Ontario Population Trends in Improved Mortality: Informing Sustainability & Equity of the health care system”

Wide variations in health care utilization and mortality across the population are a signal that the health system is not functioning to its full potential for all members of society. Advancements in medical and public health interventions have led to large improvements in population health and mortality; however, not all groups have benefited equally. Despite a universal health system, there is ample evidence that individuals of higher socio-economic status (SES) have experienced greater reductions in mortality than the less well off. Importantly, these trends are greater among marginalized groups. These disparities have implications for overall population health and health system sustainability and equity.

Project Overview

The Ontario Population Trends in Improved Mortality: Informing Sustainability & Equity of the health care system (OPTIMISE) research program represents a cross-sectoral, multidisciplinary effort to generate actionable solutions to improve both population health and health care sustainability while reducing growing mortality gaps among Ontario’s marginalized populations. The goal of the project is to use novel and comprehensive multi-linked mortality files to develop measures of health system functioning and inform health system planning in Ontario. The results of these analyses will be used to facilitate discussions with health system leaders about strategic priorities to improve health outcomes and reduce disparities in mortality declines in Ontario.

We have assembled a steering committee comprised of leaders from the major health agencies in Ontario. They are being advised by an international panel of leading mortality scholars, and teams of content experts (e.g. clinicians, epidemiologists, health economists). Our health system partners prioritize analyses, receive the results, and discuss cross-sectoral policy responses. This initiative provides a unique, collaborative opportunity to address practical and important health system questions. The results of this work are directly relevant to health policy and planning in Ontario

To learn more about our work in this area, please see the following resources:

  • Rosella, L.C., Calzavara A., Frank J., Fitzpatrick T., Donnelly P. Henry D. Narrowing mortality gap between men and women over two decades: a registry-based study in Ontario, Canada. BMJ Open. 2016; 6(11): e012564. Available from: http://bmjopen.bmj.com/content/6/11/e012564.full
  • Khan, A.M., Urquia, M., Kornas, K., Henry, D., Cheng, S.Y., Bornbaum, C., Rosella, L.C. Socioeconomic gradients in all-cause, premature and avoidable mortality using among immigrants and long-term residents using linked deaths records in Ontario, Canada. Journal of Epidemiology & Community Health. 2017. Available from: http://jech.bmj.com/content/early/2017/03/13/jech-2016-208525
  • Lachaud J., Donnelly P.D., Henry D, Bornbaum C., Kornas K, Calzavara A., Rosella L.C. A population-based study of homicide deaths in Ontario, Canada using linked death records. International Journal for Equity in Health. 2017; 16:133. Available from: http://rdcu.be/urOM
  • Lachaud J., Donnelly P., Henry D., Kornas K., Fitzpatrick T., Calzavara A., Bornbaum C., Rosella L.C. Characterizing violent deaths of undetermined intent: A population-based study, 1999-2012. Injury Prevention. Online first. Available from: http://injuryprevention.bmj.com/content/early/2017/10/06/injuryprev-2017-042376
  • Rosella L.C., Kornas K., Huang A., Bornbaum C., Henry, D., Wodchis W. Accumulation of chronic conditions at the time of death increased in Ontario from 1994 To 2013. Health Affairs. In Press