Grant: Commonwealth Fund Dissemination Award 2015-2016

Over the past 40 years, there has been increasing attention being paid to geographical differences in health care, with focus on how we can adopt lessons from well-performing health regions in order to apply them broadly throughout our health care system. In population health, metrics are increasingly used to guide health policy decisions: for example, the Seven More Years report published by Public Health Ontario suggests an additional 7.5 years in life expectancy to be gained if Ontarians improved their health-related lifestyle to those living in British Columbia. However, these comparisons are only valid if underlying data were robust and rankings consistent. Using smoking rates as our public health exposure of interest, this study seeks to measure the consistency of cross-provincial and international population health rankings based on four national and international comparison tools. These include the Commonwealth Fund's International Policy Survey of Older Adults, Organisation for Economic Co-operation and Development's Health at a Glance, the Tobacco Atlas by American Cancer Society and Canadian Community Health Survey by Statistics Canada. In addition, we will determine whether provincial rankings on smoking rates would change if the data used were based on different age groups (46-64 years vs. over 65 years). Our findings will be submitted for presentation at the 2016 annual meeting of the Canadian Association for Health Services and Policy Research, attended by over 600 health care policy makers, managers, researchers, students and stakeholders. This is the first study to evaluate the consistency of performance measures in the realm of population health. As we move into the era of large volume of data (so-called "big data"), we also need to ensure their accuracy. This line of research presents an important step towards our understanding of performance ranking across jurisdictions and will help maximize their effectiveness in shaping policy.