“We Defined Each Other:” MAP Celebrates 25 Years

In 1998, St. Michael’s Hospital’s past CEO Jeff Lozon founded MAP during a turbulent time. The hospital was facing a major financial crisis. A forced and highly controversial merger sparked fears and protest among incoming staff and physicians. Yet these two challenges ultimately defined MAP’s mission and unique value, and pushed St. Michael’s to evolve into the national leader it is today.

Stephen Hwang and Ahmed Bayoumi were two of the very first scientists recruited to what was then known as the “Inner City Health Research Unit.” In this reflective and heartfelt discussion, Jeff, Stephen and Ahmed look back at MAP’s beginnings and what it meant to embed an equity-focused research centre within St. Michael’s Hospital.

Listen: Apple Podcasts | Google Podcasts | Spotify | Audible | Amazon Music | Pocket Casts | Email Notifications

Learn More: View a timeline of MAP’s history. Read a Toronto Star piece about St. Michael’s ‘highly political’ 1998 merger with the Wellesley Hospital.

About the MAPmaking podcast

MAPmaking brings you Canada’s leading voices on the health equity issues that affect us all. Together, we will discuss and explore the scientific evidence and real-world solutions that we believe have the potential to transform our country. Our vision is a Canada where everyone has the opportunity to thrive.

Director’s update: MAP’s 2023 year in review

The past 12 months have been extremely productive for MAP, with some major successes and milestones to celebrate! The accomplishments below are thanks to our world-class team of researchers, staff and students; our partnerships with the communities we study; and our incredible donors, without whom our work would simply not be possible. I also want to thank Staples Canada leadership and associates for another very successful year of our Even the Odds partnership. Staples’ commitment and vision have been truly transformative for our centre.

This year, MAP celebrated 25 years since our founding as a tiny, one-scientist hospital unit in 1998. It has been an interesting and inspiring opportunity to reflect on our history as a centre. Recently, I had the opportunity to sit down with Jeff Lozon and Ahmed Bayoumi to reflect on MAP’s beginnings, and in particular what it meant to embed an equity-focused research centre within St. Michael’s Hospital. It was a fascinating discussion – listen here.

As we look forward to another year of growth, progress and (as always) new challenges, the imperative remains: in 2024 and beyond, we must continue to work together towards a healthier future for all. Thank you for your interest in MAP’s work, and commitment to our vision.

Sincerely,

Dr. Stephen Hwang
Director, MAP Centre for Urban Health Solutions

Chair, Homelessness, Housing and Health, St. Michael’s Hospital, Unity Health Toronto

2023 Research Highlights

🍁 MAP conducts largest-ever public consultation on primary health care: Over the past 16 months, MAP scientist Dr. Tara Kiran convened thousands of people across Canada to share their perspectives and consider new possibilities for primary care in Canada. The results are captured in five priorities panel reports, 10 population-specific roundtable reports (coming soon), and a public website of national survey data. All findings will come together in 2024 in a concrete and achievable vision for a stronger, more equitable, and effective primary care system in Canada – a system that works for everyone.


⚕️ Vending machines that dispense free HIV test kits, safe-injection supplies and Naloxone begin rollout across Canada: Even the Odds and MAP launched the first Our Healthbox vending machines in Atlantic Canada, followed by implementation in Ontario. More than 1,500 people have since used the machines to access the things they need for their health, including 400 HIV self-testing kits – many for people who had never been tested before. MAP scientist and Healthbox lead Dr. Sean B. Rourke has set an ambitious goal to roll out 100 Healthboxes across Canada by 2026 to help address the overdose crisis and remove barriers to HIV testing and care.


💉 MAP scales up opioid crisis response with new funding from Health Canada, partnership with NIH: Health Canada announced that MAP’s Drug Checking Service will be part of an expanded drug strategy to tackle the opioid crisis, with $2M funding to scale up the service across Ontario. Led by MAP’s Karen McDonald, the Toronto service checked more than 3,500 samples in 2023, and more than 11,000 samples since the program launched in 2019. Dosecheck, MAP’s e­­merging drug checking technology, also received new funding from Health Canada and kicked off an innovative partnership with NIH to accelerate its development.


📑 A comprehensive new set of guidelines to promote health equity in Canada: MAP scientists Dr. Nav Persaud and Dr. Aisha Lofters published new recommendations in CMAJ to improve health care for people who face barriers in accessing it, including people who are Indigenous, racialized, 2SLGBTQ+, as well as those who live with functional limitations or low incomes. The paper garnered more than 550 media hits, making it one of CMAJ’s top covered articles in 2023. MAP also released an accompanying online tool that patients and care providers can use to guide preventative care and screening decisions: screening.ca.


🏥 MAP’s Navigator Project expands to BC: Thanks to Even the Odds funding, MAP’s Navigator Project continues to scale up with a new site at St. Paul’s Hospital in Vancouver. The innovative program pairs patients who are homeless with an outreach worker to connect them to care, ensure a better recovery, and potentially reduce readmission to hospital. In addition to St. Paul’s, Navigator is currently operating at St. Michael’s Hospital and St. Joseph’s Health Centre in Toronto, with plans to launch in Montreal in 2024.


📱 New app offers 24/7 support to people with gambling concerns: MAP scientist Dr. Flora Matheson’s SPRinG app is a free journaling and tracking tool that helps users understand their gambling patterns and urges. Designed in partnership with community groups and people who have experienced problem gambling, the app has more than 250 users and is being rolled out in Playsmart Centres across Ontario. This year, Dr. Matheson’s research team also launched gamblingandpoverty.ca to share evidence and information on the strong, concerning links between homelessness and problem gambling.


