Browsing by Author "Muhajarine, Nazeem"

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Open Access
Barriers to healthy urban design policies: Perspectives from the City of Regina in Saskatchewan
(Johnson Shoyama Graduate School of Public Policy, 2024-03-06) Mahani, Akram; Lyeo, Joonsoo Sean; Fung, Agnes; Ali, Shanzey; Husack, Kelly; Muhajarine, Nazeem; Diener, Tania; Brown, Chelsea
The intricate interplay between urban design, health, and equity has emerged as a critical focal point in pursuit of the United Nations Sustainable Development Goal 11, which seeks to make cities inclu¬sive, safe, resilient, and sustainable. It reflects an increasing aware¬ness of the social determinants of health – a term encapsulating the socioeconomic variables that shape an individual’s living and working conditions. In other words, a person’s-built environment (the human-made surroundings within which people live and work) can either support or detract from their health. This relationship is underscored by the impact of urban design on equity. With Canada now 80% urbanized, it is not surprising that cities and urban centers have emerged as a primary arena for addressing current health challenges and safeguarding the wellbeing of residents. Therefore, by recognizing the relationship between urban design and health provides an opportunity to address gaps that contribute to health inequities. However, not all municipal actors and urban design professionals readily acknowledge their pivotal role in improving population health. To understand how key municipal policy- and decision-makers view the relationship between health and urban design, our team used the City of Regina as a case study. We interviewed 30 municipal actors from various roles and educational backgrounds within Regina’s municipal government. These interviews were analyzed using qualitative research methods and the findings were used to inform this policy paper. We identified three key categories of barriers to integrating health and equity into urban design policies: constrained policy-making environment, societal and cultural factors, and competing interests of stakeholders.
Open Access
Barriers to integration of health and equity into urban design policies in Regina, Saskatchewan
(2024-12-06) Mahani, Akram; Lyeo, Joonsoo Sean; Fung, Agnes; Husack, Kelly; Muhajarine, Nazeem; Diener, Tania; Brown, Chelsea
Although there is extensive literature on the impact of urban design on health, little is known about the barriers to integrating health into urban design policies. As cities increasingly lead efforts to improve health equity and population health, understanding the perspectives and experiences of municipal actors on health and equity is essential. To address this gap, we conducted semi-structured interviews with 30 stakeholders engaged with urban design policy- and decision-making at the City of Regina in Saskatchewan, Canada. We analysed our data using a qualitative thematic framework. Our research uncovered a lack of shared understanding of health among municipal actors. Interviewees identified several barriers to integrating health and equity in urban design policies, including inaccessibility of evidence; insufficient resourcing; fragmented governance structure; limited legal power of local governments in Canada; a deeply ingrained culture of individualism and lack of representation. Our findings underscore the importance of adopting an integrated and holistic approach for healthy and equitable urban design. As urbanization continues to bring a greater share of the world’s population into urban areas, it is crucial to understand how municipal governance can foster environments that promote residents’ well-being.
Open Access
Comparison of COVID-19 vaccination rollout approaches across Canada: Case studies of four diverse provinces
(McMaster University Library Press, 2023-02-01) Fitzpatrick, Tiffany; Camillo, Cheryl A.; Hillis, Shelby; Habbick, Marin; Mauer-Vakil, Dane; Roerig, Monika; Muhajarine, Nazeem; Allin, Sara
Across Canada, there were notable differences in the rollout of provincial/territorial COVID-19 vaccination programs, reflecting diverse sociodemographic profiles, geopolitical landscapes, health system designs, and pandemic experiences. We collected information regarding underlying principles and goals, governance and authority, transparency and diversity of communications, activities to strengthen infrastructure and workforce capacity, and entitlement and access in four diverse provinces (British Columbia, Saskatchewan, Ontario, Nova Scotia). Through cross-case analysis, we observed significant differences in provincial rollouts of the primary two-dose vaccination series in adults between December 2020 and December 2021. Nova Scotia was the only province to state explicit coverage goals and adhere to plans tying coverage to the relaxation of public health measures. Both Nova Scotia and British Columbia implemented fully centralized vaccination booking systems. In contrast, Saskatchewan's initial highly centralized approach enabled the rapid delivery of first doses; however, rollout of second doses was slower and more decentralized, occurring primarily through community pharmacies. In alignment with its decentralized health system, Ontario pursued a regionalized approach, primarily led by its existing public health unit network. Our research suggests explicit goals, centralized booking, and flexible delivery strategies improved uptake; however, ongoing learning will be crucial for informing the success of future vaccination efforts.
