Gender-based analysis plus

General information: Institutional GBA Plus capacity
- Governance
  - Institutional leadership and support for SGBA Plus integration
- Capacity
Core Responsibility 1: Health Care Systems
Core Responsibility 2: Health Protection and Promotion

General information: Institutional GBA Plus capacity

Governance

Health Canada is committed to systematically integrating sex, gender and diversity considerations into all of its activities through the application of quality Sex- and Gender-Based Analysis (SGBA) Plus^{Footnote 1}. Both the Health Portfolio SGBA Plus Policy (Policy) and the Health Canada SGBA Plus Action Plan 2022-26 (Action Plan) support greater integration of equity, diversity and inclusion into all Health Canada initiatives, departmental culture and operations.

Currently, the Department faces a challenge in relation to the availability of data disaggregated by identity factors. For this reason, Strategy 2 of the Action Plan is to provides for increased collection, use and analysis of disaggregated data for rigour in intersectional analysis. Efforts to address this gap are a key focus in this document.

Health Canada, the Public Health Agency of Canada, the Canadian Food Inspection Agency and the Canadian Institutes of Health Research all endorse the Policy, which positions SGBA Plus to emphasize intersectional analyses and equity, diversity and inclusion considerations and to reflect coherence with other federal frameworks and priorities (anti-racism, accessibility, 2SLGBTQI+^{Footnote 2}, etc.). The Policy also acknowledges the importance of engaging with diverse partners in all activities and the need for culturally relevant application of SGBA Plus that respects the Government of Canada's relationship with Indigenous Peoples. The Policy includes all relevant identity factors as part of SGBA Plus (including, but not limited to, sex, gender, age, race, sexual orientation, etc.).

The Action Plan provides a framework that strengthens the systematic integration of sex, gender and other intersectional factors in departmental work and decision-making while also supporting the Government of Canada's priorities on gender equality, diversity and inclusion. Health Canada framed the Action Plan under the following 3 pillars:

Accountability
Knowledge and evidence
Capacity and expertise

Priority areas under these pillars include:

Increasing governance, accountability and transparency in the integration of SGBA Plus in Health Canada's decision making;
Strengthening departmental SGBA Plus knowledge and capacity with enhanced learning opportunities, tools and resources to increase SGBA Plus competency;
Developing strategic partnerships and collaborations to enhance equity lenses and intersectional expertise in SGBA Plus;
Enabling the collection and use of disaggregated data for rigour in intersectional analysis;
Enhancing communications and guidance with clarity on SGBA Plus and intersectionality.

In 2024-25, Health Canada will continue to strengthen SGBA Plus integration, as part of the Action Plan, through the implementation of initiatives across the organization that are informed and developed through an intersectional lens.

Institutional leadership and support for SGBA Plus integration

Health Canada's SGBA Plus Centre of Excellence (SCOE) provides leadership for the implementation of SGBA Plus. The SCOE provides advice and guidance to senior management and programs to develop responsive and inclusive health research, policies, regulations, services, programs, and other initiatives that promote greater health equity. In 2024-25, the SCOE will continue to:

Provide dedicated support to implement branch-specific SGBA Plus integration plans, as recommended in the June 2021 Management Response and Action Plan: Evaluation of Health Canada's Sex and Gender Action Plan;
Enhance governance and accountability and support departmental culture change through the SGBA Plus Integration Network. Assistant Deputy Ministers appoint network delegates to systematically integrate SGBA Plus in organizational activities and processes;
Develop and deliver SGBA Plus tools and learning products, including those specific to functional areas (e.g., regulations, science, policy, etc.);
Design communications and learning opportunities to improve understanding of SGBA Plus, its associated concepts (diversity and inclusion, intersectionality, data disaggregation, etc.) and its application to Health Canada's mandate;
Collaborate with diversity and inclusion experts to support the Policy and Action Plan objectives to integrate SGBA Plus through an intersectional lens;
Provide guidance on how to incorporate SGBA Plus considerations in key policy documents, with an emphasis on regulations;
Promote and support SGBA Plus best practices, including the collection, use and analysis of disaggregated data for intersectional analyses;
Engage with programs to identify additional SGBA Plus data and indicators as part of Health Canada's annual review of program performance indicators.
Support partners to ensure that, where possible, Health Canada information holdings are consistent with the TBS Policy Direction to Modernize the Government of Canada's Sex and Gender Information Practices.

Capacity

As part of the Common Statement of Principles on Shared Health Priorities in the areas of mental health, home care and long-term care, provinces and territories agreed to work with the Canadian Institute for Health Information (CIHI) to develop 12 common indicators to measure mental health and addictions, and home, community and palliative care. In 2023 the new Shared Health Priorities funding (Working together to improve health care for Canadians) committed to reporting on disaggregated data in the areas of: primary care, health human resources, mental health and substance use, and health data. CIHI will work with the provinces and territories in 2024-25 to collect data on new common indicators that include disaggregated data. Provinces and territories will also be responsible for collecting and reporting on indicators specific to their jurisdictions' initiatives as outlined in their action plans.

Federal funding for Canada Health Infoway supports the organization's work with jurisdictions and other stakeholders in the development and adoption of digital health technologies across Canada. Infoway commissions surveys, such as the annual Canadian Digital Health Survey, to collect data on the needs, perceptions, and desires of people in Canada as they relate to digital health uses. This survey collects data on age, sex, gender, region, community size, 2SLGBTQI+ identity, language, citizenship, years living in Canada, education, employment status, household income, and health care coverage. This data will be used to inform issues such as digital health literacy.

Changes to the federal legislation on medical assistance in dying (MAID) in March 2021 required the Department to expand the federal MAID Monitoring System to collect additional information about race, Indigenous identity and disability. This was completed with a view to use this information to help determine the presence of individual or systemic inequality in the context of MAID. The expanded data collection began January 1, 2023 and will be reported in Health Canada's Fifth Annual Report on MAID in Canada, expected in fall 2024. The Department is funding research to gather additional qualitative information to improve understanding of MAID delivery and to inform policy development around MAID implementation. Research projects also focus on the experiences of and views on MAID by different population groups, including persons with disabilities, and racialized and Indigenous people to support culturally safe implementation of MAID.

In 2024-2025, Health Canada will continue to implement tools and procedures to retrieve disaggregated data from submissions for drug approval to increase public reporting on the diversity of Clinical Trial participants. As such, the Department will continue to work with international regulators and stakeholder organizations in an attempt to gain more insights and inform processes to enhance diversity in clinical trials, with the aim of:

Improving the SGBA Plus data submitted to Health Canada
Enhancing the way SGBA Plus data is analyzed and reported on by Health Canada
Increasing the SGBA Plus information available to the users of the data to build trust and transparency.

The Consumer Products Safety Program is exploring how unconscious bias and systemic racism may have affected program decision-making and design. This Deconstructing Unconscious Bias project will review program areas to identify activities where unconscious bias exists. This includes a toxicology project on identifying racial bias in skin pigmentation for assessment of irritation.

The Tobacco Control Program will engage with youth from diverse backgrounds to better understand and co-develop strategies for youth on tobacco and vaping-related issues. Sessions will seek the perspective of youth from across the country which will help inform Health Canada's work to protect youth from the harms of smoking and vaping.

Highlights of GBA Plus results reporting by program

Core Responsibility 1: Health Care Systems

Program Inventory Redesign SGBA Plus improvement

In 2023-24, Core Responsibility 1 transitioned from 15 to 3 overarching Programs. Health Canada now combines results from multiple programs in composite indicators, including data from external partners that receive transfer payment funding. Combining results allows the Department to capture its impact across multiple initiatives and sub-populations. To ensure the data from different sources is comparable, Health Canada will encourage its funding recipients to use the same data categories (e.g., sex, gender, age, geography).

Over the coming years, the Department will periodically assess the methods it uses to collect data for performance measures, including those related to SGBA Plus. As a result, it will identify best practices and lessons learned about collecting disaggregated data to create data collection tools and guidance documents. These resources will promote alignment of methodologies and categories for SGBA Plus disaggregated data, especially as it contributes to reporting on composite indicators.

