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CMA delegates make strong commitment to health equity

August 14, 2012


For the first time, the Canadian Medical Association (CMA) focused its annual general council squarely on issues of health equity with a number of delegates making it clear they felt the association should work to address the social determinants of health.

Following an evidence-laden special lecture by Professor Dr. Michael Marmot, one of the world’s leading experts on issue, delegates signaled their commitment to take action in a variety of areas with more than one speaker noting the topic was the main reason they attended the meeting.

General Council Speaker Dr. Blake Woodside reminded delegates that the discussion on this topic was intended not to set policy but rather to provide direction for future action. In his introduction, CMA President Dr. John Haggie admitted addressing health equity requires CMA “to tread in policy territory not traditionally within our purview .”

Dr. Barry Turchen, chair of the CMA’s political action committee said the CMA was a very credible body to address health equity issues and in correcting “ignorance and prejudice” among the profession and the public when it comes in dealing with vulnerable populations.

“We just don’t have to (just) look at policies … we can be the instrument to go out there and actually be part of the solution.”

“It behooves us to take a leadership role on this,” said Dr. Atul Kapur from Ottawa who noted the issues under discussion were grounded in health and other organizations the CMA would want to work with may not be as familiar with them.

During discussions, delegates raised specific social determinants of health such as the need for clean water in Aboriginal communities, and climate change, where physicians could speak up and make a difference.

Helping physicians by giving them specific knowledge and tactics on dealing with social determinants of health was identified as a key requirement during the discussion. A University of Toronto medical student also noted that medical students also feel a deficit “because we don’t have the language or concepts to address them (the social determinants of health).”

Asked to rank what priority should be assigned to four areas of future activity on health equity, delegates ranked the issues almost equally but gave highest marks to the need to develop clinical tools for physicians wishing to carry out health equity work in their practices.

The other three areas of activity were:

• Identifying practice and payment models that provide physicians with support to address the equitable delivery of, and access to, health care
• Working with key partners to create a Canadian network of physicians expert in health equity to create a venue to share their work
• Working with experts in health and social services to research and assemble the evidence base for health equity interventions

Marmot’s presentation reflected advice he gave in comments a day earlier by providing a strong evidence base demonstrating why addressing the social determinants of health is so critical for improving the health of populations.

By identifying this issue as a priority, Marmot said the CMA “can be a beacon not just to Canadians but to a broader audience around the world” by demonstrating that physicians do care.

“Equitable access to high quality care is absolutely vital but it will not abolish the social gradient of health and health inequities. That needs a much more fundamental look at how we organize ourselves in society,” he said.

In addition to being referenced by the federal health minister in her address, the growing recognition of the social determinants of health at the political level was evident in the opening remarks to the meeting by Tom Beaulieu, minister of health and social services for the Northwest Territories.

He stated that his government “joins a growing worldwide movement in recognizing that we need to look at health in a broader social context in order to have a healthy population.”

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