Sistema Único de Saúde (SUS) is Brazil’s free and universal healthcare system. With over a decade of experience as a Family and Community Physician in Brazil, Dr. Thiago Trindade discusses the strengths and challenges of this publicly funded healthcare system. Tune in to his conversation with Dr. Andrew Pinto covering:

• An overview of the Brazilian health system
• The urgent need and rationale for integrating health and social care
• Models of interventions focused on social determinants of health (SDOH) from various jurisdictions
• Future research and directions surrounding SDOH in Latin American countries

Speaker

Dr. Thiago Trindade is a Postdoctoral Fellow at Upstream Lab, working on research projects that aim to assess interventions on Social Determinants of Health in primary care settings in Canada, Brazil, and Latin America. He is a practicing family physician and family therapist and an Assistant Professor at the Department of Clinical Medicine at the Federal University of Rio Grande do Norte. He is also an International Faculty of the Department of Family and Community Medicine at the University of Toronto and a former president of the Brazilian Society of Family and Community Medicine. His work focuses on teaching and researching in Family and Community Medicine (MD program, residency program and master program), Primary Health Care, Clinical Epidemiology, Medical Education, and Global Health.

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The Upstream Lab is a non-profit research lab based at MAP Centre for Urban Health Solutions, St. Michael’s Hospital in Toronto, Ontario, Canada. We are dedicated to improving the health and well-being of the population through addressing issues related to social determinants of health.

In this Episode 4 of our Speaker Series, the speakers

• discuss myths about renters, landlords and housing affordability
• share how researchers, academics and public policy professionals can support advocates and movements to solve the housing crisis
• define ‘unruly’ research methodology and other ways we can change the landscape of conducting homelessness research

Speakers

Sophia Ilyniak is a PhD researcher at the Faculty of Environmental and Urban Change at York University, Toronto. She is interested in the role of the non-profit sector in urban development processes, and exploring the possibilities of political and social change outside of it. Her work is critically informed by experiences in frontline social services, housing research as well as neighbourhood-based organizing. In 2022, Sophia published Make-work methodology: Canadian homelessness research and its role in austerity.

Ricardo Tranjan is a political economist and senior researcher with the Canadian Centre for Policy Alternatives. Previously, Ricardo managed Toronto’s Poverty Reduction Strategy and taught at universities in Ontario and Quebec. His early academic work focused on economic development and participatory democracy in Brazil, his native country. His current research is on the political economy of social policy in Canada. Ricardo is the author of The Tenant Class book published in May 2023.

Host

Dr. Andrew Pinto is the Founder & Director of the Upstream Lab, a non-profit research lab in Canada tackling issues related to social determinants of health. He is a Public Health and Preventive Medicine specialist and family physician at St. Michael’s Hospital and a Scientist at MAP Centre for Urban Health Solutions. Dr. Pinto is also an Associate Professor in the Department of Family and Community Medicine and Dalla Lana School of Public Health at the University of Toronto.

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June 15, 2023 (Thursday) | 12 – 1 pm EDT

Virchow famously said, “Medicine is a social science and politics is nothing else but medicine on a large scale”, but are there things we should consider when healthcare gets involved with social issues? Episode 3 of the Upstream Lab Speaker Series aims to help you understand all sides of this question. Our speakers shared their experiences in Canada and the US, discussing the context and considerations surrounding the medicalization of social determinants of health.

Speakers

Dr. Arvin Garg is a Professor of Pediatrics and Vice Chair of Health Equity at the University of Massachusetts (UMass) Medical School and UMass Memorial Children’s Medical Center. Dr. Garg’s research focuses on addressing adverse social determinants of health (SDoH) within the delivery of pediatric care, particularly for low-income families, and has been cited in professional guidelines.

Dr. Kate Mulligan is the Senior Director of the Canadian Institute for Social Prescribing and Assistant Professor at the Dalla Lana School of Public Health, University of Toronto. Dr. Mulligan is a health geographer and policy professional with a critical public health orientation and a strong interest in advancing healthier and more equitable communities. Her research and policy work has been supported by Toronto Public Health, the Ontario Ministry of Health and Long-Term Care, Health Canada, and the United Nations.