Program 1: Responsive Health Care Systems

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The following initiatives and transfer payment programs contribute to this program:

Canada Health Act
Medical Assistance in Dying Monitoring Program
Funding to the Drugs for Rare Diseases and Canadian Agency for Drugs and Technologies in Health
Canadian Drug Agency Transition Office
Funding to the Canadian Partnership Against Cancer
Organs and Tissue Donation and Transplantation Initiative under the Organs, Tissues and Blood Program
Funding to Territorial Health Investment Fund
Funding to targeted projects for health care system improvements
Departmental work on pharmaceutical drugs and medical devices
Departmental work on home, community and palliative care, and long-term care

The Responsive Health Care Systems Program supports work to improve the capacity of and broad access to the Canadian health care system. Most of the Program initiatives collect data that support monitoring and reporting of Program impacts by gender and other diversity factors, notably in the areas of medical assistance in dying (MAID), cancer control, and targeted projects on health care systems improvements. However, the Department often relies on provinces and territories, organizations that receive funding and other partners to measure the results of Health Canada-funded initiatives and report disaggregated data. Some initiatives have limited disaggregated data on diverse groups such as pan-Canadian data on long-term care, home and palliative care, pharmaceutical drugs, and organ and tissue donation and transplantation. A better understanding of the program's impact on diverse populations will help Health Canada to ensure that initiatives are appropriate and accessible for all people living in Canada. These data limitations stem from reliance on partner data and a lack of harmonized data methodology, making the regular collection and reporting of national data complex as well as expensive. The Department will find ways to limit over reliance on partner data and find ways to enhance harmonization amongst partner data.

Shared Health Priorities

The Department provides funding to provincial and territorial governments in areas of shared health priorities. Each province and territory has flexibility to design and implement initiatives that are specific to the needs of their populations. Health Canada encourages provinces and territories to consider how their specific initiatives will address the needs of diverse populations and provide disaggregated data to monitor their outcomes.

As part of the Common Statement of Principles on Shared Health Priorities in the areas of mental health, home care and long-term care, provinces and territories agreed to work with the Canadian Institute for Health Information (CIHI) to develop 12 common indicators to measure mental health and addictions, and home, community and palliative care. 2 of the home, community, and palliative care indicators include some disaggregated data by sex and are available via Your Health System: In Brief
In 2023 the new Shared Health Priorities funding (Working together to improve health care for Canadians) committed to reporting on disaggregated data in the areas of: primary care, health human resources, mental health and substance use, and health data. CIHI will work with the provinces and territories in 2024-25 to collect data on new common indicators that include disaggregated data. Provinces and territories will also be responsible for collecting and reporting on indicators specific to their jurisdictions' initiatives as outlined in their action plans.
In 2024-25, all committed indicators in the Common Statement of Principles on Shared Health Priorities will have publicly reported data. This will be the second year with complete information available, allowing a limited analysis of trends to take place (although a longer timeframe will provide more detailed and accurate analysis). CIHI has also already published the first report related to the initial 8 common indicators as part of the Working Together plan.

Health Data Initiatives

While data gaps remain, various initiatives are underway to improve the regular collection of disaggregated health data. Health Canada will continue to work with CIHI and Statistics Canada to provide national-level sex, gender, and diversity disaggregated data that support departmental initiatives, for example through targeted questions in the Canadian Community Health Survey. This data will inform initiatives in the Responsive Health Care Systems Program and allow the Department to assess, monitor and report on their impact on diverse populations. For example:

CIHI will continue to collect demographic, clinical, functional and resource use information on clients of publicly funded home care programs in Canada through its Home Care Reporting system. This supports front-line planning and quality improvement at the point of care and supports Health Canada planning and policy making.
Additionally, the Department is working with partners to support transparency on long-term care. Current indicators on CIHI's website provide insights into the conditions experienced by those living in long-term care homes, and include some disaggregated data by sex. Health Canada will continue to support indicator improvements including the collection of disaggregated sex, gender and diversity data (where possible). This supports the development of standards so that those in long-term care can live in safe and dignified conditions.
As part of the Territorial Health Investment Fund (THIF), territories rely on external organizations, such as Statistics Canada, to make data available. The small population base makes gender and diversity disaggregated data a challenge, and even more so with disaggregation by multiple characteristics, such as sexual orientation. The Department will renew grant agreements for 10 years of THIF funding in 2024-25. As part of collaborative work plan development for the renewed funding, Health Canada will continue to encourage territories to implement sex, gender and diversity considerations in the design of their THIF activities and indicators. The Department will continue to monitor progress on indicators for compliance.

Recipient Organizations

Health Canada will continue to work with recipient organizations and encourage them to consider diverse populations in the design of their initiatives. The Department also encourages recipients to disaggregate their data by sex, gender and other identity factors to the greatest extent possible in their progress and performance reporting. Recipient data will support Health Canada's capacity to perform SGBA Plus analysis on the program's impacts and inform decision-making to continually improve implementation. The following initiatives illustrate the work of the Department's recipient organizations on advancing and measuring outcomes among diverse populations:

Federal funding for Canada Health Infoway supports the organization's work with jurisdictions and other stakeholders in the development and adoption of digital health technologies across Canada. Infoway commissions surveys, such as the annual Canadian Digital Health Survey, to collect data on the needs, perceptions, and desires of people in Canada as they relate to digital health uses. This survey collects data on age, sex, gender, region, community size, 2SLGBTQI+^{Footnote 2} identity, language, citizenship, years living in Canada, education, employment status, household income, and health care coverage. This data has been critical to informing issues such as digital health literacy. Infoway will also continue to collaborate with partners and leverage additional surveys, such as the Commonwealth Fund's International Health Policy Survey of Primary Care Physicians, to draw key digital health insights, including equity considerations.
Canadian Partnership Against Cancer (CPAC) continues to support the implementation of the 2019-29 Canadian Strategy for Cancer Control. One of the action areas under the Strategy is to provide better services and care adapted to the specific needs of people of diverse socio-economic and cultural backgrounds, age groups and identities. The Strategy calls for more practical research to gain a deeper understanding of barriers faced by specific groups. This will be done in partnership with First Nations, Inuit and Metis governments, organizations and communities to ensure culturally relevant approaches and strategies. CPAC will contribute to this research and disaggregate data whenever possible to inform their programming, for example in developing First Nations, Inuit and Metis peoples cancer plans.
Canadian Agency for Drugs and Technologies in Health (CADTH) will continue to progress its Reconciliation with Indigenous Peoples and establish a process to better incorporate the voices of equity deserving populations within the evidence products. This will support health care system decision makers to enhance health equity. CADTH will work with Health Canada to build SGBA Plus indicators under the renewed contribution agreement for 2024-25. The intention is for these indicators to be more relevant and capable of communicating the impact of CADTH's work on diverse populations through performance measurement and reporting.
Canadian Blood Services (CBS) will continue to improve access to health information and organ donation and transplantation services for all Canadian populations, regardless of geography or income-level. They will continue to work with the Department to strengthen the collection of SGBA Plus data as part of their performance measurement framework. SGBA Plus data will be strengthened through the Pan Canadian Organ Donation and Transplantation (ODT) Data System Project. The ODT Health Data will become available publicly through CIHI.
CBS is committed to further diversifying donor population to ensure meeting the needs of patients, from all communities; to engage with ethnically diverse, equity-deserving and Indigenous communities to build trust and strengthen relationships. Awareness campaigns will continue to take a more focused approached to reduce discrimination, improve accessibility and effort to advance inclusion and remove further barriers to donation.
CBS will continue to reach out to specific communities through annual surveys to generate data to better inform public awareness and education activities. Through engagement partnership with diverse communities across the country, CBS will work towards removing barriers to inclusion for donors and registrants and to ensure patients of all backgrounds and identities receive the support they need.
Through public education and awareness resources, CBS will continue to support knowledge products that will raise awareness among the public (e.g., youth, underserved populations) about the importance of ODT.

Regulations and Legislation

Health Canada regulations and legislation commitments will continue to be informed by collaborative work with partners, including those with lived experience, to ensure access to quality health care services. Some legislation primarily protects underserved and marginalized communities.

Changes to the federal legislation on MAID in March 2021 required the Department to expand the federal MAID Monitoring System to collect additional information about race, Indigenous identity and disability. This was completed with a view to use this information to help determine the presence of individual or systemic inequality in the context of MAID. The expanded data collection began January 1, 2023 and will be reported in Health Canada's Fifth Annual Report on MAID in Canada, expected in fall 2024.
As part of the Government of Canada's work to develop a Safe Long-Term Care Act, extensive consultations were conducted in Spring 2023 to Fall 2023. These included federal, provincial, and territorial governments, Indigenous Peoples, experts, stakeholders, and people with lived experience, including people from official language minority communities and members of 2SLGBTQI+ communities. The Act will take into account the needs of diverse populations. The new Act could outline a pan-Canadian vision and principles for the safe operation and delivery of care in long-term care homes, including aspects such as culturally safe and trauma-informed care.
To administer compliance with the Canada Health Act, Health Canada monitors whether provincial and territorial health insurance plans are providing access to insured health services without direct charges at the point of service to the public. To do so, Health Canada will draw on provincial and territorial government correspondence and publications, non-governmental organizations, media reports, and correspondence received from the public. The same information sources will also be used to inform the Department's understanding of insured and non-insured health care services available to certain groups, for example access to gender-affirming care and reproductive health services.

