Gender-based analysis plus

On this page

• Section 1: Institutional GBA Plus governance and capacity
• Section 2: Gender and Diversity Impacts, by Program
  • Core Responsibility 1: Health Care Systems
    • Program 1: Responsive Health Care Systems
    • Program 2: Healthy People and Communities
    • Program 3: Quality Health Science, Data and Evidence
  • Core Responsibility 2: Health Protection and Promotion
    • Program 4: Pharmaceutical Drugs
    • Program 5: Biologic and Radiopharmaceutical Drugs
    • Program 6: Medical Devices
    • Program 7: Natural Health Products
    • Program 8: Food and Nutrition
    • Program 9: Air Quality
    • Program 10: Climate Change
    • Program 11: Water Quality
    • Program 12: Health Impacts of Chemicals
    • Program 13: Consumer Product Safety
    • Program 14: Workplace Hazardous Products
    • Program 15: Tobacco Control
    • Program 16: Controlled Substances
    • Program 17: Cannabis
    • Program 18: Radiation Protection
    • Program 19: Pesticides
    • Program 20: Health Canada Specialized Services

Section 1: Institutional GBA Plus governance and capacity

Governance

Health Canada, as part of the Health Portfolio, has a Sex and Gender-Based Analysis Plus (SGBA Plus)^{Footnote 1} Policy (Policy) which provides a mandate to integrate SGBA Plus in the Department. The Department's SGBA Plus Action Plan outlines its strategy to implement the Policy and includes a logic model and indicators to assess progress. This 4-year Action Plan (2022-26) demonstrates Health Canada's continued commitment to advance equity and improve its approach to diversity and inclusion. It provides a framework to strengthen the integration of sex, gender and other intersectional factors^{Footnote 2} in the externally and internally facing work of the Department.

The SGBA Plus Centre of Excellence (SCOE) provides leadership for the implementation of SGBA Plus at Health Canada. The SCOE advises and collaborates with senior management, branch leads and colleagues to provide oversight, direction, support and monitoring of the implementation and ongoing practice of SGBA Plus in the Department by:

• Providing leadership, expertise, advice and guidance on incorporating an intersectional approach to diversity considerations in all activities across the department;
• Reporting on departmental SGBA Plus activities;
• Providing a challenge function on the quality of SGBA Plus analyses (e.g., Cabinet documents, regulations, and budget proposals);
• Leading on the SGBA Plus Integration Network and Community of Practice;
• Providing employee training, digital resources, communications and events to strengthen awareness and knowledge;
• Coordinating the ongoing development of the Health Portfolio SGBA Plus Policy and the accompanying Health Canada SGBA Plus Action Plan; and,
• Leading and collaborating on horizontal policy issues and intra/interdepartmental committees and task forces.

In 2023-24, Health Canada made substantial progress in the second year of the SGBA Plus Action Plan by:

• Demonstrating activities aligned with the 5 strategies of the Action Plan. Each branch within the Department has an Assistant Deputy Minister appointed delegate to the SGBA Plus Integration Network, who is responsible for ensuring the development and implementation of their SGBA Plus Branch Integration Plans. The SCOE is active in supporting the department in carrying out the horizontal implementation of the five strategies.
• Incorporating SGBA Plus into program indicators, resulting in a 100% rating in the latest Management Accountability Framework. As part of the annual review of program performance indicators, Health Canada engaged closely with programs, ensuring the disaggregation of indicators by sex, gender, and diversity where appropriate. Through processes such as the Performance Information Profile review and the review of program results indicators in Treasury Board submissions, the Department provided input to ensure that all programs included at least 1 SGBA Plus-related indicator. This collaborative effort identified additional data to support robust analysis and reporting of impacts on gender and diversity, further advancing Health Canada's commitment to equity.
• Increasing awareness of the SGBA Plus Policy and Action Plan and their associated responsibilities over the past 2 years, as demonstrated by the 2022 SGBA Plus Employee Pulse Survey. This heightened awareness reflects significant progress in embedding SGBA Plus principles within departmental practices, reinforcing Health Canada's growing commitment to equity, diversity, and inclusion, while contributing to the development of more effective, responsive, and inclusive policies and programs.

In line with the Privacy Management Framework of Health Canada, the Department's core functions include ensuring that its programs comply with the Privacy Act and Treasury Board privacy policies and directives. Responsibilities include:

• Developing privacy policies, procedures, and practices;
• Delivering privacy training and awareness programs to staff;
• Assessing and reporting on privacy breaches;
• Coordinating the departments input of InfoSource;
• Providing privacy analysis and advice using a number of tools including Privacy Impact Assessments and Privacy Protocols.

In 2023-24, Health Canada conducted a complete analysis of how SGBA Plus considerations could be incorporated into the Privacy Management Framework. As a result, privacy risk practices have been updated to ensure that all privacy-related functions consider SGBA Plus. This includes updates to Privacy Impact Assessments, Privacy Protocol procedures, Privacy Breach Response Products and Preliminary Risk Assessments.

Capacity

Health Canada continues to assess for opportunities where SGBA Plus may be integrated or improved within Departmental processes to ensure it is reflected in business practices and tools. In 2023-24, Health Canada made substantial progress in advancing Departmental SGBA Plus capacity through the following actions:

• Appointed an official department Champion of SGBA Plus. This role was created to help support cultural change by increasing awareness of the responsibilities and value of SGBA Plus and strengthening the incorporation of intersectional principles into our day-to-day work.
• Revised the SGBA Plus Guidance Document and Template for use in the development of Memorandum to Cabinet, Treasury Board Submissions, and budget and regulatory proposals. This revision supports a stronger intersectional lens in the approach to analysis. Additionally, the template is now in an accessible format.
• Launched the SGBA Plus Step-by-Step Guide for regulatory projects in December 2023. A pilot project was launched to gather feedback through a brief questionnaire, aiming to increase SGBA Plus integration into regulatory operations and evaluate the guide's effectiveness in achieving this goal.
• Launched the SGBA Plus Learning Path at the end of March 2023 to provide managers and employees a framework to develop their SGBA Plus capacity. The Learning Path, promoted widely over the course of the year, includes course recommendations which provide an intersectional approach to SGBA Plus in line with the Policy and Action Plan. These course options include more focused learning on topics such as anti-racism, accessibility and culturally distinct Indigenous perspectives. Extensive work was completed this past year to enable ease of access and tracking on Health Canada's learning platform for launch in May 2024.
• Piloted the SGBA Plus Training of Trainers Program this past year to assist qualified employees to intensify their knowledge of intersectional SGBA Plus and acquire basic skills to facilitate SGBA Plus learning activities and effectively communicate SGBA Plus concepts and applications. This program provided a community of practice of employees with greater knowledge to develop SGBA Plus capacity building activities.

To further expand SGBA Plus awareness and enhance the department's understanding of intersectionality, Health Canada hosted several forums, events, and learning opportunities in 2023-24 aimed at achieving a common goal:

• Hosted a plenary session on SGBA Plus at the annual Health Canada Science Forum in February 2024 which gathers government scientists, regulators, policymakers, and experts from Health Canada and the broader Canadian federal Health Portfolio. The plenary session included guest speaker, Dr. Imogen Coe, and focused on the collection and use of disaggregated data in research.
• Held its Science Symposium XII. The event focused on "The Challenges of Inclusive Research: Making Anti-Racism Science a Reality". The purpose of the Symposium was to help familiarize Health Canada scientists, regulators, policy analysts and risk assessors with anti-racism policies (or lack thereof) in both health product clinical trials and agri-food applications. Internal and external experts presented and participated in a panel discussion to share their insights and expertise to help staff better understand the benefits of anti-racism policies for health products and what to consider when setting guidance to best serve all Canadians.
• Hosted 3 SGBA Plus learning events with the SGBA Plus Community of Practice to further enhance knowledge and skills. The focus this past year was on increased learning on the intersectional aspects of SGBA Plus such as 2SLGBTQI+, accessibility, culturally relevant SGBA Plus, and anti-racism.

Human resources FTE (full-time equivalents) dedicated to GBA Plus

Health Canada SGBA Plus FTEs are employees dedicated to SGBA Plus and consistently engaged in activities such as governance of SGBA Plus implementation, monitoring, and reporting; organizing and promoting SGBA Plus training and awareness activities; assuming the role of an SGBA Plus champion and /or focal point; facilitating SGBA Plus implementation through formalized research to support a disaggregated data strategy; leading on functional and horizontal SGBA Plus related action plans; advising on SGBA Plus departmental processes; participating in SGBA Plus communities of practice and accountability networks; and reviewing cabinet documents for SGBA Plus quality.

Health Policy Branch (excluding the Health Canada SGBA Plus focal point): 5.5 FTE

The SGBA Plus Centre of Excellence (Health Canada SGBA Plus focal point): 6.5 FTE

Controlled Substances and Cannabis Branch: 5 FTE

Digital Transformation Branch: 3.5 FTE

Communications and Public Affairs Branch: 3.5 FTE

Chief Financial Officer Branch: 1 FTE

Pest Management Regulatory Agency: 0.5 FTE

Corporate Services Branch: 3 FTE

Regulatory Operations and Enforcement Branch: 1 FTE

Health Products and Food Branch: 4.5 FTE

Healthy Environments and Consumer Safety Branch: 9 FTE

Oral Health Branch: 3 FTE

Section 2: Gender and Diversity Impacts, 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).

Program 1: Responsive Health Care Systems

Program goals: The program enables improvements across health care systems to address gaps and needs, including population-specific challenges. Support to P/Ts and other partners enhances access to care and enables effective and equitable health care delivery, without financial or other barriers.

Target population: All Canadians

A particular demographic group: The program is designed to provide benefits to all Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Responsive Health Care Systems Program and its transfer payment programs encompass a wide range of activities that address the diverse needs of various populations within Canada.

Key program impacts on gender and diversity:

Each of the initiatives listed below carries out their own key program impacts on gender and diversity. As a result, there is no GBA key program impacts on gender and diversity for the entire program. Key program impacts on gender and diversity by initiative is therefore described below.

Health Canada is working with the Canadian Agency for Drugs and Technology in Health (CADTH) to improve performance indicators on its products and services as part of the ongoing contribution agreement with CADTH, with a particular focus on improving the application of SGBA Plus considerations in its work. In 2023-24, CADTH drafted an Inclusion, Diversity, Equity, and Accessibility statement and created two senior leader positions to build capacity and reconciliation space. Since then, CADTH:

• developed an organizational land acknowledgement which affirms CADTH's commitment to reconciliation and to its role as an advocate, amplifier, and ally to Indigenous Peoples, communities and organizations in Canada;
• published new insights on how to search for Indigenous Health Information and Knowledge, in collaboration with the Strategic Partner for Indigenous Engagement and Partnerships; and
• redeveloped its internal recruitment process and expanded external programs like the Symposium Travel Award to be more inclusive and reflective of the diversity found in Canada.

In February 2023, the Government of Canada announced the Working Together to Improve Health Care for Canadians plan, outlining an investment of close to $200 billion over ten years to improve health care for Canadians. As part of this plan, the Government of Canada has signed two bilateral agreements with each province and territory:

• Working Together bilateral agreements feature an investment of $25 billion over ten years to support four shared priorities:
  • Accessing family health services
  • Building a resilient health workforce and addressing backlogs
  • Accessing mental health and substance use services
  • Modernizing the health system through digital health and health data

This builds on Budget 2017 funding of $2.4 billion over four years to improve access to mental health and addictions services.

• Aging with Dignity bilateral agreements provide $2.4 billion over four years for home and community care (Budget 2017) and $3 billion over five years for long term care (Budget 2021) to help Canadians age with dignity, closer to home, through funding for long term care and home and community care. These agreements are being amended to include an additional federal commitment of $1.7 billion over five years to support wage increases as well as the retention and recruitment of personal support workers.

Health Canada is also collaborating with P/Ts under the Working Together to Improve Health Care for Canadians Plan. Key initiatives include:

• Signing bilateral agreements by March 31, 2024, that prioritize digital health, health data, and diversity.
• Advancing SGBA Plus objectives through principles that ensure health services address the needs of First Nations, Inuit, Métis, and underserved populations, including racialized communities and 2SLGBTQI+.
• Supporting integration of sex, gender, and diversity in all agreements, with initiatives available online.
• Committing to accountability by refining and publicly reporting on eight key common indicators, including two digital health indicators, and sharing disaggregated data to monitor policy impacts on diverse populations through an SGBA Plus lens.