Dr. Ritika Goel is a family physician in the Department of Family and Community Medicine at the University of Toronto working with the St. Michael’s Hospital Academic Family Health Team. Dr. Goel has been engaged in health-related activism, medical education, public speaking and writing on issues at the intersection of health and social justice throughout her career. She has served as the Faculty Lead for Social Accountability at the Department of Family and Community Medicine, and Chair of the Social Accountability Working Group at the College of Family Physicians of Canada.

Host

Dr. Andrew Pinto is the Founder & Director of the Upstream Lab, a non-profit research lab tackling issues related to social determinants of health. He is a Public Health and Preventive Medicine specialist and family physician at St. Michael’s Hospital. Dr. Pinto 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.

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April 27, 2023 (Thursday) | 12 -1 pm EDT | Online

For the second episode of the Upstream Lab Speaker Series, we invited professors, who are also physicians, to share their experiences teaching the social determinants of health in Canada, the USA, and Scotland.

Tune in to learn

• Why is teaching about social determinants so important for future physicians and others?
• What have been some of the challenges?
• What has seemed to really work – at least for certain students – that inspires them to think in a different way?
• How is medical education linked to changing the health system to be more oriented upstream?

Speakers

Dr. Ashti Doobay-Persaud is an internal medicine specialist in Chicago, IL and has over 16 years of experience in the medical field. She has taught cases for medical students as part of the Global Health Delivery Project at Harvard University. Dr. Doobay-Persaud is also the Co-Director of the Robert J. Havey, MD Institute for Global Health and an Associate Professor of Medicine and Medical Education at Northwestern University.

Dr. David Blane is the Academic Lead for the Deep End GP project in Scotland, a collaboration between academics and frontline GPs working in areas of concentrated socio-economic disadvantage. Within the Institute of Health and Wellbeing, he is the Co-Lead for the Determinants of Health and Health Inequalities theme. Since 2010, he has been involved in the Deep End project, which represents GPs working in the most socio-economically deprived practices in Scotland.

Host

Dr. Andrew Pinto is the Founder & Director of the Upstream Lab, a non-profit research lab in Canada tackling issues related to social determinants of health. He is a Public Health and Preventive Medicine specialist and family physician at St. Michael’s Hospital and a Scientist at MAP Centre for Urban Health Solutions. Dr. Pinto is also an Associate Professor in the Department of Family and Community Medicine and Dalla Lana School of Public Health at the University of Toronto.

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The first episode of our Speaker Series features an insightful conversation between a community advisor and a family physician, delving into stories and realities of engaging with people experiencing homelessness.

Speakers

Alexander Zsager is a researcher, consultant and advisor for over 20 years with organizations such as the Mental Health Commission of Canada, St. Michael’s Hospital, Dixon Hall, Toronto Metropolitan University, Ontario Health Team, Homeless Connect Toronto and many others. “As a person with lived experience, I am also passionate about the issue of housing and homelessness… Collaborating with the Upstream Lab has given me valuable learning opportunity in research.” — Alexander

Dr. Mathieu Isabel is a PhD student under the supervision of Dr. Andrew Pinto at the Dalla Lana School of Public Health. He is also a practicing family physician and an Assistant Clinical Professor at the Université de Montréal Department of Family and Emergency Medicine. He is part of a community clinic delivering care to people experiencing homelessness.

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Canada faces a crisis in access to high-quality primary care. The Upstream Lab hosted an in-person working meeting with policymakers, researchers, providers, and patients to discuss the crisis and emerge with the next steps towards new approaches with a system for accountability. The event was held from November 30 to December 1, 2023.