Data Collection on Diversity

Health Canada will continue to improve and expand data collection on diversity throughout 2024-25 in the following areas:

The Department is funding research to gather additional qualitative information to improve understanding of MAID delivery and to inform policy development around MAID implementation. Research projects also focus on the experiences of and views on MAID by different population groups, including persons with disabilities, and racialized and Indigenous people to support culturally safe implementation of MAID. Sex, gender and other diversity information will be part of performance and results reporting with funding recipients, where appropriate.
The Canadian Drug Agency Transition Office (CDATO) has engaged extensively with provinces and territories, stakeholders, representatives from Indigenous communities, patient advocates and international leaders in pharmaceuticals management on the potential scope and functions of a Canada Drug Agency. The CDATO continues to work with partners and stakeholders to develop core functions, including appropriate prescribing, use, and data and analytics, in which gender and diversity considerations feature prominently.
In its first year of implementation, the National Strategy for Drugs for Rare Diseases is providing funding to CADTH and CIHI to improve the collection and use of evidence to support decision-making. This work undertaken by our partners will facilitate future monitoring and reporting of the National Strategy's impacts by gender and diversity, where possible (i.e., in cases where sample size is sufficient to allow for public reporting).
Health Canada is collaborating with Statistics Canada's Health Care Access, Experiences and Related Outcomes project to launch a palliative care survey entitled "Living with a Life-Limiting Illness: Access to Care and Related Experiences" in 2024. This will collect information to understand the experiences of individuals with life-limiting illnesses and those who are caring for them, including their needs (physical, social and emotional), access to care and services designed to improve quality of life throughout the course of a serious illness. Experiences, needs and challenges accessing palliative care may vary across different groups of Canadians. The questionnaire asks for sex and gender, sexual orientation, racialized identity and geography – allowing analysis for under-represented groups when participation rates permit.

Data to Inform Strategies, Policies and Initiatives

Throughout 2024-25, SGBA Plus data and analysis will also be used to inform the development of strategies, policies, and initiatives. Public awareness campaigns are one area where the Department will expand its focus to underrepresented populations and monitor their increased awareness, with the hope that it will lead to uptake of health care services among these populations.

Health Canada continues to focus on its Action Plan on Palliative Care commitments to: raise awareness of the importance of palliative care; provide public education on grief; improve palliative care skills and supports for health care providers, families, caregivers, and communities; enhance data collection and research; and improve access to care for underserved populations and to culturally safe palliative and end-of-life care. Change in public perception about palliative care is being tracked with data disaggregated by factors including gender and target population (e.g., race). When conducting public surveys, including the palliative care public awareness campaign, the Department's marketing staff do not acquire desegregated data directly. They may use advertising or social media metrics or ask the agency conducting the survey for existing data on media habits of respondents by gender or other factors.
Canadian Blood Services will continue to raise awareness about the need for all genders and people of diverse heritage to register their intent to donate and have discussions with their families about their decision. Awareness campaigns will continue to take a more focused approached to reduce discrimination, improve accessibility and effort to advance inclusion and remove further barriers to donation. Canadian Blood Services will continue to reach out to specific communities, such as 2SLGBTQI+, through annual surveys to generate data to better inform public awareness and education activities.
To support the National Strategy for Drugs for Rare Diseases, the Department launched an Implementation Advisory Group, which comprises representatives from a cross section of the rare disease experience, including patients, clinicians, private drug plans, and the pharmaceutical industry. It will provide patient-centered advice to Health Canada and other health system partners on the implementation of the Strategy and be a forum to exchange information and best practices. The Advisory Group includes individuals with a diverse set of backgrounds (e.g., gender, age, ethnicity) from across Canada, ensuring that advice reflects the experiences and perspectives of a range of rare disease patients and other stakeholders. National Indigenous organizations were also invited to attend. The Program will assess further Indigenous participation to ensure the perspectives of First Nations, Metis and Inuit patients are included. Indigenous Services Canada is present during Advisory Group meetings as an observer.
The Department established the Appropriate Use Advisory Committee to guide work towards the development of a pan-Canadian Appropriate Use Strategy and corresponding Canadian Drug Agency appropriate use program. This includes considerations for data collection and measurement of prescribing and use practices and trends in the development of evaluation and reporting activities. Data and measurement is disaggregated by sex, gender, Indigeneity, race, ethnicity, age, disability, and community of residence (e.g., rural, remote). This work will continue to assess stakeholders' pharmaceutical drug data analytics capacities and needs including their ability to assess inequalities in health outcomes and inequitable access to drugs among equity deserving communities.

Addressing Data Gaps

Health Canada will continue working with Statistics Canada and CIHI to fill data gaps and develop a strong evidence base in key policy areas. These national data sets and guidance on gender, diversity, and inclusion data collection and analysis will be used to inform program decision-making and ensure SGBA Plus data is available to the public.

The Department will consider whether transfer payment programs can be used to fund policy and research projects to address other data gaps through recipient reporting and targeted calls for proposals.

Equity, Diversity and Inclusion

Recipient organizations will continue to implement equity, diversity and inclusion initiatives, positions, and committees to demonstrate their commitment to an equitable workplace and embed SGBA Plus into all their organization's work. This will support structural equity and diversity considerations in their programming.

Program 2: Healthy People and Communities

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The following initiatives and transfer payment programs contribute to this program:

Official Languages Health Program
Funding to Healthcare Excellence Canada
Funding to Mental Health Commission of Canada and other targeted mental health projects
Funding to the Canadian Thalidomide Survivors Support Program
Funding to targeted projects on health care improvements

The initiatives in the Healthy People and Communities Program target inadequate and unequal access to health care services and promote culturally appropriate care. Initiatives are funded to target underserved groups and diverse communities. Initiatives will collect disaggregated data to enable monitoring and reporting impact by sex, gender and other identity factors as relevant to ensure they are reaching their intended audience. Statistics Canada and the Canadian Institute for Health Information (CIHI) also analyze and report on national-level disaggregated data, including self-reported data. For example, data on perceived mental health status is reported by education level, gender, sexual orientation, geography, racialized communities, Indigeneity, and immigration status to measure the impacts of federal investments on the mental health of diverse populations.

Transfer Payment Programs

Sex, gender and diversity considerations are an integral part of transfer payment programs work and a key criterion for funding decisions and performance measurement reporting requirements. For example, applicants are asked to describe their SGBA Plus approach or how the project would take intersectionality into account, including sex, gender, and other identity factors. This ensures the selection of applicants and initiatives is set up from the beginning to incorporate SGBA considerations and appropriate monitoring of diverse impacts.

In 2024-25, the initiatives in the Healthy People and Communities Program will be working collaboratively with funding recipients to improve the collection and use of SGBA Plus data. The Department develops tools, templates and guidance for recipients on performance measurement plans that collect SGBA Plus data wherever applicable. Some Health Canada initiatives also monitor the target population's access to and level of satisfaction with services. The following transfer payment programs highlight the Department's work in this area:

Sexual and Reproductive Health Program will provide support to funding recipients as they develop performance measurement strategies to collect and report outcomes and impacts from projects with data disaggregated. Further to the requirement for funded recipients to disaggregate project data for SGBA Plus, an additional request will be made for organizations to report whether interventions are felt to be culturally appropriate by the population(s) impacted or communities served.
Canadian Thalidomide Survivors Support Program will use an annual survey to monitor survivors' level of satisfaction with the services and whether the program continues to meet survivor needs so they may age with dignity. The program continues to collect data related to sex and gender, geographic location, official languages, and survivor disability levels. This will allow the program to assess survivors' unique and evolving needs, and to tailor services and administrative procedures to better meet survivor needs where possible.
Healthcare Excellence Canada (HEC) is a recipient organization that works with Health Canada to help healthcare organizations implement quality and safety innovations at an organizational level. HEC supports data collection by sex, gender and other identity factors to the extent possible, and reports on this data annually through indicators in its performance measurement framework. HEC considers the potential impact of its initiatives and activities through a SGBA Plus lens, including incorporating gender and diversity considerations in the quality and safety innovations HEC supports.