To ensure Canadians receive the care they deserve, the government is developing a Safe Long-Term Care Act, following extensive consultations in 2023 with experts, stakeholders, Indigenous partners, and individuals with lived experience. Budget 2024 confirmed the Act's introduction to support new national long-term care standards.

The Government of Canada's Action Plan on Palliative Care (2019) invested $24.7 million (2019-21) and an additional $29.8 million (2021-27) to enhance palliative care, with a focus on improving access for underserved populations and providing culturally safe care for Indigenous communities. Healthcare Excellence Canada, in partnership with the Canadian Partnership Against Cancer, launched a national initiative that empowered 23 communities to develop palliative care models tailored to people experiencing homelessness or vulnerable housing. These efforts address barriers related to social determinants of health, such as race, ethnicity, and gender identity. A national palliative care awareness campaign has consulted racialized groups and people with disabilities to develop and track data disaggregated by sex and other factors, supporting targeted messaging and measuring changes in public perception.

Health Canada is also taking measures to support Canada's health workforce. Currently there are significant challenges facing health workers that provide care to Canadians, including labour shortages and vacancies, and difficult working conditions. An example of efforts to support the workforce in 2023-24 includes the launch of the Nursing Retention Toolkit, which was created 'by nurses, for nurses'. This resource is designed to be used by employers to improve retention in nursing workplaces. The resource draws on the expertise of the nursing community, evidence-based practice, and current lived experiences of front-line nurses to improve nursing retention. As there is a much higher proportion of women in the nursing profession (in 2021, 91% of regulated nurses were female), and research continues to show that women perform the majority of the housework and caring for children, these were considerations in the development of the toolkit. The toolkit includes eight themes that impact a nurses day to day work life, and certain themes are more influenced by nursing being a feminized profession:

• Flexible and balanced ways of working which promotes nurse autonomy and flexibility in scheduling and career progression. This allows for increased work-life balance by offering greater control over their schedules and flexibility that addresses their individual needs and preferences.
• Clinical governance and infrastructure which ensures that supportive clinical governance and infrastructure is in place to promote nurses having a core role in decision-making and are at the forefront of driving the development of a sustainable health system. This allows more nurses to feel respected and recognized for their skills, competencies and knowledge, and can positively influence the dated perceptions of the nursing profession.

Medical Assistance in Dying (MAID) is available to all Canadians who are 18 and over and meet eligibility criteria in the Criminal Code. Data was initially being collected by Health Canada on the age and gender of those who request and/or receive MAID. Beginning on January 1, 2023, data collection was expanded to include information on race, Indigenous identity, and disability. This information will be used to help determine whether specific populations are receiving differential or inequitable access to MAID or the presence of any individual or systemic inequality or disadvantage in the MAID system for key populations and will serve to inform future F/P/T policy and program decision-making.

The federal legislation for MAID sets out the legal framework for the lawful provision of MAID by establishing eligibility criteria, safeguards for its application and Criminal Code exemptions for preliminary assessors, physicians and nurse practitioners who conduct eligibility assessments; for physicians and nurse practitioners who provide MAID and for pharmacists and pharmacy technicians who dispense medications for the purpose of MAID, in accordance with the framework. Not all healthcare providers feel comfortable with MAID due to personal or religious beliefs. Federal legislation respects this by ensuring that no one is obligated to provide or assist in MAID.

The federal government collects data on MAID through the Regulations for the Monitoring of MAID, requiring preliminary assessors, healthcare providers, and pharmacists to submit information, which is published annually by the Minister of Health. Health Canada's four Annual Reports (2019, 2020, 2021, 2022) show that MAID recipients are almost equally split between men and women, typically in older age groups.

Health Canada seeks to support the expansion of interoperability and e-prescribing in Canada by providing funding to Canada Health Infoway. Though surveys commissioned by Infoway and support of digital health technologies that are adopted by P/Ts health systems, Infoway works with P/Ts and other partners to consider whether and how SGBA Plus factors could inform their work.

Moreover, through the Canadian Partnership Against Cancer (CPAC), Health Canada aims to accelerate cancer control across the country by implementing the 10-year Canadian Strategy for Cancer Control, refreshed in 2019. Key initiatives include:

• Engaging 7,500 Canadians, including First Nations, Inuit, and Métis, to identify cancer control priorities and challenges.
• Reducing disparities in access to care and outcomes between jurisdictions, communities, and population groups.
• Improving cancer care, experience, and outcomes for all people in Canada, regardless of identity or location, with a focus on equity and inclusivity.

The Canada Health Act establishes criteria and conditions related to insured health services and extended health care services that the P/Ts must fulfill to receive the full federal cash contribution under the Canada Health Transfer The aim of the Canada Health Act is to ensure that all eligible residents of Canada have reasonable access to insured health services on a prepaid basis, without direct charges at the point of service. Health Canada monitors the operations of provincial and territorial health care insurance plans in order to provide advice to the Minister of Health on possible non-compliance with the Canada Health Act.

• Active monitoring of access to abortion services identified patient charges for abortion services in New Brunswick and Ontario. Both provinces were subject to deductions to their Canada Health Transfer payments in March 2024, totaling $142,075, as a result of patient charges that occurred in 2021-22.
• Though the private clinic in New Brunswick where patient charges were occurring closed in February 2024, the retrospective nature of reporting under the Canada Health Act means that New Brunswick will still face Canada Health Transfer deductions for patient charges that were levied in 2022-23 and 2023-24.
• In March 2024, Ontario received partial reimbursement of its March 2022, March 2023, and March 2024 Canada Health Transfer deductions under the Canada Health Act Reimbursement Policy totaling $43,296 for implementing elements of its Reimbursement Action Plan (RAP) in which Ontario committed to revisiting the framework for funding abortion services. To this end, as detailed in Ontario's 2024 RAP status update, the province introduced new legislation in 2023.
• Over the course of 2023-24, the Department worked closely with P/Ts to explain the policy and determine when jurisdictions would be able to implement any necessary legislative or regulatory changes.

With reference to the National Strategy for Drugs for Rare Diseases, improving drug coverage will likely have positive impacts for women, racialized groups, and marginalized communities. However, many data gaps associated with rare diseases and access to drugs exist. Several activities involving collection and use of evidence were launched in 2023-24, which could improve understanding of population-based impacts. For example, a Newborn Screening Advisory Panel was created to address variation in practices and support equity and activities on real world evidence generation and disease registries to build knowledge around population impacts. Furthermore, the Canadian Institute for Health Information (CIHI) launched a Pharmaceutical Data Tool, helping to identify geographic disparities in drug plans and coverage.

Canadian Blood Services (CBS) is the sole recipient of the Organs, Tissues, and Blood funding. The Organs, Tissues, and Blood seeks to improve the environment for all Canadians by providing support for safe, effective, accessible, and responsive organ, tissue and blood systems while respecting F/P/T scopes of authority.

Under the Organ and Tissue Donation and Transplantation Initiative, CBS has continued to raise awareness about the need for all genders and people of diverse communities to register their intent to donate and have discussions with their families about their decision. Awareness campaigns (e.g., Leave Well) have taken a more focused approach to targeting underrepresented groups. Annual surveys are being created to generate data to promote an understanding of deceased (Blood.ca) and living donation (Blood.ca) in diverse communities.

Key program impact statistics:

Each of the initiatives listed below carries out their own key program impact statistics. As a result, there is no GBA key program impact statistics for the entire program. Key program impact statistics by initiative is therefore described below.

Supplementary information sources:

Home, Community and Palliative Care

2018 General Social Survey: Caregiving and Care Receiving

Home and community care indicators available through the CIHI led process on shared health priorities:

Your Health System | CIHI

Statistics Canada Data: Census 2016 labour data: Occupation, Employment Income Statistics, Immigrant Status and Period of Immigration, Work Activity During the Reference Year, Age and Sex

Access to Palliative Care in Canada

Gender and palliative care: a call to arms

Framework on Palliative Care in Canada

Action Plan on Palliative Care

Two-Spirit and LGBTQ+: Proud, Prepared and Protected

Medical Assistance in Dying

The Regulations for the Monitoring of Medical Assistance in Dying

Fourth Annual Report on Medical Assistance in Dying in Canada, 2022

Canadian Partnership Against Cancer

CPAC has started publicly reporting on progress made against the priorities of the Canadian Strategy for Cancer Control (the Strategy).

Organs, Tissues, and Blood Program

Organ replacement in Canada: CORR annual statistics | CIHI

GBA Plus Data Collection Plan:

Each of the initiatives listed below carries out their own data collection. As a result, there is no GBA Plus data collection plan for the entire program. Data collection by initiative is described below.

Canadian Agency for Drugs and Technologies in Health (now Canada's Drug Agency)

Starting in 2024-25, Canadian Agency for Drugs and Technologies in Health (CADTH) transitioned to Canada's Drug Agency (CDA) on May 1, 2024, and will be collecting new indicators that will have data disaggregated and reported by: gender, official language, geographic location, racialized groups, Indigeneity, and 2SLGBTQI+.

Health Canada is collaborating with CDA to review and refine indicators that capture the SGBA Plus impacts within CDA's work and will update these indicators accordingly.

Medical Assistance in Dying

Collection of additional MAID data on race, disability, and Indigenous identity to help determine any individual or systemic inequality or disadvantage with respect to MAID began on January 1, 2023. Publication of this expanded demographic data for 2023 will occur, where possible in late in 2024 with the release of the Fifth Annual Report on MAID in Canada.

Health Canada is funding research on MAID to improve understanding of MAID delivery and help to inform policy development around MAID implementation. Sex, gender and other diversity information will be part of performance/results reporting with funding recipients, where appropriate.

Health Canada is currently engaging with Indigenous Peoples to gain an understanding of their views and perspectives on end-of-life care, including palliative care and MAID. A component of this engagement includes an online survey for Indigenous people to share their views on and/or their experiences with MAID. This survey is collecting voluntary, confidential information and can be analyzed according to demographic information, including gender identity, Two-Spirit and/or 2SLGBTQI+ identification, and residence.

Digital Health

As part of Working Together and Aging with Dignity agreements, F/P/T governments acknowledge the importance of supporting health data infrastructure, data collection and public reporting and will work together to improve the collection, sharing and use of de-identified health information, including collecting disaggregated data on key common health indicators with the CIHI and the Canada Health Infoway (Infoway).

For example, Infoway's annual Canadian Digital Health Survey provides key data collection on these shared health indicators that the federal government has committed to reporting on related to equity, including the percentage of Canadians who can access their own comprehensive health record electronically (by age, gender, region etc.). Another example, the National Survey of Canadian Physicians shows the percentage of family health service providers and other health professionals (e.g., pharmacists, specialists, etc.) who can share patient health information electronically, which is disaggregated based on gender, age, and region/practicing jurisdiction. CIHI publishes data on shared health priorities annually through Your Health System. Common indicators are updated and released annually, which include gender-disaggregated data on hospital stays, self-harm, early intervention for mental health and substance use among children and youth, as well as navigation of mental health and substance use services.

CIHI is leading a process, in collaboration with P/Ts, to refine and expand upon common indicators on shared health priorities through the Shared Health Priorities Advisory Council. CIHI is working with data providers and P/Ts to ensure that relevant disaggregation of indicators is built into future reporting as data allows, particularly for under-served and under-represented groups.

Canada Health Infoway

Infoway works with P/Ts, and other partners to consider whether and how sex and gender-based factors could inform their work. Infoway, through its agreements with third-party recipients of project funding and through the surveys that Infoway commissions directly, supports the collection of user data by sex and/or gender (to the extent practical and as permitted under provincial/territorial agreements and other relevant regulations and legislation).

Infoway's annual Canadian Digital Health Survey includes key considerations related to sex, gender, and diversity. To ground the survey and its insights in equity considerations, the 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 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 2022 International Health Policy Survey of Primary Care Physicians, to draw key digital health insights, including equity considerations. Taken together, Infoway will aim to ground its work in a comprehensive performance measurement approach to manage interoperability activities towards desired outcomes for Canadians and their health care system.

Canadian Partnership Against Cancer

As part of CPAC's contribution agreement with Health Canada, the organization submits a Performance Report every June 30th. The Performance Report is an evergreen package of documents consisting of the Canadian Strategy for Cancer Control, the logic model, the previous year's inventory of outcomes and indicators and the planned outputs and outcomes for the upcoming year. CPAC endeavors to maintain its commitment to addressing the diagnostic and treatment needs of men and women, girls and boys, and gender-diverse Canadians in its SGBA Plus data collection plans and activities where appropriate. This includes the application of SGBA Plus and strengthening and promoting the collection of sex and gender disaggregated data.

