The Intersection of Policy and Health Equity in Primary Health Care: A Policy Scan of 3 Canadian Provinces

Health equity is increasingly being recognized as an important aspect of healthcare. A focus on health equity allows everyone to reach their full potential. Yet there are gaps in healthcare to address health equity. The aim of this Canadian study was to assess how policy facilitates and hinders health equity within team-based primary healthcare settings in 3 provinces: British Columbia (BC), Ontario (ON), and Nova Scotia (NS), identify the similarities and differences across the Canadian provinces, and provide recommendations and actions to advance health equity at policy and systems levels.

We used the OPTIC-PHC conceptual framework developed by the study team to better understand the implementation of primary healthcare teams. The Systemic Equity Action-Analysis Framework was used as the theoretical foundation for the work. The study used a policy scan approach to identify, review, and analyze primary healthcare policy documents in the 3 participating provinces. Sixty-two documents were included in the study.

Health equity did not appear in policy documents consistently until 2018. Four key themes were identified in the policy scan: partner engagement; Community Health Centres, Indigenous health, and equity initiatives.

Health equity is now much more prevalent in policy documents. What is unknown, is whether equity approaches/initiatives have been implemented and/or evaluated. There is significant opportunity for collaboration between patients, caregivers, community members, healthcare providers, decision-makers, and policy-makers to develop health equity initiatives, to implement clearly articulated principles and initiatives to drive health equity, and to measure outcomes of these initiatives in primary healthcare settings.