Local Public Health Unit Priorities, Actions, and Barriers in Addressing Inequities During the COVID-19 Pandemic in Ontario, Canada.

CONTEXT: The COVID-19 pandemic required a major response from local public health to reduce infections and manage inequities in COVID-19 outcomes. It is important to consider lessons learned from the COVID-19 pandemic response across local public health in order to prepare for future public health emergencies.

OBJECTIVE

This study examined how local public health units (PHUs) in Ontario, Canada, addressed inequities in COVID-19 outcomes in their pandemic response.

DESIGN

We contacted all 34 Ontario PHUs to participate in a survey on priorities, actions, and barriers to address health inequities in their COVID-19 response and conducted inductive content analysis on responses to identify themes.

SETTING

Ontario, Canada.

PARTICIPANTS

A total of 25 out of 34 local Ontario PHUs completed the survey.

MAIN OUTCOME MEASURE: Public health unit-reported priorities and actions in addressing health inequities in their COVID-19 response.

RESULTS

PHUs reported varied priorities in addressing health inequities. PHUs played a key role in coordinating an equity-focused response, including data analysis and reporting, engaging with community groups, and making cross-sector connections. However, important barriers remained, including a lack of community trust, frequent changes in guidance, lack of access to data on the social determinants of health, and a shortage of staffing and resources.

CONCLUSION

Findings suggest ways to prioritize health equity in a public health emergency, including through properly resourcing PHUs, early planning and trust building, and improved equity-based data collection.