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

Public health encompasses a broad range of policies, programs, and initiatives implemented to promote community health and well-being. In times of austerity, governments tend to divest in public health, which may have devastating consequences for population health. Evidence identifying the health impacts of cuts to public health spending is limited. Furthermore, understanding how the impact of public health cuts on health inequities is essential for better population health. The current climate of austerity in Ontario presents an important opportunity to study the impact of public health divestments on population health. Specifically, we will measure changes to public health financing and delivery by examining Annual Service and Budget Plans for each public health unit. Secondly, we will administer questionnaires and in-person interviews with the Medical Officers of Health to identify how each public health unit prioritizes programs in response to budget cuts. Finally, we will conduct natural experiments analyzing secondary data, such as the Canadian Community Health Survey (CCHS), to determine the impact of budget cuts. The overall goal of this study is to establish an open access data system for tracking public health expenditures, governance and delivery over time in Ontario and to examine the relationship between public health financing and population health and health inequities. The project will involve working with the frontline public health sector, such as the Medical Officer of Health of Toronto Public Health, and the Ontario Public Health Association, to develop our research questions and methodology, and plan for dissemination of our findings. The research fills a critical gap regarding the impact of divesting in public health on population health and health inequities in Ontario. New evidence will be generated to inform government and policy makers on how to best fund public health and prioritize which public health policies and programs.