The Intersection of Policy and Health Equity in Primary Health Care: A Policy Scan of 3 Canadian Provinces
Bibliographic record
Abstract
INTRODUCTION/OBJECTIVES: Health equity is increasingly being recognized as an important aspect of healthcare. A focus on health equity allows everyone to reach their full potential. Yet there are gaps in healthcare to address health equity. The aim of this Canadian study was to assess how policy facilitates and hinders health equity within team-based primary healthcare settings in 3 provinces: British Columbia (BC), Ontario (ON), and Nova Scotia (NS), identify the similarities and differences across the Canadian provinces, and provide recommendations and actions to advance health equity at policy and systems levels. METHODS: We used the OPTIC-PHC conceptual framework developed by the study team to better understand the implementation of primary healthcare teams. The Systemic Equity Action-Analysis Framework was used as the theoretical foundation for the work. The study used a policy scan approach to identify, review, and analyze primary healthcare policy documents in the 3 participating provinces. Sixty-two documents were included in the study. RESULTS: Health equity did not appear in policy documents consistently until 2018. Four key themes were identified in the policy scan: partner engagement; Community Health Centres, Indigenous health, and equity initiatives. CONCLUSIONS: Health equity is now much more prevalent in policy documents. What is unknown, is whether equity approaches/initiatives have been implemented and/or evaluated. There is significant opportunity for collaboration between patients, caregivers, community members, healthcare providers, decision-makers, and policy-makers to develop health equity initiatives, to implement clearly articulated principles and initiatives to drive health equity, and to measure outcomes of these initiatives in primary healthcare settings.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: yes · About a Canadian topic: yes | Observational | low |
| gpt | no category Domain: not available · Genre: Other About the Canadian research system: yes · About a Canadian topic: yes | Other design | low |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.004 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".