Who We Are
The Upstream Lab was founded in 2016 by Dr. Andrew Pinto to bring together a number of linked projects and initiatives around social determinants of health
Our Founder & Director
Dr. Andrew Pinto is a Public Health and Preventive Medicine specialist and family physician at St. Michael’s Hospital. He is a Scientist at MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, and an Associate Professor at the University of Toronto, appointed to the Department of Family and Community Medicine, Faculty of Medicine and with status appointments at Dalla Lana School of Public Health and the Institute for Health, Policy, Management and Evaluation. He serves as the Associate Director for Clinical Research at UTOPIAN and is the lead for artificial intelligence at EXITE .
After completing my training in family medicine and public health, I committed myself to working with many others – community members, students, health providers, academics, educators, advocacy organizations and policymakers – to create the Upstream Lab as a space to incubate new approaches to addressing the fundamental determinants of health. We seek to rigorously and objectively evaluate these interventions. Our ultimate goal is for the Upstream Lab to be a community resource that supports diverse individuals, organizations and movements which seek to improve health and reduce inequities.
The Upstream Lab is dedicated to:
- Incubating novel interventions that tackle social factors impacting health, in collaboration with patients, health providers, community organizations and policymakers
- Conducting rigorous evaluation of interventions, using a variety of methods
- Sharing our findings widely
- Training and empowering community members to become agents of change
We recognize that the social determinants of health are not only about material needs but about social justice.
We adopt community-based research principles and work closely with frontline health providers, patients, community and social service agencies, charitable organizations and foundations, advocacy organizations and the government to develop creative interventions to address social determinants.
We view these solutions as complex interventions and hence, any evaluation must be iterative, adaptable to new information and use both qualitative and quantitative data. Our methods are informed by clinical epidemiology, developmental evaluation and realist evaluation.
We also acknowledge the critical roles of broad social, economic, and political factors in enforcing societal hierarchies and contributing to health inequity. Our interventions, therefore, address social determinants of health at multiple levels: individual- or family-level, neighbourhood- or organizational-level, and population- or policy-level.
The Upstream Lab strives to not only examine health inequity through a social justice lens, but also to develop innovative solutions to optimize population health. We are committed to leveraging evidence for concrete actions to effect social change and respond to population and public health challenges.
To facilitate effective transformation of evidence into solutions and to promote continuous learning and improvement in our healthcare system, our research is arranged into three streams:
The objective and approach of some initiatives may be positioned in the intersectionality of multiple streams.
Our Three Research Streams
This stream describes research and interventions that address the social needs of individuals (e.g., housing, income) in healthcare settings, such as primary care clinics or hospitals. It includes development of screening tools for social needs and other research that explores opportunities for optimizing the role of health services in facilitating social care provision.
Previous projects include screening primary care patients for financial need and connecting them to relevant resources, as well as developing a precarious employment screening tool. Examples of current projects are SPARK study and a systematic review on food insecurity interventions in health settings.
The second stream is concerned with research and interventions that tackle issues related to social determinants of health at population level. This stream is comprised of initiatives focusing on policy reforms and advocacy, development and evaluations of community- or neighbourhood-level interventions, and studies that aim to improve social infrastructure.
Some examples of projects within this stream include EMPOWER project that seeks to better understand the work conditions of personal support workers and an initiative to improve access to employment for people living with HIV.
A Learning Health System is a system characterized by rapid adaptation in response to trends detected in public health data and promotes a culture of shared responsibility and synchrony of efforts across the health sectors. It also cultivates public engagement and collaborations across system-level leadership.
Through this stream, our lab aims to utilize both public health data and informatics, particularly Artificial Intelligence (AI) and Big Data, to improve the planning and operations of our health systems. Some projects that belong to this stream include utilization of AI to predict vulnerable older patients and development of guidance for patient engagement in AI implementation in healthcare.