Preventive care recommendations to promote health equity

Area of Science:

• Public Health
• Health Equity Research
• Preventive Medicine

Background:

• Persistent health outcome disparities exist in Canada's publicly funded healthcare system.
• Significant investments have not fully eliminated avoidable health inequities.
• There is a need for targeted preventive care strategies to address disadvantages.

Purpose of the Study:

• To develop evidence-based preventive care recommendations promoting health equity.
• To prioritize interventions for populations experiencing socioeconomic or health-related disadvantages.
• To guide clinicians, policymakers, and healthcare organizations in addressing health disparities.

Main Methods:

• Guideline development involved primary care providers, patients, and experts.
• Systematic reviews and randomized controlled trials informed recommendations.
• The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and Appraisal of Guidelines for Research and Evaluation (AGREE II) frameworks were utilized.

Main Results:

• Fifteen screening and preventive care recommendations and one policy recommendation were developed.
• Prioritized outreach for colorectal cancer screening (starting at age 45) and cardiovascular disease risk assessment.
• Recommendations include HPV self-testing, HIV self-testing, tuberculosis screening, and screening for depression, substance use, intimate partner violence, and poverty.
• Automatic connection to primary care for disadvantaged individuals is recommended.

Conclusions:

• Effective preventive care interventions can mitigate health inequities when focused on disadvantaged groups.
• Evidence-based actions are crucial for clinicians, healthcare organizations, and governments to advance health equity.
• Tracking progress in promoting health equity across Canada is essential.