Equity-oriented Monitoring
Overview
Equity-oriented monitoring aims to supplements routinely collected public health data with indicators that help decision makers understand about how health-related policies impact some groups of people in different ways. Co/Lab is currently supporting the development of an equity-oriented framework that prioritizes the structural determinants of health. This approach is driven by existing evidence demonstrating that modifiable risk factors primarily arise from the social, political, and structural contexts in which people who use drugs and alcohol exist. An overview of Co/Lab’s Co/Lab Substance Use Monitoring Framework based largely on Solar & Irwin (2010), is provided below. Click the * to learn more about different aspects of the framework.
Monitoring and surveillance refers to the ongoing measurement of health indicators in a population. This is a core function of public health and is how we keep track of trends in health. It is common that public health researchers will create indicators that either already exist or are known to relate to each other. For instance, they may monitor the price of alcohol, the amount of alcohol that is consumed per person, and mortality from causes that are known to involve alcohol. These indicators relate together: price influences the amount people drink, which in turn affect rates of mortality from alcohol-related causes.
In Co/Lab, we will create additional indicators to “monitor” the social and structural determinants of health and services and supports for substance use, and add them into a more comprehensive framework of substance use and health. Some of these new indicators are already available; others we will create ourselves. In addition, while we have some understanding of how these new indicators will fit into a framework (how they are related to each other and to other indicators of health) and where the gaps in data availability exist. We will also need to plan and conduct studies to evaluate and improve our framework. It is important to get the indicators and their impacts right if Co/Lab is going to generate the evidence that is needed to improve health and reduce inequities.
Resources
Pauly, B., van Roode, T., Carter, C., & Urbanoski, K. (2024). Co/Lab Substance Use Monitoring Framework: Equity-Oriented Monitoring of Substance Use and Health [Overview]
CoLab Community of Practice: Equity-oriented monitoring framework for substance use
+ BC Alcohol and other drug (AOD) Monitoring Project
In 2007, CISUR (then CARBC) was awarded a contract from the Provincial Health Services Authority and Health Canada to pilot a comprehensive alcohol and other drug epidemiological monitoring system for Canada. Subsequently a number of other funding partners contributed to the full roll-out of this system for British Columbia and some elements were implemented in other Canadian provinces.
In 2018-19, the AOD Project became a subsidiary project of BC Co/Lab. Key findings of this project are presented in the Facts & Stats section of the CISUR website. Additional information on the methods and a link to the AOD analyzer tool is available here. Upon request, the AOD team can put together information from the various research components to create regional profiles that will assist policy-makers within to identify and address issues facing their communities.
+ Equity Lens in Public Health (ELPH)
Equity Lens in Public Health (ELPH) was a 5-year program of research funded by the Canadian Institutes of Health Research (CIHR) and the Public Health Agency of Canada (PHAC). Our aim was to produce new knowledge for systemic promotion of health equity. The findings of the associated ELPH projects and resources were a key input to the equity-based monitoring work of Co/Lab. More information about this project including tools, publications and presentations can be found on the ELPH website.