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Health Equity

Health equity is woven into everything that the Toronto Central LHIN does.  This commitment to health equity extends from our Board throughout the organization.  The LHIN recognizes that the only way to achieve a healthier community and an affordable health care system for all is by addressing disparities in access to needed health care services for poor and marginalized individuals.

Agrowing body of evidence shows that disadvantaged and marginalized people have both the greatest health care needs and the worst health outcomes. 

The statistics are striking:

  • The incidence of diabetes is twice as high in low income versus high income neighbourhoods;
  • Immigrant to Canada are more likely to have cardiovascular disease which is worsened by language and other barriers to getting appropriate health care in addition to lifestyle, diet and other factors related to stress if settling into a new country;
  • More low income people are living with pain and disability because they are receiving 60 per cent fewer hip replacements than people with higher incomes.

View: Diversity At A Glance: Neighbourhood Profiles:


The following are some of the activities the Toronto Central LHIN has undertaken to address the issue of Health Equity in our community.

On May 5, 2011, a consultation was held at Mt. Sinai Hospital with 44 representatives of various health networks, health service providers and key community health partners. The purpose was for a variety of groups to provide expert advice to the LHIN regarding a focused set of priorities for action on health equity in the next one to three years.

The Toronto Central LHIN Equity Stakeholder Consultation Report is a summary of all the feedback received.

The recommendations and input from the Equity Stakeholder Consultation helped to inform the development of an Equity Action Plan.   The plan outlines areas that the LHIN will be advancing, commencing with:

1)     Equity data collection and equity indicators

2)     A shared TC LHIN-wide interpretation and language system

3)     Strategies to improve access for non-insured clients

HE Report cover  small


2010 Health Equity Through Language Access reportIn 2009, the Toronto Central LHIN launched Partnership for Service Improvement, an initiative to support LHIN health service providers to partner on projects to improve back office and clinical support services, while reducing duplication and costs. During the same year, Toronto Central LHIN hospitals submitted their first Hospital Health Equity Plans which identified common equity issues, gaps and areas for coordinated action.

In response to the strong interest in enhancing interpretation services across Toronto expressed by health service providers involved in these initiatives, the Toronto Central LHIN is supporting the development of a LHIN-wide interpretation model.

The Hospital for Sick Children in collaboration with stakeholders across health care sectors led the development of a model for language services designed to expand the reach and enhance the quality of interpretation services in the Toronto Central LHIN. The implementation of the recommended model has the potential to have a major impact on health equity for patients/clients and their families, while supporting providers to deliver high quality care.

The Toronto Central LHIN and the Hospital for Sick Children are currently exploring funding options for start up costs.

Read the full report: 

Health Equity Impact Assessment (HEIA)

HEIA is a decision support tool which walks users through the steps of identifying how a program, policy or similar initiative will impact population groups in different ways. HEIA surfaces unintended potential impacts. The end goal is to maximize positive impacts and reduce negative impacts that could potentially widen health disparities between population groups—in short, more equitable delivery of the program, service, policy etc. 

HEIA Tool and access general information and resources on HEIA on the MOHLTC public website: www.health.gov.on.ca/en/pro/programs/heia

What does the HEIA tool look like?
The HEIA tool includes a template and a workbook that provide users with step by step instruction on how to conduct an HEIA. The workbook walks users through four steps: 1) Scoping, 2) Impact Assessment, 3) Mitigation, and 4) Monitoring. The results are recorded in the HEIA template.

There is also a companion French Language Services Supplement that has been developed for MOHLTC and LHIN staff who have distinct responsibilities under the French Language Services Act, 1986 (FLSA).

French Language Services Supplement for HEIA (pdf)

HEIA Tool Fireside Chat (November 2010)

On November 18, 2010, the Toronto Central LHIN, in partnership with the Ministry of Health and Long-term Care, Equity Branch, offered a fireside chat about the Health Equity Impact Assessment (HEIA) tool.  A copy of the Power Point presentation can be viewed below.  This HEIA webinar was intened to be part of an ongoing discussion about addressing health equity across the greater Toronto area and to promote the tool as a way to plan initiatives, strategies and services with an equity lens.

Hospital Health Equity Plans

In 2008/09, the Toronto Central LHIN worked with the Hospital Collaborative on Marginalized Populations drawn from the LHIN’s 18 hospitals to develop Hospital Health Equity Plans.  This is the first time hospitals in the Toronto Central LHIN and, in fact, anywhere in Ontario, has been asked to document their equity challenges, gaps, practices and improvement plans.

All Toronto Central LHIN hospitals completed their first equity plans in February 2009.  A number of LHIN-funded projects have been initiated in response to the hospital plans, including streamlined and coordinated interpretation services, equity-relevant data collection and providing services for uninsured people.  

Hospital Health Equity Plans - Refresh 2010

In June 2010, hospitals were asked to refresh their plans and to include in their plans specific detail on how equity issues are being incorporated into hospital planning processes and/or service delivery, particularly with respect to concrete commitments moving forward.

Toronto Central LHIN expects that this process will further advance building equity into hospital decision-making, planning and service delivery, and contribute to analyzing and advancing system-wide equity priorities. In 2011, Toronto Central LHIN commissioned a report through the Wellesley Institute to provide analysis and recommendations coming from the 2010 plans.  The report and Summary and Recommendations Report can be accessed below:

All information and anlaysis from this report can be found on the "Analysis of Toronto Central LHIN Hospital Health Equity Plans 2010" website: 


Healthy Connections 2010: Self-Managing Care Conference

The Toronto Central LHIN was pleased to support this one day conference which follows up from the extremely successful Healthy Connections 2008 conference.

In June 2008, Healthy Connections Conference, sponsored by the Toronto Central LHIN, brought together front-line workers, administrators, policy-makers, consumers and families to learn about the realities of health inequity as well as strategies for creating more inclusive and just local health care system. 

Hospital Collaborative on Marginalized Populations

In April 2010, Toronto Central LHIN and the Hospital Collaborative on Marginalized Populations presented at the 18th International Conference on Health Promoting Hospitals and Health Services - Tackling Causes and Consequences of Inequalities in Health: Contributions of Health Services and the HPH Network.

Health Equity Discussion Paper

In July 2008, Bob Gardner, Director of Healthcare Reform and Public Policy for the Wellesley Institute, submitted a Health Equity Discussion Paper and  Executive Summary  for the Toronto Central LHIN that sets out key actions to promote health and equity.