Canada Health Act

Health Canada will continue to actively monitor provincial and territorial compliance with the Act, including SGBA Plus related issues (e.g., barriers to abortion services, anti-Indigenous racism at the plan level), through analysis of available information including: correspondence with P/Ts, publications from P/Ts and non-governmental organizations, media reports and concerns received from the public (related to access issues). When issues of non-compliance are suspected, the Department will encourage P/Ts to share detailed information including the number of patients affected and costs. The data will be used to understand the size and scope of the issues and will be used to apply deduction amounts to P/Ts Canada Health Transfer payments when issues cannot be resolved through collaboration.

National Strategy for Drugs for Rare Diseases

To ensure inclusion of underserved groups and/or populations in disadvantageous circumstances in any scoping decisions and moving forward with the National Strategy more broadly, Health Canada launched a multi-stakeholder Implementation Advisory Group, which includes diverse patient and stakeholder perspectives in the governance and advisory structures for the National Strategy and supplements ongoing engagement during implementation of various activities.

There is limited data on rare diseases and on drug coverage status more generally, and what is available is not typically disaggregated by SGBA Plus factors. Proposed infrastructure investments associated with the National Strategy will help to improve use of real-world data and evidence in the evaluation of treatment effectiveness for broader populations than what is typically included in a clinical trial. As part of future funding agreements and investments, the Department will also seek agreement from P/Ts to support the measurement and reporting of progress to improve access to drugs for rare diseases, with a focus on SGBA Plus information where possible (i.e., in cases where sample size is sufficient to allow for public reporting).

Organs, Tissues, and Blood Program

Health Canada will continue to work with CBS to strengthen the collection of SGBA Plus data, as well as to strengthen the diversity and inclusion data.

A modernized and integrated pan-Canadian data and performance system will address current data limitations and facilitate understanding of which population subgroups may be experiencing barriers for accessing high-quality organs. The system was to be rolled out in April 2024, and it is anticipated that it will collect appropriate standardized data from both donors and recipients across the country, including standard socio-demographic variables.

Program 2: Healthy People and Communities

Program goals: Health Canada supports equitable access to health and oral health care, addressing disparities linked to socio-economic status, identity, and geography. Through the Healthy People and Communities Program, targeted interventions and partnerships foster inclusive, people-centred solutions, aiming to improve care for priority populations and reduce health outcome disparities across Canada.

Target population: All Canadians

A particular demographic group: The program is designed to provide benefits to all Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Healthy People and Communities Programs and its transfer payment programs encompass a wide range of activities that address the diverse needs of various populations within Canada.

Key program impacts on gender and diversity:

Each of the initiatives listed below carries out their own assessment of key program impacts on gender and diversity. As a result, there are no GBA key program impacts for the entire program. Key program impacts on gender and diversity by initiative are therefore described below.

A major initiative of Health Canada was focused on oral health. The interim Canada Dental Benefit (until June 2024) and the Canadian Dental Care Plan are intended to help ease financial barriers to accessing oral health care for eligible families and individuals with an adjusted family net income of less than $90,000 and with no access to private dental insurance.

In 2023-24, Health Canada implemented in collaboration with partners (including Statistics Canada, Employment and Social Development Canada, Canada Revenue Agency) various data collection tools and approaches to closely monitor the Canada Dental Benefit and the Canadian Dental Care Plan in Canada, including through the use of administrative databases, Statistics Canada's population-based surveys, and public opinion research surveys.

The Canada Dental Benefit provided direct payment to eligible applicants, to help cover the costs of oral health care for children under the age of 12. Over 431,000 children have benefited from the Canada Dental Benefit as of March 31, 2024. Approximately, 47% of children were aged between 7 and 11 years old, 36% were between 3 and 6 years old, and 17% were between 0 and 2 years old. The highest proportion (34%) of applications^{Footnote 3} were from families with Adjusted Family Net Income between $20,000 and $40,000. The Canada Dental Benefit data is published through the Canada Revenue Agency.

The Statistics Canada Canadian Oral Health Survey data was collected in 2023-24 and will be published in 2024-25. It included questions to support data disaggregation by sex, gender, education, insurance coverage, Indigenous identity, race, disability, and by region.

In August 2023, Health Canada published Public Opinion Research on the Canada Dental Benefit to evaluate the effectiveness and reach of marketing and advertising activities, and barriers to accessing the benefit and dental care. Data analysis included SGBA Plus considerations by gender, educational status, household income, language and region, racialized groups, Indigenous status, as well as by people with/without insurance.

In February 2024, Health Canada published data from Public Opinion Research on the Canada Dental Benefit and the upcoming Canadian Dental Care Plan. The objectives were to determine the level of awareness of the existing Canada Dental Benefit and the Canadian Dental Care Plan, to identify barriers in accessing these benefits and dental care in general, and, to identify opportunities to maximize uptake of the Canadian Dental Care Plan. Data analysis included expanded SGBA Plus considerations by gender, family composition, age groups, disability status, race, geographic region, educational status, household income, language, Indigenous status, as well as by people with/without insurance.

Other program activities intended to create awareness of the Canadian Dental Care Plan among key sub-population groups were also implemented in 2023-24. For example, various fact sheets were developed specifically for seniors, children, and persons with disabilities - to highlight how the Canadian Dental Care Plan can help them improve health outcomes - and were distributed with partners and stakeholders to be further disseminated among their members.

Results in 2023-24 also focused on mental health, promoting Minority Official Languages and addressing Anti-Indigenous Racism in Canada's health care. Some examples are cited below.

Health Canada worked with the Standards Council of Canada to engage third party organizations to develop resources for 6 priority areas in mental health and substance use. All products included SGBA Plus considerations and engagement with individuals from diverse communities such as 2SLGBTQI+ groups, racialized groups, Indigenous Peoples, and individuals who work in these communities. For example, Foundry BC led the development of a Guidance Document on Integrated Youth Services (IYS). The Guidance Document provides a roadmap for new and existing IYS organizations and networks to design, plan, deliver and expand IYS in their communities. Recommendations included in the document were co-developed with youth to define what it means to provide care that is gender-affirming, culturally sensitive, accessible, and trauma-informed.

The federal government continued to work with P/Ts, Indigenous communities, and stakeholders to help develop and expand IYS, which provide a "one-stop shop" of supports adapted to the unique needs of youth in the community. In 2023-24, a total of 92 IYS hubs were in operation and another 51 were in development. IYS has reached youth who often experience health inequities with 26-38% identifying as racialized, 8-14% as Indigenous, and 30-40% as 2SLGBTQI+.

Correspondingly, Wellness Together Canada, a bilingual online mental health and substance use resource portal, continued to deliver services during its final year of funding until April 3, 2024. In 2023-24, the Department continued to work with the consortium responsible for the Wellness Together Canada portal to ensure ongoing engagement with diverse stakeholders to identify how to make the portal more useful, particularly for persons with lived experience in mental health and substance use, and diverse populations. Data showed that people aged 19 to 29, an age demographic that is particularly affected by low self-rated mental health, accounted for over 30% of registered users, double their proportion of the Canadian population. Additionally, the portal offered free, immediate mental health supports and services to everyone in Canada, thus potentially benefiting groups that have higher barriers to accessing mental health and substance use care. These groups include persons living with disabilities, persons with existing mental health issues, Indigenous Peoples, racialized communities, newcomers, 2SLGBTQI+ communities and rural and remote populations. By providing free, low-barrier access to supports in both official languages, the portal may also have benefited people without insurance or means to pay for mental health support, as well as those residing in official language minority communities. On April 3, 2024, the Government transitioned away from Wellness Together and PocketWell, and Canadians can now access information on mental health resources, supports and services through the new Canada.ca/mental-health page.

Health Canada provided significant support to the Mental Health Commission of Canada (MHCC). In 2023-24, significant engagement with Indigenous communities led to mental health care products that were more culturally appropriate for the Indigenous population. For example, advisory committee members who self-identified as First Nations, Inuit, or Métis led to the incorporation of the Indigenous lens into the action plan of the Criminal Justice Initiative, a project that support people who interact with the criminal justice system. Deepened engagement with the Métis National Council (MNC) resulted in a partnership between the MHCC and the MNC to co-host a forum which explored cannabis use and mental health among Métis peoples, and the development of related reports for Health Canada's legislative review of the Cannabis Act. Dedicated policy briefs targeted on other specific populations, such as women, youth, First Nations, Inuit, immigrants, refugees, ethnocultural, racialized, 2SLGBTQI+ and gender-diverse populations were also produced in consultation with diverse stakeholders for the review of the Cannabis Act.

Focused engagement with Quebec and francophone communities led to the incorporation of a francophone lens into MHCC's work, including the launch of health care provider training modules for suicide prevention in both official languages, incorporation of francophone perspectives into workforce competencies for health care practitioners, a partnership with the Alliance des radios communautaires du Canada, which produced public service announcements for 15 radio stations on reducing mental health stigma during Mental Health Week, presentation of Roots of Hope, a community-led approach to suicide prevention and a life promotion model during the Réseau québécois sur le suicide, les troubles de l'humeur at les troubles associés 2024 Symposium in Montreal.

In 2023-24, the MHCC made significant improvements to its data collection to measure and report on accomplishments regarding SGBA Plus, including processes for reporting of results for First Nations, Inuit, Métis, immigrant, refugee, racialized, ethno-cultural, and 2SLGBTQI+ populations. They reported on SGBA Plus progress semi-annually.

In 2023-24, Health Canada provided funding to Healthcare Excellence Canada's initiatives to benefit seniors and people who were experiencing homelessness or were vulnerably housed. These included:

• Working on Re-Imagining Long-Term Care, which functions to build capacity for quality improvement as part of pandemic recovery, including supporting the implementation of projects in alignment with the new national Long-Term Care Services Standard.
• Improving Equity in Access to Palliative Care, which worked to help people experiencing homelessness or vulnerable housing receive appropriate care in a timely and safe way without discrimination, to reduce emergency department visits and hospital admissions, and to allow people to receive palliative care in the environment of their choice.

Another example is the Sexual and Reproductive Health Fund (SRHF), which seeks to support the sexual and reproductive health (SRH) of underserved populations across Canada. Funded projects must address one or more of these key underserved populations: Indigenous people; racialized people; migrants (new immigrants, temporary workers, refugees, international students, etc.); people with disabilities and/or complex health concerns; people experiencing homelessness and under-housed people; sex workers; 2SLGBTQI+ people; women; youth including their parents or caregivers.

The SRHF has improved support for pregnant women and pregnant people who face barriers in seeking travel and logistical support for abortion services. Projects are helping to reduce barriers to accessing abortion care, by providing the financial and logistical resources required to access culturally-safe, stigma-free abortion care across Canada. In addition, health care providers have received training and support to enhance access to abortion services.

Projects have produced evidence-based information resources/tools and education for health care providers to better provide SRH care to underserved populations. For example, to serve the targeted SRH needs of specific populations, such as youth and 2SLGBTQI+ people, people living with disabilities and/or complex health conditions as well as other underserved populations.

Finally, funding to Address Anti-Indigenous Racism in Canada's Health Care Systems supports actions to address anti-Indigenous racism through two funding streams: enhancing health system equity (Project Stream) and supporting capacity building (Engagement Stream). Funding supports organizations in developing culturally appropriate solutions and engaging communities, while providing tools to collect and report performance data on equity-seeking groups and project outcomes.

The following groups of recipients were eligible for funding under the Address Racism and Discrimination in Canada's Health Systems Program:

• Not-for-profit organizations and charities
• Indigenous recipients, including governments, communities, and organizations
• Academia and public institutions
• Municipal, P/Ts governments and their health systems service providers and associations

Key program impact statistics:

Each of the initiatives listed below collects their own key program impact statistics. As a result, there are no SGBA Plus key program impact statistics for the entire program. Key program impact statistics by initiative are therefore described below.

Supplementary information sources:

Statistics Canada Canadian Oral Health Survey

Statistics Canada Canadian Health Measures Survey

Public Opinion Research on the Canada Dental Benefit

Public Opinion Research on the Canada Dental Benefit and the Canadian Dental Care Plan

GBA Plus Data Collection Plan:

Each of the initiatives listed below carries out their own data collection. As a result, there is no GBA Plus data collection plan for the entire program. Data collection by initiative is therefore described below.

Oral Health

Notable actions taken in 2023-24 to continue to improve Canadian Dental Care Plan data collection tools and analysis are:

• 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 present a vision for future data collection to map and identify opportunities to fill oral health data gaps (this includes a SGBA lens).

