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Introduction: International evidence shows that enhancement of primary health care (PHC) services for disadvantaged populations is essential to reducing health and health care inequities. However, little is known about how to enhance equity at the organizational level within the PHC sector. Drawing on research conducted at two PHC Centres in Canada whose explicit mandates are to provide services to marginalized populations, the purpose of this paper is to discuss (a) the key dimensions of equity-oriented services to guide PHC organizations, and (b) strategies for operationalizing equity-oriented PHC services, particularly for marginalized populations. Methods: The PHC Centres are located in two cities within urban neighborhoods recognized as among the poorest in Canada. Using a mixed methods ethnographic design, data were collected through intensive immersion in the Centres, and included: (a) in-depth interviews with a total of 114 participants (73 patients; 41 staff), (b) over 900 hours of participant observation, and (c) an analysis of key organizational documents, which shed light on the policy and funding environments. Results: Through our analysis, we identified four key dimensions of equity-oriented PHC services: inequity-responsive care; trauma- and violence-informed care; contextually-tailored care; and culturally-competent care. The operationalization of these key dimensions are identified as 10 strategies that intersect to optimize the effectiveness of PHC services, particularly through improvements in the quality of care, an improved 'fit' between people's needs and services, enhanced trust and engagement by patients, and a shift from crisis-oriented care to continuity of care. Using illustrative examples from the data, these strategies are discussed to illuminate their relevance at three inter-related levels: organizational, clinical programming, and patient-provider interactions. Conclusions: These evidence- and theoretically-informed key dimensions and strategies provide direction for PHC organizations aiming to redress the increasing levels of health and health care inequities across population groups. The findings provide a framework for conceptualizing and operationalizing the essential elements of equity-oriented PHC services when working with marginalized populations, and will have broad application to a wide range of settings, contexts and jurisdictions. Future research is needed to link these strategies to quantifiable process and outcome measures, and to test their impact in diverse PHC settings. [ABSTRACT FROM AUTHOR]

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Abstract: Compensation for losses of non-market values experienced by aboriginal peoples, due to adverse impacts on their land or resource base caused by others, is an important issue for law and social justice. Yet the standard methods of economic valuation as a basis for determining compensation are not always suited to addressing the diverse values of aboriginal people. This paper discusses an approach to valuation that employs concepts and methods of decision analysis, informed by behavioral decision research, in an applied context. It uses a multi-attribute value assessment as a basis for characterizing the relative significance of resource damages that affect deeply held, complex, intangible values. We draw on the experience of conducting analyses for three Metis settlements in Alberta, Canada, to illustrate the approach using a case study. Interpretations of the results as a basis for negotiation regarding compensation are examined. [Copyright &y& Elsevier]

This paper is an analysis of income and expenditure patterns of two samples taken from First Nation communities in Saskatchewan. A number of hypotheses related to socioeconomic characteristics are tested. Contrary to the received view, it is found that the residents of the reserves are no worse off, by conventional standards of well-being, than their urban counterparts. In fact we found that the poverty rate in the urban sample was higher. Furthermore, those on the reserve had a higher educational attainment than those living off-reserve. For both communities, a minimum high school diploma significantly raises income, but trade certificates do not. [Copyright &y& Elsevier]

Copyright of Canadian Journal of Sociology is the property of Canadian Journal of Sociology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Injuries are a leading cause of death and morbidity. While individual Aboriginal identifiers are not routinely available on national administrative databases, this study examines unintentional injury hospitalization, by cause, in areas with a high percentage of Aboriginal-identity residents. Methods: Age-standardized hospitalization rates (ASHRs) and rate ratios were calculated based on 2004/2005-2009/2010 data from the Discharge Abstract Database. Results: Falls were the most frequent cause of injury. For both sexes, ASHRs were highest in high-percentage First Nations-identity areas; high-percentage Métis-identity areas presented the highest overall ASHR among men aged 20-29 years, and highpercentage Inuit-identity areas presented the lowest ASHRs among men of all age groups. Some causes, such as falls, presented a high ASHR but a rate ratio similar to that for all causes combined; other causes, such as firearm injuries among men in highpercentage First Nations-identity areas, presented a relatively low ASHR but a high rate ratio. Residents of high-percentage Aboriginal-identity areas have a higher ASHR for hospitalization for injuries than residents of low-percentage Aboriginal-identity areas. Conclusion: Residents of high-percentage Aboriginal-identity areas also live in areas of lower socio-economic conditions, suggesting that the causes for rate differences among areas require further investigation. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Geographer is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)