Discoveries for life

The faces of health research 2025

Title

Advancing Equity, Access and Capacity in Canada’s Primary Health Care Systems

Agnes Grudniewicz, Associate Professor, University of Ottawa

Lindsay Hedden, Assistant Professor, Simon Fraser University

Ruth Lavergne, Associate Professor, Dalhousie University

Dr. Lindsay Hedden, Dr. Agnes Grudniewicz, and Dr. Ruth Lavergne join forces to address a critical issue: Canada’s primary health care system is overwhelmed with increasing demand and workforce strain, leaving many without timely and equitable access to quality care.

With support from the CIHR Institute of Health Services and Policy Research (IHSPR’s) Catalyst Grants and CIHR’s Project Grants, Dr. Hedden, Dr. Grudniewicz, and Dr. Lavergne in collaboration with a large team of researchers and system leaders across Canada, offer a comprehensive, data-driven exploration of Canada’s primary care system, focusing on equity, workforce capacity, practice management, payment reform, virtual care and the rise of privatization.

Dr. Hedden, Dr. Grudniewicz, and Dr. Lavergne’s research leverages cross-Canadian collaboration through their national Health Systems Research Lab and engages with varied groups including family physicians, nurse practitioners, health care policy makers and patients, across multiple provinces and territories.

A broad network of partners including provincial governments, regional health authorities and clinician associations strengthens the relevance and impact across the Canadian health care landscape. For example, cross-provincial findings emphasize that policy reforms must explicitly prioritize equity and demonstrate the urgent need for stronger oversight to prevent the negative consequences of privatization in Canada’s health care system. The research addresses social and economic disparities and tackles timely and significant issues — whether it is alignment of primary care capacity with demographic trends, changing access patterns, physician payment reforms, new models of care or the expansion of private health care — ensuring the findings are highly relevant to policy and decision makers.

“Primary care impacts everyone, yet those with the greatest needs often face the most barriers. While strong primary care is essential to a high-performing health system, we still have work to do to ensure it serves all patients, communities, and providers equitably. Our CIHR-funded research is helping fill critical gaps—particularly in understanding how primary care is managed and how its organization, delivery, and workforce can better meet diverse needs.”

Dr. Lavergne, Dr. Hedden & Dr. Grudniewicz

To learn more about their work, see articles on Disparities in access to primary care in Canada and understanding how private financing and for-profit delivery operate within Canadian healthcare and the Health System Research lab webpage, a research lab they share with colleagues across provinces.

Their work is also supported by Michael Smith Health Research British Columbia and Research Nova Scotia, and Dr. Lavergne holds a Tier II Canada Research Chair in Primary Care.

Helping Babies Breathe: Pulmonary Surfactant for Premature Infants with Respiratory Distress

Dr. Fred Possmayer (right) with a former trainee, Dr. Ruud Veldhuizen (left), Associate Professor, Physiology and Pharmacology, UWO. Dr. Possmayer’s research on pulmonary surfactant was continuously funded by MRC/CIHR from 1972 to 2006.

As a result of his laboratory’s development of BLES, Dr. Possmayer was awarded the Order of Ontario in 2023.

Fred Possmayer, PhD
Professor Emeritus
Western University

When I began my MRC/CIHR-supported research on pulmonary surfactant in 1972, the major cause of newborn mortality was premature babies dying of the Respiratory Distress Syndrome (RDS). This condition made breathing difficult because their lungs didn’t have sufficient surfactant—a substance that helps keep the lung’s terminal air sacs, the alveoli, open.

In collaborations with Dr. Goran Enhorning, University of Toronto, a clinical formulation, Bovine Lipid Extract Surfactant (BLES), was developed for treatment. BLES administration buys premature infants sufficient time to produce their own surfactant. Today, BLES is used across Canada and in more than 20 other countries.

Further investigations in my laboratory led to other insights into surfactant function. For example, we discovered two small hydrophobic proteins, SP-B and SP-C, present in natural surfactant, that are essential for surfactant function. Studying these two proteins helped us discover a number of mechanisms related to surfactant action, both in the laboratory and in the body.

Thanks to treatment with clinical surfactants, such as BLES, and other improvements in paediatric care, the number of babies dying from RDS in Canada and the USA has fallen dramatically, from over 10,000 deaths per year to less than 200.

