Patricia O'Campo

• PhD
• Professor (Full) at St. Michael's Hospital

The City of Toronto opened COVID-19 Isolation and Recovery Sites (CIRS) in 2020 in response to the need for supported isolation spaces for people experiencing homelessness. As a team of academic researchers and community partners, we assessed how lessons from the CIRS can inform post-pandemic policies for people experiencing homelessness. We focuse...

Background World economies increasingly rely on non-standard employment arrangements, which has been linked to ill health. While work and employment conditions are recognized structural determinants of health and health equity, policies aiming to protect workers from negative implications predominantly focus on standard employment arrangements and...

Background To date, no studies have assessed how the World Health Organization’s (WHO) work operationalizes health equity in practice. To fill the gap, this study investigates the WHO’s Urban Health Equity Assessment and Response Tool (Urban HEART) that focuses on assessing and responding to inequities within cities. This qualitative research answe...

Background Regular cervical screening can significantly reduce the onset and prevalence of cervical cancer. In Ontario, Canada, South Asian women have the lowest rates of cervical cancer screening among major ethnic groups in the province. Methods Using an innovative and participant-driven method called Concept Mapping (CM), we set out to understa...

Precarious employment (PE) is a major determinant of population health and contributor to health and social inequities. The purpose of this article is to synthesize and critically appraise available evidence on labor market initiatives addressing PE identified through a systematic review. Of the 21 initiatives reviewed, grouped into four categories...

Background Latina women in the United States experience intimate partner violence (IPV) at high rates, but evidence suggests Latinas seek help for IPV at lower rates than other communities. Safety planning is an approach that provides those experiencing IPV with concrete actions to increase their safety and referrals to formal services. While safet...

Introduction: Research has established that experiences of substance use and housing insecurity leads to violence, alienation, and health deterioration for women. However, no literature has assessed how the gendered nature of substance use and housing insecurity influence the ontological insecurity of women. This paper examines the relationship bet...

Background Scholarly critiques have demonstrated that the World Health Organization (WHO) approaches the concept of health equity inconsistently. For example, inconsistencies center around measuring health inequity across individuals versus groups; in approaches and goals sought in striving for health equity; and whether considerations around healt...

Background : Regular cervical screening can significantly reduce the onset and prevalence of cervical cancer. In Ontario, Canada, South Asian women have the lowest rates of cervical cancer screening among major ethnic groups in the province. Methods : Using an innovative and participant-driven method called Concept Mapping (CM), we set out to under...

Cervical cancer is largely preventable through screening and treatment of cervical lesions. In the province of Ontario, South Asian women have some of the lowest rates of screening. The roles of service providers—those in healthcare and community services—and their interactions with screen-eligible people can greatly impact the uptake of screening....

This article presents synthesized evidence from 16 studies examining initiatives with potential to mitigate workers’ exposure to precarious employment through the adoption of minimum wage policies. All studies were set in low-income countries and focused on both formal and informal workers. A systematic review of evaluated initiatives addressing pr...

Background An October, 2021 review of Public Health Ontario's COVID-19 guidance for congregate settings such as shelters and long-term care homes demonstrated that this guidance did not include references to ventilation or filtration. In April 2022, an interdisciplinary team with expertise in indoor air quality (IAQ), engineering, epidemiology, com...

This study investigated the impact of non-physical intimate partner violence (IPV), including emotional and verbal abuse, and coercive/controlling behaviors, on Ontario Health Insurance Plan costs, the universal healthcare provider in the province of Ontario, Canada. Women exposed to non-physical IPV alone had 17% higher healthcare costs over 10 ye...

This study investigated the impact of non-physical intimate partner violence (IPV), including emotional and verbal abuse, and coercive/controlling behaviors, on Ontario Health Insurance Plan costs, the universal healthcare provider in the province of Ontario, Canada. Women exposed to non-physical IPV alone had 17% higher healthcare costs over 10 ye...

Precarious employment (PE) is non-standard employment with uncertain and unstable contract duration, low wages, and limited labour protections and rights. Research has associated PE with workers’ poor mental health and well-being; however, this association has been studied primarily using quantitative methods. This qualitative study seeks to examin...

Staff at violence against women (VAW) organizations provide essential services for survivors of violence. The increase in VAW during the COVID-19 pandemic placed additional pressures on VAW staff. We investigated the impacts of the pandemic on the mental health of VAW staff in the Greater Toronto Area to inform recommendations for policy and practi...

