We founded Toronto Community Health Profiles Partnership (TCHPP) to fill an important knowledge gap: community organizations and health and social services providers had little access to urgently-needed, community-level, demographic, socioeconomic, and population health information about the areas and populations they served. In 2005, TCHPP expanded to become Ontario Community Health Profiles Partnership, a publicly accessible, searchable health database and service that many health and community organizations across the province today depend on to help plan and evaluate their programs.
We published one of the first-ever papers in a general medical journal describing the links between homelessness, housing and health. The paper was widely recognized as groundbreaking – changing the conversation about homelessness and housing worldwide. It has since been cited in more than 1000 academic publications. In 2014, we published a follow-up to the article, this time in the world’s highest-impact general medical journal: the Lancet. It focused on reviewing evidence-based solutions, and highlighted Housing First as a proven approach to end chronic homelessness.
Recommendations we developed with Stanford University and Duke University were adopted by the U.S. Centres for Disease Control (CDC) to expand HIV screening for all patients 13-64 years in all health care settings. Our economic analysis showed that routine HIV screening for everyone was cost effective and a good use of health care resources, even where prevalence of HIV is low.
The startling results of our Diabetes Atlas, developed with ICES, received widespread media attention, including an interactive website launched by the Toronto Star. The findings informed the Ontario Ministry of Health and Long-Term Care’s 2008 Chronic Disease Management Strategy, and was immediately recognized by the City of Toronto, the Toronto Transit Commission (TTC) and the provincial government as an important guide for policy decision-making. Follow-up research included the Peel Diabetes Atlas and Healthy Development Index.
We were the first to quantify the profound impact that homelessness can have on a person’s life expectancy, proving that homeless men are eight times as likely to die as men in the general population. A large follow-up study, looking at 11 years of national data, found that among those who were homeless or marginally housed across Canada, the probability of survival to age 75 was only 32%. These stark findings were used to advance advocacy and policy arguments across Canada.
We led the Toronto arm of the Mental Health Commission of Canada At Home/Chez Soi study (2009-13), the largest randomized controlled trial in history to evaluate solutions to address homelessness. Our success testing the “Housing First” approach influenced the province of Ontario to set a goal to end chronic homelessness within the next ten years. Citing our evidence, the Ontario Ministry of Health and Long-Term Care also committed to invest $4M long-term funding to sustain housing and support to At Home participants in Toronto, and the federal government committed resources to scale up Housing First interventions across the country.
Our research advanced advocacy leading to the Ontario Ministry of Health and Long-term Care’s life-saving decision to start distributing naloxone to inmates just prior to their release. Our studies showed that 10% of overdoses in Ontario were associated with release from incarceration, and that the highest-risk period was the first few days to two weeks after release – before most people can see a healthcare provider.
Our research exploring the value and feasibility of supervised injection facilities was fundamental to establishing the evidence base for these services in Canada. Public health officials, community groups, and elected officials used our research to support applications to the federal government that resulted in the introduction of supervised injection facilities in Toronto. The Toronto Board of Health relied on these findings to appeal to the Federal Government to relax criminal restrictions on supervised injection.
An advisory council set up by the Liberals proposed a national project to implement a universal public program for prescription drugs. Our first-of-its-kind research was endorsed and cited in the report as as a key resource and starting point for major pharmaceutical policy reform in Canada. In the years that followed, we continued to advance the pharmacare debate in Canada by proving that if everyone in Canada could access essential medications free of charge, it would not only improve the country’s health overall, but would save the health-care system billions of dollars.
When the pandemic struck, MAP scientists moved quickly to direct our expertise where it was most needed. MAP created COVID-19 data models to help front-line organizations predict spread in their local, client populations, led COVID-19 clinical trials, and worked to build a better health and social system. We provided expert opinion and informed public health responses in real time. MAP’s research showed that lower-income Toronto neighbourhoods were disproportionately impacted by COVID-19, which led to public policy that prioritized vaccinations for these hotspots. As Canada shifted focus to pandemic recovery, MAP launched a task force to identify the interventions and policy changes most likely to address COVID-19-related inequities in a post-pandemic world.
MAP research was instrumental in winning Health Canada’s landmark approval of the first HIV self-test in Canada: a one-minute, finger-prick blood test that can be purchased online and completed at home. Working together with community organizations, the health sector, and funders including Even the Odds, we are now distributing 50,000 HIV free self-testing kits across Canada through innovative mobile apps that support testing and connections to care, and “smart” vending machines that dispense HIV self-tests as well as free naloxone kits, harm reduction supplies and health information.
We 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. We worked quickly to launch and complete a Mpox vaccine modelling study that provided a roadmap for vaccination.
In 2016, we were successful in advocating for new municipal policy in Toronto that would open cold weather drop-ins earlier in the season, and allow them to remain open continuously over the coldest winter months. Our 2019 and 2023 studies prompted the City of Toronto to increase temperature thresholds for activating warming centres from -15C to -5C. An evidence-based brief summarizing the research remains one of the most-visited pages on the MAP website.
Health Canada’s Substance Use and Addictions Program (SUAP) announced more than $21 million in federal funding for projects including the expansion of MAP’s multisite Drug Checking Service (a Canadian first) and our groundbreaking DoseCheck technology. This support will expand the life-saving services, promote our provincial monitoring of the unregulated drug supply, and directly contribute to better outcomes for people who use drugs.
MAP is world-leading research centre dedicated to creating a healthier future for all. We are a team of 60 scientists, investigators and postdoctoral fellows and more than 160 staff and students. We are home to six prestigious Canada Research Chairs and more than $100M in active studies. For 25 years we have been central to St. Michael’s mission to serve the disadvantaged and we are proud to remain based in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital, now a site of Unity Health Toronto.