Topics

How do you care for the growing number of people living with chronic diseases? How can those living with chronic pain be better supported? How do you ensure people have a sustainable source of water in an age of pollution and climate change? All are pressing health questions facing policymakers, researchers and the general public. The McMaster Health Forum seeks to help stakeholders learn more and do more to address these pressing concerns. To learn more about the Forum's work on each of the following topics, please visit our Products page.

Current topics

Specialty clinics in Ontario
This project was initiated to assist the Ontario Ministry of Health and Long-Term Care as it considers how to support the creation and growth of not-for-profit, community-based specialty clinics that offer a variety of procedures, tests and assessments that have historically been offered in hospital settings. Surgical procedures such as cataract surgery, diagnostic tests such as colonoscopies, and a wide range of clinical assessments, are among the services that could be offered at these clinics. An evidence brief to inform deliberations at a stakeholder dialogue provides relevant research evidence and addresses issues such as how to determine which services should be offered in specialty clinics, and how to commission, fund and govern such clinics.

Patients living with three or more chronic conditions
The challenges related to caring for patients who have multiple chronic health conditions (multimorbidity) are examined in this project, which started with the development of a knowledge synthesis that summarizes the best available global, national and provincial research evidence on issues related to the delivery of healthcare to this population. Multimorbidity is faced by a growing number of citizens, and has a significant impact on healthcare utilization and costs. It also affects quality of life, ability to work, employability and mortality. The knowledge synthesis will form the basis of an issue brief that will inform discussions at a stakeholder dialogue planned for the fall of 2013.

Student mental health at McMaster
The prevalence of mental health concerns in the student population and how to address the growing need for mental health services on the McMaster campus is the focus of this project, which included the Forum’s first student-led dialogue. The issue brief developed to inform discussions at the dialogue examined the factors contributing to the increased demand for services, how existing services are provided and utilized, and options for engaging students and administrators to ensure the need for appropriate and sustainable programs and resources is creatively addressed by all campus stakeholders. (Dialogue held April 10, 2013)

Avoidable mortality indicator for Canada
Over the past three decades, Canada has made substantial progress in reducing the national rate of 'avoidable' deaths – those that could potentially have been avoided through disease prevention or healthcare services. Despite the progress made in this area, there are still variations in rates across the provinces, territories and various population groups. As well, the focus on reporting, monitoring and making decisions related to avoidable mortality rates has been primarily in the academic community. An issue brief and stakeholder dialogue are being undertaken to explore what is known about the limited use of the avoidable mortality indicator in Canada, and to consider approaches to support the use of the indicator. (Dialogue held February 15, 2013)
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Recent topics

