Generating Knowledge to Inform Public Health System Transformation

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Organization: Public Health Agency of Canada

Date published: 2022-01-18

Chief Public Health Officer's Report on the State of Public Health in Canada 2021

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The 2021 annual report of Canada’s Chief Public Health Officer (CPHO) provides a forward-looking vision to transform Canada’s public health system.  

One way to kickstart transformation is by generating the knowledge needed to inform and advance key areas of action. This knowledge may come from new research or be synthesized or mobilized from existing knowledge sources. It could also include exploring ideas from other sectors or disciplines that could be adapted or scaled for the public health context.   

This document outlines high-level research priorities to support advancement of Dr. Theresa Tam’s vision for the future of public health in Canada. The priorities are based on key themes that emerged from the development of her annual report, A Vision to Transform Canada’s Public Health System. The report was informed by a wide range of evidence sources including peer reviewed and grey literature, community expertise and traditional ways of knowing, as well as consultations with public health leaders, practitioners, researchers, and policy-makers. While not exhaustive, and not representative of a full research agenda, these priorities can guide researchers, funding agencies, community members, governments or other institutions in developing future research or knowledge-generation initiatives.

Advancing knowledge for public health transformation will require diverse approaches. There is a need to advance research that has a clear path to practice, that can be applied in real world settings, and that considers the rapidly changing and complex landscape of health in Canada.

The promotion and protection of health and well-being among First Nations, Inuit, and Métis Peoples is an essential component of a strong and transformed public health system. In support of this, Dr. Tam commissioned the development of an independent companion report led by Indigenous public health experts, Dr. Margo Greenwood and Dr. Evan Adams, entitled Visioning the Future: First Nations, Inuit, and Métis Population and Public Health (PDF).

The current document includes Indigenous public health research priorities identified by Dr. Greenwood and Dr. Adams. These priorities can provide guidance for research proposals on First Nations, Inuit, and Métis Peoples public health. In addition, considerations towards the roles of self-determination, reconciliation, engagement, and cultural safety are included throughout all priority areas of research for system transformation.

Cross-cutting principles

The CPHO report articulates a set of principles to guide public health transformation that can also be applied to supporting research and knowledge generation initiatives.

Population health approach

Population health is a shared goal and responsibility among many sectors, organizations, and actors. Inquiries should aim to take multidisciplinary approaches and engage cross-sectorally.

Equity driven

Long-standing inequities have an impact on populations’ health. Inquiries should consider equity in design and implementation and aim to reduce inequities. Particular attention is needed to ensure that research and knowledge is collected in a culturally safe way.


A public health system that is credible and trusted translates into better health outcomes. New knowledge should consider approaches to build trust, including ensuring open access to information, clear communication, equitable partnerships, accountability and transparency.

Evidence informed and effective

Effectiveness refers to policies and programs achieving their potential impact under real world conditions, while also promoting equitable outcomes. Solution-focused inquiries should incorporate efforts to monitor and evaluate outcomes across settings. 


Inquiries related to improving population health and well-being should be informed by those with lived experience. This means working in collaboration with community partners and promoting community self-determination through authentic engagement and co-production.

Research priority areas for public health system transformation

The following is a list of potential research areas that would support advancement of the CPHO’s vision for public health system transformation, aligned to the 6 building blocks of Canada’s public health system. The building blocks represent how public health systems are organized in Canada and are used as a frame throughout the CPHO 2021 annual report.

Impactful and lasting public health policies and programs

Connected, responsive, and equitable knowledge and information systems

State-of-the-art medical and digital health technology

A strong and supported public health workforce

Sufficient and stable financing across public health systems

Effective governance across jurisdictions and sectors

Indigenous public health research priorities

In addition to the above priorities on public health system transformation, the following research priorities build on issues identified by Indigenous public health experts to support catalyzing action on the commissioned report on Indigenous public health.

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