Saying it out loud: explicit equity prompts for public health organization resilience.

Introduction: In the early days of the COVID-19 pandemic there were numerous stories of health equity work being put "on hold" as public health staff were deployed to the many urgent tasks of responding to the emergency. Losing track of health equity work is not new and relates in part to the need to transfer tacit knowledge to explicit articulation of an organization's commitment to health equity, by encoding the commitment and making it visible and sustainable in policy documents, protocols and processes. Methods: We adopted a Theory of Change framework to develop training for public health personnel to articulate where and how health equity is or can be embedded in their emergency preparedness processes and documents. Results: Over four sessions, participants reviewed how well their understanding of disadvantaged populations were represented in emergency preparedness, response and mitigation protocols. Using equity prompts, participants developed a heat map depicting where more work was needed to explicitly involve community partners in a sustained manner. Participants were challenged at times by questions of scope and authority, but it became clear that the explicit health equity prompts facilitated conversations that moved beyond the idea of health equity to something that could be codified and later measured. Over four sessions, participants reviewed how well their understanding of disadvantaged populations were represented in emergency preparedness, response and mitigation protocols. Using equity prompts, participants developed a heat map depicting where more work was needed to explicitly involve community partners in a sustained manner. Participants were challenged at times by questions of scope and authority, but it became clear that the explicit health equity prompts facilitated conversations that moved beyond the idea of health equity to something that could be codified and later measured. Discussion: Using the indicators and prompts enabled the leadership and staff to articulate what they do and do not know about their community partners, including how to sustain their involvement, and where there was need for action. Saying out loud where there is - and is not - sustained commitment to achieving health equity can help public health organizations move from theory to true preparedness and resilience.

Agiles, efficients et en évolution : la réponse rapide des Centres de collaboration nationale à la COVID-19 au Canada

Depuis décembre 2019, on assiste à une explosion mondiale de la recherche sur la COVID-19. Au Canada, les six Centres de collaboration nationale (CCN) en santé publique constituent l’un des piliers de la prise de décisions informées par les données probantes, car ils recueillent, résument et traduisent les connaissances émergentes. Financés par l’Agence de la santé publique du Canada et répartis sur le territoire, ils favorisent et soutiennent l’utilisation des résultats de la recherche scientifique et d’autres connaissances pour renforcer les pratiques, les programmes et les politiques en santé publique. Cet article fournit un aperçu de la manière dont les CCN participent à la mobilisation des connaissances en santé publique au Canada, met en évidence leur contribution à la lutte contre la COVID-19 et décrit les nombreuses difficultés rencontrées.

'Back to better': amplifying health equity, and determinants of health perspectives during the COVID-19 pandemic.

INTRODUCTION: Equity and social justice have long been key tenets of health promotion practice, policy and research. Health promotion foregrounds the pertinence of social, economic, cultural, political and spiritual life in creating and maintaining health. This necessitates a critical structural determinants of health perspective that actively engages with the experiences of health and wellbeing among diverse peoples. The inequitable impacts of pandemics are well documented, as are calls for improved pandemic responses. Yet, current pandemic and emergency preparedness plans do not adequately account for the social and structural determinants of health and health equity. METHODS: Through five one-hour online conversations held in April 2020, we engaged 13 practice, policy, research and community leaders on the intersections of COVID-19 and gender, racism, homelessness, Indigenous health and knowledge, household food insecurity, disability, ethics and equitable futures post-COVID-19. We conducted a thematic analysis of speaker and participant contributions to investigate the impacts and influence of COVID-19 related to the structural and social determinants of health. We analyzed which policies, practices and responses amplified or undermined equity and social justice and identified opportunities for improved action. FINDINGS: Analysis of the COVID-19 pandemic revealed four broad themes:• oppressive, unjust systems and existing health and social inequities;• health and social systems under duress and non-responsive to equity;• disproportionate impacts of COVID-19 driven by underlying structural and socioeconomic inequity; and• enhanced momentum for collective mobilization, policy innovations and social transformation. DISCUSSION: There was a strong desire for a more just and equitable society in a post-COVID-19 world, going 'back to better' rather than 'back to normal.' Our analysis demonstrates that equity has not been well integrated into pandemic planning and responses. Social movement and systems theories provide insight on ways to build on existing community mobilization and policy openings for sustained social transformation.

Nimble, efficient and evolving: the rapid response of the National Collaborating Centres to COVID-19 in Canada. / Agiles, efficients et en évolution : la réponse rapide des Centres de collaboration nationale à la COVID-19 au Canada.

Since December 2019, there has been a global explosion of research on COVID-19. In Canada, the six National Collaborating Centres (NCCs) for Public Health form one of the central pillars supporting evidence-informed decision making by gathering, synthesizing and translating emerging findings. Funded by the Public Health Agency of Canada and located across Canada, the six NCCs promote and support the use of scientific research and other knowledges to strengthen public health practice, programs and policies. This paper offers an overview of the NCCs as an example of public health knowledge mobilization in Canada and showcases the NCCs' contribution to the COVID-19 response while reflecting on the numerous challenges encountered.

The explosion of research on COVID-19 in Canada and around the world called for an improved capacity to support evidence-informed decision making (EIDM). Canada is fostering various mechanisms to achieve this goal; the National Collaborating Centres (NCCs) for Public Health are central to supporting EIDM during the pandemic. The NCCs, a network of networks anchored on six unique knowledge hubs, are well connected to provincial, territorial, local and international partners. In response to COVID-19, the NCCs are making an important contribution to building knowledge, skills and capacity in the public health sector, and to supporting public health professionals in synthesizing and using evidence-informed knowledge in policy and practice.

L'explosion de la recherche menée sur la COVID-19 au Canada et ailleurs dans le monde a nécessité une augmentation de la capacité à soutenir la prise de décisions informées par les données probantes. Parmi les divers mécanismes préconisés par le Canada pour atteindre cet objectif, les Centres de collaboration nationale (CCN) en santé publique jouent un rôle essentiel pendant la pandémie pour soutenir la prise de décisions informées par les données probantes. Les CCN, qui constituent un réseau de réseaux s'appuyant sur six centres de connaissances, ont des liens étroits avec plusieurs partenaires provinciaux, territoriaux, locaux et internationaux. Pour lutter contre la COVID-19, les CCN renforcent de façon significative les connaissances, les compétences et les capacités en santé publique et soutiennent les professionnels en santé publique en synthétisant des connaissances fondées sur des données probantes pour leur intégration aux politiques et aux pratiques.