Vancouver HIV/AIDS
Care Co-ordinating Committee
Public Sections
Documents: Environment Report 1999-2002
This is a companion document to the Strategic Plan and a work in progress; this version March 31, 2000
INTRODUCTION
Every day 11 Canadians become infected with HIV, and there have been disturbing increases among those who are often socially and economically vulnerable. Injection drug users, women living in poverty, aboriginal peoples, young gay men and prison inmates are much more likely to become infected by HIV disease than others in the population (Canadian Strategy on HIV/AIDS, Health Canada, 1998).
The prevalence of HIV infection has been clearly linked with the social and economic determinants of health. Risk for HIV infection and the capacity to manage and maintain health while living with HIV disease are determined, in part, by factors such as income level, education, access to caring and supportive social networks, early childhood experiences, use of alcohol or drugs, and access to health care services.
Vancouver currently has the highest HIV infection rate in North America and there is an intense concentration of the epidemic in the Downtown Eastside. The epidemic is spreading to increasingly vulnerable populations, including those who are mentally ill, homeless, addicted, living in extreme poverty, involved in the sex trade and who face cultural or other barriers.
In 1994, the Vancouver HIV/AIDS Care Coordinating Committee (VH/ACCC) was formed to co-ordinate information sharing and collaboration among service organizations in tackling the HIV epidemic. The committee developed its first strategic plan in 1995 (Vancouver Strategic Plan for HIV/AIDS Care, 1995-98) with an emphasis on care services.
In September 1998, the Committee adopted a population health approach to the development of its second strategic plan with an added emphasis on prevention. In preparing the VH/ACCC Strategic Plan 1999-2002, Committee members first developed a draft discussion document for broad review and hosted a forum with approximately 125 participants at St. Paul’s Hospital on March 18, 1999. The purpose of the forum was to seek input into the development of the plan from member agencies and other government and non-profit health and social service providers and consumer agencies involved in HIV/AIDS-related service delivery.
The population health approach provides a unifying framework with which to examine the individual, social and economic forces shaping the current HIV epidemic in Vancouver. By using this approach, the committee was able to identify population groups who are vulnerable to HIV infection, to identify partner sectors and organizations that can help address systemic challenges, and to develop a framework for collaborative strategic action.
The Environmental Report is intended as a companion document to the VH/ACCC Strategic Plan 1999-2002. It provides the research and analysis to support the strategic goals, objectives, outcomes and priority strategies in the plan. The Environmental Report examines the current HIV epidemic in terms of four broad determinants of health: Living and Working Conditions, Individual Capacities and Skills, Social Environments and Health Services. Within each category, the Environmental Report addresses a range of specific determinants of health.
The VH/ACCC Strategic Plan is accompanied by two other supporting documents: a Strategies Report and Implementation Plan. The committee acknowledges that its focus on population health and prevention is an evolving one. Therefore, the strategic plan and companion documents will need to be regularly reviewed and updated.
The strategic documents have been prepared in the context of a renewed federal AIDS strategy, The Canadian Strategy on HIV/AIDS: Moving Forward Together (Health Canada, 1998), a new provincial framework on HIV/AIDS, British Columbia’s Framework for Action on HIV/AIDS (BC Ministry of Health, 1998) and a new Aboriginal HIV/AIDS strategy, The Red Road; Pathways to Wholeness: An Aboriginal Strategy for HIV and AIDS in British Columbia (BC Aboriginal HIV/AIDS Task Force, 1999). These plans all include discussions of population health principles and the determinants of health.
The Vancouver Richmond Health Board will be developing a regional HIV/AIDS plan in accordance with the provincial framework and in consultation with community service providers and consumers. The VH/ACCC Strategic Plan is not intended to become the regional HIV/AIDS plan. However, it is hoped that the Health Board will use the VHACCC Strategic Plan and companion documents to guide its own planning for HIV/AIDS.
The committee has been particularly grateful for the support of Health Canada in providing expertise on population health and in helping to produce the final documents. The committee also appreciates the research support of the Community Health Resource Project (CHRP) in providing access to original study findings. CHRP is an ongoing research project investigating the economic costs and related social issues of HIV and AIDS in Vancouver. The CHRP team is located at the Department of Health Care and Epidemiology, University of British Columbia, and receives funds from Health Canada and the British Columbia Ministry of Health.
