A Policy Research Agenda for Health Systems in Canada's North

In Canada, remoteness is mainly a northern phenomenon, with Indigenous residents constituting the majority population in the vast majority of northern communities. Despite this reality, there has been a surprising lack of research focus on the interface between remote and Indigenous health. From the perspective of health policy and system reform in Canada's north, there are at least three areas that are worthy of far greater research attention. The first, and perhaps most pressing, field of research would involve comparing various models and approaches for regional and Indigenous governance and administration and delivery of health services. The second concerns a program of research on the inevitable trade-offs in cost, responsiveness and quality between providing a broader range of health services in northern communities or transporting northern residents to southern urban centres for such services. The third research area should explore the ways in which primary care can be made even more effective in remote areas. Properly designed comparative research can take advantage of the past and current policy and system differences in the provinces and territories.