The way we define health care has to fundamentally change, shifting from a reactive hospital-based system to one that integrates social supports such as housing, food security, mental health access and more.
This was one of the key takeaways from physicians, medical learners, policy-makers and patients who took part in the June 17 virtual event entitled “Lessons learned from COVID-19: How do we close Canada’s health gap?”
“Factors like race, gender, income level, housing and disability are really what define people’s health. This was true long before COVID, but it is all the more evident now.” — Dr. Katharine Smart, CMA president-elect
Keynote speaker and former federal health minister Dr. Jane Philpott said COVID-19 exacerbated the existing structural barriers in health care. She pointed to the importance of listening to Indigenous leaders, with Indigenous communities continuing to fight for basic needs and human rights.
“A rights-based approach to health is where we need to go,” she said.
She also highlighted that the pandemic has presented an opportunity, showing how health care can be effectively delivered through national coordination and interdisciplinary health teams.
“Let’s not go back into our silos,” she said.
Panellist Dr. Naheed Dosani, a palliative care physician, said improving health care in Canada means completely overhauling how we define it.
“Housing is public health, access to mental health is public health, having money in your bank account is public health, food in your fridge is public health … we’re talking about the integration of services and health care in our society,” he said.
For panellist and patient advocate Nicole Nickerson, who lives with heart disease, accessing care in rural Nova Scotia is hindered by geography. She described her local hospital as short-staffed, with the demands far exceeding its resources.
“Many residents don’t have a primary care physician … they are relying on emergency departments for prescription refills and all other medical needs,” she explained. “This leaves little to no room for preventative care or follow-up.”
Following the panel discussion — moderated by journalist Althia Raj — summit participants joined small breakout groups to discuss topics related to achieving health equity, including how to improve health outcomes for racialized communities and what services will be needed post-pandemic to make health care more responsive.
“We need to rethink our resources so that we have latent capacity for the next crisis,” said one participant. “We were so short on everything coming into the pandemic … there was no slack in the system to protect our workers and to ensure we had reserves for this 14-month marathon.”
Other discussions touched on coordinating national efforts to address inequities, expanding access to virtual care, scaling up anti-racism work in health care systems and providing better supports for caregivers.
Dr. Smart wrapped up the session looking to the future, referencing the final Health Summit session on Aug. 22. It will focus on reimagining the culture of medicine. The insights gained during the Health Summit are helping to inform the CMA’s Impact 2040 strategy, which aims to reshape health systems, the health workforce and medical culture.
“As we see light at the end of the tunnel, it’s time to take stock of the lessons the pandemic has taught us and emerge with a stronger commitment to health equity,” she said.