Addressing Health Equity for COVID-19 Through a Neighbourhood Approach

Introduction

In December 2020, East Toronto Health Partners (ETHP), the Ontario Health Team (OHT) serving East Toronto, launched a collective COVID-19 immunization strategy for the communities it serves. Comprised of 50-plus community, primary care, home care, hospital and social services organizations working together to create an integrated system of care, the partnership has worked together to deliver COVID-19 vaccines using a nimble, adaptive neighbourhood approach rooted in health equity. This approach has helped protect local communities disproportionally impacted by COVID-19, offering a model that other OHTs and health system partners may follow to equitably and effectively deliver vaccines to priority populations.

Aims Objectives Theory or Methods

This presentation will showcase ETHP’s neighbourhood- and health equity-based approach to vaccine distribution, which includes mass clinics and mobile and pop-up efforts. It uses Thorncliffe Park as a case study, a rapidly growing, multicultural neighbourhood in Toronto that is home to many newcomers and essential workers who live in high-density apartment buildings and multigenerational households. These factors have put residents at increased risk of COVID-19 during the pandemic, necessitating a hyperlocal, neighbourhood-based approach to vaccine distribution that engages multiple community partners to help ensure vaccines reach the arms of individuals who need them most.

Highlights or Results or Key Findings

On March 29, 2021, less than 10 per cent of eligible individuals in Thorncliffe Park had received one dose of the COVID-19 vaccine. By May 10, nearly 40 per cent of eligible residents in this community had been vaccinated with one dose. This was due largely to ETHP’s neighbourhood approach to vaccine distribution in Thorncliffe Park, which is rooted in healthy equity, trusted partnerships, distributed leadership, embedded primary care and the ability to be nimble and adaptive. Furthermore, the success of ETHP’s immunization strategy in Thorncliffe Park did not happen overnight. It was built on the OHT’s existing COVID-19 response efforts in the neighbourhood, which, since March 2020, has involved pop-up testing sites, outreach to local schools, wraparound supports and building vaccine confidence with trusted voices. These efforts have strengthened ETHP’s relationships with community agencies and residents in Thorncliffe Park, providing a strong foundation for the partnership’s local vaccination efforts.

Conclusions

A neighbourhood approach to vaccine distribution rooted in healthy equity, trusted partnerships, distributed leadership and embedded primary care has positive, tangible effects on communities that have been disproportionately impacted by COVID-19. By working together across sectors, ETHP has helped increase vaccination rates for some of Toronto’s most vulnerable populations.

Implications for applicability/transferability sustainability and limitations

As COVID-19 transitions from a global pandemic to an ongoing health equity issue, this neighbourhood approach may be helpful for ongoing COVID-19 testing, case management and seasonal vaccinations. Furthermore, this community-based model may be leveraged to manage and navigate other illnesses.