title: The reallocation challenge: Containing Canadian medical care spending to invest in the social determinants of health.
abstract: We argue that Canadian provincial governments should contain medical care spending in order to invest more in the social determinants of health (SDH). Others have said this, many times. Doing it has not proven easy. We therefore emphasize the potential contribution of the priority-setting and resource allocation literature. This literature identifies formal tools and approaches that have built cultures of support for resource shifts, while providing pragmatic means for advancing efficiency and equity. Although reallocation towards SDH from other areas of the health care system is financially viable and supported by existing research, it will require new emphasis on the design of population health interventions that make reallocation politically expedient.
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. neale.smith@ubc.ca.|School of Public Health, University of Alberta, Edmonton, AB, Canada. neale.smith@ubc.ca.
authors.forename: Neale
authors.initials: N
authors.lastname: Smith
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.|School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Craig
authors.initials: C
authors.lastname: Mitton
authors.affiliation: School of Population and Public Health, University of British Columbia, Human Early Learning Partnership, Canada.|Founder, Generation Squeeze, Vancouver, BC, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Kershaw
mesh_terms: D002170:Canada; D003695:Delivery of Health Care / Q000191:economics*; D015276:Health Care Rationing / Q000458:organization & administration*; D006292:Health Priorities; D006801:Humans; D064890:Social Determinants of Health / Q000191:economics*