The main objective of this research was to qualitatively examine the impacts of Housing First (HF) specifically on those participants who identified themselves as female in response to question asking what their gender was. The data analyzed are from a larger, muti‐site, randomized controlled trial. χ ² analysis was used to compare the life changes...

Regular cervical screening can largely prevent the development of cervical cancer and innovative methods are needed to better engage people in screening. In Ontario, Canada, South Asian women have some of the lowest rates of screening in the province. In this study, we used concept mapping to engage two stakeholder groups—South Asian service users...

Intimate partner violence (IPV) is a major global health issue, yet few studies explore its long-term public healthcare burden in countries with universal healthcare systems. This study analyzes this burden among Canadian women using data from the Neighborhood Effects on Health and Wellbeing survey and Ontario Health Insurance Plan (OHIP) records f...

Precarious Employment (PE) is characterized by job, income, and benefit insecurities. Studies surrounding PE and well-being have been predominantly quantitative, leaving a gap in rich descriptions of employment experiences. We recruited a sample of 40 adults aged 25-55 who were involved in PE during the beginning of the COVID-19 pandemic or lost em...

Introduction Exiting sex work is a complex process which can be facilitated by integrated action on health and its social determinants such as housing and employment. Few programs offer such coordinated support, and even fewer have been evaluated. We assessed if and how Exit Doors Here, a program anchored in the Critical Time Intervention (CTI) mod...

Background Poverty is associated with intimate partner violence (IPV), but whether exogenous increases in wage could reduce IPV among low-income women is still unclear. We examined whether the 2018 minimum wage hike led to a reduction in IPV risk among women. Methods Using the 2015–2019 Korean Welfare Panel Study, we employed a difference-in-diffe...

Background The World Health Organization (WHO) has focused on health equity as part of its mandate and broader agenda—consider for example, the “health for all” slogan. However, a recent scoping review determined that there are no studies that investigate the WHO’s approach to health equity. Therefore, this study is the first such empirical analysi...

Using population-wide health administrative data in Alberta, Canada (10/2015-05/2021, n = 3,493,864), we find that cannabis legalisation was not associated with significant increases in cannabis-related hospitalizations. Hospitalization rates were higher in young adults (18–24) compared to those 25+, and the introduction of edibles was associated w...

(Abstracted from JAMA Network Open 2023;6(5):e2315301) Women of low socioeconomic position are more likely to have poorer pregnancy outcomes than those of higher socioeconomic position, according to a growing body of epidemiological studies. Residence in low socioeconomic areas is associated with limited availability, access, and quality of health...

Over the last three decades, integrated care has emerged as an important health system strategy to improve population health while addressing the unique needs of structurally marginalised communities. However, less attention has been given to the role of integrated care in addressing issues related to inequities in health and health care. In this c...

Purpose: Bidirectional intimate partner violence (IPV), the reporting of both IPV victimization and perpetration, is likely the most common form of violence among gay, bisexual, and other sexual minority men (GBM) and is thought to be part of a larger syndemic of stressors. This purpose of this study was to examine associations between syndemic fac...

Given that racism is present worldwide, we believe it is imperative to address racism in the pursuit of health equity in cities. Despite the strengths of global urban health efforts in improving health equity, these initiatives can be furthered by explicitly considering systemic racism. Because racism is a major contributor to health issues, utiliz...

Background: Recreational cannabis policies are being considered in many jurisdictions internationally. Given that cannabis use is more prevalent among people with depression, legalisation may lead to more adverse events in this population. Cannabis legalisation in Canada included the legalisation of flower and herbs (phase 1) in October 2018, and...

Objective: The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. Methods: Data from a population-based survey (N=123,995) were linked to health administrative data (2002-201...

The aim of this chapter is to review some of the intricate ties between the nursing profession, gender inequalities, and public sector employment and the resulting consequences of these interactions for nurses’ education, professional status, and employment conditions. While nurses play key roles in health service delivery, State investments in nur...

In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the...

Importance: Residing in a low-income neighborhood is generally associated with worse pregnancy outcomes. It is not known if moving from a low- to higher-income area between 2 pregnancies alters the risk of adverse birth outcomes in the subsequent birth compared with women who remain in low-income areas for both births. Objective: To compare the...

Background: Living in low-income neighbourhoods and being an immigrant are each independently associated with adverse neonatal outcomes, but it is unknown if disparities exist in the neonatal period for children of immigrant and nonimmigrant females living in low-income areas. We sought to compare the risk of severe neonatal morbidity and mortalit...