Mental Health Standards

Through the CIHI-led process on shared health priorities, common indicators for mental health will be updated and released annually through Your Health System. CIHI data will be disaggregated by gender and/or age as appropriate. Over time, these indicators will tell a clearer story about access to mental health supports across the country, identify where there are gaps in services and help to make meaningful changes in order to improve the experiences of Canadian patients and their families. Health Canada will continue to require the MHCC to report semi-annually, focused on data disaggregation and impact reporting of their initiatives funded by Health Canada.

Healthcare Excellence Canada (HEC)

HEC has developed and implemented its performance measurement framework, aligned with its strategy, to cover its 2021-26 Contribution Agreement. It includes two metrics that will specifically be broken down by sex and gender, where data is available: leaders reached by HEC offerings, and leaders reporting increased preparedness (to lead health care improvement efforts) as a result of their engagement with HEC.

Promoting Minority Official Languages in the Health Care Systems

As part of the renewal of the OLHP (2023-28), the OLHP reviewed its performance measurement tools to expand the capacity to measure and assess the impacts of the program on gender and diversity throughout the 5-year cycle (2023-28). This review aimed to enhance the integration of sex, gender, and diversity considerations, improve the monitoring and analysis of progress made by recipients towards achieving targets and ensure adequate implementation of measures and policies that consider SGBA Plus. The revised tools will continue to be used by program recipients (the Société Santé en français, the Association des collèges et universités de la francophonie canadienne - Consortium national de formation en santé, the Community Health Social Services Network and McGill University) until the end of the 5 year funding phase to monitor and collect disaggregated data on sex and gender and report (annually or as required) on progress toward achieving expected results.

Thalidomide

The SGBA Plus data collection plan for the CTSSP currently captures data based on sex and gender, level of disability, language and P/T. The Programs' impact continues to be assessed and analyzed to better understand survivor needs as they age, using an Annual Outreach survey. This allows the CTSSP administrator to build on existing enhancements and improve communication strategies and processes.

Although the current collection plan will mainly remain as is to support consistency when analyzing the data, the Annual Survey is reviewed for relevance. For example, for 2023-24, some forward looking questions related to future needs of survivors were included. These will help identify where gaps exist and will allow the program to assess if and how these can be addressed.

Sexual and Reproductive Health Fund

The SRHF requests applicant organizations to demonstrate how they will apply SGBA Plus considerations to their proposed project. Applicants must describe how their project will consider and engage the populations they seek to reach, including diversities within those populations; and they must demonstrate that leadership from within the target population is part of the project's structure.

The SRHF collects data to enable it to monitor/report impacts by SGBA Plus. Specifically, each funded recipient has developed a Performance Measurement strategy to report outcomes/impacts from projects with data disaggregated for SGBA Plus. An additional request is for recipients to report whether interventions are felt to be culturally appropriate by the population(s) impacted (or communities served).

Program 3: Quality Health Science, Data and Evidence

Program goals: Health Canada fosters science and research excellence, coordinating pan-Canadian data generation in underdeveloped areas and supporting emerging health system issues. Through the Quality Health Science, Data and Evidence Program, it builds research capacity, collaborates with P/Ts, and stakeholders, and ensures data is accessible, advancing sustainable and modern health care systems.

Target population: All Canadians

A particular demographic group: The program is designed to provide benefits to all Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Quality Health Science, Data and Evidence Program and its transfer payment programs encompass a wide range of activities that address the diverse needs of various populations within Canada.

Key program impacts on gender and diversity:

Each of the initiatives listed below carries out their own key program impacts on gender and diversity. As a result, there is no GBA key program impacts on gender and diversity for the entire program. Key program impacts on gender and diversity by initiative is therefore described below.

The CIHI receives federal funding to provide comparable and actionable data and information that are used to accelerate improvements in health care, health system performance and population health across Canada.

For example, the CIHI integrates sex and gender considerations into data collection, research methodologies, frameworks, and reporting practices. CIHI is pivotal in Canada's health data ecosystem, gathering extensive data from stakeholders like provincial governments, hospitals, and practitioners. They promote standardized sex and gender identifiers and enhance data collection for SGBA Plus. CIHI establishes national data standards, advocates for equity stratifiers, and develops frameworks for Indigenous cultural safety. Their initiatives, including the Measuring Health Inequalities Toolkit and pan-Canadian standards for race-based data, aim to bolster health equity measurement. CIHI's ongoing efforts aim to improve data accessibility and ensure culturally safe practices in health systems. They are committed to refining their performance measurement strategy to better serve diverse community data needs.

In addition, the Blood Research and Development Initiative intersects with issues in gender and diversity. Sex, gender, and diversity are key considerations for CBS and the research it supports. These considerations are applied whenever a call for applications for any research and training programs is issued.

The Blood Research and Development Initiative supported two community-based research projects in the past year that aimed at addressing system barriers to donation within some South Asian communities as well as individuals of African descent. This work is ongoing and similar objectives are expected into the future, with an aim to ensure that patients from all communities receive the best possible treatment and care.

Officially launched on September 28, 2023, CBS implemented the Reconciliation Action Plan to serve as a roadmap and living document for how CBS intends to work and collaborate with Indigenous partners, donors, employees, and communities.

Moreover, the Canada Brain Research Fund Program enhances Canadian neuroscience by boosting research capabilities to tackle brain health disorders. Health Canada funds Brain Canada, which matches federal contribution through donations from private, public, and charitable partners, advancing prevention, diagnosis, and treatment efforts as identified by stakeholders.

Brain Canada research projects examine sex and gender differences and aims to enhance outcomes across diverse populations. Research awards applicants are required to describe how SGBA Plus considerations will be integrated in their proposed projects and to demonstrate the anticipated impacts of the work through an SGBA Plus lens.

Brain Canada continues to proactively support awardees from diverse backgrounds. In 2023-24, Brain Canada launched the 'Personnel Awards for Indigenous Scholars' competition. It also continued its 'Personnel Awards for Black Scholars' competition, increasing the number of highly qualified Black trainees across Canada working in the fields of heart and/or brain research.

Key program impact statistics:

Each of the initiatives listed below carries out their own key program impact statistics. As a result, there is no GBA key program impact statistics for the entire program. Key program impact statistics by initiative is therefore described below.

GBA Plus Data Collection Plan:

Each of the initiatives listed below carries out their own data collection. As a result, there is no GBA Plus data collection plan for the entire program. Data collection by initiative is therefore described below.

Canadian Institute for Health Information (CIHI)

Although CIHI has no direct authority over what data is collected, it establishes pan-Canadian standards for data submitted by P/Ts jurisdictions, actively promoting the use and adoption of standardized identifiers for sex, gender, and ethnicity within the data sources. This enables expanded data collection in support of SGBA Plus.

Finally, CIHI has developed, in close collaboration with Statistics Canada, a data standard for sex, gender, and sexual orientation, providing consistent data collection and reporting on SGBA Plus groups, which in turn can help inform decision-making to support health programs, delivery and health outcomes, etc. Standardized data for sex, gender, and sexual orientation at the point of collection, can help to ensure that there is good reporting on discrimination, stigma and/or other harm experienced in health services.

Canada Brain Research Fund Program

In 2023-24 the Canada Brain Research Fund Program worked with the Recipient to refine the Program's Performance Measurement Strategy. The Strategy includes a commitment from Brain Canada to provide supplementary documentation on the qualitative impacts of Brain Canada's research initiatives, including those that impact certain demographic groups. In 2023-24 this additional reporting highlighted research initiatives including: youth mental health & social media use, childhood brain cancer, and the potential links between diet and Amyotrophic lateral sclerosis (ALS). In addition, the Performance Measurement Strategy revisions included updated select terminology for demographic groups to align more closely with Canada's research inter-agency Dimensions initiative charter on Equity, Diversity, and Inclusion.

Also in 2023-24, the Recipient published its SGBA Plus and EDI Action Plan 2022-25. The plan identifies short-term activities to improve the quality and relevance of brain research in Canada by addressing sex and gender brain science and integrating SGBA Plus and equity, diversity, and inclusion considerations throughout all of Brain Canada's activities. The plan is organized by five key areas of focus: research practices, organizational capacity, leadership and governance, human resource practices, and data, reporting, and communications.

Core Responsibility 2: Health Protection and Promotion

Program 4: Pharmaceutical Drugs

Program Goals: The Pharmaceutical Drugs Program ensures that pharmaceutical drugs sold in Canada are safe, effective and of high quality through regulatory activities and the provision of relevant information to the Canadian population and health professionals.

Target Population: People in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

All Canadians (i.e., rather than specific sub-groups).

Key program impacts on gender and diversity:

In 2023-2024, the Department analyzed feedback from Canada Gazette, Part I publication of the Regulations Amending Certain Regulations Made Under the Food and Drugs Act (Agile Licensing) to prepare for Canada Gazette, Part II. Industry stakeholders support alignment of the disaggregated data requirements with those of the European Medicines Agency and the US Food and Drug Administration.

In June 2023, Health Canada delivered a keynote at the DIA Conference entitled Navigating the Constellation of Efforts to Increase Representation in Clinical Research and presented to DIA on Integrating Equity, Diversity, and Inclusion Across the Drug Product Lifecycle in October 2023.

Note that the Pharmaceutical Drugs program impacts also apply to the Biologic and Radiopharmaceutical Drugs program.

GBA Plus Data Collection Plan:

An SGBA Plus lens applied to pharmaceutical drugs can help in determining the differential impacts when assessing safety and effectiveness of these drugs. 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.

There is global support for improving demographic data collection within clinical trials; however, an international approach is needed. It will take time and energy to harmonize data requirements. Health Canada has a plan to support international harmonization through the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use. Similarly, on the device side, the Department is working with the International Medical Device Regulators Forum on data harmonization.

Additionally, the Department considers any relevant data that is made available through reporting requirements through the Canada Vigilance Program to support SGBA Plus assessments in the post-market environment.

Note that the data collection plan for the Pharmaceutical Drugs Program is the same for the Biologic and Radiopharmaceutical Drugs program.

Program 5: Biologic and Radiopharmaceutical Drugs

Program Goals: The Biologic and Radiopharmaceutical Drugs Program ensures that biologic and radiopharmaceutical drugs sold in Canada are safe, effective and of high quality through regulatory activities and the provision of relevant information to the Canadian population and health professionals.

Target Population: People in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

People in Canada (i.e. rather than specific sub-groups).

Key program impacts on gender and diversity:

The Scientific Advisory Committee on Health Products for Women met in November 2023 to discuss the Department's SGBA Plus Action Plan, the Disaggregated Data Strategy and global harmonization of clinical trial demographic data. Meetings were also held in September 2023 and March 2024 with industry stakeholders to discuss inclusive clinical trial design, best practices in recruiting diverse populations in clinical trial, and steps were taken toward the development of a global framework for demographic data collection.

Note that the Pharmaceutical Drugs program impacts also apply to the Biologic and Radiopharmaceutical Drugs program.

GBA Plus Data Collection Plan:

Note that the data collection plan for the Pharmaceutical Drugs Program is the same for the Biologic and Radiopharmaceutical Drugs program.

Program 6: Medical Devices

Program Goals: The Medical Devices Program ensures that medical devices sold in Canada meet applicable safety, effectiveness and quality requirements through regulatory activities and the provision of relevant information to the Canadian population and health professionals.

Target Population: People in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

People in Canada (i.e., rather than specific sub-groups).

Key program impacts on gender and diversity:

The draft machine learning-enabled medical device guidance for manufacturers was published for consultation in 2023. It includes recommendations to apply SGBA Plus analysis across the device lifecycle for medical devices that contain a machine-learning component and to consider diverse factors among user populations (e.g., age, sex, gender, ethnicity). Recommendations also include collecting and analyzing data as appropriate (e.g., disaggregated data on clinical studies subgroups).

Health Canada participated in developing international guiding principles to assist International Medical Device Regulators Forum (IMDRF) working groups in considering health equity principles, where relevant, when they develop IMDRF technical documents (published by IMDRF February 2024).

GBA Plus Data Collection Plan:

An SGBA Plus lens applied to medical devices can help in determining the differential impacts when assessing safety and effectiveness of these devices. 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.

Under the Medical Devices Regulations, Health Canada expects that clinical data referred to or used by manufacturers adequately represent the Canadian population and clinical practice. Any clinical data used by the manufacturer to demonstrate a device's safety and effectiveness should reflect the population for whom the device is intended.