Performance Measurement Tools

In 2024-25, the Department's initiatives will review their performance measurement tools. These include primary data collection tools and guidance for recipients to monitor and analyze progress in implementing initiatives within diverse populations and to improve the program's ability to report on expected results. For example:

The Mental Health Commission will continue to find solutions to expand data collection for program monitoring and reporting by gender and diversity. For example, they will collect disaggregated data on gender and key population groups, such as children and youth, seniors, rural and remote communities, First Nations, Inuit and Metis, 2SLGTBQI+^{Footnote 2} individuals, incarcerated or detained individuals, individuals who are experiencing homelessness, immigrants, refugees, religious minorities, and ethnocultural and racialized groups. The Commission will also implement its recently developed comprehensive equity framework to help guide mental health policy and programming.This broader data collection approach will help them better understand and address the unique needs and experiences of diverse populations.
The Official Languages Health Program will continue to adapt and improve its current performance measurement tools which were revised at the end of the 2018-23 funding phase. It will continue to explore ways to expand the capacity to measure and assess the impacts of this program on gender and diversity. This continuous improvement will aim to enhance the integration of gender and diversity considerations, and improve Health Canada's monitoring and analysis of progress made by recipients towards achieving targets. This will ensure adequate implementation of measures and policies that take into account SGBA Plus. The revised tools are also used by the program recipients to monitor and collect disaggregated data on sex and gender and report on progress made on achieving expected results.
The Health Care Policy and Strategies Program will compile information from internal surveys that are completed at the end of each project. These surveys include a section to assess and report on a recipient's success in collecting SGBA Plus data and gather best practices and lessons learned. This information will be used to strengthen advice to recipients on SGBA Plus data collection.

Oral Health Branch

The Department provides dental care for Canadians under 12-years-old through the Interim Canada Dental Benefit (CDB). The CDB intends to help lower dental costs for families earning less than $90,000 per year with a child under 12 years old who does not have access to a private dental insurance plan. The interim CDB is available until June 2024. The data on CDB uptake among children in Canada is disaggregated by age, geographic area, family structure and income.

The new Canadian Dental Care Plan (CDCP) will improve access to oral health care, oral health outcomes and potentially social and economic outcomes (as part of improvements to quality of life). It will do this by extending its eligible populations to Canadian residents with annual family incomes below $90,000 who do not have access to private dental insurance.

The Oral Health Access Fund will be a new grants and contributions program led by Health Canada. It will address non-financial barriers to accessing oral health care faced by various segments of the population, as well as improve access to preventative services and programming.

The Department will collect data as each program is implemented. It is anticipated that the following data sources will be leveraged to provide baselines and measure SGBA Plus impacts of these new initiatives:

a) CDCP administrative data

Administrative data collected for the CDCP, including enrolment and claims data, will be disaggregated to enable SGBA Plus analysis. It is anticipated that this will use existing variables in the program dataset. Where possible, data will be disaggregated by geographic location, gender, age, official language, and income. The program will make efforts to disaggregate data for additional socio-demographic characteristics.

b) Existing and new Statistics Canada surveys with oral health modules

Health Canada will continue to use existing national oral health and dental care data to conduct SGBA Plus analyses. This includes the oral health modules in Statistics Canada's Canadian Community Health Survey (2018 and 2022), and Canada Health Measures Survey (2007-09). The available data, though limited, provides some insight to current inequities in oral health outcomes and between certain populations, particularly by income-level and age groups.

Through Budget 2023, Statistics Canada received $23.1 million over 2 years to collect data on oral health and access to dental care in Canada. Health Canada is collaborating with Statistics Canada to develop a data framework to fill identified gaps in oral health data to ensure information is available to measure progress towards program outcomes. It is expected that the new self-reported Canadian Oral Health Survey (conducted in late 2023 to early 2024) and Canada Health Measures Survey, Cycle 7 will provide key baselines for the CDCP and support data disaggregation for SGBA Plus.

The Canadian Oral Health Survey sample size is expected to allow for disaggregation by provinces (with efforts to be made to disaggregate for territories) and CDCP target population. Further disaggregation will be possible (e.g., gender, age group, language, racialized groups), but will vary across geographies due to the sampling approach.

Health Canada is working with Statistics Canada to ensure that the ongoing data collection tools and related data sources described above will address some of the current disaggregation limitations.

c) Project Reports

For the Oral Health Access Fund, data to support SGBA Plus analysis is expected to be collected by the Department through regular progress and performance reports as well as case studies from recipient organizations. As the Fund is focused on Canadian residents experiencing barriers in accessing oral health care, it is anticipated that the information will help fill the knowledge gap on dental care access and oral health for some sub-populations who are not reached by national surveys.

Program 3: Quality Health Science, Data and Evidence

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The following initiatives and transfer payment programs contribute to this program:

Blood Research and Development Initiative under the Organs, Tissues and Blood Program
Canada Brain Research Fund Program, funding to Brain Canada Foundation
Funding to the Canadian Institute for Health Information
Funding to targeted projects for research and evidence

The Quality Health Science, Data and Evidence Program funds research, data and evidence generating activities to support decision-makers across the health care system and address data gaps across many policy areas. For example, funding to the Canadian Institute for Health Information (CIHI) will provide essential data and analysis as a key evidence source for comparable, pan-Canadian data on Canada's health systems and the health of people in Canada. A number of initiatives under this program collect disaggregated data to enable monitoring and reporting impact by sex, gender and other diversity factors. In scientific research, biological sex is a routinely collected variable. Health Canada will encourage organizations receiving funding to collect data disaggregated by other identity factors as appropriate and support work on under-researched populations.

While these initiatives are often a source of evidence informing a range of departmental initiatives in the health care system, there are opportunities to improve the data collection of sex, gender and other identity factors to enhance overall program impact.

Recipient Organizations

In 2024-25, Health Canada will collaborate with organizations receiving funding under the Quality Health Science, Data and Evidence Program to develop tools, templates and guidance for recipients on the collection and use of SGBA Plus data. Recipient organizations measure progress and performance and will report on their research outcomes among diverse populations and other disaggregated data, as available. The Department will work with funding recipients to review and make improvements to performance measurement strategies that support the integration of sex, gender and diversity considerations and data collection, disaggregation and analysis.

Canada Brain Research Fund (CBRF) Program will continue to validate and align its performance measurement methodology with current best practices and terminology. Specifically, the recipient works with partner organizations and researchers to further promote the practice of collecting disaggregated self-identification data (including but not limited to: gender, geographic location, training level) across its research awards applications. It will also explore alternative data collection methodologies (such as bibliometric analysis) to complement traditional survey collection. Select CBRF Program data (such as gender of grant and award recipients, and diversity considerations of research projects and activities) currently contribute to Health Canada's Quality Health Science, Evidence and Data Program.
Canadian Blood Services (CBS) receives Health Canada funding to support research that maintains and increases the safety, supply and efficiency of the Canadian blood system. Sex, gender, and ethnic diversity are key considerations for CBS and the research it supports. These considerations are applied to the design of the applications and peer review process for any competitive research and training programs. For example, the eligible applicants must demonstrate how they integrate sex, gender and other social determinants of health into their projects, and CBS monitors the review panels' composition and training on biases.
CBS will continue efforts on building trust and engagement strategies to improve understanding of Indigenous perspectives over the coming years through reconciliation circle discussions, cultural awareness training, resource materials, and its Indigenous engagement strategy.

Canadian Institute for Health Information

Through their funding agreement with the Department, CIHI collects data from provincial and territorial governments, hospitals, regional health authorities, medical practitioners and other stakeholders, including disaggregated data when possible. Historically, many CIHI databases have included data by sex and/or gender, and some have included information on sexual orientation, where available. CIHI has recently implemented new standards for the collection of sex and gender data across data providers. The enhanced standards and their implementation will encourage jurisdictions to submit data in a standardized format and promote the use and adoption of standardized identifiers to allow for more comprehensive data collection for sex and gender across Canada.

CIHI will continue work on renewing their organization's performance measurement strategy to improve their ability to measure, collect, analyze and report on disaggregated data. This will enable the Department to monitor whether the program is serving the data needs of diverse communities.

Health Canada Data Experts

Health Canada's data experts will continue to provide advice to departmental staff and assist in retrieving and using disaggregated data to inform the Department's initiatives.

