Developing Meaningful Indicators to Measure Population Health and Health Equity in Health Systems

It is critical for health systems to invest in a population health approach to function optimally and ensure system sustainability. Where health systems remain vulnerable to competing priorities and fiscal constraints, the implications of health service and delivery systems not investing in population health cannot go ignored. In Canada, socioeconomic health inequalities results in $6.2 billion of direct health care costs annually (representing 14% of acute care costs in the form of inpatient hospital admissions, prescription drug costs, and physician consultation services); furthermore, 60% of these direct costs are attributed to persons within the lowest income group. 


Inequities in health that arise due to the social determinants of health are a global killer requiring urgent, intersectoral, whole-of-government attention and action; adopting an upstream approach within the health system is recognized to make the most meaningful impact on population health.

Nova Scotia is confronted with significant health system challenges that coincide with poor health in the population and health inequities. The Nova Scotia Health Authority (NSHA) – the legislated provincial health service and delivery system for Nova Scotia-undergoing rapid transformation and provides an opportunity to be a test case to generate evidence within an emerging area of health services and policy research. In order to achieve full system impact and transformation, measurement is key. Health system decision makers and stakeholders must be equipped with meaningful indicators, related tools and metrics to assess progress in system transformation and impact around population health and health equity action.

Read our snapshot on this topic here.

Flagship Project Co-Leads


Dr. Mohammad Hajizadeh

Faculty of Health

Dr. Katherine Fierlbeck

Department of Political Science

Flagship Project Community Lead:

Meaghan Sim


Translating Research into Action



Co-Lead Dr. Hajizadeh investigated factors underlying the difference in psychological distress and suicidal behaviours between non-Indigenous and Indigenous populations living off-reserve in Canada.

Read the paper here.

March 8, 2021


The HPI "Indicators" Flagship Team has released a commentary exploring Public Health investment in Nova Scotia. They analyzed Nova Scotia Department of Health and Wellness budgets from 2015−2016 to 2019–2020 and observed that less than 1% of funding was budgeted for public health annually, an amount well below the recommendation that 5–6% of healthcare funding be spent on public health.

Read the full article here.

February 24, 2021


Co-Lead Dr. Fierlbeck provides input on why she thinks that this Flagship Project is so valuable and why she is a member of HPI. Read her interview here.