Catalyst Grant : Impacts of financial and organizational restructuring of public health – Full Application
Academic Unit: Inquire with unit
Memorial Deadline: Monday 23rd, December 2019
External Deadline: Tuesday 7th, January 2020
SIRI will be offering support with application development for this opportunity. Prospective applicants are encouraged to contact Jennifer Stevens (email@example.com) early during the development process to discuss the services available to them.
Robust public health systems are a vital part of reducing disease and injury and improving wellbeing, longevity and health equity. Government public health agencies play a lead role in delivering public health services including assessment, surveillance, health promotion, health protection and hazard management, disease prevention, and emergency management. The structure, organization and funding of these government agencies impacts the design and provision of services and, ultimately, the health and health equity of the populations they serve.
Existing evidence demonstrates that investment in public health is not only cost-effective – it is cost-saving. A leading systematic review highlights that governments save on average $14 in healthcare costs over a 10-year period for every $1 invested in public health. Despite knowing the value and cost-savings that result from public health investment, there is limited evidence measuring health, economic and equity impacts of divestments from and the reorganization of public health systems. Clearly understanding how changes to the financing, governance and delivery of public health services will impact population health and broader health systems is critical to the design and implementation of effective policies in this domain.
In Canada, investment in public health accounts for 5.5% of total health spending – an amount that includes food and drug safety, health inspection, health promotion, occupational health, community mental healthcare, and services delivered by public health nurses. In recent years, a number of Canadian provinces have made significant changes to the financing, governance, and delivery of public health services. In some cases, these changes were subtle and went unnoticed; in others, they generated strong reactions in the media. Broadly speaking, few were scrutinized from a scientific perspective.
These changes present a unique scientific opportunity for analysis of the positive, negative and unintended effects of changes to the public health system on population health, health systems, and health equity. The study of whether and how recent and ongoing changes in jurisdictions across Canada impact citizens, patients, communities, health system stakeholders and other sectors will generate evidence valuable to a range of actors including governments looking to identify strategies to improve the health of their populations in an era of fiscal constraint and competing political priorities.
The intent of this funding opportunity is to catalyze foundational work needed to further our understanding of the positive, negative and/or unintended impacts of recent and ongoing changes to the financing, governance and delivery of public health services and responsibilities in Canada. The goal being that the resulting evidence will be used to inform decisions and policies related to public health organization, financing and delivery. Specifically, the initiative will fund projects that:
- Examine the impacts of recent and ongoing changes to public health financing, governance and delivery on population-level physical and mental health risk factors, behaviours and outcomes, including the impacts of these changes for health equity and for populations experiencing conditions of marginalization;
- Measure the impacts of recent and ongoing changes to public health financing, governance and delivery on the healthcare system, including health services access and use, demand on healthcare providers for public health services, utilization of primary and secondary healthcare, and healthcare expenditures;
- Develop approaches, methodologies or tools to measure real-time population-level changes in health risk factors, behaviours, outcomes and health services use that may be impacted by changes to the financing, governance and delivery of the public health system;
- Establish data systems and measures that allow for multi-jurisdictional tracking and comparison of public health expenditures over time; and
- Develop economic data, models, or tools to evaluate the economic impact of changes to the financing, governance and delivery of the public health system.
Generating evidence on real-world interventions in real-time involves a myriad of disciplinary perspectives and can benefit from a range of research designs, theories and methodological approaches. Studies that apply novel approaches emanating from different disciplinary traditions across from the health and social sciences are welcome (e.g., economics, epidemiology, law, political science, sociology).
CIHR and partner(s) financial contributions for this initiative are subject to availability of funds. Should CIHR or partner(s) funding levels not be available or are decreased due to unforeseen circumstances, CIHR and partner(s) reserve the right to reduce, defer or suspend financial contributions to grants received as a result of this funding opportunity.
- The total amount available for this funding opportunity is $1,000,000, enough to fund approximately five (5) grants. The maximum amount per grant is $200,000 for 1 year. This amount may increase if additional funding partners participate.
The Measuring the impacts of financial and organizational restructuring of public health opportunity is expected to:
- Generate evidence on how changes to the funding, organization and/or delivery of public health services impact population health, health systems and health equity;
- Improve data and methods for measuring the benefits, costs, harms and trade-offs of changes in public health funding, organization and /or delivery; and
- Develop evidence that can be used to inform future decisions or policies related to public health resourcing and organization.
Additional information can be found at Research Net.