Open Access
COVID-19 Vaccination and Public Health Countermeasures on Variants of Concern in Canada: Evidence From a Spatial Hierarchical Cluster Analysis
(JMIR Publications Inc., 2022-05-31) Adeyinka, Daniel A.; Neudorf, Cory; Camillo, Cheryl A.; Marks, Wendie N.; Muhajarine, Nazeem
Background There is mounting evidence that the third wave of COVID-19 incidence is declining, yet variants of concern (VOCs) continue to present public health challenges in Canada. The emergence of VOCs has sparked debate on how to effectively control their impacts on the Canadian population. Objective Provincial and territorial governments have implemented a wide range of policy measures to protect residents against community transmission of COVID-19, but research examining the specific impact of policy countermeasures on the VOCs in Canada is needed. Our study objective was to identify provinces with disproportionate prevalence of VOCs relative to COVID-19 mitigation efforts in provinces and territories in Canada. Methods We analyzed publicly available provincial- and territorial-level data on the prevalence of VOCs in relation to mitigating factors, summarized in 3 measures: (1) strength of public health countermeasures (stringency index), (2) the extent to which people moved about outside their homes (mobility index), and (3) the proportion of the provincial or territorial population that was fully vaccinated (vaccine uptake). Using spatial agglomerative hierarchical cluster analysis (unsupervised machine learning), provinces and territories were grouped into clusters by stringency index, mobility index, and full vaccine uptake. The Kruskal-Wallis test was used to compare the prevalence of VOCs (Alpha, or B.1.1.7; Beta, or B.1.351; Gamma, or P.1; and Delta, or B.1.617.2 variants) across the clusters. Results We identified 3 clusters of vaccine uptake and countermeasures. Cluster 1 consisted of the 3 Canadian territories and was characterized by a higher degree of vaccine deployment and fewer countermeasures. Cluster 2 (located in Central Canada and the Atlantic region) was typified by lower levels of vaccine deployment and moderate countermeasures. The third cluster, which consisted of provinces in the Pacific region, Central Canada, and the Prairies, exhibited moderate vaccine deployment but stronger countermeasures. The overall and variant-specific prevalences were significantly different across the clusters. Conclusions This “up to the point” analysis found that implementation of COVID-19 public health measures, including the mass vaccination of populations, is key to controlling VOC prevalence rates in Canada. As of June 15, 2021, the third wave of COVID-19 in Canada is declining, and those provinces and territories that had implemented more comprehensive public health measures showed lower VOC prevalence. Public health authorities and governments need to continue to communicate the importance of sociobehavioural preventive measures, even as populations in Canada continue to receive their primary and booster doses of vaccines.
Open Access
How Municipal Actors Leverage Evidence to Support Urban Planning: Perspectives from the City of Regina
(University of Toronto Press, 2024-11-14) Mahani, Akram; Lyeo, Joonsoo Sean; Fung, Agnes; Husack, Kelly; Muhajarine, Nazeem; Diener, Tania; Brown, Chelsea
Despite growing calls for evidence-informed policy-making, policy- and decision-makers in municipal governments often face barriers to the integration of evidence into their work. These barriers may be especially prominent in small-to-medium-sized cities, which are often comparatively resource-strained relative to the larger cities that are the focus of much of the existing literature. We interviewed 30 municipal actors involved in urban planning at the City of Regina—the municipal government representing the medium-sized city of Regina located in western Canada. Our study revealed that evidence was often positioned differently among policy- and decision-makers. Interviewees had different definitions of evidence, accessed various sources of evidence, placed differing levels of trust in certain forms of evidence, and experienced different barriers to the integration of evidence into their day-to-day work. This article contributes to a better understanding of the role of evidence among urban planners and has important lessons on how to bridge the gap between urban planning policy- and decision-makers and producers of evidence.