In addition to applying the SGBA Plus lens to the post market risk assessment, a Guidance Document on Clinical Evidence Requirements for medical devices provides guidance on Health Canada's expectations for clinical data, such that clinical data used by manufacturers adequately represents Canada's diverse population and clinical practice.

Proposed Regulations Amending Certain Regulations Made Under the Food and Drugs Act (Agile Licensing) include new provisions that expand the scope of use of terms and conditions on medical device licences imposed at licensing and in the post market, which may also help enable disaggregated data collection.

Program 7: Natural Health Products

Program Goals: The Natural Health Products Program ensures that natural health products sold in Canada meet applicable safety, effectiveness and quality requirements through regulatory activities and the provision of relevant information to the Canadian population and health professionals.

Target Population: People in Canada

Distribution of benefits

Distribution	Group
By gender	Fourth group: 60 per cent - 79 per cent women
By income level	Fourth group: somewhat benefits high income individuals (Somewhat regressive)
By age group	Third group: primarily benefits seniors or the baby boomer generation

Specific demographic group outcomes:

People in Canada (i.e. rather than specific sub-groups).

Key program impacts on gender and diversity:

In 2023-24, the SGBA Plus toolbox acted as a resource to guide data collection on sex, gender, and diversity. The guiding principles in the toolkit were recently applied to the public opinion research survey conducted by the Department in December 2023 and is to be published in 2024. The objective of this research was to gather data on Canadian consumers' current level of knowledge, attitudes, awareness, and behaviours with respect to self-care products and to use the data to inform policy and regulatory approaches with respect to natural health products, non-prescription drugs and health products containing cannabis.

GBA Plus Data Collection Plan:

The SGBA Plus toolbox will be used to consider sex, gender, and other identity factors when collecting consumer data. This toolbox provides important resources on sex, gender and diversity concepts and definitions, key words to use in a literature search, data analysis tools, description of the methodology of sex and gender analysis, and references to publications that have used SGBA Plus.

Program 8: Food and Nutrition

Program Goals: The Food and Nutrition Program aims to change the state of the food and nutrition landscape in Canada by ensuring that the Canadian population is equipped to make safe and healthy eating choices, and that Canada maintains a world-class food safety system.

Target Population: People in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

People in Canada (i.e. rather than specific sub-groups).

Key program impacts on gender and diversity:

Health Canada continued to strengthen application of SGBA Plus, health literacy considerations, into social science and consumer behaviour research on the monitoring and evaluation of the January 2024 updates to nutrition labelling regulations and labelling approach for supplemented foods. The integration of health literacy considerations helped address the challenges faced by the increasingly diverse Canadian population in accessing and understanding labelling information when making food choices. The Department also conducted food toxicology research on flame retardant contaminants in food with a focus on refining the threshold levels that may pose risks to infants as well as to pregnant women and pregnant people.

GBA Plus Data Collection Plan:

Health Canada works with Statistics Canada on questionnaires that allow for collection of SGBA Plus data to provide information related to food and the Canadian population and future policy development related to healthy eating across diverse groups of the Canadian population. The Canadian Community Health Survey is a key tool for Health Canada to collect data.

As part of its Strategy to monitor food advertising to children in Canada, the Department works with experts to collect data on children's exposure to food advertising in a range of media and settings. Whenever possible, data is collected across diverse groups to assess whether some children are more exposed to food advertising than others.

Program 9: Air Quality

Program goals: The Air Quality Program supports actions to improve air quality and health for the people in Canada. Key activities include research on exposure to air pollution and its health impacts; assessments of health risks from air pollutants and sources; and quantification of health benefits from actions to improve air quality.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	First group: primarily benefits youth, children, and/or future generations Third group: primarily benefits seniors or the baby boom generation

Specific Demographic Group Outcomes:

While the program benefits all people in Canada by supporting actions to improve air quality and health, program activities have an SGBA Plus focus on protecting sub-populations who may be more susceptible and/or highly exposed to air pollution:

• Pregnant women and pregnant people
• Children and Youth
• Seniors
• Persons with disabilities or health issues or their caregivers
• Persons living in urban areas, near industrial facilities, or near wildfire zones
• Persons working in environments which may have poor air quality

Key program impacts on gender and diversity:

Health Canada's Air Quality Program benefits all people in Canada by supporting actions to improve air quality and health. Some individuals have a higher risk of health problems from exposure to air pollution (e.g., children, seniors and people with existing illnesses or chronic health conditions, such as those affecting the lungs and heart). Others may have higher risk from exposure because of where they live, their occupation, and other factors. Health Canada conducts science, research, and assessment work to better understand and address the health risks to these individuals.

For example, Health Canada calculates the health impacts of air quality beyond deaths (e.g., asthma symptom days) and by age, and also sets guidelines and conducts risk assessments. The Department communicates health risks to people in Canada, including outreach to sub-populations who may be more susceptible or highly exposed. This includes communicating the Air Quality Health Index (AQHI), which is designed to communicate health risk associated with the index reading (e.g. Low, Moderate, High, or Very High) with a particular emphasis on populations at a disproportionately higher level of risk such as seniors, children, and people with pre-existing illnesses. In addition, the Department undertakes outreach activities targeting Indigenous peoples and communities to better inform them of the health risks associated with air pollution which includes adapting Health Canada messaging and materials for Indigenous populations.

Human health science assessments for ambient air pollutants characterize SGBA Plus susceptibility and/or vulnerability to air pollution. In 2023-2024, Health Canada published Proposed Residential Indoor Air Quality Guidelines for Benzene to provide guideline values, below which health effects are unlikely to occur. The Guideline outlines health risks for humans from benzene exposure, and particularly notes children and pregnant women and pregnant people as sub-populations at greater risk of adverse health effects.

Health Canada conducts research on exposure to, and the health effects of, air pollution which considers sex, gender, and diversity throughout the research process, including the planning phase. These research studies frequently report on sex, socioeconomic, regional, or other differences in exposure to air pollution or the health effects of air pollution. For example, a Health Canada study identified that exposure to fine particles with a high oxidative potential and warm summer temperatures may be a significant factor contributing to acute cardio effects, particularly amongst older adults and women. Another study showed areas in Canadian cities with a higher prevalence of low income and Indigenous identity had higher mortality attributable to air pollution. This work is helping to understand populations who may be disproportionately impacted by air pollution.

Supplementary Information Sources:

Health Impacts of Air Pollution in Canada in 2018 report estimating mortality and morbidity outcomes and the associated monetary value was updated in March 2024.

Daily Summer Temperatures and Hospitalization for Acute Cardiovascular Events: Impact of Outdoor PM 2.5 Oxidative Potential on Observed Associations Across Canada - PubMed

GBA Plus Data Collection Plan:

Health Canada will continue to collect data on, study, and assess health effects attributable to air pollution, including sex- and gender-specific health endpoints and studying impacts on pregnant women and pregnant people and birth outcomes. Health Canada will also continue to collect data on, study, and assess who is reached by the AQHI and how the associated health messaging is used, particularly among sub-populations who may be more susceptible or highly exposed to air pollution. As part of the AQHI public opinion research planned for 2025-26, Health Canada will prioritize collecting data on AQHI usage among different populations as part of 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

Program goals: The Climate Change Program aims to increase climate change and health knowledge, capacity, and tools available to partners across Canada. It increases awareness of climate-related change health risks (e.g., extreme heat health risks), and ways to protect against and reduce heat risks among people in Canada.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Climate Change Program aims to build climate-resilient health systems that address the climate's disproportionate impact on marginalized and underserved populations, and prioritizing action to protect the communities and populations most vulnerable to the impacts of climate change.

Key program Impacts on Gender and Diversity:

SGBA Plus considerations are used to gain a more comprehensive understanding of climate change awareness and impacts among groups that may be disproportionately impacted to better target policy and awareness programs. In June 2023, the Government of Canada released its first National Adaptation Strategy, which establishes a shared vision for climate resilience in Canada and includes a focus on Health and Wellbeing. Equity and inclusion are at the center of the Strategy goals and guiding principles, underscoring the Strategy's support to promote environmental justice and address the factors that make people more vulnerable to climate change.

Supplementary Information Sources:

Public Opinion Research 2022

GBA Plus Data Collection Plan:

The Department conducts public opinion research (POR) to collect data on the level of awareness and the use of evidence-based measures to reduce the health impacts of climate change every five years. In the 2022 POR, "Public perceptions of the health impacts of climate change in Canada", women (43%, vs. 36% of men) were more likely to report that they have a member of their immediate household that they think would be especially vulnerable to the health impacts of climate change. Women were more likely to be able to identify at least 1 potential health impact of climate change (79%, vs. 71% of men), were more likely to have taken protective action (65%, vs. 53% of men), and were more likely to have sought medical attention for health-related impacts from climate change (10%, vs. 5% of men). This percentage was even higher for Indigenous people (18%, vs. 7% of non-Indigenous people).

The next public opinion research will be conducted in 2027. Health Canada 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

Program goals: The Water Quality Program helps manage potential health risks associated with water quality. The program works with other federal government departments and agencies, P/Ts to establish the Guidelines for Canadian Drinking Water Quality, which are used by all jurisdictions in Canada responsible for establishing drinking water quality requirements.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

Health Canada's Water Quality Program generally benefits all people in Canada by developing guidelines, including maximum acceptable concentrations or treatment goals, that are used by the federal government and P/Ts to set regulations and policies for drinking water quality in their respective jurisdictions.

Key program Impacts on Gender and Diversity:

When developing drinking water quality guidelines, the program considers and often bases maximum acceptable concentrations of contaminants on health endpoints related to SGBA Plus considerations of at-risk populations and sex, when available. These include most notably the impacts on pregnant women and pregnant people and birth outcomes, along with other potentially disproportionately impacted populations based on other considerations (e.g., age, geography).

When reviewing the existing scientific evidence available during the development of a guideline, Health Canada considers health endpoints related to sub-populations who may be disproportionately impacted by poor drinking water quality, such as infants, pregnant women, and pregnant people. Health Canada highlights any population differences in the guidelines.

GBA Plus Data Collection Plan:

Data collection is part of the development of the Canadian Drinking Water Quality Guidelines. Health Canada collects existing and emerging scientific evidence and analyzes SGBA Plus data, such as those related to sex, gender, age, and/or geography. Using all information gathered, Health Canada identifies critical health endpoints affecting human health from water contaminants, including the determination of whether certain sub-populations may have greater susceptibility to exposure or effects of exposure, to inform a protective concentration level.

Program 12: Health Impacts of Chemicals

Program goals: The Health Impacts of Chemicals Program helps protect people in Canada through assessing and managing health risks associated with environmental contaminants. Risk assessment and management processes apply SGBA Plus considerations where data exist. The effectiveness of risk management is assessed with a focus on sub-groups who may be disproportionately impacted.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific Demographic Group Outcomes:

• Pregnant women and pregnant people
• Children and Youth
• People living near industrial facilities

Key program Impacts on Gender and Diversity:

Health Canada assesses the extent to which its risk management activities have reduced the potential for exposure to harmful substances. When Health Canada identifies a particular risk to a sub-population (e.g., infants or pregnant women and pregnant people), risk management actions are put in place to address those risks, and the Department then examines the extent to which the potential exposure has been reduced for this identified sub-population. For example, Health Canada's risk management performance evaluation of Bisphenol A (BPA) found that the Government of Canada's risk management activities lead to a 96% decrease in exposure to BPA between 2008 and 2014 for infants who were bottle-fed formula. These studies are conducted once sufficient time has passed to reasonably expect to see the effects of risk management activities.

In the context of chemicals management, Health Canada recognizes that there are groups of individuals within the Canadian population who, due to greater susceptibility or greater exposure, may be at an increased risk of experiencing adverse health effects from exposure to substances. This greater susceptibility may be due to factors such as age, life stage and sex. Greater exposure may be experienced due to factors such as behaviour (for example infant mouthing), culture (for example diet or product use considerations) and geography (for example, living near industrial facilities).

Certain subpopulations are routinely considered throughout the assessment process, such as infants, children, and people of reproductive age. For instance, age-specific exposures are routinely estimated, and developmental and reproductive toxicity studies are evaluated for potential adverse health effects. In the updated draft assessment for the substances NMP and NEP, risk assessment outcomes were influenced by risk estimates in these subpopulations.

In addition, people living near points of release, whose exposure may be elevated from these sources, are considered. For example, the updated draft assessment for hydrogen sulfide (H2S), sodium sulfide (Na(SH)) and sodium sulfide (Na2S) took into account people who have asthma and who may be more susceptible to respiratory effects from exposure to hydrogen sulfide release from inactive oil and gas wells.

