Promise and peril: how health system reforms impacted public health in three Canadian provinces

Researchers examined the impact on public health if power, resources and responsibilities in health systems are centralized.

Interviews with 58 public health system leaders showed improved coordination of public health programs in Alberta. Challenges emerged in maintaining effective intersectoral actions in Alberta & Quebec. Ontario leaders expressed concerns about the potential loss of local partnerships. Leaders across all provinces highlighted the impacts of decreased funding on core public health operations and the workforce.

To address these challenges, inclusive decision-making and collaborative governance play crucial roles. Involving diverse stakeholders and experts ensures appropriate expertise and contribution to resource allocation, policy formulation, and planning processes.

This study highlights the need for stable public health investments and offers valuable insights for reform strategies: leverage the strengths of centralized health systems and mitigate the unintended consequences.



Authors: Tamika Jarvis, Robert W. Smith, Harman Singh Sandhu, Muriel Mac-Seing, Meghan O’Neill, Laura Rosella, Sara Allin, Andrew D. Pinto  

Year: 2023