🦠 A call for a national inquiry into Canada’s COVID-19 ‘failures’: MAP scientist Dr. Sharmistha Mishra co-authored a series of papers in the British Medical Journal that explored Canada’s successes and failures re: COVID-19 pandemic response. Dr. Mishra emphasized that Canada’s successes, such as high vaccination rates, often overshadow the geographical, social and economic COVID inequities across the country. Media coverage included The Toronto Star, CTV News and an opinion piece in the Globe & Mail.


❄️ Policy impact: Toronto increases temperature threshold for activating warming centres: In their 2023/2024 Winter Services Plan, The City of Toronto raised the warming centre threshold from -15C to -5C. Although there is still more work to be done, the Toronto Star attributes this positive change to a 2019 MAP study that showed that most cases of cold-related injury and death in Toronto happen in moderate winter weather. MAP Director Dr. Stephen Hwang and MAP scientist Dr. Carolyn Snider also gave powerful deputations to the City of Toronto in early 2023, urging the city to take stronger action in protecting the health and wellbeing of unhoused people in Toronto this winter. 


🤝 MAP hosts second Solutions for Healthy Cities Symposium: On March 23, MAP gathered almost 200 researchers, service providers, policymakers, students and community experts to explore and discuss this year’s symposium theme, The Science and Practice of Implementation Success. Step by step, each learning session walked participants through a stage of the Active Implementation Framework, illustrated by presenters’ real-life experiences, challenges and lessons learned.


🧪 “A game changer”: Dual HIV-Syphilis rapid test approved for use in Canada: Federal regulators have approved an all-in-one rapid device that allows people in Canada to be simultaneously tested for HIV and syphilis, and get their results in as little as 60 seconds. The approval was made possible, in part, by the results of a two-year clinical trial led by MAP scientist Dr. Sean B. Rourke and researchers at the University of Alberta. The test will be a crucial tool in the fight against a recent, alarming increase in babies born with congenital syphilis – particularly in Canada’s prairie provinces.


🏫 APPLE Schools expands to five new elementary schools: APPLE Schools is an internationally recognized best practice that has been proven to help kids move more, eat better, and feel happier – erasing many of the long-term health effects of childhood poverty. In 2023 Dr. Katerina Maximova, MAP’s Murphy Family Foundation Chair in Early Life Interventions, brought the program to five new elementary schools in Ontario. Since September 2022, MAP and Even the Odds have implemented and begun evaluation of the program at 15 schools in total (Ontario and Alberta), reaching more than 4,500 students.


💊 MAP research continues to strengthen the case for universal pharmacare: MAP’s CLEAN Meds study published startling new findings: providing prescriptions free of charge to patients saves the public health care system an average of $1,488 per patient per year by helping to prevent unexpected trips to the hospital, ED visits and other avoidable health care costs. These findings and others from MAP scientist Dr. Nav Persaud’s CLEAN Meds trial continues to strengthen and advance the case for universal pharmacare, and a federal commitment may be on the horizon.


🎙️ Education to help end ‘race correction’ in health care: In partnership with the Canada-US Coalition to End Race Correction and the Li Ka Shing Knowledge Institute, MAP helped to present the education series Ending “Race Correction” in Health Care, which explores the ways that Black people are systematically excluded from timely access to diagnoses and treatment. To date, more than 3,000 people including clinicians, medical students and researchers from universities, clinics and hospitals in a range of jurisdictions have watched the talks, including a presentation on what race correction means for systematic reviews and research.


Want more research updates?

Subscribe to MAP’s Junction e-newsletter for short, monthly updates on our studies, our solutions, and the issues we study. You can also follow MAP on Twitter and LinkedIn, and subscribe to our MAPmaking podcast.

APPLE Schools helps kids become healthier for life

From an article by the University of Alberta

APPLE Schools is a philanthropically supported school-focused health promotion initiative that supports the nutritional, physical activity and mental health habits of 21,000 students per year working with schools across British Columbia, northern Alberta, Northwest Territories, and Manitoba.

Principals like Jeff Power know the strength of an APPLE school … even if it sometimes comes in the form of a starfruit.

Power recalls the time his students tried starfruit as part of a program with APPLE Schools, a project working to help kids step into healthy futures. Trying this vitamin-packed fruit — new for many students — was part of a regular end-of-the-week ritual to teach about different and healthy choices. 

“They loved it and went home and told their parents about it, and it started showing up in their lunches the next week,” Power said.

“That’s just one way that APPLE Schools is a game-changing organization in the health promotion world,” said Allan Markin, a philanthropist who supports the project. 

Founded in University of Alberta research, APPLE Schools is marking its 15th year of working with vulnerable school populations across Canada. The initiative (an acronym for “A Project Promoting Healthy Living for Everyone in Schools”) improves students’ lifelong mental health, healthy eating and physical activity habits. 

“APPLE is now an award-winning health promotion project, internationally recognized for its ability to give kids the tools they need to live a healthy, happy life,” said Markin. “To date, it has helped more than 100,000 kids in vulnerable school communities and saved Canada hundreds of millions of dollars.”

And the numbers bear that out. Children in APPLE school communities are 35 per cent more physically active and have a 40 per cent drop in obesity risk compared with peers who didn’t go to an APPLE school in their childhood. The healthy habits will lower the risk for chronic diseases and avoid health care costs.

At Power’s elementary school, which became an APPLE school in 2010, students have a whole new awareness of healthy choices they can make for themselves. “I hear them say, ‘I need an apple. I need to go outside, I need to spend less time on my screens,’” Power said. “They’re more equipped to make healthier choices.” 

Started in 2007 at the U of A as a pilot project, the initiative has grown into a large independent, very successful program, said Paul Veugelers, a professor in U of A School of Public Health. It’s his research into child health that has become the foundation of APPLE Schools. 

“Every day we are reaching thousands of children,” Veugelers said. “And it’s something to feel good about, that we launch kids into a healthier future.” 

Using scientific studies from Veugelers and other researchers from the School of Public Health and around the U of A, APPLE Schools passes that data along so its member schools can use them to tailor programming to support their specific school communities in the quest for better health habits.

