1. Health Disparity: Analysis to Intervention Dr. Mark Lemstra Senior Epidemiologist Dr. Cory Neudorf Chief Medical Health Officer Saskatoon Health Region

2. Initial Study: Health Disparity by Neighbourhood Income Substantial disparity in all health outcomes between six contiguous low and five high income neighbourhoods Examples: Infant mortality – 448% higher Suicide attempts – 1458% higher Chlamydia – 1389% higher

3. 200 Knowledge Transfer/ Community Consultations Regional and Provincial Government Community Groups Community Agencies Low Income Residents

4. Random Survey of 5,000 Saskatoon Residents Most believe that there should be 0% difference in health outcomes by income status 83.2% believe health disparity can be reduced Most support for interventions: Work earning supplements (84.1%) Strengthen early intervention (83.8%)

5. Initial Intervention Health Region transferred over 1 million dollars of resources to low income neighbourhoods Paediatricians, public health nurses, mental health workers, etc. Changes to strategic vision Government of Saskatchewan $40 million for low income subsidized housing City of Saskatoon Doubled the budget for affordable housing

6. Initial Intervention (continued) United Way and Health Region $80,000 annually for after school programs Partnerships with Saskatoon Tribal Council Inner City Immunization Clinic, HIV Clinic, Research

7. More Research – Examples CCHS Data Merge (n = 5,948) Multiple health and behaviour outcomes Saskatoon School Health Survey (n = 4,093) Prospective, longitudinal cohort CCHS Data Linkage with Health Records (n = 3,433) Systematic Literature Reviews First Nations Regional (Saskatoon) Longitudinal Health Survey

8. Main Findings (CCHS & SSHS) Age and income have the strongest associations with disease/disorder prevalence Aboriginal cultural status a has more limited association with poor health outcomes and risk behaviours after multivariate adjustment

9. Literature Review Reviewed 10,076 published and unpublished articles on effectiveness of interventions to reduce health and social disparity 42 evidence based policy options to reduce disparity in income, education, housing, employment and access to health care Review and input from government and community groups Another 100 knowledge transfer sessions

10. Support for Health Disparity Reduction Plan Saskatoon Health Region Saskatoon Tribal Council Greater Saskatoon Catholic School Board Saskatoon Public School Board United Way Regional Intersectoral Committee Various clinical departments, community groups City of Saskatoon Province of Saskatchewan