Health Canada considers sex and gender when researching and monitoring the health effects of exposure to chemicals in humans. This begins in the planning phase, where all proposals are required to consider SGBA Plus in their design. Study results frequently report on sex, socioeconomic, regional, or other differences in exposure to chemicals or the health effects of chemicals. Since 2007, nationally representative biomonitoring data have been collected through the Canadian Health Measures Survey (CHMS) to inform risk assessment and risk management actions. Ongoing analysis of disaggregated data is being carried out to identify potentially disproportionately impacted populations using existing national biomonitoring data from the CHMS. For example, in 2023-24 Health Canada released three biomonitoring fact sheets that provide general information about certain environmental chemicals and the levels of these chemicals measured in people. Levels are shown for the Canadian population as well as for specific sub-groups, such as First Nations Peoples and pregnant women and pregnant people, where information is available. In addition, the Canadian Biomonitoring Dashboard was launched on the Health Infobase platform. The dashboard is a resource that is publicly available and shows the levels of environmental chemicals for the total Canadian population, as well as by age group and by sex, as measured through the CHMS. This dashboard will continue to be updated as new data become available.

Supplementary Information Sources:

Consideration of vulnerable populations in risk assessment

GBA Plus Data Collection Plan:

Health Canada will continue to collect data on, study and assess health effects attributable to toxic substances, including sex- and gender-specific health endpoints with a significant focus on studying the impacts on pregnant women and pregnant people and birth outcomes. Health Canada has started to implement a work plan to advance progress on addressing the needs of sub-populations who may be more susceptible or highly exposed in the context of chemicals management and SGBA Plus. Activities include developing targeted guidance for risk assessors, exploring data needs and additional opportunities for acquisition of data in this area.

Program 13: Consumer Product Safety

Program goals: The Consumer Product Safety Program manages health and safety risks posed by consumer products and cosmetics in the Canadian marketplace. The program identifies, assesses, manages, and communicates these risks to people in Canada. SGBA Plus identifies disproportionate risks to sub-groups (e.g., infants or children) and works to reduce these risks.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific Demographic Group Outcomes:

• Children and Youth

Key program Impacts on Gender and Diversity:

Planned risk-based compliance verification projects completed by the Consumer Product Safety Program include products intended for, or that may pose a risk to children. In 2023-24 these included corded window coverings, second hand children's products, toys, cradles and bassinets, and children's sleepwear.

Other Key program Impacts:

Health Canada's consumer outreach often focuses on the safe use of products intended for children. For example, in 2023-24, Health Canada partnered with Canadian stakeholders for the Safe Sleep Week campaign. The design of consumer product outreach campaigns considers SGBA Plus populations when appropriate, including new immigrants, low-income families, families with young children, seniors, and Indigenous populations.

Supplementary Information Sources:

Creating a safe sleep environment for your baby: Decorate the room, not the crib

GBA Plus Data Collection Plan:

Health Canada's Consumer Product Safety Program is exploring how unconscious bias and systemic racism may have affected program decision-making and design through Project Deconstructing Unconscious Bias. The project focused on reviewing program areas (Triage and Surveillance, Risk Assessment, Risk Management, Compliance and Enforcement, and External Relations) to identify activities where unconscious bias may exist. As a result, several recommendations were made, including developing a program SGBA Plus integrated plan and toolkit, establishing guiding principles on inclusive language and imagery, creating more opportunities for diversity of thought and challenging biases, and consolidating communications and outreach efforts.

The Consumer Product Safety Program also completed an Anti-Racism in Science toxicology project as part of a deliverable within the scope of Project Deconstructing Unconscious Bias. This focused on identifying racial bias in skin pigmentation for the assessment of irritation in certain regulated cosmetic ingredients. The project resulted in 15 recommendations in four main areas: data reporting, skin irritation study participant inclusion and representation, industry guideline revision and recommendations, and industry and consumer communication and engagement. The program will continue its work in this area to follow up on detected data gaps and address identified issues.

Health Canada undertook a fact-based survey in 2023-24 to assess consumer behaviours and awareness related to consumer products and cosmetics regulated by Health Canada.

Information collected was disaggregated where possible by SGBA Plus factors including sex assigned at birth, age, and Indigenous status and will be used to inform program activities and policies.

In addition, Health Canada is planning a project to determine how to better use identity factor data found in the United States Consumer Product Safety Commission National Electronic Injury Surveillance System (NEISS) data set which includes age, sex, race, and geographic location. NEISS is a statistically valid injury surveillance and follow-back system designed to collect data on consumer product-related injuries occurring in the United States, which is used to produce nationwide estimates of product-related injuries.

Program 14: Workplace Hazardous Products

Program goals: The Workplace Hazardous Products Program supports and enforces suppliers' provision of critical health and safety information on hazardous chemicals to employers and workers. It supports the F/P/T Workplace Hazardous Materials Information System to make available the information workers need to be protected from workplace chemicals.

Target Population: People in Canada who work with hazardous products

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific Demographic Group Outcomes:

People in Canada who may be exposed to hazardous chemicals in their workplace

Key program Impacts on Gender and Diversity:

As part of the Globally Harmonized System of Classification and Labelling of Chemicals, workplace hazardous products in Canada display hazard and safety information on labels and safety data sheets that include potential acute and chronic effects (such as cancer) from short- and long-term exposures. This system also includes identification of chemicals that may cause adverse effects on sexual function and fertility in adult men and women as well as developmental toxicity in children, including via lactation. This allows workers to take measures to protect themselves when using these products by following the precautionary statements in the safety data sheets.

Informing workers on the safe use of workplace hazardous chemicals is intended to reduce the number of injuries or illnesses at work, which is also anticipated to have secondary impacts for the workers' families and communities.

SGBA Plus considerations are included for regulatory proposals and in the development of educational and compliance promotion activities.

Supplementary Information Sources:

Precarious or Non-Standard Employment and Vulnerable Workers

GBA Plus Data Collection Plan:

Health Canada is proposing to extend hazard communication requirements to consumer products used in workplaces. As part of this proposal Health Canada will conduct an impact analysis including SGBA Plus. Work on the proposal will continue in 2024-25.

Health Canada is continuing to explore 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 (Precarious or Non-Standard Employment and Vulnerable Workers). These workers are likely disproportionately employed in physically demanding or hazardous jobs, which puts them at higher risk for workplace injuries and illnesses. Work is underway to consider the impacts of 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 SGBA Plus considerations for workplace illness and injury among various demographic groups. This work will serve to inform compliance promotion and enforcement of accurate hazard communication to workers in at-risk sectors.

As part of a fact-based survey on consumer products carried out in 2023-24, Health Canada collected information on workplace incidents involving a consumer product. Responses were disaggregated by SGBA Plus factors which demonstrated that people who identified as male were more likely to have experienced such an incident in the last 12 months than people that identify as female. Information collected through the survey will inform the work being undertaken on extending hazard communications to consumer product chemicals used in the workplace.

Program 15: Tobacco Control

Program goals: Tobacco Control Program aims to reduce the prevalence of tobacco use in Canada through uptake prevention efforts and helping people who use tobacco to quit. The program also addresses the health risks of using vaping products and works to prevent their use among youth and Canadians who do not smoke.

Target population:

All Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

Overall, Tobacco program activities are aimed at all Canadians to decrease the death and disease caused by tobacco use. Tobacco use is not spread equally across the population. To address that, Health Canada implemented policies and interventions that are specifically targeting adults who smoke, youth and/or people who do not smoke. The long-term objective is to reduce tobacco use among all people in Canada.

Key program impacts on gender and diversity:

The Tobacco Control Program continues to incorporate SGBA Plus information in the development of policies, programs, and legislation. The program monitors smoking and vaping trends based on socio-demographic characteristics and considers targeted measures to address high prevalence rates amongst population groups as appropriate. For example, the program works to address concerns regarding youth vaping and aims to protect youth and non-users of tobacco products from nicotine addiction.

In 2023-24, Canada's Tobacco Strategy continued to support Health Canada's core responsibility of health protection and promotion by minimizing risks to the health of Canadians resulting from the use of tobacco and vaping products. The Department also continued to address the health risks and potential benefits associated with the use of vaping products and worked to prevent the use of vaping products among youth and Canadians who do not smoke.

Health Canada funded 5 projects through the Substance Use and Additions Program (SUAP) focused on prevention, protection, and/or cessation of use of tobacco and vaping products. Projects informed Canadians about harms and risk of tobacco and vaping products, including projects designing cessation interventions for people who smoke as well as youth who vape.

To improve SUAP's capacity for collecting and reporting on demographic data and to support funding recipients, SUAP undertook the following in 2023-24:

• Collected aggregate project-level data (e.g., diversity and ethnicity demographics) at the front-end of a project's life cycle (current and ongoing).
• Provided a demographic data collection guide to recipients which supports the collection of relevant SGBA Plus data. This guide included examples of quantitative and qualitative demographic data collection tools.
• Provided an information session for funding recipients on collecting performance measurement data, including requirements for demographic data collection.
• Launched an updated progress report template with a dedicated demographic data collection annex.

Supplementary information sources:

• Canadian Tobacco and Nicotine Survey (CTNS) 2022
• Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS) 2021/22
• Public Opinion Research (119-22) Examining barriers and enablers of smoking cessation among Canadian adults who smoke, with a focus on SGBA/equity

GBA Plus Data Collection Plan:

The Department's SGBA Plus data collection plans include collaborating with Statistics Canada to assess key aspects of tobacco use through population health surveys, such as the Canadian Community Health Survey and the Canadian Tobacco and Nicotine Survey.

In 2023-24, the program used the CCHS 2022 cycle as the data source for monitoring the primary indicator of prevalence of cigarette smoking and of tobacco use among people in Canada. The CCHS collects information related to health status, health care utilization and health determinants for the Canadian population, including age and socio-demographic characteristics. The CCHS uses the two-step sex and gender approach to separate the concepts of sex and gender, which allows for examination of diverse gender identities. Information on sexual orientation is also captured. A key strength of the CCHS is its examination of socio-demographic characteristics and identity factors including province, region (urban/rural), education, household income, industry group, country of birth, cultural background, racial identity, and Indigeneity.

The Canadian Tobacco and Nicotine Survey (CTNS) measures the prevalence of cigarette smoking, vaping, cannabis, and alcohol use among Canadians aged 15 years and older. The CTNS collects demographic information such as age and gender; in the 2022 cycle, the survey also collected information on education, sexual orientation, racialized and Indigenous identity. Understanding Canadian trends in tobacco, nicotine, cannabis, vaping, and alcohol use is vital to the effective development, implementation and evaluation of national and provincial strategies, policies, and programs. The 2022 cycle of CTNS marks the end of this surveillance tool, as the survey has been discontinued.

The program also collected and analyzed data among Canadian students using the CSTADS. The CSTADS 2021/22 cycle collected information on tobacco, alcohol, cannabis, and drug use. This cycle of the survey also included new questions on self-reported physical and mental health, as well as on bullying.

A Public Opinion Research project was conducted this fiscal year (POR 119-22), taking a deep dive into the barriers and enablers of smoking cessation among Canadian adults who smoke, and exploring whether attitudes and behaviors around smoking cessation differ by high and low prevalence groups.

The program changed its analysis plans, primary data sources and projects to collect and report on a variety of equity indicators. As noted above, a key strength of the CCHS is its examination of socio-demographic characteristics and identity factors including province, region (urban/rural), education, household income, industry group, country of birth, cultural background, racial identity, and Indigeneity. These disaggregated data are foundational information enabling initiatives to integrate SGBA Plus into their work. Such analyses have been applied to examine:

1. Cigarette smoking, among Canadians aged 15+ years, using data from CCHS 2021 and 2022
2. Vaping, stratified by smoking status, among Canadians aged 15+ years, using data from CCHS 2020.

Gender and other demographic data are collected through Performance and Progress Report templates submitted by recipients funded through the Health Canada SUAP on a bi-annual basis and data are aggregated/rolled-up by Health Canada. SUAP requests for indicator data to be disaggregated by demographics such as age, location, gender, and language, and priority populations such as Indigenous, 2SLGBTQI+ and racialized people/communities.

In the future, SUAP will be looking for approaches to improve demographic data collection, including through improved qualitative data collection. SUAP would like to increase the team's access to SGBA Plus training in areas such as reconciliation and Indigenous groups, 2SLGBTQI+, engagement with people with lived and living experience and harm reduction and stigma.