“It’s a unique research-practice cycle,” said Jenn Flynn, executive director of APPLE Schools. “U of A researchers measure something, then we shift our programs and share that with the schools, they shift their programs and we measure what’s happening. So it’s not just knowledge translation, but knowledge mobilization.”

Today, APPLE Schools is an effective tool for helping kids, she added. 

“It’s amazing that what started out as a pilot project is still around and improving after 15 years, and this partnership with the U of A continues to impact so many Canadians.”

Years of U of A research demonstrates that APPLE Schools programming is effective, and it makes a good case for investment in long-term public health programs, Flynn noted.

“Having peer-reviewed, published data showing that this program is effective is essential to show that we make a difference. APPLE Schools relies on donors, so it’s important that they understand they’re funding something meaningful. And our school communities love it because it shows they’re investing their time and energy into something that makes a difference.”

The research fuelling APPLE Schools has also shown that their work reduces the health inequities that children in vulnerable communities face, Veugelers said. 

“Around the world, these inequities have been amplified by the pandemic but the innovative programming by APPLE Schools has effectively mitigated the negative impact of pandemic among their students.” 

These kinds of partnerships are also important part of creating knowledge, educating public health professionals and advancing the public’s health, said Shanthi Johnson, dean of the School of Public Health. 

“At the School of Public Health, we are committed to engaging with our community partners,” said Johnson. “APPLE Schools play a vital role in cultivating and promoting health and wellness among children and adolescents. As a strong supporter of comprehensive school health programs and community partnerships, the School of Public Health is proud to recognize the continuing contribution APPLE Schools is making to promote healthy school environments.” 

Investment in health

The project got its start as Veugelers was researching ways to make a difference in the health of schoolchildren in terms of their eating habits and physical activity, to keep them healthy and to reduce the risk for chronic diseases later in life. 

Using a timely $5-million donation to the U of A from philanthropist and alumnus Markin, Veugelers became the pilot project’s director, and worked with founding program manager Marg Schwartz to map out a plan to turn his research into action. 

Further supported by 10 talented facilitators trained in nutrition, physical activity and community development, the programming began in 10 Alberta schools in 2008. Staff, students and parents developed plans to meet their specific needs, organizing fun activities like classroom gardens, after-school cooking classes and physical exercise.

Within two years, research from the program revealed promising results: an improvement in diet quality and an increase in physical activity levels among students in participating schools.

The project, supported over the years by subsequent contributions from Markin to the program totalling $16 million, expanded to more schools across Alberta. Now, in other provinces, APPLE Schools continues to support more school communities through corporate and individual giving. 

The fun, hands-on programming that APPLE Schools promotes is the reason for its success, Flynn believes. 

“It meets people where they are, whether they want to focus on mental wellbeing or physical activity, or something else,” she said. “And when you see kids taking charge of their own health, the word ‘tremendous’ doesn’t capture it. It’s astonishing what the schools are doing.”

In its own action plan, Power’s school has everything from optional Halloween candy exchanges for healthier snacks, to monthly themes that encourage eating for bone health, winter exercise and other ways to stay healthy. Staff also take part in activities like after-school yoga for their own health.

Older students learn about topics like food labels, then share that with every classroom in the school. “We let our kids be the leaders,” he said. The result gives students an appreciation for their overall wellbeing, not just a single aspect like nutrition or exercise, Power noted. 

“They are more in tune to healthy behaviours, as opposed to thinking about it in one dimension.” 

Success keeps building

APPLE Schools became its own entity in 2013, and its partnership with Veugelers and other U of A researchers continues to flourish. In 2021, programming reached more than 20,000 students, almost 40,000 family members, 2,400 staff and 74 school communities in Alberta, British Columbia, Manitoba and the Northwest Territories. 

Professors, graduate students and post-doctoral fellows from the School of Public Health and the faculties of Agricultural, Life & Environmental Sciences, Education, Kinesiology, Sport, and Recreation, Medicine & Dentistry, and Nursing have worked with APPLE Schools, including practicums, research, presentations and in some cases employment.

They studied issues like the pandemic and its effect on children’s mental health and well-being, children’s dietary choices, sleep and physical activity, as well as the economic return on investment of a project like APPLE Schools. 

“It gives budding health researchers valuable experiences, because they have the opportunity to work in a highly effective program,” Veugelers noted. “The pandemic brought a lot of unhealthy lifestyle choices, and all children in Canada took a hit, so this is a good time to try to reach more of them.” 

In partnership with APPLE Schools and Katerina Maximova, whose research focuses on solutions to improve the well-being of children and youth experiencing poverty, he continues researching the effects of the pandemic on schoolchildren and ways to address its toll on mental and physical health. 

“We know this is an urgent and critical need for society, and APPLE Schools continues to engage and seek funding to meet this need.”

MAP hosts 2023 Solutions for Healthy Cities Symposium

On March 23, 2023, MAP hosted the second Solutions for Healthy Cities Symposium at the beautiful Symes in Toronto. Almost 200 researchers, service providers, policymakers, students and community experts gathered to explore and discuss this year’s theme: the science and practice of implementation success.

About the 2023 Symposium

A healthier, more equitable future depends on policy and service innovation – doing things differently – across sectors. However, even the most promising new approaches can, and often do, fail to create their intended impacts. How can we beat the odds and give equity interventions the best shot at implementation success?

Participants joined us to gain the knowledge, skills and tools needed to be more successful in advancing, improving and scaling up complex interventions; use proven strategies and tools from the field of implementation science to avoid and overcome common implementation roadblocks; and be more effective in fostering and benefiting from crucial partnerships with scientific, service provider, and community partners.

