Pauly Bernadette Bernie, MacDonald Marjorie, Hancock Trevor, Martin Wanda, Perkin Kathleen
School of Nursing and, Centre for Addictions Research of BC (CARBC), University of Victoria, Box 1700 STN CSC, Victoria, BC V8W 2Y2, Canada.
BMC Public Health. 2013 Jun 6;13:550. doi: 10.1186/1471-2458-13-550.
Within Canada, many public health leaders have long identified the importance of improving the health of all Canadians especially those who face social and economic disadvantages. Future improvements in population health will be achieved by promoting health equity through action on the social determinants of health. Many Canadian documents, endorsed by government and public health leaders, describe commitments to improving overall health and promoting health equity. Public health has an important role to play in strengthening action on the social determinants and promoting health equity. Currently, public health services in British Columbia are being reorganized and there is a unique opportunity to study the application of an equity lens in public health and the contribution of public health to reducing health inequities. Where applicable, we have chosen mental health promotion, prevention of mental disorders and harms of substance use as exemplars within which to examine specific application of an equity lens.
METHODS/DESIGN: This research protocol is informed by three theoretical perspectives: complex adaptive systems, critical social justice, and intersectionality. In this program of research, there are four inter-related research projects with an emphasis on both integrated and end of grant knowledge translation. Within an overarching collaborative and participatory approach to research, we use a multiple comparative case study research design and are incorporating multiple methods such as discourse analysis, situational analysis, social network analysis, concept mapping and grounded theory.
An important aim of this work is to help ensure a strong public health system that supports public health providers to have the knowledge, skills, tools and resources to undertake the promotion of health equity. This research will contribute to increasing the effectiveness and contributions of public health in reducing unfair and inequitable differences in health among population groups. As a collaborative effort between public health practitioners/decision makers and university researchers, this research will provide important understanding and insights about the implementation of the changes in public health with a specific focus on health equity, the promotion of mental health and the prevention of harms of substance use.
在加拿大，许多公共卫生领域的领导者长期以来都认识到改善所有加拿大人的健康状况的重要性，尤其是那些面临社会和经济劣势的人群。未来要通过针对健康的社会决定因素采取行动来促进健康公平，从而实现人口健康状况的进一步改善。许多得到政府和公共卫生领导者认可的加拿大文件都阐述了改善整体健康状况和促进健康公平的承诺。公共卫生在加强针对健康的社会决定因素的行动以及促进健康公平方面可发挥重要作用。目前，不列颠哥伦比亚省的公共卫生服务正在进行重组，这为研究公平视角在公共卫生中的应用以及公共卫生对减少健康不平等的贡献提供了一个独特的机会。在适用的情况下，我们选择了促进心理健康、预防精神障碍以及物质使用危害作为范例，以考察公平视角的具体应用。
方法/设计：本研究方案基于三种理论视角：复杂适应系统、批判社会正义和交叉性理论。在这个研究项目中，有四个相互关联的研究项目，重点是综合知识转化和资助结束时的知识转化。在总体协作和参与式研究方法中，我们采用多重比较案例研究设计，并纳入多种方法，如话语分析、情境分析、社会网络分析、概念图绘制和扎根理论。
这项工作的一个重要目标是帮助确保建立一个强大的公共卫生系统，支持公共卫生服务提供者具备促进健康公平所需的知识、技能、工具和资源。本研究将有助于提高公共卫生在减少人群健康方面不公平和不平等差异方面的有效性及贡献。作为公共卫生从业者/决策者与大学研究人员之间的合作努力，本研究将提供有关公共卫生变革实施情况的重要理解和见解，特别关注健康公平、促进心理健康以及预防物质使用危害。
