What happened and why? Exploring the development, implementation and impact of COVID-19 public health policies in Ontario using a health equity lens

Communities who experience social and economic inequities were hardest hit by the COVID-19 pandemic. One-size-fits-all public health policies (PHPs) do not sufficiently address inequities. It is essential that PHPs be developed and implemented with health equity in mind. As we prepare for a post-pandemic recovery and for future health emergencies, it is important for us to look back and assess how and why PHPs were developed and implemented in Ontario. In Objective 1 of the study, we will answer "what happened" by categorizing all PHPs pertaining to vaccinations and isolation supports in Ontario and querying whether and how they considered health equity. In Objective 2 of the study, we will determine "why" public health policies were developed or implemented using (or not using) a health equity lens. In Objective 3, we will determine "what we could have done differently" by using mathematical models to compare the potential impacts of different PHP combinations. In Objective 4, we will learn "what it would take to do things differently" by asking public health actors to describe the barriers and enablers to developing and implementing PHPs that prioritize the needs of those most at-risk of infection and negative health outcomes. Our team includes government and public health decision makers from the federal, provincial, and local/regional levels. Our team also includes representatives of health-equity focused organizations, who supported implementation of public health policies at the provincial and local/regional levels.