2023 Keynote: Dr. Ibram X. Kendi

Dr. Ibram X. Kendi joined the event virtually, in conversation with MAP Director Dr. Stephen Hwang and followed by a Q&A with the audience. The thoughtful and moving discussion explored how racist ideas and assumptions can shape policies, research questions, and health care experiences. Dr. Kendi emphasized the importance of antiracist interventions that address the social determinants of health.

Dr. Ibram X. Kendi is the founding director of the Boston University Center for Antiracist Research and author of many highly acclaimed books including Stamped from the Beginning: The Definitive History of Racist Ideas in America, and How to Be an Antiracist. In 2020, Time magazine named Dr. Kendi one of the 100 most influential people in the world.

Learning Sessions

Presentations were focused on implementation: turning strong evidence into successful policies, programs and services. Step by step, each learning session walked participants through a stage of the Active Implementation Framework, illustrated by presenters’ real-life experiences, challenges and lessons learned. All sessions included a special focus on equity and partnerships in the context of implementation – elements that are challenging to get right and are crucial to an intervention’s success.

Presenters

Dr. Patricia O’Campo, Tier 1 Canada Research Chair in Population Health Intervention Research
Cathy Watts, Co-Founder, Peer2Peer Consultants
Karen McDonald, Research Manager, Centre on Drug Policy Evaluation
Matt Johnson, Health Promoter, Safe Consumption Services, Parkdale Queen West Community Health Centre
Dr. Sean B. Rourke, Director, CIHR Centre for REACH in HIV/AIDS
Lena Soje, Social Worker, Philip Aziz Centre
Debby Warren, Executive Director, ENSEMBLE Services Greater Moncton
Dr. Stephen Hwang, Director, MAP Centre for Urban Health Solutions, Unity Health Toronto
Kathryn Gibb, Program Manager for Supportive Housing, SHIP (Services and Housing In the Province)
Dr. Stefan Baral, Director, Key Populations Program, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health

In Participants’ Words

“All of the speakers were amazing! Great blend of disciplines and topics.”

“The program progression and accompanying guide were really helpful, no matter what stage, focus or level of expertise.”

“There was such a diversity of people in attendance – excellent to meet people in all types of work.”

“I loved the thoughtful planning to connect the different projects. Really excellent and seamless event!”

“A highlight was the opportunity to ask questions of Ibram X. Kendi – fantastic!”

“I appreciated the breaks, food, and care for us so that we could be fully present to learn.”

“The affordability was amazing and really opened doors for access.”

“I loved that all the presentations were focused on equity-seeking projects.”

Thank You

This symposium was made possible thanks to Even the Odds (a partnership of MAP and Staples Canada), the St. Michael’s Foundation, and the generous contributions of our visionary donors.

Staples Canada and MAP kick off third year of ‘Even the Odds’ partnership with fundraising campaign

Annual fundraising campaign runs until May 7; all fundraising efforts raised more than $2.1 million in 2022

Staples Canada and MAP kick off third year of 'Even the Odds' partnership with fundraising campaign. (CNW Group/Staples Canada ULC)

RICHMOND HILL, ON, April 17, 2023 – What would a future that’s fair for everyone look like? Staples Canada and leading research centre MAP have once again partnered to Even the Oddsraising awareness of inequity in Canada and funding the development of program and policy solutions via in-store and online donations.

“One of Staples Canada’s core beliefs is that everyone should be given the opportunity to thrive,” said Wanda Walkden, Chief Human Resources and Communications Officer, Staples Canada. “With this in mind, we’re so proud of our partnership with MAP. We have made great strides since Even the Odds launched in 2021, and we are ready to continue building this momentum to drive positive change and make a true impact within our communities.”

Since its launch in 2021, the Even the Odds campaign has raised more than $3.3-million – surpassing its campaign goals in 2021 and 2022 thanks to the support of Staples’ customers, associates, and vendor-partners as well as corporate match donations.

In Canada, income, education, and experiences of discrimination strongly affect our odds of staying healthy. That’s because social and economic status determine how easy it is to access the resources that are essential for good health. Even the Odds will continue making an impact by funding research and solutions throughout Canada, focusing on four core projects in 2023:

  • Expanding Our Healthbox to three additional provinces: In early 2023, Our Healthbox launched “smart” vending machines in several Eastern Canadian communities, dispensing free HIV self-tests, naloxone kits, COVID-19 rapid tests and other health supplies on demand. Even the Odds will support an additional expansion throughout 2023 to three additional provinces.
  • Continued investment in Clinique Mauve: In 2022, Université de Montréal and the Centre de Recherche en Santé Publique partnered with Staples Canada and MAP to launch a research project for Clinic Mauve, a specialized clinic in Quebec designed to meet the needs of racialized and migrant communities who are LGBTQI+.
  • Expanding APPLE Schools, an award-winning health promotion project: In 2022, Even the Odds brought a tailored version of APPLE Schools to kids in underserved school communities across Alberta. In 2023, Even the Odds will expand the program to schools in Ontario.
  • Launching an innovative outreach program for homeless hospital patients in British Columbia: The Navigator Program helps patients who are homeless to stay well after a hospitalization, by connecting them with health care and social services in the community.

“The growth and progress Even the Odds has seen over the past two years has made an incredible difference in the impact we’re making in communities across Canada,” said Dr. Stephen Hwang, Director, MAP. “We’ve set big goals for the year ahead and are very proud to continue doing this meaningful work with Staples.”

Staples customers can donate Even the Odds at any one of Staples Canada’s 300+ stores or online at Staples.ca/EvenTheOdds.

About MAP

MAP is a world-leading research centre dedicated to creating a healthier future for all. Through big-picture research and street-level solutions, MAP scientists tackle complex community health issues—many at the intersection of health and equity. MAP’s 34 scientists and over 130 staff and students work in partnership with communities, researchers, and government leaders across Canada to address issues such as homelessness, unequal access to health care and medicine, and the lifelong effects of childhood poverty. MAP is part of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto. For more information, visit maphealth.ca.