Preventing suicide in Canada
Suicide is consistently among the top five to 10 causes of death in North America annually, yet it lacks the level of attention often given to other public health problems that result in fewer deaths. In Canada, there is no coordinated national strategy that provides a clear picture of the magnitude of the problem, identifies those most affected by suicide, and presents the complex array of risk factors in order to address gaps in programs and services. In this project, an evidence brief was prepared to identify ways to facilitate the coordination and integration of strategies aimed at preventing suicide in Canada. The brief informed discussions at a stakeholder dialogue planned for the fall. (Dialogue held November 9, 2012)
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Promoting healthy weights in Canada
The growing number of Canadians who are overweight or obese is both a health and economic burden for the country. Recent data show one in four adults in Canada is overweight or obese, and an array of health-related problems such as diabetes, cardiovascular disease, respiratory and mental health issues, and some types of cancer have been demonstrated to be associated with being overweight. This project involves preparing an evidence brief that examines the problem and the related evidence, and offers options to be considered by stakeholders who took part in a dialogue to consider how best to identify ways to promote healthy weights using population-based interventions. (Dialogue held September 17, 2012)
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Genetic tests and related services
Coordinating the present and future use of genetic tests and related services has been identified as an important policy issue in many provincial jurisdictions. However, there are many challenges inherent in addressing the issue, including scarce resources, relatively fixed infrastructure, a constantly evolving landscape with new and emerging genetic and genomic technologies, and increased demands for genetic testing. This project focused specifically on the province of British Columbia’s ongoing planning, funding, delivery and evaluation of genetic tests and related services. An evidence brief examining the challenges faced by the province, describing possible options for addressing them, and highlighting research related to the subject, was prepared to inform discussions at a stakeholder dialogue convened in Vancouver. (Dialogue held June 19, 2012)
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Hospital-based tobacco-use cessation support
While tobacco use remains the number one preventable cause of death and disease in Canada, kills more than 16,000 Ontario residents each year, and is a key driver of healthcare costs, Ontario hospitals lack a common, feasible, cost-effective and sustainable approach to delivering tobacco-use cessation supports. Since tobacco-related illness can boost a user’s motivation to quit, and brings them into healthcare settings where providers have an opportunity to encourage and enable tobacco cession, hospitals are in a unique position to identify tobacco users, initiate cessation supports, and facilitate appropriate follow-up. This project included an evidence brief that examined the need for, existence of, and potential to improve, hospital-based tobacco-cessation supports, which was the focus of deliberations at a stakeholder dialogue. (Dialogue held January 18, 2012)
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Aging at home
The health of the aging population has been identified as a high priority for the province of Ontario, and is one of the province’s most pressing health and social policy issues. As the number of residents aged 65 and older continues to grow, the challenges that Ontario faces in supporting the health and social care needs of this population will intensify significantly. A critical part of the continuum of care for seniors requires planning to support aging in the community in the long-term. In this project, an evidence brief was prepared to inform a stakeholder dialogue that focused on options for organizing a care system for older adults in Ontario. (Dialogue held November 14, 2011)
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Measuring health system efficiency
Canada’s ability to measure health system efficiency in order to better understand how to maximize what the health system can effectively do with a given level of resources, is hampered by a variety of challenges. These include a lack of consensus about how to define the objectives, inputs and outputs of the health system, lack of availability of necessary data, and no agreed-upon methods to measure inputs and outputs. This project was designed to feed into a report and analysis framework on health system efficiency by the Canadian Institute for Health Information, which is an organization uniquely positioned to measure health system efficiency in Canada. (Dialogue held November 7, 2011)
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Poverty and its impact on health
Evidence shows that living in poverty is a cause of poor health, and in the City of Hamilton, dramatic inequalities in health between neighbourhoods correspond closely with long-standing patterns of neighbourhood concentrations of poverty. However, these inequalities are avoidable and more can be done to redress inequities between neighbourhoods. This project involved developing an evidence-informed issue brief and bringing together a broad range of high-level representatives from Hamilton’s anchor institutions to develop collaborative, action-oriented approaches to address poverty concentration and its impact on health. (Dialogue held October 6, 2011)
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Advanced practice nursing
The skills that advanced practice nurses can contribute to the breadth and quality of healthcare are not being adequately utilized across Canada, due to a lack of full integration of these professionals in primary and acute healthcare settings. With the growing burden of chronic disease, the increased complexity of healthcare needs, and the need to improve the delivery of effective programs and services to patients who need them, it is crucial that health systems better incorporate the role of nurse practitioners and clinical nurse specialists. This project involved two stakeholder dialogues, informed by individual issue briefs that examined the scope of the challenge in each of the primary healthcare and acute healthcare setting, respectively, and offered options to address the various issues in order to move towards fuller integration of these professions in the delivery of healthcare. (Dialogues held July 6 and 7, 2011)
View Topic Overview 1 (primary health care)
View Topic Overview 2 (acute healthcare)

Global health
As globalization erodes the protective effect that national borders once offered to the health of Canadians, it's becoming increasingly important for countries to look at new ways to protect their citizens. In Canada, responses to these erosions have not always been commensurate with current and possible future challenges. This project involved preparing an issue brief and convening a dialogue at which participants deliberated on the interdependence among emerging global issues, the need to improve collaboration across traditional divides to identify and address such issues, and the value in engaging the appropriate stakeholders to develop agendas and take well-considered actions to better protect Canadians from current and emerging global issues that could threaten their health. (Dialogue held May 12, 2011)
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Chronic pain management
Chronic pain is a serious health problem given its prevalence, associated disability, impact on quality of life and the costs associated with the extensive use of healthcare services by people living with chronic pain. Overall, provincial and territorial health systems do not adequately support the management of chronic pain. An evidence brief and a stakeholder dialogue involving participants drawn from across Canada, examined the problem in order to develop creative, sustainable ways to support those with chronic pain. A second dialogue and issue brief focused on engaging health system decision-makers in supporting comprehensive pain management. (Dialogues held December 9, 2009 and April 11, 2011)
View Topic Overview - Dialogue 1
View Topic Overview - Dialogue 2