Equity, Diversity and Inclusion

Organizations receiving funding from the Department are continuing to implement diversity, equity and inclusion initiatives, positions, and committees to demonstrate their commitment to an equitable workplace and embed SGBA Plus into all the organization's work. This will support upstream equity and diversity considerations in their programming. For example:

Brain Canada continues to build its organizational and programming capacity in Equity, Diversity, and Inclusion (EDI) and SGBA Plus. Following planning and consultations work completed in 2023-24, the recipient established an internal EDI and SGBA Plus Committee which is expected to oversee the implementation of recommendations of an organizational EDI Action Plan. In 2024-25, the CBRF is anticipated to continue delivering targeted awards to Black and Indigenous scholars with the aim of strengthening representation of these communities in the Canadian research ecosystem.
CBS will continue to collect diversity-related data regarding staff. They have an ongoing Diversity, Equity, and Inclusion Program (an executive-level responsibility) and are expanding their recruitment and career development programs to better reflect the needs and foster the potential of diverse team members. They are learning from engagement, with equity-deserving community groups, about how the organization is diverse, equitable and inclusive.

Core Responsibility 2: Health Protection and Promotion

Program 4: Pharmaceutical Drugs

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

Health Canada's SGBA Plus Action Plan for Health Products will continue to improve the Department's capacity to collect, analyze, and report on disaggregated data and its impacts over a period of 5-10 years.

In 2024-25, Health Canada will continue to implement its SGBA Plus Action Plan as it relates to the Department's Pharmaceutical Drugs Program (Program 4), Biologic and Radiopharmaceutical Drugs Program (Program 5), Medical Devices Program (Program 6) and Natural Health Products Program (Program 7). This will ensure that people in Canada have access to information that supports informed decision-making regarding treatment options, based on the safety and efficacy profiles of people like them.

As part of Phase I, launched in October 2022, Health Canada began collecting baseline data from sponsors regarding the diversity of clinical trial participants. Phase II will begin in 2024 with the anticipated publication in Canada Gazette, Part II and coming into force of the Agile Licencing Regulations. Sponsors will be required to submit disaggregated data broken down by sex, age and race if that data has been submitted to the US Food and Drug Administration or European Medicines Agency (Agile Licencing).

In Phase III, the Department will build on transparency and implementation with a focus on updating electronic submission forms to include a table for Sponsors to provide a breakdown of disaggregated data. Health Canada will also change information technology systems and processes to enable receipt of disaggregated data.

There are certain trial participant identity factors that are not collected globally that would be useful to support intersectional analyses as part of the drug review process. These include: gender, geography, socioeconomic status, etc. In Phase IV, the Department will work with international stakeholders (industry and regulators) to support the collection of this data in clinical trials. This phase will be ongoing beginning in 2025-26.

Additionally, Health Canada will explore the use of digital technology to collect pharmacovigilance information from diverse subpopulations (e.g., patient opt-in apps to collect data during post-market surveillance). It will also take steps to obtain more patient information (e.g., race / ethnicity, etc.) to identify populations who are more likely to experience adverse events.

The proposed Agile Licensing Regulations will facilitate the Department's ability to collect and analyze disaggregated clinical trial data, allowing for improved assessments of safety and efficacy differences in subpopulations. This would also allow the department to be more transparent about the diversity of clinical trial participants for each drug product. The intent is to publish demographic breakdowns of clinical trial populations on Health Canada's website. This will ensure that people in Canada have access to information that supports informed decision-making regarding their treatment options, based on the safety and efficacy profiles of people like them.

Additionally, the Department will continue to ensure SGBA Plus data is considered during the review of risk management plans.

Through the International Council for Harmonization, Health Canada will work with international stakeholders with the aim of creating harmonized guidance around developing inclusive clinical trials and increasing diversity and inclusion of people who are pregnant or breastfeeding in trials.

The Department will also update its current Guidance Document on Inclusion of Women in Clinical Trials to integrate additional considerations. These include equity, diversity and inclusion factors (e.g., age, race, and ethnicity) and how industry sponsors can improve recruitment of traditionally underrepresented populations in clinical trials.

Other relevant communication materials and existing guidance (e.g., disaggregated data, developing inclusive clinical trial supplementary materials) will also be updated and the scope will be broadened to include an intersectional lens.

Program 5: Biologic and Radiopharmaceutical Drugs

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

Please refer to Program 4: Pharmaceutical Drugs for an overview of the Action Plan for Health Products. Additionally, it is important to note that all plans noted above related to the Agile Licencing Regulations also apply to this program.

Program 6: Medical Devices

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, Health Canada will further develop SGBA Plus data collection as it relates to the Medical Devices Program. To ensure SGBA Plus data is considered, health equity factors will continue to be integrated into guidance, procedures and templates for the review of safety and effectiveness of devices, where relevant.

At the pre-market stage, the Department applies SGBA Plus when reviewing medical device licence applications, based on indicated populations and the specifics of the product. Expectations on the incorporation of health equity factors in device clinical studies are outlined in Health Canada's Guidance Document on Clinical Evidence Requirements for Medical Devices published in 2022. To provide more information to manufacturers, in 2024-25 the Department is planning to publish guidance for Machine Learning-Enabled Medical Devices. This will outline how they should consider the unique anatomical, physiological and identity characteristics of patients, and follows public consultation on the draft guidance in 2023-24.

In addition, updates to the International Medical Device Regulators Forum's (IMDRF) Table of Contents submission template will propose a section where manufacturers can indicate whether disaggregated data has been included in an application package. Health Canada will update its medical devices licence application form for manufacturers to indicate whether disaggregated data has been included in an application package. This initiative will raise awareness and collect data to report on the Program impacts by SGBA Plus.

To support SGBA Plus in the post-market environment, the Department will continue to consider data made available through reporting requirements. Health Canada will continue to apply an SGBA Plus lens when reviewing risks of products and any additional information provided by the manufacturer regarding the safety and effectiveness of the device.

The Department is also working with international partners through IMDRF to advance the integration of health equity considerations in the development and oversight of medical devices. Health Canada is the lead to develop Health Equity Guiding Principles for IMDRF Working Groups to consider in the development of their technical documents. After a public consultation in 2023-24, an updated draft of the Guiding Principles will be presented to the IMDRF Management Committee for approval in 2024-25.

Please refer to Program 4: Pharmaceutical Drugs for additional planned activities that apply to health products.

Program 7: Natural Health Products

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, the Department will continue to apply SGBA Plus to its data collection tools and analysis to inform policy and regulatory decisions. Health Canada will leverage the SGBA Plus toolbox, which was developed in 2021 as a result of its partnership with the Canadian Institutes of Health Research to promote the significance of sex, gender, and other identity factors when collecting consumer data. The SGBA Plus toolbox guides data collection that will enhance the Department's ability to further integrate SGBA Plus in its decision-making for the Natural Health Products Program.

Please refer to Program 4: Pharmaceutical Drugs for an overview of the Action Plan for Health Products.

Program 8: Food and Nutrition

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, Health Canada will further develop SGBA Plus data collection as it relates to the Food and Nutrition Program. It will continue its efforts to monitor food and nutrient intakes and associated health status of the Canadian population. The Department will explore ways to include gender and diversity considerations in its data collection and analysis. This will inform the future development of regulations for foods for a special dietary purpose and strengthen the scientific foundations of policy and program activities in the Food and Nutrition Program.

Health Canada's Food Guide Friendly Initiative encourages publicly funded institutions to create healthier food environments by increasing the availability and appeal of nutritious foods and beverages. Principles have been drafted and are being tested to support institutions in their efforts to be Food Guide Friendly. These principles take into consideration a variety of SGBA Plus factors, such as culture, traditions, and geography.

Targeted initiatives and other resources will improve awareness, understanding and use of nutrition labelling when making food choices by people at risk of limited or marginal health literacy. The Department will continue to make the people of Canada aware of the new labelling elements on supplemented foods so that they can make informed choices. In 2024-25, the initiative will continue to focus on sub-groups of the population that could be at higher risk of health issues associated with the nature of some supplemental ingredients. These include children under the age of 14, pregnant or breastfeeding people, and people who consume supplements or supplemented foods, as identified by the SGBA Plus analysis. Health Canada will continue to explore research partnerships and projects to address consumer awareness, understanding, and use of the front of package labelling.

In addition, the Department is conducting food toxicology research on poly fluoroalkyl substances and other flame retardants (forever chemicals) in food. This will focus on refining the threshold levels that may pose risks to females versus males, pregnant persons and infants.

