Perspectives on Health Equity in Canadian Pediatric Academic Hospitals: A Qualitative Study

Researchers and health care professionals are increasingly asserting the urgent need for effective practices and policies to address child health inequities. However, there is a paucity of data on current approaches implemented in pediatric hospitals. We sought to explore health care professionals' and interest holders' perspectives on addressing health equity in Canadian pediatric academic hospitals.

We conducted an interpretative descriptive qualitative study involving semi-structured interviews with a purposive and snowball sample of pediatrics residents, staff pediatricians, allied health professionals, and key stakeholders working at pediatric academic hospitals in Canada. We conducted interviews via video conferencing between 2021 and 2023 and analyzed data using reflexive thematic analysis.

We interviewed at least 1 pediatric resident and 1 staff member (including pediatricians, allied health professionals, and key stakeholders involved in health equity) at all 17 pediatric academic hospitals in Canada. Through the 42 interviewees, the following 5 main themes (along with 12 subthemes) emerged: (1) health equity was evolving across institutions; (2) institutions were navigating reactive and proactive approaches; (3) there were siloed efforts and missed opportunities for enhanced collaboration; (4) there were gaps and ethical considerations in health equity data collection; and (5) to achieve health equity throughout an organization, institutional representation and engagement was a necessity. Barriers and facilitators to health equity work were identified, as well as examples of applicable interventions.

There were a myriad of health equity interventions that exist in Canadian pediatric hospitals, although they were evolving and maturing. Learnings can be shared across institutions.