Program 16: Controlled Substances

Program goals: The Controlled Substances Program authorizes legitimate activities with controlled substances and precursor chemicals, while managing the risks of diversion and associated harms that could affect public health and safety. The program regulates manufacturing, medical, and scientific industries on the possession, production, provision and disposition of controlled substances and precursor chemicals.

Target population: All Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts on income
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Controlled Substances Program directly benefits all Canadians, as the primary target group. There are some program initiatives that address the needs of populations disproportionately impacted by substance related harms. Many factors have an influence over health and well-being, including income, access to safe and affordable housing, trauma and adverse childhood experiences, and race and racism. The program leads the implementation of the Canadian Drugs and Substances Strategy (CDSS), the Government of Canada's comprehensive framework to address the toxic drug and overdose crisis, centered on promoting public health and protecting public safety. The renewed CDSS builds on the previous strategy by continuing to take a public health approach to all substances and introduces a new key principle of equity to support targeted actions for most affected populations.

Key program impacts on gender and diversity:

In 2023-24, Health Canada continued to apply SGBA Plus when reviewing and developing policies and practices to consider equitable access to a continuum of substance use services and supports. These include harm reduction services, such as supervised consumption sites and urgent public health need sites, commonly known as overdose prevention sites. In 2023-24, Health Canada launched the renewed CDSS. The renewed CDSS introduced the principle of equity, alongside the principles of compassion, collaboration, and comprehensiveness to help guide federal actions to address the overdose crisis and the complex factors that contribute to substance-related harms, including links with mental health, housing, economic insecurity, and chronic pain, among others. This strategy puts into concrete terms our guiding principles; including ensuring culturally appropriate, equitable supports and services for all Canadians, informed by data and evidence. In alignment with the principle of equity, the evaluation of the CDSS was completed in August of 2023 using an SGBA Plus lens, acknowledging how issues of substance use have differential impacts for different population sub-groups. As well, in 2023 the CDSS Data and Evidence Framework was published. The Framework sets out clear processes to identify gaps, challenges, and opportunities to enhance existing federal data collection and analysis, and further promoting the use of data to establish linkages, identifies substance use trends, informs progress on federal policies and interventions.

Health Canada continued to collect, analyze, and disseminate SGBA Plus data, and where possible, indicator data is disaggregated by various demographics such as geographic location, language, sex, and gender, with consideration of target populations such as Indigenous, 2SLGBTQI+ and racialized peoples and communities. To address identified gaps in data collection, national surveys on substance use were enhanced to collect better SGBA Plus information including data on official languages and disability. Further, the sample size for the Canadian Alcohol and Drugs Survey (CADS) 2023 was increased to 36,000 to allow for more disaggregated reporting of results. The data was collected between May and December 2023 and the report will be released in June 2024.

In 2023-24, through the Substance Use and Addictions Program (SUAP), 242 projects addressed a variety of needs including improving access to harm reduction and treatment, naloxone training and distribution, identifying best practices for medication-assisted treatments, improving access to different types of treatment, identifying innovative models for opioid replacement therapy, improving the lives of people in chronic pain, and reducing harms for people who use alcohol.

To improve the SUAP's capacity for collecting and reporting on demographic data and to support funding recipients, SUAP undertook the following in 2023-24:

• Collected aggregate project-level data (e.g., diversity and ethnicity demographics) at the front-end of a project's life cycle (current and ongoing).
• Provided a demographic data collection guide to recipients which supports the collection of relevant SGBA Plus data. This guide included examples of quantitative and qualitative demographic data collection tools.
• Provided an information session for funding recipients on collecting performance measurement data, including requirements for demographic data collection.
• Launched an updated progress report template with a dedicated demographic data collection annex.

Other key program impacts:

Health Canada continued the digital advertising campaign, Ease the Burden, targeting men working in trades, to reduce the stigma of asking for help. The campaign surpassed all targets; digital ads were shown 209.5 million times, audio and video ads were completed 49.6 million times, and users clicked on ads 579.1 thousand times (September 2022 to March 2024). As well, the Know More Opioids Awareness Programover 185,000 teens and young adults on the facts surrounding opioids, ways to reduce risks, and the harms of stigma through high school and post-secondary awareness programs (April 2018 - March 2024).

Supplementary information sources:

• Canadian Drugs and Substances Strategy
• Canadian Community Health Survey
• Canadian Alcohol and Drugs Survey
• Canadian Student Tobacco, Alcohol and Drugs Survey
• Canadian Postsecondary Education Alcohol and Drug use Survey
• Ease the Burden
• Know More: Opioid public awareness
• Public Awareness of Alcohol-related Harms Survey

GBA Plus Data Collection Plan:

To support the government's tracking and monitoring of the overdose crisis and broader substance use trends in 2023-24, the program, in collaboration with federal partners, led the development of a new CDSS Data and Evidence Framework. This framework will guide the development of indicators, as well as the collection, analysis, and dissemination of timely and meaningful data and information on the use and impacts of drugs and substances in Canada. These actions will help ensure that equity and SGBA Plus are key considerations when developing or modifying data collection activities and analysis.

Gender and other demographic data are collected through Performance and Progress Report templates submitted by recipients funded through the Health Canada SUAP on a bi-annual basis and data are aggregated/rolled-up by Health Canada. SUAP requests for indicator data to be disaggregated by demographics such as age, location, gender, and language, and priority populations such as Indigenous, 2SLGBTQI+ and racialized people/communities.

In the future, SUAP will be looking for approaches to improve demographic data collection, including through improved qualitative data collection. SUAP would like to increase the team's access to SGBA Plus training in areas such as reconciliation and Indigenous groups, 2SLGBTQI+, engagement with people with lived and living experience, harm reduction and stigma.

Program 17: Cannabis

Program goals: The Cannabis Program supports the Government of Canada in the administration of the Cannabis Act and associated regulations, which strictly regulates activities with cannabis, including its production, sale, import/export, possession, and research.

Target population: The program is intended for all Canadians. More specifically, the program aims to protect the health of young persons by restricting their access to cannabis, while providing adults of legal age with access to regulated products.

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

More recent Public Opinion Research directly employed an SGBA Plus approach by targeting three subgroups who are at increased risk of harm from cannabis use: i) sexual and gender minorities ii) older adults (55+) iii) people engaged in daily/almost daily cannabis use. The objective of this work was to qualitatively explore perspectives and experiences surrounding cannabis use and legalization on various public health and safety indicators relevant to the Cannabis Program (e.g., social norms, motives for use, sourcing cannabis, cannabis impaired driving, and exposure to public education). In total, 61 focus groups were conducted and included 512 participants across all provinces and northern communities in the territories. Results can help inform various elements of public health strategy including ongoing and future data surveillance and monitoring, access to cannabis for medical purposes, and public education campaigns and initiatives on the risks of using cannabis and ways to reduce those risks.

Key program impacts on gender and diversity:

In 2023-24, Health Canada continued to promote and enable the collection and use of disaggregated data for intersectional analysis of cannabis survey data. The Department conducted the 2023 Canadian Cannabis Survey and released the results in December 2023. This survey collected data on age, P/T, sex assigned at birth, gender, sexual orientation, race, Indigenous identity, community size, education level, and household income. The data from this survey are used to help inform public education and awareness activities, regulatory policy decisions, and health risk assessments but has also been used to support the work of the Expert Panel conducting the Legislative Review of the Cannabis Act.

The Cannabis Program also conducted Public Opinion Research on the state of access to cannabis for medical purposes in Canada, via online surveys with patients aged 16+ and health care practitioners. The patient survey included questions about self-identified sex, gender, age, geography, education, health status, ethnicity, income, and sexual orientation. The health care practitioner survey included questions about gender, age, and geography. Where possible, sex- and gender-based analyses were considered. The report is used to inform future policy and regulatory work.

The Cannabis Program continues to develop and implement public education programs for youth, young adults and parents or guardians. These include educational programs such as Get the Facts, Pursue Your Passion, and All About Cannabis, as well as national campaigns such as the Cannabis Use and Mental Health Campaign and the Cannabis Poisonings in Children Campaign (more information on each is below). School-based programs were presented virtually. They were developed to allow for a diverse range of students across various demographics to access the information and resources provided, and to be included equally in the initiative, regardless of health determinants such as gender, race, ethnicity, socioeconomic status, etc. All programs and campaigns are based on emerging data and trends and aim to help people in Canada make informed decisions about their health.

Pursue Your Passion: In March 2023, this updated program for grades 7 to 8 students was launched in various schools in most provinces across Canada through interactive sessions with virtual ambassadors. This campaign encourages youth to pursue activities that can help them feel their best without the potential health and safety risks of cannabis use. Over 400 sessions have been completed since March 2023. In 2023, Pursue Your Passion content was also assessed for cultural appropriateness, and was translated into Cree and Ojibway and launched as a teacher-led version on the Health Canada Experiences web portal in March 2024.

Get the Facts: This new program was launched in February 2024 and educates youth (grades 4 to 6) on the risks of using alcohol, cannabis, tobacco, and vaping products. The goal of the campaign is to provide the foundational building blocks for youth to help delay the age of initiation (~141 years old) and influence lower risk behaviour later in life (making healthy choices). Over 50 sessions were completed in March 2024.

All About Cannabis: This new program was launched in early March 2024 and aims to educate youth (grades 9 to 12) on what cannabis is; its different properties and uses; the immediate and long-term effects of cannabis use on mental health and brain function; addiction and stigma; and provides youth with healthy habits to help cope with their mental health. Over 20 sessions were completed in March 2024.

Cannabis and Mental Health Campaign: Launched in Spring of 2024, this campaign aimed to educate young adults on the risks associated with cannabis use on their mental health, and to provide lower risk use tips to enable them to make informed decisions about their health. As part of the campaign, the cannabis and mental health webpage was updated to provide information on how cannabis use can affect mental health and brain function, particularly when it comes to daily or near daily use. In March 2024, the Department worked with four social media influencers to reach young adults to raise awareness about the impact of cannabis use on mental health and brain function. An SGBA Plus approach was taken when developing the campaign to ensure there was diversity when it came to both influencers and target audience, including Indigenous Peoples, people who identify as 2SLGBTQI+, and people residing in both rural and urban locations. In addition, a search engine marketing advertising campaign was also launched in March 2024 to complement the influencer campaign and generate visits to the updated cannabis and mental health webpage among people who were seeking out this type of information.

Cannabis Poisonings in Children Campaign: In Spring of 2023, a national campaign on accidental poisonings in children from edible cannabis was launched following reports of an increase in emergency department visits and calls to poison centers. The campaign primarily targeted parents and guardians of young children and aimed to raise awareness about this issue and the harms associated; informing them what a poisoning looks like and what to do; and educating them on preventative measures. This campaign included the development and distribution of a brochure, a national mail out, an educational video, new web content on cannabis poisonings and safe storage of cannabis, as well as articles for news outlets, magazines, blogs, and radio spots for radio shows and podcasts across Canada. Campaign products were disseminated in a number of ways:

• Reaching approximately 5 million households across Canada in areas with the highest saturation of children 14 years and younger, the direct mail campaign launched in Spring 2023;
• Made the 'How to Help Prevent Cannabis Poisoning in Children' brochure available in tourist and recreational locations throughout Ottawa and the GTA from April 2023-March 2024
• Developed a partnership with the Canadian Pediatric Society to mail out the brochure to approximately 4300 pediatricians and child health providers across Canada in June 2023;
• Distributed the brochure to a network of 2,200 childcare centres, daycares, Montessori schools and YMCA locations across Canada (excluding Quebec) in January 2024; and,
• Delivered a direct mail package consisting of copies of the brochure and a newly developed poster was sent to approximately 12,000 health care professionals including hospitals and pharmacies across Canada (excluding Quebec), in March 2024.

Health Canada continued work to implement strategies aimed at enabling a diverse and competitive cannabis industry comprised of small and large businesses, and increase the participation of Indigenous, Black, and other racialized communities. The Department created new webpages and revised current webpages to be more accessible and provide clearer guidance to industry:

• Launched a new webpage that provides ongoing cannabis program updates;
• Updated the Cannabis Tracking and Licensing System to include responses to frequently asked questions from micro-class licence holders;
• Gathered demographic data to better understand the diversity of the cannabis industry;
• Leveraged social media campaigns to help disseminate information to a more diverse audience;
• Enhanced communication between Health Canada and its stakeholders through its Virtual Learning Series; and
• Gathered feedback from industry through the use of surveys to support program improvements and to inform the streamlining of processes.

