Grant: Catalyst Gr: Impacts of financial/organizational restructuring of public health

Public health spending made up only 6.4% of the overall health budget across Canadian provinces and territories in 2018, yet, governments continue to target public health for funding cuts. Finding a way to estimate the value of public health programs for decision makers is key to ensure funding from provincial governments. Across Canada, one of the key responsibilities of provincial/territorial public health departments is vaccination, including large-scale adult vaccination programs, such as shingles and influenza. These programs make up a large amount of public health budgets, and it is important for provincial/territorial governments to understand the direct benefits of these vaccines, and gather evidence on which large-scale adult vaccination programs they should fund. Therefore, we aim to determine what mix of adult vaccination programs give the best health outcomes under various potential budgets. We will estimate the health and monetary outcomes (e.g., deaths and hospitalization prevented, and the associated costs) that provincial governments could expect with changes to the adult vaccination budget. For example, with a budget reduction of $1 million dollars for adult vaccines, we would see an increase of X number of hospitalizations, and X number of deaths. This project will help governments determine which vaccines to focus on in the future, and directly see what they are losing when they choose to defund public health. We will also consider the impact on equity, by determining how policy-advisors value health outcomes for different sub-populations (e.g., age groups and sex) and the various diseases targeted for vaccination (e.g., common but mild vs. uncommon but severe), and how those values may impact the optimal mix of adult vaccination programs.