About Staples Canada

Staples Canada is The Working and Learning Company. The privately-owned company is committed to being a dynamic, inspiring partner to customers who visit its 300+ locations and staples.ca. The company has two brands which support business customers: Staples Preferred for small businesses and entrepreneurs, and Staples Professional for medium to large-sized enterprises, as well as seven Staples Studio co-working facilities across Canada. Through Solutionshop, Canadians can access a variety of pack and ship options, as well as a broad suite of business services. Staples is a proud partner of MAP through its Even the Odds campaign, which aims to tackle inequities in communities across Canada and helps make a future that’s fair for everyone. Visit staples.ca for more information or engage with us at @StaplesCanada on FacebookTwitterInstagramLinkedInTikTok or Pinterest.

Announcing: Solutions for Healthy Cities Symposium, March 23, 2023

We are excited to announce that the next Solutions for Healthy Cities Symposium will be in Toronto on March 23, 2023! Join us for a full day of talks, discussion and Q&As with MAP scientists and exciting guest speakers. Connect with others who are working to implement new programs and practices in their communities, and learn from leaders in implementing equity-focused interventions.

Keynote: Dr. Ibram X. Kendi, the founding director of the BU Center for Antiracist Research and author of How to Be an Antiracist

Date: March 23, 2023, 9:30-5pm

Venue: The Symes, 150 Symes Rd, Toronto, ON

Cost: $35.00 ($39.55 incl. HST). Fee includes breakfast, lunch and reception. If this fee is cost prohibitive, please contact alex@sparkinc.net.

Harm reduction dispensing machines to be installed across Canada

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Program led by St. Michael’s Hospital to dispense free HIV self-testing kits, harm reduction, sexual health supplies

The east coast launch of Our Healthbox is funded by Even the Odds, a partnership between Staples Canada and MAP.

TORONTO – Machines that dispense free self-testing kits for HIV and COVID-19, naloxone kits, new needles, condoms and other essential harm reduction and sexual health supplies will soon appear in communities across Canada.

The ‘smart’ machines, called Our Healthbox, work like a vending machine, and also provide health information and a service directory for people to find much-needed health care and supports in their community. The initiative, led by researchers at St. Michael’s Hospital, a site of Unity Health Toronto, will launch in four communities in New Brunswick on Jan. 23, with plans to launch up to 50 machines across Canada in 2023. The goal is to install 100 machines over the next three years, and to evaluate how well they support people with their health needs.

The initiative launches as new HIV cases in Canada rise and the country’s opioid crisis claims the lives of 20 Canadians each day. Providing access to harm reduction and health care supplies for free to people in spaces they frequent is a strategy experts consider as key to reaching people who are underserved and who have barriers to accessing testing, harm reduction materials, treatment, care and prevention due to racism, homophobia, stigma and discrimination.

“Everyone in Canada deserves to have what they need, when they need it, to take care of their health. But we know that this is not the case, and so we are doing everything we can to bridge that gap in ways that work for each person in their community,” said Dr. Sean B. Rourke, a scientist at MAP Centre for Urban Health Solutions, a world-leading research centre housed at St. Michael’s Hospital, and the Director of REACH Nexus, a national research group working on how to address access and treatment for HIV, Hepatitis C and other sexually transmitted and blood-borne infections.

Our Healthbox is the latest phase of work led by Rourke to connect those with complex health and social circumstances to testing, treatment and prevention. In 2019, Rourke spearheaded a cross-Canada clinical trial which evaluated and proved the accuracy of HIV-self tests – Health Canada approved the tests for use in November 2020 based on the results of the trial. In June 2022, Rourke launched the I’m Ready research program, distributing 10,000 free HIV self-testing kits across Canada to reach people who are undiagnosed and get them connected to care, with the goal of identifying the factors that affect access to testing and care.

Rourke and his team will work with local community-based organizations, public health authorities, and health centres to host and maintain Our Healthbox program. Each agency determines the supplies needed in the machines to serve the people in their community. The east coast launch of Our Healthbox is funded by Even the Odds, a partnership between Staples Canada and MAP Centre for Urban Health Solutions.

“Our Healthbox will ensure underserved individuals in the community have low barrier access to resources that not only reduce their risk of infections, but in fact save their lives,” said Deborah R. Warren, Executive Director at ENSEMBLE, a community-based organization in Moncton, N.B. that works to address complex social issues by providing support, education and prevention initiatives. “We are currently in the midst of a substance use crisis that sees the death of one New Brunswicker every four days. Providing access to free naloxone will save many lives.”

Our Healthbox is funded by the Canadian Institutes of Health Research (CIHR), the Public Health Agency of Canada, the Canadian Foundation for AIDS Research (CANFAR), the St. Michael’s Hospital Foundation, and Even The Odds (Staples Canada and MAP).

About MAP Centre for Urban Health Solutions

MAP is a world-leading research centre dedicated to creating a healthier future for all. Through big-picture research and street-level solutions, MAP scientists tackle complex community health issues—many at the intersection of health and equity. MAP works in partnership with communities, researchers, and government leaders across Canada to address issues such as homelessness, unequal access to health care and medicine, and the lifelong effects of childhood poverty. MAP is part of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Unity Health Toronto. For more information, visit maphealth.ca.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit unityhealth.to.

About Even the Odds

Staples Canada and MAP have come together to create Even the Odds: an initiative to raise awareness of inequity in Canada and to help build vibrant, healthy communities. The partnership is based on the shared belief that everyone should have the opportunity to thrive. Even the Odds will support MAP’s research and programs across Canada. It is a bold commitment to make a difference in Canada’s unique and diverse communities through corporate donations, fundraising and awareness. For more information, visit staples.ca/eventheodds

Media Contact

Hayley Mick or Jennifer Stranges: communications@unityhealth.to

Des distributeurs automatiques de fournitures de réduction des méfaits et des risques seront installés partout au Canada

Un programme dirigé par l’Hôpital St Michael destiné à distribuer gratuitement des trousses d’autodépistage du VIH, ainsi que des fournitures de réduction des méfaits et des risques et de santé sexuelle.