Introduction Le gouvernement canadien s’est engagé à mettre en œuvre un Plan d’action national pour mettre fin à la violence envers les femmes. Toutefois, aucun plan officiel de mise en œuvre n’a été publié. En nous appuyant sur les recommandations déjà formulées et les consultations réalisées, nous avons effectué la première analyse qualitative of...

Biomedical advances in healthcare and antiretroviral treatment or therapy (ART) have transformed HIV/AIDS from a death sentence to a manageable chronic disease. Studies demonstrate that people living with HIV who adhere to antiretroviral therapy can achieve viral suppression or undetectability, which is fundamental for optimizing health outcomes, d...

Objective There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes...

Importance: Evidence indicates that immigrant women and women residing within low-income neighborhoods experience higher adversity during pregnancy. Little is known about the comparative risk of severe maternal morbidity or mortality (SMM-M) among immigrant vs nonimmigrant women living in low-income areas. Objective: To compare the risk of SMM-M...

Introduction The Canadian government has committed to a national action plan (NAP) to address violence against women (VAW). However, a formalized plan for implementation has not been published. Building on existing recommendations and consultations, we conducted the first formal and peer-reviewed qualitative analysis of the perspectives of leaders,...

Objective We assessed the critical role of Housing First (HF) programs and frontline workers in responding to challenges faced during the first wave of the COVID-19 pandemic. Method Semi-structured interviews were conducted with nine HF frontline workers from three HF programs between May 2020 and July 2020, in Toronto, Canada. Information was col...

The aim of this case study was to explore the abilities and limitations of trade unions in their response to undeclared work, which has received scant attention in research on working conditions and industrial relations. The authors use power resource theory to examine the outcome of a Swedish government initiative aimed to boost the ability of the...

Introduction: Recreational cannabis policies are being considered in many jurisdictions internationally. Given that cannabis use is more prevalent among people with depression, legalisation may lead to more adverse events in this population. Cannabis legalisation in Canada included the legalisation of flower and herbs (Phase 1) in October 2018, and...

Objective Cannabis use may reduce the effectiveness of antipsychotic medication and treatment adherence in schizophrenia patients. This study examined the impact of cannabis legalization on cannabis-related acute care among schizophrenia patients. Methods Using health administrative data in Ontario, 119,848 individuals who were diagnosed with schiz...

To date, no studies have assessed how those involved in the World Health Organization’s (WHO) work understand the concept of health equity. To fill the gap, this research poses the question, “how do Urban Health Equity Assessment and Response Tool (Urban HEART) key informants understand the concept of health equity?”, with Urban HEART being selecte...

Legalization of recreational cannabis in Ontario included the legalization of flower and herbs (Phase 1, October 2018), and was followed by the deregulation of cannabis retailers and sales of edibles (Phase 2, February 2020). Research on the impact of cannabis legalization on acute care utilization is nascet; no research has investigated potential...

Background Precarious employment (PE), characterized by reduced worker rights, and employment and income insecurity, has complex public health implications including negative impacts on workers’ mental and physical health, occupational health and safety, wellbeing, and inequities in access to health and social protections. There is, however, a know...

Background While the Canadian universal health system provides access to basic services, key health benefits are employer dependent. Given that non-standard workers (NSWs) only rarely have access to such benefits they have increased vulnerability to the many insecurities derived from their precarious employment, as clearly seen during the pandemic....

An emerging approach to facilitating exiting sex work is through applying the Critical Time Intervention [CTI] model. CTI represents a time-limited approach that supports marginalized individuals during periods of transition. We performed a fidelity assessment as part of a process evaluation of Exit Doors Here [EDH], a program supporting women who...

Despite the widespread acceptance of the need for intersectoral and multisectoral approaches, knowledge around how to support, achieve, and sustain multisectoral action is limited. While there have been studies that seek to collate evidence on multisectoral action with a specific focus (e.g., Health in All Policies [HiAP]), we postulated that succe...

Background: Allostatic load, a multisystem composite measure of chronic stress reflecting the cumulative wear and tear on the body, has utility in explaining maternal and child health disparities and predicting future health when measured during the peripartum period. Research using cross-sectional data has demonstrated an inverse association betwe...

