Health equity does matter.

The Institute of Population and Public Health (IPPH) of CIHR recently released its 2009-2014 strategic plan titled: “Health Equity Matters”. The plan is entirely anchored on a public health imperative to promote health equity and tasks IPPH to provide the tools to support this mission. It identifies four research priorities: 1) improving the understanding of the pathways which promote health equity, 2) determining the impact of complex population health interventions, 3) studying implementation systems for interventions and 4) stimulating theoretical and methodological innovations in knowledge generation, synthesis and transfer. These priorities stem from the recognition of the need to move beyond descriptive studies of health inequities, to the development, implementation and evaluation of real-life solutions. In particular, the field of intervention research is central to the strategic plan. Population health interventions include policies, programs and resources allocation. They are often complex which means that they involve a multitude of players and targets, multiple interventions and delivery mechanisms and are implemented in complex societal systems. Research in population health interventions is necessarily multidisciplinary, requires substantial resources and time, and will necessitate the development of new theoretical and methodological approaches to intervention design and evaluation. It will also require strong partnerships among practitioners, decision-makers and researchers to ensure that research results are relevant and applicable to the real world. Most interestingly, intervention research will often emerge from “natural experiments”, including policies introduced in local jurisdictions, new municipal bylaws, changes in zoning, changes in the physical environment and the numerous laws enacted yearly in the various provinces. Hence, research into implementation systems or delivery mechanisms for population interventions will be critical for the widespread uptake of promising innovations. Although the absence of global health from the plan is a glaring omission considering that North-South health and economic discrepancies represent one of the most obvious and preventable inequities in the world today, one must salute the judiciousness of the objectives and strategies identified by IPPH as they will provide focused directions for the development of highly relevant research in Canada over the next several years. Despite less than optimal growth prospects in research funding in Canada, I hope that IPPH will be able to continue and expand its successful partnerships with governmental and non-governmental organizations here and abroad to forge an innovative and wide-ranging research agenda that not only is ground-breaking but truly enhances health equity.