Le lancement de Notre Boîtesanté sur la côte Est est financé par À chance égale, un partenariat entre Bureau en Gros et du Centre MAP.

TORONTO – Des machines distribuant gratuitement des trousses d’autodépistage du VIH et de la COVID-19, des trousses de naloxone, des nouvelles aiguilles, des condoms et d’autres articles essentiels à la réduction des méfaits et des risques et à la santé sexuelle feront bientôt leur apparition dans les communautés à travers tout le Canada.

Ces machines « intelligentes », appelées Notre Boîtesanté, fonctionnent comme des distributeurs automatiques. Elles fournissent également des informations en matière de santé et un répertoire de services qui permet aux individus d’obtenir, dans leur communauté, d’indispensables soins de santé et services de soutien. L’initiative, dirigée par des chercheurs de l’Hôpital St Michael, un établissement d’Unity Health Toronto, sera inaugurée le 23 janvier au sein de quatre communautés du Nouveau-Brunswick, et il est prévu d’installer jusqu’à 50 machines à travers le Canada en 2023. L’objectif est d’installer 100 distributeurs au cours des trois prochaines années et d’évaluer dans quelle mesure ils apportent une réponse adaptée aux besoins des individus en matière de santé.

Cette initiative est lancée alors que le nombre de nouveaux cas de VIH au Canada est en augmentation et que la crise des opioïdes coûte la vie à 20 Canadiens chaque jour. Fournir aux personnes un accès gratuit à des fournitures de réduction des méfaits et des risques et à des soins de santé au cœur des espaces qu’elles fréquentent est une stratégie que les experts considèrent comme essentielle pour rejoindre les personnes habituellement mal desservies ou qui se heurtent à des obstacles pour accéder au dépistage, au matériel de réduction des méfaits et des risques, aux traitements, aux soins et à la prévention. Ces barrières à l’accès peuvent survenir en raison du racisme, de l’homophobie, de la stigmatisation ou de la discrimination.

« Pour prendre soin de sa santé, tout le monde au Canada mérite d’avoir accès à ce dont il a besoin, quand il en a besoin. Mais nous savons que ce n’est pas le cas, alors nous faisons tout ce que nous pouvons pour combler ce fossé avec des moyens qui fonctionnent pour chaque individu au sein de sa communauté », a déclaré le Docteur Sean B. Rourke, chercheur au sein du MAP Centre for Urban Health Solutions, un centre de recherche de calibre mondial situé à l’Hôpital St Michael, et directeur de REACH Nexus : un groupe de recherche national travaillant sur la façon de gérer au mieux l’accès aux soins et aux traitements pour le VIH, l’hépatite C et d’autres infections transmissibles sexuellement et par le sang.

Notre Boîtesanté est le plus récent développement du travail mené par le Docteur Rourke afin de connecter les personnes confrontées à des circonstances sanitaires et sociales complexes au dépistage, aux traitements et à la prévention. En 2019, le Docteur Rourke a dirigé un essai clinique pancanadien qui a évalué et prouvé la fiabilité des tests d’autodépistage du VIH – Santé Canada a approuvé l’utilisation de ces tests en novembre 2020 sur la base des résultats de l’essai. En juin 2022, le Docteur Rourke a lancé le programme de recherche I’m Ready/J’AGIS, visant à distribuer gratuitement 10 000 trousses d’autodépistage du VIH partout au Canada pour rejoindre les personnes non encore diagnostiquées et les arrimer aux soins. Ce programme a permis de déterminer les facteurs qui influencent l’accès au dépistage et aux soins.

Le Docteur Rourke et son équipe visent à travailler avec des organismes communautaires locaux, des autorités de santé publique et des centres de santé afin de mettre en place et faire fonctionner le programme Notre Boîtesanté. Chaque organisme déterminera les articles qu’il faudra mettre dans les machines pour répondre au mieux aux besoins des personnes de sa communauté. Le lancement de Notre Boîtesanté sur la côte Est est financé par À chance égale, un partenariat entre Bureau en Gros et le MAP Centre for Urban Health Solutions.

« Notre Boîtesanté permettra à des personnes mal desservies de la communauté d’avoir un accès à faible barrière à des ressources qui non seulement réduisent leurs risques d’infections, mais qui peuvent carrément leur sauver la vie », a déclaré Deborah R. Warren, directrice générale d’ENSEMBLE, un organisme communautaire de Moncton, au Nouveau-Brunswick, qui s’efforce de résoudre des problèmes sociaux complexes en offrant des services de soutien, d’éducation et de prévention. « Nous sommes actuellement au beau milieu d’une crise de toxicomanie qui entraîne la mort d’un Néo-Brunswickois tous les quatre jours. L’accès gratuit à la naloxone sauvera de nombreuses vies ».

Notre Boitesanté est financée par les Instituts de recherche en santé du Canada (IRSC), l’Agence de la santé publique du Canada, la Fondation canadienne de recherche sur le sida (CANFAR) et la Fondation de l’Hôpital St Michael, et À chance égale (Bureau en Gros et MAP).

À propos du Centre MAP

Ce centre de recherche de premier plan à l’échelle mondiale se consacre à la création d’un avenir plus sain pour tous. Grâce à des recherches qui donnent une vision d’ensemble et à des solutions concrètes, les scientifiques du Centre MAP s’attaquent à des problèmes de santé communautaire complexes, dont bon nombre se situent au croisement de la santé et des inégalités. Le Centre MAP travaillent en partenariat avec des communautés, chercheurs et dirigeants gouvernementaux partout au Canada pour s’attaquer à des problèmes tels que l’itinérance, l’accès inégal aux soins de santé et à la médecine, et les effets à vie de la pauvreté chez les enfants. Le Centre MAP fait partie du Li Ka Shing Knowledge Institute de l’hôpital St. Michael’s d’Unity Health Toronto. Pour obtenir plus de renseignements, consultez le site maphealth.ca/fr.