Health Canada will continue to strengthen SGBA Plus within its chemicals management activities by, for example, implementing tools and training materials to better consider SGBA Plus more systemically in its risk assessment and risk management activities.

Program 9: Air Quality

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Air Quality Program conducts scientific research and health risk assessments related to air pollution, including examining sex-specific health endpoints; health effects by sex; and differences based on life stages, underlying health conditions and socio-economic status. Other epidemiological studies assess whether there are differences in the relationship between air pollution and adverse health outcomes by sex. The Program currently reports on mortality and hospitalizations attributable to short-term exposure to outdoor air pollution, ground-level ozone (O₃) and fine particulate matter (PM_2.5) by age, sex and region through the Canadian Environmental Sustainability Indicators Air Health Trends indicators. These activities inform the development of Canadian Ambient Air Quality Standards and Health-Based Air Quality Objectives.

Health Canada will continue to collect data on health effects attributable to air pollution, and assess their impact on age-, sex- and gender-specific health outcomes. This includes a significant focus on sub-populations who may be at risk, including pregnant women and pregnant people, infants, children and seniors.

The Air Quality Health Index (AQHI) is a scale designed to help people in Canada understand what the air quality around them means to their health. The Department will continue to assess who is reached by the AQHI and how associated health messaging is used. This focuses on sub-populations who may be more susceptible or highly exposed to air pollution including those living in rural and remote areas and Indigenous peoples. Health Canada will prioritize collecting data on AQHI usage among different populations within the AQHI public opinion research planned for 2025-26. These results will inform ongoing efforts to improve awareness of the tool so that people in Canada can better protect themselves from the health risks of air pollution.

Program 10: Climate Change

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Climate Change Program conducts public opinion research (POR) on public understanding and perceptions of climate change every five years. This POR reports applicable results related to sex, gender and diversity, which are used to gain a more comprehensive understanding of climate change awareness and impacts among priority groups to better target policy and awareness programs.

The last survey was conducted in 2022 and the next POR is planned for 2027-28. Survey results are disaggregated to enable a more comprehensive understanding of climate change awareness among sub-populations who may be disproportionately impacted. Socio-demographic information including sex, gender, age, geographic location, ethnic identity, language, and Indigenous identity are collected and reported if significant and data permitting. The Department will continue to collect and assess data on the health effects attributable to climate change impacts and collaborate with federal partners to identify ways to enhance these considerations, including SGBA Plus-specific health endpoints.

Program 11: Water Quality

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

When developing a guideline, Health Canada reviews the existing scientific evidence to consider health impacts in sub-populations who may be disproportionately impacted by poor drinking water quality, such as infants, pregnant women and pregnant people. The Department highlights any population differences in the guidelines.

Data collection is part of the ongoing development of the Canadian Drinking Water Quality Guidelines. In 2024-25, Health Canada will continue to collect existing and emerging scientific evidence and analyze SGBA Plus data, such as those related to sex, gender, age, and/or geography. Using all information gathered, the Department will identify critical human health effects from water contaminants, including determining whether certain sub-populations may be particularly at-risk to exposure or effects of exposure, to inform a protective concentration level. The Program is also collaborating with other federal health risk assessment programs to identify ways to enhance SGBA Plus considerations in water risk assessments.

Program 12: Health Impacts of Chemicals

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Program conducts health risk assessments, including examining sex-specific health endpoints; health effects by sex; and differences based on age. As part of the risk assessment process, certain sub-groups (e.g., infants, children and people of reproductive age) are routinely considered to determine whether there are age- or sex-specific differences in biological susceptibility. Sub-groups that may have higher exposures due to factors such as their behaviour (such as infants or toddlers exposed through mouthing objects) or where they live (e.g., people living near industrial sites exposed to releases occurring there) are also considered. This type of information on susceptibility and exposure is necessary to identify sub-populations who may be disproportionately impacted, with biomonitoring data collected through, for example, the Canadian Health Measures Survey (CHMS) and the Maternal-Infant Research on Environmental Chemicals (MIREC) study. The CHMS, which has collected and continues to collect nationally representative biomonitoring data since 2007, reports the levels of environmental chemicals disaggregated by age and sex for the Canadian population. MIREC collects information on levels of chemicals and their health effects during pregnancy, in infancy and in childhood by sex, and continues to follow parents and children to puberty and to menopause.

When risk assessment of a substance identifies a particular risk to a sub-group (e.g., infants or pregnant women and pregnant people), risk management actions are put in place to address them. The Program's performance measurement activities, intended to assess the extent to which risk management activities have reduced the potential for exposure to harmful substances, include a particular focus on sub-populations who may be disproportionately impacted when applicable.

Health Canada will continue to collect data on and assess health effects attributable to chemical substances, including sex-and-gender-specific health endpoints. These have a significant focus on studying the impacts on pregnant women and pregnant people, and outcomes at birth and during childhood. The Department is implementing a work plan that will incorporate SGBA Plus principles towards addressing the needs of sub-populations who may be more susceptible or highly exposed in the context of chemicals management. Internal guidance has been developed to enhance the consideration of populations who may be disproportionately impacted in chemical risk assessments, as well as a placemat on inclusive language related to sex and gender. Ongoing and planned activities include exploring data needs and additional opportunities for obtaining data in this area.

Current and future cycles of the CHMS will also collect information on the sex and gender identity of respondents and on a new at-risk sub-population (1-2 years of age). Health Canada's research, monitoring and surveillance activities (including biomonitoring) will continue to include collection of SGBA Plus data to inform risk assessment, risk management, policy, and ultimately performance measurement.

The Department conducts public opinion research to collect data on the level of knowledge, awareness, and behaviours on environmental health issues. The last survey was conducted in 2022, with the plan to repeat every five years. Survey results are disaggregated by gender, age, and geography to enable SGBA Plus analysis. These provide a more comprehensive understanding of environmental health awareness and behaviours and will inform more targeted outreach efforts.

Program 13: Consumer Product Safety

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Consumer Product Safety Program identifies risks pertaining to certain sub-groups (e.g., infants or children) when assessing health and safety risks of consumer products and, as applicable, takes risk management and compliance actions to address identified risks. The Program then uses case studies to measure the impact of program performance on people in Canada and will continue to consider impacts on SGBA Plus sub-populations in upcoming case studies.

The Program is exploring how unconscious bias and systemic racism may have affected program decision-making and design. This Deconstructing Unconscious Bias project will review program areas to identify activities where unconscious bias exists. This includes a toxicology project on identifying racial bias in skin pigmentation for assessment of irritation.

Program 14: Workplace Hazardous Products

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

Health Canada is collecting SGBA Plus data through consultations with partners, stakeholders, and the public in order to inform policy and decision-making as it relates to workplace hazardous products.

The Department is developing proposed amendments to remove the consumer product exclusion from the Hazardous Products Act. As part of this process, Health Canada is exploring the protection of workers at greater risk of injury. In this context, this may include young, new, aging, migrant or immigrant workers and workers who have precarious employment. These workers are likely disproportionately employed in physically demanding or hazardous jobs, which puts them at higher risk for workplace injuries and illnesses. The Department administered the fact-based industry awareness survey in August 2023. This gauged workers' knowledge of the hazard and safety information available to them when using hazardous workplace products, including consumer chemical products that meet a hazard classification under the Hazardous Products Regulations. Survey results were disaggregated by gender, age, region, income and language to identify potential demographic groups that may be at a higher risk of not being informed by their employer on the safe use and storage of workplace chemicals. Additional work is underway to consider the impacts for certain injuries and illnesses and to identify the potential relationship between these injuries and illnesses and the use of chemical products at work. These data will be disaggregated to the extent possible to enable a better understanding of workplace illness and injury among various demographic groups. This work will also inform compliance promotion and enforcement of accurate hazard communication to workers in sectors that may be at-risk.

Program 15: Tobacco Control

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, Health Canada will continue to monitor trends in tobacco and vaping product use based on socio-demographic characteristics and consider targeted measures to address high prevalence rates amongst population groups, as appropriate. Priorities include addressing concerns regarding youth vaping and protecting youth and non-users of tobacco products against the risks of nicotine products. The program's SGBA Plus data collection plans include collaborating with Statistics Canada to assess key aspects of tobacco and vaping products use through population health surveys, such as the:

Canadian Community Health Survey (CCHS)

The CCHS is a large nationally representative annual survey conducted by Statistics Canada. The CCHS collects sociodemographic data including sex, gender, sexual orientation, racialized group, geographic region (provincial data is collected annually while territorial data is collected biennially), household income, job type, and education. These data can be disaggregated to explore links to health status and health behaviours. This survey is the primary source of information on tobacco and vaping product use in Canada. It enables the Department to identify disparities in use among subpopulations. The annual nature of the survey will support continued monitoring of program impact by groups that may be disproportionately affected by program initiatives.

