that that part of it school rather

than the whole tool so there's many ways

to use the tool back to that question

but I just mindful of time for now yeah

no one I think yeah I know and we do

have to move on I think you make a good

point about the team by and maybe that

team approach to filling out some of the

tools helps with that as well and I if

there are any published studies either

by Cydia Delta or others that you can

provide I would appreciate your sharing

the links with me and then we can share

them with

participants of the webinar as well so

we do have a couple of evaluation

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YouTube Transcript:Applying a Health Equity Lens to Program Planning