Open Access
Making (in)visible: Marginality, neurodiversity and COVID-19 in urban Saskatchewan
(Faculty of Graduate Studies and Research, University of Regina, 2024-07) Knopf, Maren Francesca Savarese; Stewart, Michelle; Carter, Claire; Muhajarine, Nazeem
People with disabilities have been coined invisible citizens during the COVID-19 pandemic. This research responds to the ways people with disabilities and other intersecting marginalities were made invisible during COVID-19 in urban Saskatchewan. Using arts-based participatory this research asks, “what are the practices that worked to invisibilize people with disabilities and intersecting marginalities during the COVID-19 pandemic?” To explore this question the project worked with three community-based organizations and individuals with disabilities in Regina Saskatchewan to unpack stories and truths while co-designing a creative outcome focused on lived experiences of COVID-19. Analysis explores the broader contexts in which people with disabilities were made invisible but includes particular emphasis on four focus areas: housing precarity, mental health, food insecurity and substance use. In doing so, the research is grounded in theoretical underpinnings from queer theory and disability justice. Both of which offer frameworks to examine the systems of compulsory able-bodiedness and heterosexuality that codify ideas surrounding normativity and influence pandemic responses. By telling the often-overlooked stories of people with disabilities, participants asserted that these stories are of importance and are fundamental to a collective understanding of how things happened during COVID-19. In such, the paper discusses how stories and artistic contributions from participants require the development of a radical imagination for post-pandemic futures. Keywords: Neurodiversity, COVID-19, Arts-Based Methods, Intersectionality, Invisibilization, Disability Justice
Open Access
Making Early Years a Priority
(Johnson Shoyama Graduate School of Public Policy, 2014-05-08) Muhajarine, Nazeem
Open Access
Saskatchewan’s Commission on Medicare: Five Commentaries
(Saskatchewan Institute of Public Policy, 2001-04) McIntosh, Tom; Rushton, Michael; Kouri, Denise; Horsburgh, Martha E.; Labonte, Ronald; Muhajarine, Nazeem
Table of Contents Contributors......................................................................................................................... v A Fyke in the Road: The ‘New’ Politics of Health Reform........................................... 1 Tom McIntosh Economics, Incentives, and the Fyke Commission on Medicare .................................. 5 Michael Rushton Health System Governance After Fyke........................................................................... 9 Denise Kouri The Fyke Report & Nursing in Saskatchewan ............................................................. 13 Martha E. Horsburgh Caring for Medicare or Caring for Health? Why Health Care Reform is Only a Small Piece of the Puzzle ................................................................................................ 19 Ronald Labonte & Nazeem Muhajarine
Open Access
The Impact Of Provincial Proof- Of-Vaccination Policies On Age-Specific First-Dose Uptake Of COVID-19 Vaccines In Canada
(Health Affairs (Project Hope), 2023-11-01) Fitzpatrick, Tiffany; Camillo, Cheryl A.; Hillis, Shelby; Habbick, Marin; Roerig, Monika; Muhajarine, Nazeem; Allin, Sara
Requirements of proof of COVID-19 vaccination were mandated for nonessential businesses and venues by Canada’s ten provinces throughout the fall of 2021. Leveraging variations in the timing of these measures across the provinces, we applied event study regression to estimate the impact the announcement of these measures had nationally on age-specific first-dose uptake in the subsequent seven-week period. Proof-of-vaccination mandate announcements were associated with a rapid, significant increase in first-dose uptake, particularly in people younger than age fifty. However, these behavioral changes were short- lived, with uptake returning to preannouncement levels—or lower—in all age groups within six weeks, despite mandates remaining in place for at least four months; this decline occurred earlier and was more apparent among adolescents ages 12–17. We estimated that nationally, 290,168 additional people received their first dose in the seven weeks after provinces announced proof-of-vaccination policies, for a 17.5 percent increase over the number of vaccinations estimated in the absence of these policies. This study provides novel age-specific evidence showing that proof-of-vaccination mandates led to an immediate, significant increase in national first-dose uptake and were particularly effective for increasing vaccination uptake in younger to middle-aged adults. Proof-of- vaccination mandates may be effective short-term policy measures for increasing population vaccination uptake, but their impact may differ across age groups.