Applying « Health in All Policies » to Federal & Provincial Government Budget Allocations Between Ministries

Kershaw, Paul W | $315,563

British Columbia University of British Columbia 2021 CIHR Project Grant


Background: Research shows that government spending on social programs (e.g., poverty reduction, housing, childcare, etc.) has a stronger association with population health than does public investment in medical care. A higher social/medical spending ratio (i.e. more spending on social issues than illness-treatment) associates with greater life expectancy and fewer potential years of lost life among OECD countries and Canadian provinces. These findings align with scholarship showing that social determinants of health exert stronger influence over population health than does the medical system. Problem: Canadian public finance has deviated from this research, which constitutes the evidence-to-policy gap on which we focus. A large and growing proportion of government budgets has gone to medical care since 1976, while social spending is much lower. Goal: We will implement a knowledge translation (KT) project designed to mobilize decision-makers at the highest levels of government to close the evidence-to-policy gap in order to build Better Budgets for Wellbeing (#WellBudgets). Guided by « health political science » KT methods, our team will perform activities to translate the evidence into actionable policy recommendations; capacity-building activities to ensure stakeholders have adequate ability to act on the evidence; and strategic activities to enhance the motivation of key stakeholders to act. Opportunity: The emergency response to the pandemic has opened a unique window for this KT, because governments directed more money to income supports (eg. CERB and Wage Subsidy) than to additional investments in the medical system. The opportunity we take on in this grant is to support governments in transitioning to a sustained, longer-term approach to aligning the social/medical spending ratio with the best available evidence. Research anticipates that doing so will increase Canadians’ resilience to conquer the pandemic-recession and reduce avoidable mortality.

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