The Human Immunodeficiency Virus (HIV) epidemic significantly impacts African, Caribbean, and Black (ACB) immigrants in Canada. Health scholarship has revealed striking injustices within Canada’s public healthcare system that restrict access to healthcare and violate the human rights of ACB immigrants living with HIV who are marginalized. We conduc...

Biomedical advances in healthcare and antiretroviral treatment or therapy (ART) have transformed HIV/AIDS from a death sentence to a manageable chronic disease. Studies demonstrate that people living with HIV who adhere to antiretroviral therapy can achieve viral suppression or undetectability, which is fundamental for optimizing health outcomes, d...

Background In 2008, Ecuador introduced Plan Nacional para el Buen Vivir (PNBV; National Plan for Good Living), which was widely recognized as a promising example of Health in All Policies (HiAP) due to the integration of policy sectors on health and health equity objectives. PBNV was implemented through three successive plans (2009–2013, 2013–2017,...

Aims: This paper describes the use of three governance tools for health in all policies utilised to facilitate implementation in the municipality of Kuopio, Finland: impact assessments, a city mandate (the Kuopio strategy), and shared budgets. Methods: An explanatory case study was used. Data sources included semistructured interviews with 10 go...

Homelessness is associated with excess cardiovascular morbidity and mortality. This study reports on the long-term effects of a Canadian housing first initiative, compared to treatment as usual, on major cardiovascular events among adults experiencing homelessness and mental illness. Over the 7-year follow-up period, 34 of 527 participants (6.5%) e...

Legalization of recreational cannabis in Ontario included the legalization of flower and herbs (Phase 1, October 2018), and was followed by the deregulation of cannabis retailers and sales of edibles (Phase 2, February 2020). Research on the impact of cannabis legalization on acute care utilization is nascet; no research has investigated potential...

The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health...

Background Homelessness continues to grow globally. The Housing First (HF) model offers immediate access to housing and support services without preconditions and has a growing body of evidence documenting its effectiveness at ending homelessness. HF has a robust theory of change that hypothesizes how unique program components (i.e., immediate acce...

The effects of the coronavirus disease‐2019 (COVID‐19) pandemic on the lives of underserved populations are underexplored. This study aimed to identify the impacts of the COVID‐19 pandemic and associated public health responses on the health and social well‐being, and food security of users of Housing First (HF) services in Toronto (Canada) during...

African, Caribbean and Black immigrants face persistent legislative barriers to accessing healthcare services in Canada. This Institutional Ethnography examines how structural violence and exclusionary legislative frameworks restrict the right to HIV healthcare access for many Black immigrants. We conducted semi-structured interviews with Black imm...

The prevalence of precarious employment has increased in recent decades and aspects such as employment insecurity and income inadequacy have intensified during the COVID-19 pandemic. The purpose of this systematic review was to identify, appraise, and synthesise existing evidence pertaining to implemented initiatives addressing precarious employmen...

Background It is widely recognized that one’s health is influenced by a multitude of nonmedical factors, known as the social determinants of health (SDH). The SDH are defined as “the conditions in which people are born, grow, live, work and age, and which are shaped by the distribution of money, power and resources at global, national and local lev...

Background: Health in All Policies (HiAP) encompasses collaboration across government and the consideration of health in various governmental sector's policies and decisions. Despite increasing advocacy, interest, and uptake in HiAP globally, empirical and evaluative studies are underrepresented in this growing literature, particularly literature...

Background The major determinants of health and well-being include wider socio-economic and political responses to poverty alleviation. To data, however, South Korea has no related social protection policies to replace income loss or prevent non-preferable health conditions for workers. In particular, there are several differences in social protect...

Scientific evidence suggests that COVID-19 is transmitted through the air, and can be mitigated using indoor air quality measures such as ventilation and filtration. We set out to explore how Public Health Ontario (PHO) responded to this evidence. PHO is mandated by legislation to share "scientific and technical advice and support" and "contribute...

Scientific evidence suggests that COVID-19 is transmitted through the air, and can be mitigated using indoor air quality measures such as ventilation and filtration. We set out to explore how Public Health Ontario (PHO) responded to this evidence. PHO is mandated by legislation to share scientific and technical advice and contribute to efforts to r...

Background: Physical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory's tenet that interacting systems of power, oppressions, and privileges work together, we hyp...

Purpose To conduct a multi-dimensional and time-patterned analysis to identify distinct well-being trajectory profiles over a 6-year follow-up period among adults experiencing homelessness and mental illness. Methods Data from 543 participants of the At Home Chez Soi study’s Toronto site were examined over a 6-year follow-up period, including meas...

