Region plans to address health inequities

A letter from the Winnipeg Health Region

Winnipeg Health Region Interim President & CEO
Wave, September / October 2015

Lori Lamont
Lori Lamont

Every successful organization needs a plan to help guide the way it carries out its mandate.

The Winnipeg Health Region is no different. Every five years, it undertakes a major review of its goals and objectives in a bid to determine how it might be able to better deliver care to people living in our community.

The results from this process, which includes extensive consultation with staff and members of the public, are used to shape the Region's strategic plan, a document that sets out the organization's priorities for the coming five years.  

The Region's new strategic plan, which has been approved by the organization's Board of Directors, was unveiled just a few weeks ago. You can find the plan at As you might expect, the new plan, set to take effect in 2016, bears many similarities to the current one, which expires at the end of this year.

For example, the new five-year plan contains many of the same strategic directions outlined in the existing one, including commitments to enhance patient experience, improve quality and integration, and foster public engagement.

But there are also some important differences. Perhaps the most important one concerns the Region's commitment to health equity.

For those unfamiliar with the concept, health equity is a term used to describe efforts to ensure each individual in our community reaches their full potential for health and well-being. In a more practical sense, it means working to address health gaps that exist between residents living in lower-income neighourhoods and those living in higher-income neighbourhoods.

These differences were quite evident in the Region's most recent Community Health Assessment, released earlier this year. (You can read more about the Community Health Assessment and health equity by visiting and searching: community health assessment or health equity.)

As the report notes: "Within the Region, factors that impact health (e.g., education, employment, income, and other socio-economic factors) are unequally distributed. Generally, higher-income communities have better health across the Region."

In many cases, these health gaps arise from unfair and modifiable social circumstances.

Here are some examples of health gaps cited in the Community Health Assessment:  

  • Residents in lower-income communities are more likely to die and to die at an earlier age. During 2007-11, there was a nearly 17-year difference in female life expectancy and a 15-year difference in male life expectancy between the lowest-income neighbourhood cluster of Point Douglas South and the highest-income cluster of River East. The premature mortality rate in the lowest- income cluster was five-fold higher than that of the highest-income cluster in 2007-2011.
  • Lower household income was associated with higher infant mortality rates. There were four times more deaths in children in Downtown and Point Douglas community areas (low-income) compared to the highest-income areas of the Region.
  • Lower-income community residents are more likely to be diagnosed and treated for chronic diseases such as hypertension, diabetes, and ischemic heart disease.
  • Lower-income communities tended to have higher mental disorder and substance abuse prevalence.
  • Intentional and unintentional injury hospitalization rates for residents living in the lowest-income quintile are more than double the rates of those living in the highest-income quintile.
  • Newborns from families in lower income communities are more likely to be exposed to known risk factors prenatally and more likely to be born prematurely.
  • Dental extractions are the removal of teeth, in hospital, from young children with severe tooth decay. Anesthesia beyond levels available in a dentist's office is required. Nine times more children living in the lowest-income quintile of the Region require hospital-based dental extractions than those children living in the highest income quintile.

Clearly, these health gaps are not acceptable. Not only are they taking a terrible toll on people living in our community, they are also estimated to be responsible for as much as 15 to 20 per cent of total health-care costs.

Now, I'm not about to suggest that we as a Region can address all the circumstances that cause these health gaps. But I do believe there are things we can do as a Region to make things better.

In fact, some things are already being done. The Families First program is a prime example. As our story on page 26 of this issue of Wave points out, this program is designed to help parents learn how to better provide a healthy home for the physical, emotional and intellectual growth of their children. As the story explains, this is important because children have a better chance of reaching their full potential if they are raised in a positive family environment. As the story notes, children in the program were 10 per cent more likely to be fully immunized by the age of two, 25 per cent less likely to be taken into care by Child and Family Services, and 41 per cent less likely to be hospitalized for an injury due to maltreatment. 

There are other examples of programs and initiatives underway that promote the goals of health equity. But we can do more.

That's why we have taken steps to embed health equity in our mission, vision and values statement. It's also why we have added a commitment to address health inequities to our six strategic directions for the next five years.

Through these actions, we are making a statement that we take the concept of health equity seriously and that we consider reducing health inequities a key priority in our efforts to provide the best health care possible.

As noted in our mission, vision and values statement, our efforts on this matter are aimed at helping each individual in our community "achieve their full health potential." It's part of our plan.

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