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Optimizing Independence, Mobility, and an Active Life for Older Adults

Hans Schulte, taking part in exercises developed for the OPTIMAL Fitness Study to improve strength, energy, and mobility.

Dr. Alexandra Papaioannou
Professor & Executive Director
McMaster University & Hamilton Health Sciences

Our CIHR-funded OPTIMAL Fitness study has helped older Canadians to regain strength, confidence, and independence. We have developed a program that combines supervised exercise, nutrition, and medication review to help individuals enhance their balance and energy levels. Our community-based program, developed at the Geras Centre for Aging Research, Hamilton Health Sciences and McMaster University, addresses frailty and sarcopenia in adults aged 65 and older.

We randomly assigned participants to one of three groups over four months: a control group that received only vitamin D, a second group that participated in tailored exercise classes and home workouts, and a third group that received exercise, protein supplements, and a pharmacist-led medication review. With over 300 individuals engaged through YMCA sites, our research shows that frailty can be improved and that aging at home is both achievable and sustainable. One participant from group three shared that they felt “more light, more energetic,” while another remarked that they were “much more willing to test myself to go to my limits — generally more hopeful.”

These outcomes highlight the power of tailored interventions for older adults to restore energy, resilience, and well-being.

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A new medication to treat "black fever" parasitic disease

Dr. Kishor M. Wasan
Co-founder of the Neglected Global Diseases Initiative and retired adjunct professor at the University of British Columbia

Fungal and parasitic infections affect millions of people around the world. One example is visceral leishmaniasis, a parasitic disease caused by insect bites that is almost always fatal if untreated. Also called kala-azar, which means "black fever", the disease sometimes causes the skin to darken alongside other symptoms including fever and enlargement of the spleen and liver.

Though treatments do exist, tens of thousands of people die annually due to visceral leishmaniasis, primarily in Brazil, East Africa, and India, due to the high cost of treatments and limited availability. Injection is the only mode of treatment currently available, and it comes with serious side effects.

Since 2007, with CIHR funding, our team at the Neglected Global Diseases Initiative at the University of British Columbia has been working on a groundbreaking solution: an oral medication with no serious side effects, invented by Drs. Kishor and Ellen Wasan. It's safe, cost-effective, stable in tropical climates, and has successfully undergone Phase 1 clinical trials. Now, we’re partnering with industry to get this medication into the hands of those who need it.

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Powering and muscling a healthier Canada, one bone and one muscle at a time

Dr. Jérôme Frenette
Full professor, Department of Rehabilitation, Faculty of Medicine, Université Laval

With CIHR support, our team was the first to uncover a novel role for RANK/RANKL/OPG pathway, a key regulator of bone metabolism, in skeletal muscle dysfunction and cardiac hypertrophy. We showed that a 10-day treatment with osteoprotegerin (OPG) nearly reversed muscular dystrophy in fast-twitch muscles, while a two-month regimen anti-RANKL prevented cardiac hypertrophy in aging dystrophic mice. This groundbreaking discovery revealed a critical bone-muscle connection biology, sparking a wave of international research. Notably, S. Ferrari (Switzerland, 2019) reported that denosumab (anti-RANKL antibody) improved grip strength in post-menopausal and osteoporotic women and A. Bonetto (USA, 2021) found that RANKL blockade reduced cancer-induced cachexia and bone loss in mice. Through preclinical and translational research, our lab has identified promising therapeutic strategies to prevent bone, skeletal and cardiac muscle dysfunction. These findings hold potential to prolong physical independence and reduce frailty and fall risk in aging populations and individuals with muscle-wasting diseases.

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Empowering youth: Transforming substance use health education to support youth well-being

Dr. Lisa Bishop
Professor, School of Pharmacy, Memorial University of Newfoundland

Canada is experiencing an unprecedented number of substance-related overdoses and deaths, especially among youth. Youth identified a lack of education to help inform their substance-related decisions. More effective educational, prevention, and harm reduction approaches are needed to better meet the needs of youth and protect their health and wellness.

