Population health scientist Laura Rosella wants to know what makes entire societies healthy. She’s an associate professor at the University of Toronto’s Dalla Lana School of Public Health, a multidisciplinary school that brings together researchers to probe how different policies and interventions can impact human health.
“We use data and evidence to try and inform how we can keep people healthy and prevent disease before it actually starts,” says Rosella.
We interviewed her and several researchers in her lab, the Population Health Analytics Laboratory, to learn more about how to implement better health equity in Canada. This is a key element to make sure more citizens get access to high quality care.
“When we think about a population, we think about segments in that population who are the most disadvantaged,” says epidemiologist Meghan O’Neill.
“What we do in our lab is we really care about that group of people, and we want to make their experiences in our healthcare system better. We want to make integration better for those people.”
A first step in reaching those populations is to identify them and, to that end, spatial epidemiologist Emmalin Buajitti looks for them where they live.
“We’ve produced a series of reports summarizing the geographic distribution of mortality in Ontario, and it shows that there are actually massive, massive disparities in premature mortality in Ontario and in Canada,” says Buajitti.
These health disparities mean there either geographic factors that are making people sick, or barriers to accessing care. Policies and infrastructure need to address these differences to make sure every citizen has the equitable access to resources.
Making the case for investing in resources carries more impact when they can be tied to an economic benefit, and so that’s another aspect of the work in Rosella’s lab. Epidemiology evaluator Kathy Kornas calculates the impact of various what-if scenarios.
For instance, active transportation infrastructure like better sidewalks and bike lanes can encourage people to incorporate exercise into their daily routines. These lifestyle behaviours can have a positive impact on health, preventing diseases like diabetes. Kornas estimates the number of diabetes cases that can be prevented and the cost savings for the healthcare system.
“Sometimes it’s hard to communicate what the impact of certain decisions will be,” explains Kornas. “When you can put a dollar value on these decisions, it becomes very impactful for people in municipal office or politicians.”
These tools can forecast what might happen in the near future, but they can also peer decades ahead to what might happen twenty years from now.
“The work that we’re doing in developing tools to help people do planning more easily, to estimate the economic impacts of those prevention approaches, is really going to pay itself back,” says Rosella, “both in terms of the health of the population, which has always been our focus, but also the sustainability of our healthcare system.”