Last week, Holland Bloorview Kids Rehabilitation Hospital VP of Programs and Services, Diane Savage, and I were fortunate to be able to speak at the annual Pediatric Health Equity Collaborative conference, which was hosted by Holland Bloorview.
The Pediatric Health Equity Collaborative is an outgrowth of the Disparities Leadership Program at the Disparities Solutions Center at Massachusetts General Hospital. Five Holland Bloorview leaders attended the program in 2014 and 2015 to advance our work of equity, diversity and inclusion. The Collaborative works to establish best practices, lessons learned and recommendations with regard to race, ethnicity, language and other demographic data collection in pediatric care settings.
Among the organizations participating in the conference were: Disparities Solutions Center at Massachusetts General Hospital; Boston Children’s Hospital; Children’s Mercy Hospitals and Clinics; Holland Bloorview Kids Rehabilitation Hospital; Johns Hopkins Medicine; Monroe Carell Jr. Children’s Hospital at Vanderbilt; Sinai Health System (Toronto); Nationwide Children’s Hospital (Columbus, Ohio); Nemours Children’s Health System (Wilmington, Delaware); Seattle Children’s Hospital; The Hospital for Sick Children (SickKids) (Toronto); and St. Christopher’s Hospital for Children (Philadelphia, Pennsylvania).
At Holland Bloorview we are proud of our commitment to equity, diversity and inclusion. Over the last five years we have embedded structures such as our Equity, Diversity and Inclusion Steering Committee, our grass roots Equity, Diversity and Inclusion (EDI) Council and we have seen the evolution of our employee social committee which has taken leadership in hosting different celebrations of diversity in partnership with the EDI Council.
Some of our key successes include:
- an organizational equity survey of staff, the results of which help us prioritize and plan
- our respect campaign to raise awareness and promote mutual understanding
- an equity lens toolkit to bring EDI to the design of new services and organizational structures
- health equity client and family surveys to understand who we serve and how care is experienced
And, as is always the case at Holland Bloorview, we have co-created these approaches with our child, youth and family leaders and our Client and Family Integrated Care team.
We know our communities at Holland Bloorview are diverse culturally, economically and geographically. Nearly 50% of the population of Toronto immigrated to Canada and nearly 50% are visible minorities. Toronto is also home to some of Canada’s largest urban indigenous communities. It is imperative we better understand the communities we serve or we will not be able to deliver the kind of care that creates the most meaningful and healthy futures for our children and youth, and the adults they will become.
As part of modeling the change we want to see in the health care, we also have to do better at reflecting the diversity of the people we serve with our own organization. Being reflective of those we serve can help advance better health outcomes, effective models of service delivery, efficiency, heightened care experiences and a just culture of acceptance where staff, clients and families feel safe bringing their whole selves to their place of care and work.
Data from our own health equity survey tells us that nearly 30% of families we serve earn less than $60,000 per year and nearly 16% earn less than $30,000. This is in a city that has the highest cost of living in the country with some of the most expensive housing costs in North America. With this knowledge, we are currently exploring how financial barriers impact how often families miss appointments. It is only through this work that we can identify effective solutions to ensure our clients and families are getting the care they need.
We have to do better for the children and youth we serve, regardless of their backgrounds. We have to create health, social and educational systems that work for everyone and we need to partner in ways that are innovative, fiscally responsible and gives us opportunities to learn and share what we know.
It’s 2017 and it is simply no longer acceptable for the social determinates of health to determine child and youth health outcomes.