An interdisciplinary team focused on this problem is led by Drs. Lisa Bishop and Jennifer Donnan, and includes youth, people with lived and living experience, healthcare professionals, educators, and policy makers. Together, they have developed the DECYDE (Drug Education Centred on Youth Decision Empowerment) substance use prevention and harm reduction strategy that helps support youth in making informed choices about their substance use health. The strategy is rooted in equity and trauma-informed practices, and includes open access lesson plans and resources for teachers, youth, guardians, and mentors of youth.

DECYDE is currently being piloted in Newfoundland and Labrador schools. Teachers highlighted the practicality and ease of use of materials and the importance of this education in promoting student wellbeing amidst rising substance use in schools. An evaluation plan has been created for full implementation of DECYDE, with plans to collect robust data to assess youth knowledge, behaviours, and attitudes.

This entry won first place in the infographic category of the 2024 IHDCYH Talks competition.

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Calling all youth thinking of joining a clinical trial!

Spotlight on a video resource co-created by youth for youth and their families

INFORM RARE Youth Advisory Group
Co-led by Maureen Smith, patient partner and Beth Potter, Professor
INFORM RARE research network, University of Ottawa

Opportunities for children and youth with rare diseases to participate in clinical trials are increasing as new treatments are developed and require evaluation. The Clinical Trials for Youth with Rare Diseases animated video was co-developed with youth advisors from INFORM RARE, a Canadian pediatric rare disease research network, in partnership with students from the University of Toronto. This animated video, available in English and French, is designed to simplify the complexities of clinical trials for a younger audience and their families and describe them in a rare disease context. The youth advisors (12-19 years old) chose topics and messages that were meaningful to them as youth with lived experience. The video describes distinct features of rare disease clinical trials and key questions to consider before joining a trial. It also describes the importance of autonomy and what youth can expect after joining a clinical trial. People with expertise in trial methods and ethics reviewed the final content to ensure accuracy.

This video won first place in the 2024 IHDCYH Talks video competition.

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Expanding the use of SGLT inhibitors to improve cardiorenal disease

Deepening our understanding of cardiorenal syndrome and reshaping the course of cardiovascular and kidney diseases

Dr. Ayodele Odutayo
MD, DPhil, Sunnybrook Health Sciences Centre; University of Toronto

Currently, sodium glucose co-transporter inhibitors (SGLTi) are approved for use in specific populations, including people with both diabetes and advanced kidney disease or heart failure. However, this medication has yet to be tested in people without diabetes who are at risk for heart failure and kidney disease. To determine whether this medication can be safely expanded for use in this population considered to have cardiorenal syndrome, Dr. Odutayo's research will focus on designing and conducting a new clinical trial to examine the effect of SGLTi in this new population.

These RCTs can improve our understanding of cardiorenal syndrome, including the potential to prevent co-morbidities associated with heart failure and kidney disease, and provide an opportunity to alter the natural history of cardiovascular and kidney disease.

Related to this work, Dr. Odutayo has been recently awarded the 2025 Rising Star Award in Diabetes Cardiorenal and Metabolic Medicine.

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Climate Change and Adolescents: Understanding Health Challenges

Exploring the Impact of Extreme Weather and Related Events on Adolescents' Lives

Dr. Gina Martin
Assistant Professor, Faculty of Health Disciplines, Athabasca University

Dr. Gina Martin from the Faculty of Health Disciplines at Athabasca University is leading research to understand how climate change impacts adolescent health. More than previous generations, today's adolescents are increasingly facing extreme weather events, such as wildfires, extreme heat, and floods, which are becoming more frequent and severe due to climate change. Despite this, there is a significant gap in research on how these events affect adolescent health and wellbeing. Thanks to funding from the SickKids Foundation and the CIHR-Institute of Human Development, Child and Youth Health, Dr. Martin and an interdisciplinary team will explore a variety of potential health and wellbeing impacts of these events on adolescents across Canada. This study aims to help fill key knowledge gaps by providing evidence that can inform strategies for mitigating impacts.

This research is novel in its focus on cumulative and repeated exposures to extreme weather events and their effects on adolescent health across the country. Also, by identifying modifiable factors, it can provide insights for developing strategies to help moderate impacts. The findings will contribute to the emerging field of climate change and health, assisting practitioners, policy makers, and advocates in safeguarding the health and wellbeing of adolescents.

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