Canadian Health Survey on Children and Youth (CHSCY)

The CHSCY explores issues that have an impact on the physical and mental health of children and youth, such as physical activity, use of electronic devices, time spent in school and extracurricular activities, mental health, childhood experiences, suicidal thoughts, substance use and impact of the COVID-19 pandemic. The CHSCY also collects demographic and SGBA Plus information such as age, sex, gender, racialized group, household income. These data can be disaggregated to explore links health status and health behaviours.

Public Opinion Research

Health Canada also develops and implements supplementary research projects, such as public opinion research, to gather information about Canadians' knowledge and attitudes about tobacco and vaping products. These consider demographic characteristics, such as age, sex, gender, language and geography.

Data is collected through the Performance and Progress Report templates submitted by recipients funded through Health Canada Substance Use and Addictions Program on a bi-annual basis. Recipients are required to submit demographic data for certain performance measurement indicators such as age, location, gender, language, and target population factors such as Indigenous, 2SLGBTQI+^{Footnote 2} and racialized people or communities.

These surveillance tools allow Health Canada to analyze the distribution of tobacco use and vaping behaviours among the Canadian population, including the identification of subgroups with high prevalence rates.

Notable future initiatives to integrate SGBA Plus considerations into activities include:

Engage with people with lived and living experience to better understand their perspectives on existing programming and services and potential strategies related to tobacco and vaping-related issues. The Department is developing an engagement strategy that will reflect SGBA Plus principles.
Engage with Indigenous Peoples through Ministerial roundtable(s), to better understand and co-develop strategies on tobacco and vaping-related issues. The information gathered during this roundtable will inform next steps.
Engage with youth from diverse backgrounds to better understand and co-develop strategies for youth on tobacco and vaping-related issues. Sessions will seek the perspective of youth from across the country which will help inform Health Canada's work to protect youth from the harms of smoking and vaping.
Continue applying a SGBA Plus lens to public education campaigns targeting smoking and vaping behaviours in youth and older adults. Youth Vaping Prevention Campaigns and Adult Tobacco Cessation Campaign will continue in 2024-25.

Program 16: Controlled Substances

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, Health Canada will continue to apply SGBA Plus to its data collection tools and analysis, within the framework of the renewed Canadian Drugs and Substances Strategy (CDSS). This will inform policy and regulatory decisions and the development of more targeted public education campaigns to address substance use-related harms. Notably, the CDSS Data and Evidence Framework guides federal partners in the collection and dissemination of data and evidence. Through the Canadian Alcohol and Drugs Survey, Canadian Student Alcohol and Drugs Survey, and the Canadian Postsecondary Education Alcohol and Drug Use Survey, Health Canada collects SGBA Plus data on sex, gender, age, and region.

Canadian Alcohol and Drugs Survey (CADS)

The CADS is a biennial general population survey of cannabis, alcohol and drug use among Canadians aged 15 years and older. CADS collects information on age, sex, gender, sexual orientation, race, ethnicity, Indigenous identity, first official language spoken, household income and disability. Results from CADS 2023 are anticipated to be published in 2024-25. A larger survey sample is being used to ensure that Health Canada has enough information to adequately conduct SGBA Plus analysis and reporting, including intersectional analysis.

Canadian Student Alcohol and Drugs Survey (CSADS)

The CSADS is a national biennial survey conducted with students in grades 7-12 (Secondary I – Secondary V in Quebec). The survey captures information related to alcohol and drug use, including tobacco and cannabis, and other information identified by schools as priorities (e.g., bullying). The CSADS collects data on sex, gender, sexual orientation, grade, age, race, ethnicity, Indigenous identity, number of years lived in Canada, disability, self-reported mental and physical health, median household income, province, and geography (urban, rural).

Canadian Postsecondary Education Alcohol and Drug Use Survey (CPADS)

The CPADS is a national biennial survey that examines the prevalence of alcohol and substance use among students enrolled in a Canadian university, college, or CEGEP. The CPADS collects information on sex, gender, sexual orientation, race, ethnicity, Indigenous identity, age, year of study, field of study, full-time or part-time status, international student status, type of residence, province, and self-reported mental and physical health.

Public Opinion Research

Health Canada conducts public opinion research with questions on sex, gender, age, sexual orientation, household income and ethnicity to better understand the intersections between SGBA Plus variables and behaviours and attitudes.
A Public Awareness of Alcohol-Related Harms Survey (PAAHS) was conducted in 2023. It assessed the public's knowledge of and opinions regarding educational campaigns about alcohol, national drinking guidelines, standard drink measurements, awareness of alcohol-related health risks, and health labelling of alcohol products. The PAAHS collected information on region, age, sex, health literacy, community size, income, education, official language, race, ethnicity, and Indigenous identity. Where feasible to report, detailed tables of results by SGBA Plus variables will be available on the Library and Archives Canada website. The second phase of the PAAHS will use focus groups to target youth, young adults and women. Results will be disaggregated by age and gender and are expected to be released in 2024-25.
Health Canada will conduct public opinion research to understand awareness of harms associated with substance use more broadly, including polysubstance use, with results to be published in 2024-25.

Data is also collected through the Performance and Progress Report templates submitted by recipients funded through Health Canada's Substance Use and Addictions Program (SUAP) twice each year. Recipients are required to submit demographic data for certain performance measurement indicators such as age, location, gender, language, and target population factors such as Indigenous, 2SLGBTQI+^{Footnote 2} and racialized people or communities.

SUAP is providing funding to the Canadian Centre on Substance Use and Addiction (2023-25) to help inform the development of knowledge mobilization tools and activities targeting different populations. Such tools will target groups including Indigenous populations and 2SLGBTQI+ communities to ensure that the unique circumstances of people with diverse backgrounds and personal experiences are taken into account as part of efforts to address alcohol and substance use.

Information obtained from these surveillance and reporting tools will inform regulatory initiatives as well as public education and awareness activities.

Moreover, the Controlled Substances Program will continue to integrate SGBA Plus considerations into its activities:

Health Canada will continue to apply SGBA Plus in developing and implementing policies and programs to address substance use related harms through the renewed Canadian Drugs and Substances Strategy (CDSS). These efforts will be guided by the development of a CDSS Equity Action Plan which will build on the Department's SGBA Plus Action Plan. The CDSS Equity Action Plan will focus on engagement with populations disproportionately impacted by substance use related harms; intersectoral collaboration across federal governments to address the social determinants of health; and integration of research and disaggregated data into decision-making.
The Department will improve data collection and dissemination of disaggregated data relating to substance use and marginalized populations, social determinants of health, and impacts of substance use on health systems. For example, Health Canada will engage with people with lived and living experience to design new targeted surveys that will better support data and trend analysis for subsets of the Canadian population regarding substance use-related harms. This will help fill existing gaps in substance use data to better support federal policies and programming aimed at these groups.
Health Canada will continue to extend the Men in Trades Marketing and Advertising campaign with an aim to reduce the stigma of asking for help. Since 2016, men made up 3 out of 4 opioid toxicity deaths in Canada. The Department is conducting a public education campaign focused on men working in trades, as they are disproportionately impacted by substance use and addiction.

Program 17: Cannabis

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2024-25, Health Canada will continue to apply SGBA Plus to its data collection tools and analysis to help inform policy and regulatory decisions and the development of more targeted public education campaigns. SGBA Plus data collection plans include the assessment of key aspects of cannabis use through population health surveys, such as the Canadian Cannabis Survey, Canadian Alcohol and Drugs Survey, and the Canadian Student Alcohol and Drugs Survey.

Canadian Cannabis Survey (CCS)

The CCS is an annual survey that gathers detailed information about people in Canada aged 16 and over who use cannabis, including cannabis for medical purposes. It asks about knowledge, attitudes, behaviours (including high-risk behaviours such as cannabis use and driving, frequent cannabis use, etc.), product preferences, purchasing habits, and sources of cannabis. The CCS collects information on sex, gender, age, sexual orientation, household income, race and self-reported physical and mental health.

