Background
Materials and methods
Data collection
Data analysis
Theoretical framework
Results
Qualitative study findings
Framing of equity
“We just tried to get a very wide cross-section, recognizing that there are a lot of users of this street and some of them are driving, but a lot of them are taking [public transit], a lot of them are walking. Some of them have disabilities, so we have to take into account accessibility, too, and are we providing a good environment for people to get around whether they’re walking or in a wheelchair or whatever. That was a key consideration”
“There was definitely consideration of equity…Because it was so transit focused, beyond that scope, it wasn’t included”
“But what it did is it [the program] often just gave the recipient the confidence to go and seek employment and in terms of the relatively low cost of the intervention had some fabulous results in terms of employment outcomes. So that we thought was really core public health”
Prioritization of equity
“It wasn’t really a specifically articulated goal…transit in general is always an equity conversation. But explicitly we didn’t say this is about enhancing equity for people.”
“I haven’t heard much discussion about that at the table… that social aspect hasn’t really come up from my experience”
“it’s a subtext. I’d like to think it informs all of our city work, but I know that’s not the case”
“Always included always…Our goal and our mandate are to serve everyone, anybody, everybody from the community. So, in every level I would strongly emphasize that that was considered.”
“Because of what we do and who we are, and the fact that we are a food justice organization is pretty much how we try to design our program. (But) looking at the agreement, I don’t think that was necessarily a huge area of focus.”
Emergent concept
“But I think transit, improving transit always gonna be improving equity…. It was serving a fairly economically vibrant part of the city already but I’m sure that it was beneficial to people of all incomes and backgrounds. Yeah, but it wasn’t central, and I fully admit that, but it has become a very central premise in our work going forward”
“We need to spread around this approach, what can we build from it that is useful and take away from it that’s useful and start to use an equity lens to say where it would be great to do something like this...I think the whole lens of equity is an emerging, it’s always been there in some ways but it’s kind of like in my opinion it’s where the environmental lens was like 10, 20 years ago”
Challenges to embed health equity
“It really depends on how you define health like that’s really what it comes down to”
“It’s much easier to develop, to talk about the importance of local food, to talk about food culture, to talk about all of those sorts of I mean they’re important. They’re important and big picture, they all contribute towards a stronger food system but they’re much easier to talk about. Poverty and, poverty as it relates to the food system and thinking about people’s access to food for financial reasons - it’s much easier to talk about those other things.”
Style of leadership
“What we did that was really helpful was we set up sort of a leader’s table which was the Heads of the different divisions who were viewed as co-leading the project.”
“One of the reasons why setting up the leader’s table was so important was to have a venue or a forum for those opinions to be voiced and decisions to be made. There were different opinions along the way and I think just like any big initiative we worked them out and I think that actually served really well as a model for making sure that there is a forum or a process set up for decision making and conflict resolution.”
“There’s a desire to control at the top so when you reach out to others across the organization, across the city in other departments, it’s not supported, it’s a little, seems a little threatening or it has to get approval from people above and it just can’t work like that.”
“I think their relationship has been like: we give you the money and you get the money, and we just want you to tell us that this is what you’ve done.”
Core competencies of a leader
“We were able to work together, just having very open and transparent discussions helped us to overcome that and if there was a conflict, work together in order to resolve it.”
“We just want the number. We don’t want to hear about your thing… there might be better ways for us to do things; if we are all willing to have those tough conversations, but sometimes some of us are not”.
“let’s find an alternative for the kind of, the less sexy stuff that is absolutely fundamental but for whatever reason just doesn’t resonate... we were always trying to dress it up well not dress it up but just sort of package it in a way…and articulate it ‘cause it’s complex and it’s difficult in its very nature.”
“So, she negotiated with that team to get some of that money to develop a program that would accommodate low-income folks who were interested in getting their food safety training and certification.”
“it’s kind of floating back and forth but no one’s owning it”
“I think in the short term it makes it very hard to coordinate because you can’t point to any one person or any one group and say you’re responsible for ensuring the people ... have good food. Because … I don’t think there’s any organization or person that feels that’s their responsibility.”
“Without the strong leadership it just doesn’t work, none of this stuff works so that’s what we’re really trying to bring and continue going forward is when we have these big flag ship projects or major initiatives we really need to engage our leaders and have them really be more hands-on of what some of the key decision points are..”
“it can’t just be we all brief everybody independently and everyone’s okay, it’s getting them together in a room physically and building that relationship so that they can be more effective leaders collectively than independently…the second point which is just about collaboration in general, so starting with collaboration at the top with the leaders, seeing that cascade down I think is really important.”
“it’s very clear to me that interpersonal relationships play a huge role in how these multi-sectoral partnerships are successful. How they’re implemented, how they’re successful, the most successful ones are the ones that really rely on personal relationships.”
Quantitative survey findings
A synopsis of the organizational mission and vision statements
Multisectoral partnerships (MP) | Summary of partnership’s goals/ mission & vision statement |
---|---|
MP-Health #1 | This MP was formed with a specific focus on helping newcomers to settling in Canada in 2016. The aims and goals of the MP mentioned bringing social and economic equity to the lives of participants. The intervention was tailored to specific groups of people that needed the intervention most |
MP-Health #2 | This partnership was formed in 2011 and the partnership strategy was outlined in 2014. It focused on improving and connecting inner city neighbourhoods. The strategy had multiple recommendations and goals, however none of them made any explicit reference to equity, or health equity in particular |
MP-Food #3 | This MP was formed with a specific focus to promote access to good food. The program goals aimed at reaching low-income neighborhoods as well as neighborhoods having least access to transportation services and food stores. This MP did not make any direct reference to ‘equity’ or ‘health equity’ in its program goals, however, the goals were oriented around equity-seeking groups such as ‘low-income neighborhoods’, and people not having ‘adequate transit services’ |
MP-Food #4 | This MP was formed in 2012 with goals of ensuring food access for everyone, enriching local food culture and minimizing ecological footprint. It specified several recommendations, one of which was ‘reducing inequality’ |
MP-Active Transit #5 | This transportation focused MP did not mention health equity in its program aims and objectives. However, it mentioned assessing the impacts of the project, including safety of vulnerable people as well as accessibility to all |
MP5-Active Transit #6 | This MP was formed in 2015 to promote active transportation. Goals and targets of the partnership mentioned improving connectivity, safety, convenience etc., however, none of the goals or action targets mentioned health equity |