Health Canada also continued to offer a dedicated Indigenous Navigator Service, whose purpose is to help and support Indigenous-affiliated applicants throughout the federal commercial cannabis licensing process and encourage their participation in the industry. The Department issued an additional 10 licences for cultivating or processing cannabis to Indigenous-owned or affiliated applicants located across Canada, for a total of 51 licensed Indigenous businesses in 2023-24. It also awarded an additional 3 licences to Indigenous-owned or affiliated applicants to cultivate or process industrial hemp, for a total of 22 active licences at the end of 2023-24. Health Canada also has a Licensing Advisor Service to assist prospective Indigenous-affiliated applicants who have the support of their local Indigenous government prior to submitting their application.

In 2023-24, Health Canada funded 7 projects through the Substance Use and Addictions Program (SUAP) aimed at providing public education to people in Canada on cannabis and its health effects. These focused on reaching youth and young adults, Indigenous populations, health professionals and educators, service providers, and other disproportionately affected groups. Projects focused on public education, awareness, and community engagement across Canada, as well as targeting rural and remote areas.

To improve SUAP's capacity for collecting and reporting on demographic data and to support funding recipients, SUAP undertook the following in 2023-24:

• Collected aggregate project-level data (e.g., diversity and ethnicity demographics) at the front-end of a project's life cycle (current and ongoing).
• Provided a demographic data collection guide to recipients which supports the collection of relevant SGBA Plus data. This guide included examples of quantitative and qualitative demographic data collection tools.
• Provided an information session for funding recipients on collecting performance measurement data, including requirements for demographic data collection.
• Launched an updated progress report template with a dedicated demographic data collection annex.

Supplementary information sources:

Sex, Gender and Cannabis Report

Cannabis use among older adults in Canada: exploring perspectives and experiences following cannabis legalization

2023 Canadian Cannabis Survey (CCS)

2019 Canadian Alcohol and Drugs Survey (CADS)

Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS)

GBA Plus Data Collection Plan:

The Cannabis Program applies 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. The program's SGBA Plus data collection plans include the assessment of key aspects of cannabis use through population health surveys, such as the Canadian Cannabis Survey (CCS), Canadian Alcohol and Drugs Survey, and the Canadian Student Alcohol and Drugs Survey.

The CCS gathers detailed information about the knowledge, attitudes, and behaviours (i.e., including high-risk behaviours such as cannabis use and driving, frequent cannabis use, etc.), product preferences and purchasing habits and sources of cannabis amongst Canadians aged 16 and over who use cannabis, including cannabis for medical purposes. Health Canada applies an SGBA Plus lens to the analysis of cannabis survey data by including questions on sex, gender, age, and other variables.

The Canadian Alcohol and Drugs Survey (CADS) is a biennial general population survey of cannabis, alcohol and drug use among Canadians aged 15 years and older. Indicator data are disaggregated by sex, gender, Indigenous status, and age group, where possible. Note that due to data quality/sample size, Health Canada may not be able to report on some SGBA disaggregated data.

The Canadian Student Alcohol and Drugs Survey (CSADS) is a biennial national survey conducted with students in grades 7-12 (Secondary I – Secondary V in Quebec). The survey captures information related to the use of cannabis, as well as the use of alcohol and other drugs among students and other areas identified by schools as priorities. Indicator data are disaggregated by sex, gender and grouped grade, where possible.

Preferred official language data are collected in the Cannabis Tracking and Licensing System, a web-based application established and maintained by Health Canada. Applicants use this system to apply for a cannabis licence or permits and submit monthly inventory reports.

Gender and other demographic data are collected through Performance and Progress Report templates submitted by recipients funded through the Health Canada SUAP on a bi-annual basis. Data are aggregated/rolled-up by Health Canada. SUAP requests that indicator data be disaggregated by demographics (e.g., age, location, gender, and language) and priority populations (e.g., Indigenous, 2SLGBTQI+ and racialized people/communities).

In the future, SUAP will be looking for approaches to improve demographic data collection, including through improved qualitative data collection. SUAP would like to increase the team's access to SGBA Plus training in areas such as reconciliation and Indigenous groups, 2SLGBTQI+, engagement with people with lived and living experience and harm reduction and stigma.

Program 18: Radiation Protection

Program goals: The Radiation Protection Program helps protect the health and safety of people in Canada by providing information and advice about radiation health risks and risk management strategies. The program regulates the safety of radiation emitting devices and uses and applies SGBA Plus considerations in research and other program activities.

Target Population: All people in Canada

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific Demographic Group Outcomes:

• Women
• Men
• Seniors
• Children and Youth
• Individuals of particular socio-economic status (includes education level and employment status)

Key program Impacts on Gender and Diversity:

Health Canada conducted the Canadian Perspectives on Environmental Noise Survey (CPENS) in 2021 (published in 2023-24), which was an online survey that included 6,647 randomly selected Canadians, age 18 years and older, between April and May 2021. The survey investigated expectations and attitudes toward environmental noise in rural and non-rural Canada. The survey considered multiple demographic variables, including age, gender (male, female, other), sex assigned at birth, geographic area, Indigenous status, household income, education level and history of residency. Overall, about 1 in 3 Canadians reported that their environment is getting louder during the day, with about 1 in 5 indicating this to be the case during nighttime. In the fully adjusted multivariate logistic regression model, the effect of age, gender, changes in nighttime noise, road traffic noise annoyance, noise sensitivity and sleep disorder remained statistically significant. Environmental noise results were worse in suburban/urban geographic regions when compared to those responding from rural/remote geographic regions. There were no reportable differences between Indigenous and non-Indigenous Canadians.

Supplementary Information Sources:

Canadian Perspectives on Environmental Noise Survey (CPENS)

GBA Plus Data Collection Plan:

Health Canada conducted a longitudinal study in 2022 to examine personal listening device usage, leisure noise exposure and hearing outcomes. Study findings will be published in 2024-25 and will report on sex and age.

Health Canada is planning a follow up survey of ophthalmologists and optometrists regarding injuries resulting from handheld laser devices. This survey will be launched in September 2024 and will report prevalence of laser eye injuries by sex and age.

Program 19: Pesticides

Program goals: The Pesticides Program protects the health and safety of people and the environment in Canada relating to pesticide use. Some SGBA Plus metrics are considered during scientific risk assessment and public opinion research activities for potential impacts on various key populations and to inform future operations if unique findings are observed.

Target population: All Canadians

Distribution of benefits

Distribution	Group
By gender	Third group: broadly gender-balanced
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

The Pesticides Program is designed to provide benefits to "All Canadians".

Key program impacts on gender and diversity:

When a pesticide is being evaluated for its potential risks to human health, the requires Health Canada to consider greater risks that chemicals may pose to groups based on differences in biology and behaviour (e.g., differences due to sex, gender, age, and occupation). If the health and environmental risks of a pesticide cannot be mitigated, the product will not be registered for use in Canada. Consideration of priority groups, including sex, gender, age, and occupation factors are a requirement of the Pest Control Products Act. The Considerations of Sex and Gender in Pesticide Risk Assessments Infographic outlines 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.

In addition to the above, Health Canada conducts a Public Opinion Research (POR) Survey every four years to measure the impact of outreach and awareness activities on the public. In total, 2,206 respondents completed the survey in 2023, and weighting was applied to the sample to ensure that the final data reflects the adult population of Canada by region, age, and gender according to the Census. SGBA Plus metrics provide insight into variances between these groups regarding outreach and awareness activities and informs future program strategies.

Health Canada will continue to evaluate inclusion of other SGBA Plus factors with emphasis on intersectionality, where appropriate.

Supplementary information sources:

Pests and Pesticides Management Reports and Publications

GBA Plus Data Collection Plan:

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 to SGBA Plus factors such as sex, gender, and age. Health Canada will continue to evaluate feasibility and requirements regarding additional SGBA Plus data metrics with emphasis on intersectionality, where appropriate.

Program 20: Health Canada Specialized Services

Program goals

Health Canada Specialized Services offers three key services: crisis and short-term counselling referrals for public servants through the Employee Assistance Program, workplace health and safety support via the Public Service Occupational Health Program, and health protection for visiting dignitaries through the Internationally Protected Persons Program during official events in Canada.

Target population: Individual eligible federal employees, veterans (and immediate family members as applicable), and Internationally protected persons

Distribution of benefits

Distribution	Group
By gender	Fourth group: 60 per cent - 79 per cent women
By income level	Third group: no significant distributional impacts
By age group	Second group: no significant intergenerational impacts or impacts on generations between youths and seniors

Specific demographic group outcomes:

In 2023-24, the Employee Assistance Program (EAP) continued its ongoing efforts to benefit groups underutilizing EAP (such as men, youth and 2SLGBTQI+ communities) through leveraging technology (e.g. promoting live Chat and digital wellness resources), delivering training, and improving its capacity to match clients requesting a counsellor with a specific identity, lived experience or other relevant expertise.

In 2023-24, Employee Assistance Services began work on a three-year project on Black-centric enhancement to the EAP. As part of its work under the Black-centric enhancements project, EAP increased its recruitment of Black counsellors to ensure its capacity to meet the needs of Black Public Servants and their families.

The Public Service Occupational Health Program (PSOHP) provides occupational health services to federal departments in the core public administration. Individuals accessing PSOHP services are identified by their employing departments as part of their internal HR processes. PSOHP services are built on evidence-based occupational health guidelines, which include SGBA Plus considerations and are developed in collaboration with client departments.

The Internationally Protected Persons (IPP) Program coordinates the development of contingency health plans for visiting IPPs to Canada. In 2023-24, the IPP Program processed 114 health plans for 44 visits to Canada by 72 IPPs.

Key program impacts on gender and diversity:

In 2023-24, the EAP initiated several projects to enhance service for equity-deserving groups, including Black clients, under the Black-centric EAP enhancements project. These initiatives included improving client-counsellor matching with a searchable database, boosting self-identification survey completion among contracted counsellors, and starting foundational training programs for staff.

PSOHP provides occupational health services considering relevant SGBA Plus factors to ensure equitable, evidence-based recommendations to help client departments protect the occupational health of their employees. PSOHP clinicians, as licensed Canadian health professionals, participate in continuing education and SGBA Plus training to maintain clinical competencies and stay updated on cultural competency and emerging issues.

GBA Plus Data Collection Plan:

Each of the initiatives listed below carries out their own data collection. As a result, there is no GBA Plus data collection plan for the entire program. Data collection by initiative is therefore described below.

Employee Assistance Program

The EAP utilization is disaggregated by sex, gender, age, geography, language, sexual orientation, and employment equity groups (women, Indigenous peoples, persons with disabilities and racialized minorities) and various employment categories (e.g. manager, operational, administrative, scientific). EAP also incorporates a SGBA Plus lens in a telephonic client survey where data is disaggregated by gender, age, region, language, sexual orientation, and employment equity. A sample of over 950 clients who had used EAP services were surveyed. To help collect more disaggregated feedback data to inform future improvements, EAP anticipates migrating its ongoing surveys (other than the annual telephonic survey), with expanded demographic categories, to a Protected B-compliant tool enabling clients and counsellors to respond to surveys online. EAP anticipates that this tool will be implemented during 2024-25.

Public Service Occupational Health Program

By March 2023, the PSOHP new National Occupational Health Information System (NOHIS) was implemented in all regions. NOHIS enabled the collection of disaggregated data, and currently permits analysis based on factors including client employee work location, employer, position, age, and official language. Efforts are ongoing to enhance NOHIS data collection and PSOHP anticipates that NOHIS will be able to collect voluntary information related to sex and/or gender by March 2027. PSOHP is committed to extending the range of data points collected by NOHIS, as appropriate within PSOHP's role in occupational health, to enhance SGBA Plus monitoring and reporting on data related to gender and diversity as it relates to its mandated services.

Internationally Protected Persons Program

The IPP Program supported the Government of Canada's international obligations under customary International Law by ensuring the health protection of IPPs visiting Canada. IPPs are Heads of State, Heads of Government, foreign dignitaries, and their families visiting Canada for official government purposes or for personal reasons. Official visits by IPPs were at the request of government officials, such as the Prime Minister or Minister of Foreign Affairs. The IPP Program's partners in Global Affairs Canada, Heritage Canada, the RCMP and the Department of National Defence served as hosts for IPP visits and led all planning activities. Due to the contingent nature of health plans, the limited number of times they were activated and the confidential nature of medical information, there was insufficient data to measure SGBA Plus outcomes. For these reasons, the IPP Program did not collect SGBA Plus data in 2023-24 but will continue to explore ways to incorporate SGBA Plus data collection into its program activities.