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Local Public Health Unit Priorities, Actions, and Barriers in Addressing Inequities During the COVID-19 Pandemic in
Naomi Schwartz1, Ana Paula Belon, Stephen Hunter
1Author Affiliations: Public Heath Ontario, Population Health, Toronto, Ontario (Drs Schwartz and Smith); School of Public Health, University of Alberta, Edmonton, Alberta (Drs Belon, Hunter, Pabayo, and Nykiforuk); Simcoe Muskoka District Health Unit, Barrie, Ontario (Dr Rebellato); and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario (Dr Smith).
Context:
The COVID-19 pandemic required a major response from local public health to reduce infections and manage inequities in COVID-19 outcomes. It is important to consider lessons learned from the COVID-19 pandemic response across local public health in order to prepare for future public health emergencies.
Objective:
This study examined how local public health units (PHUs) in Ontario, Canada, addressed inequities in COVID-19 outcomes in their pandemic response.
Design:
We contacted all 34 Ontario PHUs to participate in a survey on priorities, actions, and barriers to address health inequities in their COVID-19 response and conducted inductive content analysis on responses to identify themes.
Setting:
Ontario, Canada.
Participants:
A total of 25 out of 34 local Ontario PHUs completed the survey.
Main Outcome Measure:
Public health unit-reported priorities and actions in addressing health inequities in their COVID-19 response.
Results:
PHUs reported varied priorities in addressing health inequities. PHUs played a key role in coordinating an equity-focused response, including data analysis and reporting, engaging with community groups, and making cross-sector connections. However, important barriers remained, including a lack of community trust, frequent changes in guidance, lack of access to data on the social determinants of health, and a shortage of staffing and resources.
Conclusion:
Findings suggest ways to prioritize health equity in a public health emergency, including through properly resourcing PHUs, early planning and trust building, and improved equity-based data collection.
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