Building a Foundation for Equity-focused Intersectoral Practice (EquIP): An exploratory intervention in intersectoral action on housing inadequacy in Owen Sound, Ontario
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Equitable access to the social determinants of health, including adequate housing, is essential to the attainment of health equity goals. Concerted intersectoral action involving public health, social services, relevant non-profit and private sector entities, multiple levels of government, and community members is necessary to ensure that all people have the conditions necessary for health and well-being. This dissertation chronicles the development and field-testing of a novel approach to building stronger and more equity-focused approaches to intersectoral action towards health equity goals. Through a participatory action research project in the rural community of Owen Sound, Ontario, a team of academic and community-based researchers worked together from 2017-2019 to design and implement a methodology for Equity-focused Intersectoral Practice (EquIP) to support local response to an escalating housing crisis. Implemented as a series of Learning Exchanges followed by an immersive Intersectoral Retreat, the novel EquIP methodology created uncommon spaces for relationship-building and knowledge co-creation among diverse intersectoral actors. Key to the methodology was the leadership of community members whose grounded expertise derives from their lived experience of housing inadequacy, poverty, and other dimensions of social marginalization. Centering their grounded expertise served to catalyze professionals from relevant agencies and institutions to reflect on the structures, beliefs, and practices that perpetuate inequitable access to the social determinants of health and impede effective intersectoral response. The research demonstrated that this “reversing the gaze” to identify gaps and disconnects in the institutional realm can broaden the lens of intersectoral action to include contextual and upstream factors, such as racism, inadequate mental health supports, and the stigmatizing effects of neoliberal austerity in social welfare policy. The research suggests that investing in authentic relationship-building among diverse intersectoral actors can help bridge the social, cultural, and epistemic distances that can impede effective and sustained intersectoral action. Through its integration of critical social science perspectives with public health practice, the EquIP model holds promise as a practical means of re-orienting intersectoral efforts towards the structural drivers and socio-economic injustices that perpetuate health inequities.