CCS Health Equity Research Grants – Advancing a more accessible and inclusive cancer care system
Highlights of the program
The purpose of this funding program is to support research projects that seek to advance cancer-related health equity. Projects must be collaborative, co-created by people both affected by cancer and by structural marginalization, and designed to address the systemic, structural, and institutional factors that sustain health disparities in Canada. Applications should take a social determinants of health perspective in identifying and defining both the health equity need and the community of focus, taking care to consider the intersectionalities of such communities.
Deadline dates
Background & Context @(Model.HeadingTag)>
Health inequalities (or disparities) are prevalent in Canada (see 1). Health inequities are defined as health inequalities that are due to avoidable (unfair or unjust) differences in health outcomes that result from systemic, structural, and institutionalized injustices based on, for example, race, gender, or sexual orientation. For First Nations, Inuit and Métis Peoples, this includes health outcomes that result from the effects of colonialism. Achieving health equity involves addressing these systemic, structural and institutionalized injustices, many of which are rooted in racism (and other ‘isms’, including sexism, ageism, ableism, heterosexism, classism, etc.), discrimination, exclusion and oppression.
The Government of Canada describes determinants of health as the broad range of personal, social, economic and environmental factors that determine individual and population health. These include:
- Income and social status
- Employment and working conditions
- Education and literacy
- Childhood experiences
- Physical environments
- Social supports and coping skills
- Healthy behaviours
- Access to health services
- Biology and genetic endowment
- Gender
- Culture
- Race / Racism
Social determinants of health refer to the non-medical factors that affect a person’s health. They include the social and economic factors that a person experiences that can influence health, such as income, education and employment. Experiences of racism, discrimination, exclusion and oppression are important social determinants of health for certain groups such as First Nations, Inuit and Métis Peoples, LGBTQ2S+ and Black people living in Canada. There is no one ‘accepted’ standard or exhaustive list of social determinants of health (2, 3, 4).
The cancer control continuum begins with prevention and proceeds through screening and early detection, diagnosis, treatment, psychosocial and palliative care, recovery and survivorship, and end-of-life care. As they pertain to cancer, specific health disparities (many of which are inequities), documented in both the US (see 5) and Canada (see 6, 7, 8, 9, 10), highlight that there is significant work to be done. For example: screening is lower in trans communities
- Cancer screening is lower in trans communities
- Homeless people have higher cancer rates than the general population
- First Nations, Inuit and Métis Peoples are more likely to be diagnosed with late-stage cancers
- Black women with endometrial cancer have a poorer prognosis compared with white women (US data) (11)
Through the lens of a social determinants of health framework (see above, including, for First Nations, Inuit and Métis Peoples, the First Nations holistic policy and planning model (12) or similar justified framework), this research funding program will support research projects that seek to advance cancer-related health equity by addressing modifiable factors that sustain health disparities. By enhancing health equity in specific populations, the health of Canada’s population as a whole, will be improved.
Program description @(Model.HeadingTag)>
Research teams will employ collaborative methods to co-design, co-implement and co-evaluate carefully considered approaches to address specific health inequities relevant to cancer prevention, detection, treatment, and/or survivorship. Applications must address a clear health equity need and be focused on a defined group (with consideration of sub-groups) that is mindful of intersecting determinants of health. For example, First Nations, Inuit and Métis, Black, and other minoritized or racialized groups are not homogenous, and intersect with other determinants of health including gender, sexual orientation, geographical location, education, other ethnicities, and economic status. Therefore, teams should make efforts to address, and be cognizant of, the limitations with respect to application of study results to a specific population.
Proposed projects should ideally address the systemic, structural and/or institutional practices that promote health inequity, but may also pursue provider-level (e.g. point-of-care) and individual (with caution - to avoid assigning blame or perpetuating harms but where supported by team members and other advisors as appropriate) approaches/interventions where relevant. Implications and intended outcomes, as well as dissemination and mobilization of the proposed research must be clearly articulated, with risks and alternative/mitigating approaches described.
Research teams will be comprised of relevant partners as integral members of the team from the outset:
- A Principal Investigator who meets the eligibility criteria, and who brings with them an authentic, demonstrated commitment to health equity research. Researchers that have not traditionally worked in cancer, but are focused on health equity research (e.g. social scientists, arts-based researchers, community-engaged researchers) are encouraged to apply. For applications involving First Nations, Inuit and Métis Peoples, the Principal Investigator or co-Principal Investigator must self-identify as Indigenous or engage (an) Indigenous Elder(s) or Knowledge Keeper(s) to provide evidence of meaningful and culturally safe engagement with Indigenous communities.
- A team (Principal Investigator, Co-Principal Investigator(s), Co-Applicant(s), People affected by cancer, Implementers and Decision-makers, Additional Authors and Collaborators) whose clear focus is on health equity, and who collectively bring the appropriate experience and expertise to bear towards achieving the research objectives. Health equity training may be required for some members of the research team (e.g. trainees) and should be described where needed.
- People affected by cancer are people both affected by structural marginalization and at risk of cancer, patients, survivors, and/or caregivers. These individuals must be integrally involved in co-creating all aspects of the research plan from the outset, beginning with the identification of a research issue of importance and relevance, through to dissemination of results. The characteristics and intersections of sub-populations should be carefully considered to ensure fair representation. Teams may consult the CIHR Strategy for Patient-Oriented Research – Patient Engagement Framework for guidance on meaningful engagement.
- Implementers and decision-makers include professionals (healthcare, community-based, administrators, policy makers) who may be involved in implementing the proposed approaches to enhance health equity. These individuals must be integrally involved in the project from the outset and must demonstrate their commitment to the proposed work.
- A detailed Terms of Reference (that can evolve over the project) for all members of the team will be required as part of the application process and regular check-ins by CCS staff throughout the duration of funding will confirm appropriate engagement of stakeholders.
We encourage inquiries about project scope and eligibility of team members. Please contact research@cancer.ca.
CCS is committed to equity, diversity and inclusivity and First Nations, Inuit and Métis Peoples rights, and strives to promote inclusive excellence in its research programs. We welcome and encourage eligible applicants of diverse backgrounds to apply for our funding opportunities.
Authentic Team Building
Recognizing that team building in an authentic, collaborative way takes time, newly formed teams may submit applications that comprise the team building and issue identification process (for up to 1 year of funding), with a subsequent application (in a future competition*) for the (cancer-related health equity) research itself. Applications framed in this way will need to provide a well-justified rationale and detailed plan for the team building activities and requested budgets should reflect the work proposed. Members of the team will need to be identified at the application stage. *Note that teams utilizing this approach will be subject to the same evaluation criteria as other applicants in a future competition
Funds available
- Funding will be available for up to $300k per grant over 3 years (max $150k/yr).
- Up to $3M may be awarded in this funding envelope.
- Budgets awarded will not exceed $300,000 over 2 or 3 years per grant. Funding will be provided to support the direct costs of research, including supplies, expenses, wages, stakeholder/partner engagement (where eligible) (including remuneration and ceremonial items for feasting and gift-giving for First Nations, Inuit and Métis Peoples), and equipment associated with the proposed work. Equipment requests of up to $10,000 can be included within the proposed budget but must be appropriately justified. For this competition, team building expenses and community-based researcher salaries (prorated to the work specific to the project) are eligible expenses. Review CCS’s Financial Administration policy for details of eligible and non-eligible expenses. Indirect costs are not eligible.
- Grants will be renewable upon submission of a full application to a subsequent competition (where offered).
How to apply @(Model.HeadingTag)>
Consult CCS eligibility and requirements. Review CCS requirements for Principal Investigators, their teams, and Host Institutions.