À propos de Unity Health Toronto

Le groupement Unity Health Toronto est composé du Providence Healthcare, du Centre de santé St Joseph et de l’Hôpital St Michael. Il s’efforce de faire progresser la santé de chacun dans nos communautés urbaines et au-delà. Notre réseau de santé dessert les patients, les résidents et les clients pour l’ensemble de la gamme des soins, notamment les soins primaires, les soins communautaires secondaires, les services de soins tertiaires et quaternaires pour la phase postaiguë, par la réadaptation, les soins palliatifs et les soins de longue durée, tout en investissant dans la recherche et l’éducation qui sont toutes deux de classe mondiale. Pour de plus amples renseignements, visitez unityhealth.to.

À propos de À chance égale

Staples/Bureau en Gros et MAP ont uni leurs forces pour créer « À chance égale », une initiative visant à sensibiliser le public aux inégalités qui subsistent au Canada et à bâtir des collectivités dynamiques et saines. Le partenariat est fondé sur la conviction partagée que chacun devrait avoir la possibilité de s’épanouir. À chance égale soutiendra la recherche et les programmes du MAP partout au Canada. Il s’agit d’un engagement audacieux à faire une différence dans les collectivités uniques et diversifiées du Canada au moyen de dons d’entreprises, de collectes de fonds et de sensibilisation. Pour de plus amples renseignements, visitez bureauengros.com/achanceegale.

Personne-ressource pour les médias

Hayley Mick ou Jennifer Stranges : communications@unityhealth.to

Director’s update: MAP’s 2022 year in review

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As 2022 comes to an end, I am delighted to provide an update of MAP’s activity and progress from this past year.

It’s been an extremely productive year, with some major successes and milestones to celebrate! We grew as a centre, worked alongside our community partners to advance many exciting new innovations and solutions, and deepened our policy partnerships and impacts.

In 2022 our team of scientists, investigators and affiliate scientists grew to more than 40, and our MAP research staff now total approximately 130. We brought on two new community scholars, and delivered the second year of our successful BIPOC student program.

Progress on the research front has been exceptional. Our scientists are truly exemplars of MAP’s research pillars of world-leading science and innovation; street-level scalable solutions; and long-term community and policy partnerships.

We are also extremely proud of our national initiative to raise awareness and funds through MAP’s Even the Odds partnership with Staples Canada. Funds raised support MAP’s work in three areas: access to care, ending chronic homelessness, and a healthy start for kids.

I am humbled to lead this amazing enterprise and very grateful for your interest and support. I look forward to what we will achieve in 2023!

Dr. Stephen Hwang
Director, MAP Centre for Urban Health Solutions

Chair, Homelessness, Housing and Health, St. Michael’s Hospital, Unity Health Toronto


2022 Research Highlights

Dr. Nav Persaud led a task force of MAP scientists to launch the Equity Roadmap report, a set of thirteen recommendations for governments at all levels across Canada. The recommendations outline the interventions/policy changes most likely to address COVID-19-related inequities during Canada’s pandemic recovery period. MAP launched an accompanying podcast series.

Dr. Sharmistha Mishra and Dr. Darrell Tan were among the first to sound the alarm re: the equity implications of mpox public health responses and related stigma, and the importance of global vaccine equity. They worked quickly to launch and complete a mpox vaccine modelling study that provided a roadmap for vaccination.

Dr. Katerina Maximova, the Murphy Family Foundation Chair in Early Life Interventions, led the scale-up of APPLE Schools – A Project Promoting Healthy Living for Everyone in Schools – an internationally recognized “best practice” for school-based interventions for healthy eating, physical activity and mental health in children from socioeconomically disadvantaged communities. Dr. Maximova is bringing a tailored version of the program to 10 new elementary schools in western Canada, with more planned in Ontario.

Dr. Andrew Pinto was awarded the CIHR Applied Public Health Chair in Upstream Prevention in Primary Healthcare AND received $10M from CIHR to develop an adaptive platform trial to evaluate COVID therapeutics in out-patient settings in six provinces across Canada.

Dr. Tara Kiran launched and completed the first phase of OurCare, an ambitious national survey and public consultation platform to capture new perspectives and possibilities for primary care in Canada. The detailed survey garnered >9,000 responses nationally as well as outstanding media coverage.

Dr. Stephen Hwang’s St. Michael’s Hospital Navigator Project expanded to a new site: St. Joseph’s Health Centre in Toronto. The innovative program pairs patients who are homeless with an outreach worker, to help prevent readmission to hospital and ensure a better recovery. The program served approximately 90 unhoused patients in 2022, and was highlighted by the Globe and Mail as a creative, “outside the box” solution to improve access to care.

Dr. Sean Rourke was awarded two large, five-year Public Health Agency of Canada grants for I’m Ready, Our HealthBox and his Positive Effect project to end HIV stigma. I’m Ready also reached a major milestone of >10,000 HIV self-tests distributed across Canada. Dr. Rourke’s new project, I Am, also launched an exciting partnership with Starbucks Canada.

Dr. Dan Werb’s drug-checking service in Toronto has now checked over 7,000 samples of drugs since it launched in Oct. 2019, the majority (50 per cent) of which is fentanyl. Werb’s recent research indicates that more of these kinds of drug-checking services are urgently needed.

Dr. Naomi Thulien premiered Searching for Home, a companion documentary to her Transitioning Youth Out of Homelessness study. The short documentary follows the lives of three young people who are transitioning out of homelessness, and highlights the potential of portable rent subsidies as a novel and promising intervention to help end homelessness.

Want more research updates?