PurposeWhile there is strong evidence that job insecurity leads to mental distress, little is known about how gender and parental responsibilities may exacerbate this relationship. Examining their contribution as potential effect modifiers may provide insights into gender inequalities in mental health and inform gender-sensitive labour policies to...

Objective: To investigate the disparity in suicide-related behaviours across sexual orientations by gender. Design: Retrospective cohort study using a linkage of population-based survey and health administrative data. Setting: Ontario, Canada between January 2002 and December 2019 Participants: 123,995 residents aged 10+ were followed up for non...

Background Intimate partner violence (IPV) is the leading cause of women's homelessness. However, what works best to respond to the needs of women experiencing IPV and homelessness remains unclear. We aimed to systematically review the effects of housing interventions on the physical, psychosocial, and economic wellbeing of women experiencing IPV....

Objectives The review is part of the Sweden-based research programme PWR, which consists of early-career and senior researchers in public health, occupational health as well as social sciences from a range of European countries, the United States, Canada and Chile. PWR started in 2019. The purpose of our review is to identify implemented initiative...

To examine the association of underemployment (operationalised as unemployment or overqualification) to fair/poor self-rated mental health (SRMH) in labour force participants, between a. immigrant vs. Canadian-born and b. recent (< 10 years in Canada; arrived 1993–2003) vs. long-term immigrant (≥ 10 years in Canada) labour force participants. Data...

Introduction Individuals who engage with sex work face barriers to maintaining overall health and well-being such as criminalization, stigmatization, and violence. An emerging approach to facilitating exiting sex work for individuals is through programs applying the Critical Time Intervention (CTI) model. CTI represents a time-limited practice that...

Debates on how sex, gender, and sexual identity relate to intimate partner violence (IPV) are longstanding. Yet the role that measurement plays in how we understand the distribution of IPV has been understudied. We investigated whether people respond differently to IPV items by sex and sexual identity and the implications this has for understanding...

Globally, healthcare systems are facing a shortage of professionally educated nurses. To address this shortage, in addition to several other strategies adopted, many high-income countries have relied heavily on the international recruitment of nurses from low income countries, which, in turn, has several implications for the nursing workforce and h...

Background Diabetes is a chronic medical condition which demands that patients engage in self-management to achieve optimal glycemic control and avoid severe complications. Individuals who have diabetes and are experiencing homelessness are more likely to have chronic hyperglycemia and adverse outcomes. Our objective was to collaborate with individ...

The COVID-19 pandemic and associated public health preventive measures such as lockdown and home confinement have posed unique challenges to female sex workers (FSW) globally, including in Canada where the sex trade is not formally recognized. In this commentary, we discuss the unintended consequences the pandemic has had on various social determin...

Background Housing First (HF)-based interventions have been implemented in North America and beyond to help people exit homelessness. The effect of these interventions on access to primary and specialist care services is not well-defined. This study assesses the long-term effects of an HF intervention for homeless adults with mental illness on prim...

We assessed the effects of the Toronto Site Housing First (HF) intervention on hospitalizations and emergency department (ED) visits among homeless adults with mental illness over 7 years of follow-up. The Toronto Site is part of an unblinded multi-site randomized pragmatic trial of HF for homeless adults with mental illness in Canada, which follow...

Background: National lockdown in the UK during the COVID-19 pandemic severely restricted the mobility of residents and increased time spent in their residential neighbourhoods. This is a unique opportunity to understand how an exogenous factor that reduces mobility may influence the association between neighbourhood social environment and mental he...

The COVID-19 pandemic is highlighting the harm perpetuated by gender-blind programs for marginalized citizens, including sexual and gender minorities (SGMs) and cisgender women. Gender-blind programs are known to augment harms associated with violence and structural stigmatization by reinforcing rather than challenging unequal systems of power. The...

Purpose: We examined the housing trajectories of homeless people with mental illness over a follow-up period of 6 years and the association of these trajectories with food security. We then examined the modifying role of psychopathology and alcohol and substance use disorders in this association. Materials and Methods: We followed 487 homeless adul...

Using gender-sensitive (ensures that resource distribution considers gender) and gender-redistributive (aims to develop balanced gendered relationships through redistributing resources) analytic lenses in urban health interventions is long overdue. The social construction of gender and its impact on the health of marginalized women, especially wome...