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Authors of women’s health report develop 10-point Health Equity Road Map

Toronto, February 28, 2012

Researchers at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences (ICES) have released a six-year women’s health report they say provides the evidence and tools to improve the health of Ontario residents.

The POWER Study (Project for an Ontario Women's Health Evidence-Based Report), examined access, quality and outcomes of health care using evidence-based indicators for the leading causes of disease and disability in the province and how they varied by sex, income, ethnicity and geography.

The researchers also developed a 10–point road map to reduce health inequities between men and women.

Evidence-based reform is a key component of the Ministry of Health and Long-Term Care’s new Action Plan for Health Care and a core aim of the government’s Excellent Care for All Act.

“The health care needs of men and women are different, and among women, health needs vary enormously depending on income, ethnicity and other social factors,” said Dr. Arlene Bierman, principal investigator of the study.

“We have more than enough evidence to make health equity a priority and move forward,” said Dr. Bierman, a physician at St. Michael’s. “We need to reduce health-inequities in our system to improve the quality of care we provide.”

The POWER Study consistently found large health inequities that the researchers said could be changed. They said these inequities place a large burden on individuals, their families and the health system. They estimated that if all Ontarians had the same health as Ontarians with higher incomes:

  • 318,000 fewer people would be in fair or poor health
  • 231,000 fewer people would be disabled
  • 3,373 fewer deaths would occur each year among Ontarians living in metropolitan areas
Further, if people from all income groups had the same hospital admissions rates as those from the highest-income group for four conditions alone (heart failure, diabetes, asthma and chronic obstructive pulmonary disease, or COPD) there would have been 15,709 (30 per cent) fewer hospitalizations for these conditions.

The POWER Study was funded by Echo: Improving Women’s Health in Ontario, an agency of the MOHLTC.

“I want to thank Echo, St. Michael's hospital and ICES for the substantive work accomplished through the Power Study and for bringing to light ways in which health system stakeholders can address the unique health needs of Ontario women. Our government is committed to reducing health inequities," said Deb Matthews, Minister of Health and Long-Term Care. "This landmark study confirms the importance of considering the unique health implications for women in all the health research we undertake."

For more information on the POWER Study and its partners, visit

POWER Health Equity Road Map

  1. Equity, a major attribute of high performing health systems and important dimension of health-care quality, is key to health system sustainability.
  2. Health equity cannot be achieved without moving upstream and addressing the root causes of disease in the social determinants of health. A multifaceted approach is required to tackle the many complex problems which contribute to greater chronic disease prevalence and poorer health outcomes in some groups.
  3. Prioritize chronic disease prevention and management to improve overall population health and reduce health inequities. Because chronic diseases and their risk factors contribute greatly to health inequities, the implementation of a comprehensive and coordinated chronic disease prevention and management strategy—one that addresses the need of at-risk populations—is the key to improving population health and achieving health equity.
  4. Focus on patient-centeredness to improve access and satisfaction with care for all.
  5. Province-wide, integrated, organized models of care delivery can improve health outcomes and reduce inequities in care. We found few inequities in the delivery of acute cancer and stroke care, areas where organized, integrated, and coordinate strategies for guideline implementation, quality improvement using performance measurement and feedback with validated quality indicators have been implemented.
  6. Coordinate population health, community and clinical responses. There are many important ongoing activities aimed at improving health in the province including: targeting population-based health promotion, enhancing the quality and capacity of community-based services, and improving the quality of care delivered in clinical settings. Efforts to integrate and coordinate these efforts could produce synergies to accelerate progress in improving health and reducing health inequities among Ontarians.
  7. Link community and health services. Both health services and community services are vital for maintaining health. Improving linkages between these sectors can help assure that people can readily access needed care and services to promote, maintain, and improve health.
  8. Routinely include gender and equity analysis in health indicator monitoring.
  9. Develop strategies for effective implementation by creating learning networks and designing innovations for scale up and spread.
  10. Create a culture of innovation and learning while building the evidence base for accelerated improvement through rigorous evaluation and research.

See More of Our Stories in 2012