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November 29, 2023

Speaker: Dr. Sara Macdonald Professor, Director of Innovation, Engagement and Enterprise (General Practice & Primary Care), University of Glasgow

Knowledge hierarchies underpin research. Biomedical research and what counts as knowledge has been contested over time and across disciplines. As a social scientist operating in a largely biomedical context, Dr. Macdonald has witnessed an evolution in attitudes towards and value attached to lay knowledge. Drawing on examples from her own research, she will share reflections on this transformation and ask where next for lay knowledge. Dr. Sara Macdonald is a sociologist who joined General Practice and Primary Care at the University of Glasgow as a Research Fellow in 2002. She worked in a number of academic and research posts, all of which were related to health and health service research. Between 2002 and 2010, Dr. Macdonald undertook a series of research posts focusing on the management of depression in primary care and primary care and cancer. She secured the position of non-clinical lecturer in primary care in 2010 and since her appointment has been working on building a portfolio of research centring on candidacy.

The Upstream Lab hosted an Adaptive Platform Trials Scientific Meeting from September 28 to 29, 2023 in Toronto, ON, Canada. Watch the session recordings to:

• Understand the concept and advantages of adaptive platform trials over traditional randomized controlled trials
• Understand the statistical methods used in adaptive platform trials, including Bayesian methods and sequential hypothesis testing
• Identify the practical challenges associated with adaptive platform trials and learn how to address them

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The Future is Now: Artificial Intelligence (AI) in Family Medicine

In collaboration with The College of Family Physicians of Canada, the Upstream Lab hosted a six-part monthly webinar series from December 2020 – June 2021 featuring family medicine leaders in Canada who shared their expertise in machine learning, natural language processing (teaching computers to understand human language), ethics, and AI research.

One Mainpro+® credit per session was offered to physicians who attended the live webinar.

Watch the videos below:

• Introduction to AI & Applications in Primary Care  (Speakers: Dr. Andrew Pinto & Dr. Jaky Kueper)

• Machine Learning to Solve Primary Care Challenges (Speaker: Dr. Anders Lenskjold)

• Machine Learning Applied to Primary Care EMR Data for Classification (Speaker: Dr. Tyler Williamson)

• Natural Language Processing & its Role in Primary Care (Speaker: Dr. Noah Crampton)

• Machine Learning for Human Resource Management & to Predict Health Service Use (Speaker: Dr. Muhammad Mamdani)

• Social and Ethical Implications of AI and Primary Care (Speakers: Dr. Melissa McCradden, Dr. Carolyn Steele-Gray,  Dr. Azza Eissa)

In May 2021, the Upstream Lab hosted a webinar featuring Canadian leaders of new models that integrate health and social care.

Check out the recorded video to learn about what makes these interventions successful, the existing challenges, and ways to find the right model for different contexts.

Panelists:

• Dr. Simone Dahrouge – ARC Patient Navigator
• Dr. Lisa Dolovich – Health TAPESTRY
• Dr. Jennifer Rayner – Social Prescribing
• Dr. Gina Agarwal – Paramedic led interventions Laura Boodram – Income Security HP Nancy Snow
• Cheryl Jeffers-Johnson – Community Health Team Navigator Program
• Jay Bodner – Manitoba MyHealth 

This event was supported by the Canadian Institutes of Health Research (CIHR).

During pandemics, historically marginalized and minoritized individuals suffer disproportionately. In response to the COVID-19 pandemic, the Upstream Lab, the Centre for Effective Practice and the Department of Family and Community Medicine at the University of Toronto developed the Online Social Care Guidance.

You can also download the pdf here: Social Care Guidance

This guide is for health and social care providers supporting people exposed to social risks that impact health, caused or exacerbated by COVID-19. It is intended as guidance and should not replace clinical judgement.

The Upstream Lab compiled lists of social resources covering food supports, housing, legal advice, social isolation and support around domestic violence in the following Canadian provinces and territories  (updated May 25, 2020).

Click on the province/territory name below to access the list of COVID social resources:

• Alberta
• British Columbia
• Manitoba
• New Brunswick
• Newfoundland & Labrador
• Northwest Territories
• Nova Scotia
• Nunavut
• Ontario (updated June 5, 2020)
• Prince Edward Island
• Quebec
• Saskatchewan
• Yukon