Grant: Catalyst Grant: Moving Upstream - Structural Determinants of Health-POR Approach

Immunocompromised Canadians, such as those with transplants, are at higher risk of severe outcomes from infectious diseases. They are among the most vulnerable during a public health crisis such as a pandemic. Their health depends on structural factors such as high-quality health policies, and on an individual patient's ability to receive, understand, and act on health information, such as getting vaccinated. Yet, transplant patients and caregivers have expressed that pandemic policies and information from governments, public health authorities, transplant centres, and health professionals have been confusing and cause stress and anxiety. They describe feeling overwhelmed by information aimed at the general public, while simultaneously having insufficient information relevant to their situations. Meanwhile, speeches about public health measures by politicians and policymakers have minimized the importance of the lives, health, and wellness of this group. This patient-oriented project will analyze how policymaking and health system practices may disadvantage immunocompromised Canadians and create health inequities. We will first examine the speeches of politicians and other policymakers related to pandemic health policies, and the language that is used to describe immunocompromised people and policies that protect them. Second, we will study how diverse transplant patients consider the complex health information landscape during their decision-making, and specifically what they think about information from their transplant centre. Third, we will examine inequities in vaccine uptake among transplant patients. We will focus our analysis on people in social positions that may be linked to additional disadvantages. This work will identify structural factors that may systemically disadvantage immunocompromised people in Canada and develop recommendations for transplant centres to support the equitable provision of health information, for more equitable health outcomes.