Subscribe to MAP’s Junction e-newsletter for short, monthly updates on our studies, our solutions, and the issues we study. You can also follow MAP on Twitter and LinkedIn, and subscribe to our MAPmaking podcast. MAP scientist were quoted in more than 130 media articles in 2022 – check out the coverage here.

Mise à jour du directeur : bilan de l’année 2022 du MAP

Alors que l’année 2022 touche à sa fin, je suis ravi de vous présenter une mise à jour de l’activité et des progrès du MAP au cours de l’année écoulée.

L’année a été extrêmement productive, avec quelques réussites et étapes importantes à célébrer! Nous avons grandi en tant que centre, avons travaillé aux côtés de nos partenaires communautaires pour faire progresser de nombreuses innovations et solutions passionnantes, et nous avons consolidé nos partenariats et nos impacts politiques.

En 2022, notre équipe de chercheurs, d’enquêteurs et de scientifiques affiliés est passée à plus de 40, et notre personnel de recherche du MAP compte désormais environ 130 personnes. Nous avons engagé deux nouveaux boursiers et nous avons assuré la deuxième année de notre programme d’étudiants PANDC.

Les progrès réalisés dans le domaine de la recherche ont été exceptionnels. Nos scientifiques du MAP sont de véritables exemples des fondements de la recherche de la science et de l’innovation de pointe dans le monde, des solutions évolutives sur le terrain et des partenariats communautaires et politiques à long terme.

Nous sommes également extrêmement fiers de notre initiative nationale de sensibilisation et de collecte de fonds par l’intermédiaire du partenariat À chance égale du MAP avec Bureau en Gros. Les fonds recueillis soutiennent le travail du MAP dans trois domaines : l’accès aux soins, la fin du sans-abrisme chronique et un départ sain pour les enfants.

C’est avec humilité que je dirige cette entreprise extraordinaire et je vous suis très reconnaissant de votre intérêt et de votre soutien. Je me réjouis déjà de ce que nous réaliserons en 2023!

Dr Stephen Hwang
Directeur, MAP
Président, Homelessness, Housing and Health, hôpital St. Michael’s, Unity Health Toronto

MAP unveils Our Healthbox at AIDS 2022

July 29 2022 – At the 24th International AIDS Conference, the world’s largest conference on HIV and AIDS, MAP scientist Dr. Sean Rourke has unveiled a tool that not only eliminates barriers to HIV testing, but connects people to care.

Minister of Health Jean-Yves Duclos stopped by to learn how the new Our Healthbox HIV self-testing kit vending machine functions and how it will help increase access to health care and reduce stigma.

Our Healthbox is “smart”, interactive dispensing machine that provides free, 24/7 access to self-testing kits for HIV as well as COVID-19, naloxone kits, and other essential harm reduction, sexual health and hygiene supplies. The machine also provides health information and a support services directory for people to find the health care they need—in their community.

Dr. Rourke’s REACH Nexus group is planning to launch 25-30 machines nationally this year, with a goal of 100 machines deployed over the next three years. The machines will be hosted and maintained in partnership with local community-based organizations, public health authorities, and health centres across the country.

In Canada, one out of 10 people who have HIV don’t know it. To reach the undiagnosed, Dr. Rourke’s REACH Nexus group launched the I’m Ready program one year ago, an app that enables free, easy access to HIV self-testing kits and support. Since then, the program distributed more than 10,000 self-tests across Canada. However not everyone has a phone, so Our Healthbox was designed to close that gap and meet people where they are.

Our Healthbox and I’m Ready are also health research programs. To access the resources, participants must register and answer a few questions about themselves. The information that is collected remains private and confidential and will help the REACH research team evaluate how well the programs are working.

If you are a community organization and want to place Our Healthbox in your neighbourhood, email ourhealthbox@unityhealth.to.

Opinion: Canada has fallen behind on diagnosing and treating people with HIV

GLOBE AND MAIL

By Sean Rourke, Trevor Stratton, Notisha Massaquoi And Bill Flanagan

Today in Montreal, Canada’s political leaders are participating the AIDS 2022 conference, bringing the world together to accelerate the fight to end HIV and AIDS globally. Unless their words can be translated into political will and action, we will be no further ahead in ending HIV in Canada.

The number of new HIV cases in Canada has been on the rise over the past five years, and in 2020 (our most recent national estimates of HIV surveillance), four people were infected with HIV every day. However, this is likely an underestimate – we expect to see a higher rate of new HIV infections in 2021 and 2022 because COVID-19 significantly restricted access to HIV testing and treatment.

It is shameful that we are still not getting testing and treatment to those who need it most.

We are among the worst of the G7 countries in making significant progress in achieving the UNAIDS 95-95-95 targets of diagnosing 95 per cent of HIV cases, getting 95 per cent of those people on life-saving treatment, and getting the virus levels of 95 per cent of that group to “undetectable” levels so they can live healthy lives. Most concerning are recent numbers from 2020 that show women are doing worse than men overall in access to testing and treatment – and Indigenous Peoples (First Nations, Métis and Inuit), racialized communities, including African, Caribbean and Black people, and people who use substances and inject drugs, are doing the worst overall.

Having HIV is no longer a death sentence, but people who are infected need to be tested and have access to treatment that will suppress the virus. Unfortunately, one out of 10 people living with HIV is undiagnosed (they have HIV but don’t know it). That’s more than 6,500 people in Canada who are not able to benefit from antiviral treatment. If they don’t get access to testing and are not properly diagnosed, they will get very sick at some point and develop AIDS. And those undiagnosed and without their virus suppressed may also unknowingly infect others.

We have all of the tools and knowledge we need to correct these shortcomings.

In November 2020, we worked to get the first HIV self-test approved in Canada, and then research programs were developed and implemented to provide low barrier access to home testing using technology platforms. But our governments have yet to take up these successful initiatives and scale them sufficiently to reach all of those who are undiagnosed across Canada.