Cancer care delivery
As cancer cases continue to rise across Canada, and improvements in treatment and care result in longer survival times for patients, it is increasingly important to find ways to improve how patients transition from being treated in a regional cancer centre to surviving in the community. This project involved preparing an evidence brief and convening a stakeholder dialogue to identify opportunities for improvement in the current care, financial and organizational arrangements between cancer centres and community programs in the Hamilton region. It is hoped the lessons learned from this demonstration area can inform developments both at the provincial level and in other regions across the province. (Dialogue held April 5, 2011)
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Previous topics

Primary health care
An evidence brief drawing on the best available research evidence about primary healthcare strengthening, an issue brief drawing on more than 40 key informant interviews, an issue brief that focused on the sub-topic of quality improvement, and a series of three stakeholder dialogues aimed to improve access to and the quality of primary healthcare across the country. This work addressed the overarching problem of limited or inequitable access to sustainable, high-quality community-based primary healthcare in federal, provincial and territorial publicly-funded health systems. (Dialogues held May 11, 2009, January 8, 2010 and June 21, 2010)
View Topic Overview on strengthening primary healthcare
View Topic Overview on quality improvement in primary healthcare

Rural health
Although all people living in Saskatchewan should have equal access to publicly insured healthcare programs and services, those living in rural areas may not be receiving the healthcare they need. With more than one third of the province's population living in rural areas, geographic location can be an important factor affecting health, healthcare and quality of healthcare, yet Saskatchewan does not have an integrated approach to addressing the healthcare challenges in these areas. An evidence brief and stakeholder dialogue were undertaken to help the province with its strategic planning process, and specifically to create a framework to address the problems underlying the current organization of rural healthcare in Saskatchewan. (Dialogue held June 17, 2010)
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Housing for people with HIV/AIDS
Many Ontarians with HIV struggle to find and maintain appropriate, stable housing, which affects their health and well-being as well as their access to health services. The purpose of this issue brief and stakeholder dialogue was to identify ways to address several fundamental problems, such as existing housing and housing-related services not meeting the needs of people with HIV, delivery methods for housing and HIV services that complicate access to these services, and funding arrangements and jurisdictional issues that make it more difficult to provide services that meet the housing and health needs of these individuals. (Dialogue held June 1, 2010)
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Civil society engagement
The lack of civil society engagement in supporting research use was the focus of an issue brief and a stakeholder dialogue that convened participants from more than a dozen countries. Civil society can be considered to be any voluntary organization apart from those under the direct control of governments or for-profit firms. Dialogue participants noted that typically civil society is not engaged in supporting research use in health systems, and there are few enablers to promote such engagement. However, they identified a number of promising ways forward. (Dialogue held November 23, 2009)
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Diabetes management
The burden of diagnosed diabetes in Ontario continues to grow, yet components of comprehensive diabetes management programs are not available or accessible to all Ontarians. Both an evidence brief and stakeholder dialogue addressed the need for greater co-ordination and integration within and across the many services, programs and initiatives that can support optimal diabetes management in Ontario. Stakeholders suggested one possible next step being the provincial government developing a comprehensive policy framework for enhancing and coordinating the key features of a diabetes-management system. (Dialogue held November 5, 2009)
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Chronic disease management
Chronic diseases are a significant and growing challenge in the province of Ontario. A stakeholder dialogue, and the evidence brief prepared to inform it, aimed to address the lack of coordinated and proactive chronic disease management in the province by working through the underlying problem, options for addressing it and key implementation considerations. One key challenge identified by dialogue participants lies in supporting people to live well with their chronic conditions. (Dialogue held October 19, 2009)
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