Canadian Alcohol and Drugs Survey (CADS)

More information can be found under Program 16: Controlled Substances

Canadian Student Alcohol and Drugs Survey (CSADS)

More information can be found under Program 16: Controlled Substances

Public Opinion Research

Health Canada conducts public opinion research with questions on sex, gender, age, sexual orientation, household income and ethnicity to better understand the intersections between SGBA Plus variables and behaviours and attitudes.

Data is also collected through the Performance and Progress Report templates submitted by recipients funded through the Health Canada Substance Use and Addictions Program on a bi-annual basis. Recipients are required to submit demographic data for certain performance measurement indicators such as age, location, gender, language, and target population factors such as Indigenous, 2SLGBTQI+^{Footnote 2} and racialized people/communities.

Information obtained from these surveillance and reporting tools will help further inform regulatory initiatives as well as public education and awareness activities.

Notable future data collection initiatives include:

Publish results from 2023-24 public opinion qualitative research for focus groups with older Canadians, frequent cannabis consumers and 2SLGBTQI+ community members.
Canadian Pediatric Surveillance Program Study on Serious and Life-Threatening Events Associated with Non-Medical Cannabis Use in Canadian Children and Youth – ongoing data collected monthly from 2018 to 2025.
Cannabis Adverse Reaction Surveillance - ongoing data collection and publication of annual reports.

Moreover, the Department will continue to integrate SGBA Plus considerations into its activities:

As part of its efforts to improve the Cannabis Program, Health Canada will continue to support a more diverse cannabis industry. The Department aims to ensure it is comprised of small and large businesses and to increase the participation of Indigenous, Black and other racialized communities. Health Canada will identify and address potential bias or barriers by consulting with license holders and providing educational webinars with targeted question-and-answer sessions; by creating and revising web pages; and by exploring options for additional guidance and support prior to cannabis application submissions.
Health Canada will also continue to offer a dedicated Indigenous Navigator Service. The purpose of this service is to support Indigenous-affiliated applicants throughout the federal commercial cannabis licensing process and encourage their participation in the industry.
Health Canada will continue to apply an SGBA Plus lens to the development and dissemination of public education and awareness activities by drawing on evidence from survey data and public opinion research to help determine gaps in public education. Using this information, the department will continue to focus outreach efforts on priority populations, including youth and young adults, Indigenous populations, pregnant and breastfeeding people, parents of children and youth, and 2SLGBTQI+ populations.

Program 18: Radiation Protection

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

In 2023-24, the Radiation Protection Program included questions in a fact-based consumer survey to determine the Canadian public's level of awareness and use of Health Canada's health and safety information regarding radiation emitting devices, with a focus on lasers. The survey is now complete and the associated disaggregated data will be evaluated to help inform outreach activities relating to laser safety for different audiences as the program prepares for implementation of proposed regulatory amendments relating to lasers under the Radiation Emitting Devices Act.

Health Canada conducts public opinion research (POR) every 5 years to collect data on radon knowledge and attitudes. In 2022-23, the POR collected information on populations who may be at risk, including those living in high radon regions, parents with young children, and smokers, and results will be reported by disaggregated sub-populations. Results of the POR will inform the outreach and behaviour change work under the National Radon Program going forward.

Health Canada is planning to conduct a survey in 2024-25 to evaluate the occurrence of, and details associated with, reported eye injuries resulting from handheld lasers. The survey will collect information from health care professionals. It will be a follow up to previous data collection in 2018 and will inform assessment of risk management strategies implemented by Health Canada. Survey results are expected to be published in 2025-26 (including disaggregated data by region, sex and age).

Program 19: Pesticides

The Program collects sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

When a pesticide is being evaluated for its potential risks to human health, the Pest Control Products Act requires Health Canada to take into account risks that chemicals may pose to groups based on differences in biology and behaviour (e.g., differences related to sex, gender, age and occupation). Evaluations also take into consideration potential risks to vulnerable subgroups including pregnant persons, infants, children, nursing parents and seniors. If it is determined that an unacceptable risk exists based on how the pesticide is intended to be used, the product will not be registered for use in Canada. The Considerations of Sex and Gender in Pesticide Risk Assessments Infographic highlights SGBA Plus metrics considered by Health Canada. The Sex- and Gender-based Considerations in the Scientific Risk Assessment of Pesticides in Canada Factsheet provides additional details on how the Department considers SGBA Plus within its operations and forward plans.

Companies applying to register a pesticide must provide Health Canada with substantial toxicology data from health and environmental studies in accordance with internationally accepted scientific standards. Health Canada scientists evaluate potential risks to human health and the environment based on the data provided, which includes consideration of SGBA Plus factors such as sex, gender, age and occupation. Health Canada requests additional information from the applicant, if necessary.

In addition to the above, Health Canada conducts and publishes findings of a public opinion research survey every 4 years to measure the impact of outreach and awareness activities. Respondents can be grouped by SGBA Plus metrics such as region, age, and gender. The metrics provide insight into whether differences exist between these groups regarding outreach and awareness activities and will inform future program strategies.

Health Canada is planning to conduct another public opinion research survey in 2025-26. SGBA Plus metrics will be analyzed to determine whether differences exist between groups regarding the impact of outreach and awareness, to inform future program strategies.

Health Canada will continue to evaluate the feasibility and requirements regarding the collection of additional SGBA Plus data, with emphasis on intersectionality.

Program 20: Health Canada Specialized Services

The Health Canada Specialized Services Program consists of 3 sub-programs.

Employee Assistance Program

Employee Assistance Services delivers the Employee Assistance Program (EAP) through a network of contracted mental health professionals.

EAP collects sufficient data to monitor and/or report on service use and general client experience (e.g., satisfaction with various stages of the service) by gender and other demographic categories (SGBA Plus). The Department will continue to collect disaggregated data, which includes sex, gender, age, geography, language, sexual orientation, and employment equity groups (women, Indigenous peoples, persons with disabilities and racialized groups).

In 2024-25 EAP will focus on the following, with the goal of improving how EAP is experienced by equity deserving groups, including Black clients, as part of Budget 2023's "An Action Plan for Black Employees in the Public Service":

Collecting information from EAP counsellors, such as their gender, racial, ethnic, 2SLGBTQI+^{Footnote 2} and religious identities, to inform targeted recruitment initiatives and improve EAP's capacity to match clients requesting a counsellor with a specific identity or lived experience;
Tracking uptake of additional training offered to EAP counsellors, focussed on Anti-Black Racism, trauma informed approaches, and cultural competency; and
Working to expand the collection of demographic data to include specific sub-groups within the "Racialized" category to enhance how disaggregated data is collected and evaluated.

As a key part of the above work, Employee Assistance Services anticipates migrating its ongoing surveys (other than the annual telephonic survey), with expanded demographic categories, to a Protected B-compliant tool enabling clients and Mental Health Professionals to respond to surveys online. This data will be used to inform future improvements.

Public Service Occupational Health Program

The Program does not collect sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Public Service Occupational Health Program (PSOHP) helps deputy heads meet the Canada Labour Code requirement to protect employee health and safety at work by: performing occupational health evaluations and providing evidence-based occupational health guidance and advice to departments on risks and issues (e.g., asbestos, tuberculosis, Legionella).

PSOHP has recently implemented the National Occupational Health Information System (NOHIS), which enables the collection of data relevant to SGBA Plus. However, NOHIS does not currently collect sufficient disaggregated data to monitor program impacts by gender and other intersectional characteristics. Efforts are ongoing to improve NOHIS data collection through refinements to the information system. PSOHP is committed to extending the range of data points collected by NOHIS throughout 2024-25 and subsequent years, with the aim of enhancing SGBA Plus monitoring and reporting on data related to gender and diversity.

Internationally Protected Persons Program

This Program doesn't collect sufficient data to enable it to monitor and/or report program impacts by gender and diversity (SGBA Plus).

The Internationally Protected Persons (IPP) Program's mandate is to coordinate the development of health plans for visiting IPPs to Canada. To coordinate the development of health plans, the IPP Program collects data about a very small group of individuals. These include heads of state, government officials, and their families who are entitled to special protection under international law when visiting Canada. This data is not sufficient to enable monitoring or reporting of program impacts by gender and diversity and is only collected if medically relevant. Use of the data is restricted to medical treatment only.

The IPP Program collaborates with program partners, primarily the Royal Canadian Mounted Police, Global Affairs Canada and Heritage Canada, to determine the level of service provided to visiting IPPs. As such, Health Canada cannot predict the volume of data that will be collected. The IPP Program will continue to work with departmental partners to identify any future actions that could be taken to enable monitoring or reporting of the program's impacts by gender and diversity.

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Date modified:: 2024-02-29