Public health officials escorted by armed police through the epicenter of an outbreak. Government officials, in an effort to contain an epidemic, announcing rules forcing people off the streets. City residents fearing for their lives as a new virus kills the frail and infirm among them. That same fear leads to widespread support for draconian public health measures as long as they keep people safe.
The spread of the coronavirus has reminded us of the darker side of epidemic control. These kinds of “security-forward” responses are among the most common ways we deal with epidemics. While the COVID-19 epidemic has made these scenes familiar to us all, the above description applies just as well to the disease epicenter of Wuhan, China, as it does to how authorities right here in the US have responded to both real and perceived local epidemics.
MAP Centre for Urban Health Solutions has launched 10 collaborative solutions networks with a common goal: to effect real-world social change by co-designing and demonstrating what works to address critical urban health challenges in our communities.
The 10 networks, made up of more than 170 scientists, community partners, policy makers, and people with lived expertise from across the country, came together March 2-3, 2020, for a symposium in Toronto.
About the Symposium
The Solutions for Healthy Cities Symposium was an important opportunity for network members to meet in person, share experiences, learn from each other, and mobilize to chart their paths forward. The agenda included a mix of working sessions in network teams, and time for discussion and learning as a full group.
The Symposium opened and concluded with remarks from Cat Criger, an Indigenous Elder, Traditional Teacher and Knowledge Keeper. Symposium speakers included:
Namaste Marsden & Leona Star: Advancing standards and processes for First Nations, Inuit and Métis engagement in research about them
Alisa Velonis: Tools for guided implementation
Sam Tsemberis: Reflections on innovation, advocacy and policy change
“It’s nice, and rare, to have an occasion for critical thinking. Symposiums and conferences are usually about self-promotion, but not this one!” – Network member
“Having the face to face time to get to know one another was so valuable. Not usually included in research funding but should be!” – Network member
The Keynote Reception
At the much-anticipated keynote event, Mayor Lori E. Lightfoot, City of Chicago, addressed network members and guests. MAP Director Dr. Stephen Hwang also spoke.
Mayor Lightfoot was then joined by Mayor John Tory, City of Toronto, for a fireside chat. The discussion was moderated by Dr. Pat O’Campo, senior MAP scientist and Executive Director of the Li Ka Shing Knowledge Institute.
Among the guests in attendance were two former premiers of Ontario, David Peterson and Kathleen Wynne, former deputy premier Deb Matthews, and former Mississauga mayor Hazel McCallion.
Co-designing for Real-world Impact: The National Solutions Networks
With the vision of creating “a healthier future for all,” the 10 solutions networks are taking on complex issues including chronic homelessness, intimate partner violence, the long-term effects of socioeconomic adversity in early life, and the links between traumatic brain injury and incarceration.
The networks’ cross-sectoral membership and partnered approach are the keys to ensuring that solutions are feasible, appropriate, and effective — and that they reflect the goals, priorities, and contexts of the communities they aim to serve.
The result will be 10 evidence-based solutions that are tested and ready for scale-up in cities across Canada.
Together, we can create a healthier future for all.
The Solutions for Healthy Cities Symposium was made possible in partnership with the St. Michael’s Hospital Foundation and thanks to the generous contributions of its visionary donors. We also wish to thank Jackman Reinvents for their incredible work bringing our message and work to life, and Spark Inc. for their superb event management.
For his work to improve the health of people experiencing homelessness and to make social justice and health equity central to medical practice, Dr. Stephen Hwang has received the University of Toronto President’s Impact Award.
A professor in the department of medicine and scientist in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Hwang is a world-renowned expert. His research and advocacy has elucidated the causes and risk factors for death among homeless people, the relationship between traumatic brain injury and homelessness, and the effects of homelessness on health status.
Hwang has played a pivotal role in advancing Canadian and international scholarship and advocacy related to homelessness. His work helped inspire the creation of the 100,000 Homes Campaign, which has mobilized officials in hundreds of cities across the U.S. to house thousands of long-term and medically vulnerable homeless individuals who were at increased risk of death.
“Homelessness affects hundreds of thousands of Canadians and takes a tremendous toll on health,” Hwang said. “Our work has shown that the Housing First approach ends chronic homelessness and should be widely implemented. This award will support our ongoing research on new interventions to meet complex health needs and improve well-being and social integration among people experiencing homelessness.”
…Stephen Hwang, MD, an internist, homelessness researcher, and director of [MAP Centre for Urban Health Solutions] at St. Michael’s Hospital in Toronto, said “living on the streets or in a shelter is a hazardous environment.”
He said neurologists treating homeless patients should be aware of the possibility that a history of TBI could be the cause of behavioral issues, seizures or unexplained cognitive deficits. He helped craft recommendations issued in October 2018 by the National Health Care for the Homeless Council that focus on the care of patients who are homeless and living with the effects of TBI. It includes recommendations for assessment of possible deficits, including which screening tools to use.
Over one billion people globally experience some form of disability, yet despite having greater health needs, people with disabilities often encounter barriers to accessing care and have worse outcomes.
In a study published in Disability and Health Journal, MAP scientists Dr. Andrew Pinto and Dr. Tara Kiran examined how patients responded to being asked about disabilities as part of a routine survey and compared survey responses to data available in medical charts.
Five cases of the mysterious Wuhan coronavirus have been confirmed in the United States, giving rise to concerns about a potential global pandemic. We’ve seen this story before, as health authorities working with threadbare data try to walk the line between epidemic readiness and needless panic. Is this new outbreak poised to become the next AIDS pandemic or a new SARS, which was stopped in its tracks after 774 deaths? To cut through the headlines, we can use a simple concept called the “epidemic triangle.” Employed by epidemiologists since the discipline’s earliest days, it is indispensable in predicting whether localized outbreaks will transform into full-blown epidemics.
…One stumbling block for approval from Health Canada has been the lack of a clinical trial in Canada showing how accurate and easy to use the kits are, and whether users will seek medical care if they test positive. So, Dr. Sean Rourke, a psychiatrist and scientist at MAP Centre for Urban Health Solutions, raised the money for a 1,000-person clinical trial across give Canadian cities on INSTI finger-prick self-testing kits. Pant Pai is running the Quebec side of the trial. They expect it to be finished in February.
Once bio-Lytical submits the results to Health Canada, Rourke predicts the government will have everything it needs to approve the kits. “Hopefully by early spring or summer, the first self-test kits will be available in Canada,” he says.
…If self-test kits are finally approved for drug-store shelves and if more Canadians living with HIV gain access to medication, it’s a whole new world.
“We can end the HIV epidemic,” says Rourke. “Other countries have targets for 2030. We can do this in three to five years.”
The three biggest problems for patients surveyed about their discharge from Ontario hospitals all concern publicly funded home care, according to new research published in an international medical journal.
The researchers hope the findings will encourage improvements in the hospital-to-home transition navigated by some one million patients every year in this province.
Children who drink whole milk are less likely to be obese, according to a study which questions international dietary guidelines.
Researchers analysed data from 28 existing studies across seven countries involving a total of 20,897 healthy children aged between one and 18 years old. They concluded those who drank whole milk had a 40 percent lower chance of being overweight or obese compared with those who drank low-fat milk. The findings were published in The American Journal of Clinical Nutrition.
