CIHR – Institute of Population and Public Health – Pillar 4 Forum March 15, 2012 – Executive Summary1

Background and Purpose

Canadian scientists are recognized internationally for their contributions to our understanding of the complex biological, social, cultural and environmental interactions that determine the health of individuals and populations. These contributions provide the scientific foundation for CIHR’s fourth Pillar, defined as “research with the goal of improving the health of the Canadian population, or of defined sub-populations, through a better understanding of the ways in which social, cultural, environmental, occupational and economic factors determine health status.”2

The CIHR-Institute of Population and Public Health (IPPH) plays a dual role as an Institute and "Pillar/Theme 4” champion, in collaboration with other Institutes and external organizations.

Given recent progress to increase the profile, understanding and appreciation of Pillar 4 research, the IPPH Institute Advisory Board (IAB) determined that it was timely to reconvene a group to explore how to further strengthen Pillar 4 research, drawing on its position of strength in Canada and internationally and positioning it strategically for the future.


  • CIHR-IPPH Institute Advisory Board (IAB) members and IPPH staff
  • Representatives with population and public health research, policy and/or practice expertise from 11 of the 12 other CIHR IABs
  • Representatives from other federal, provincial and non-governmental research funding organizations
  • A representative from CIHR University Delegates
  • Senior CIHR staff


  • Review progress/changes in the Canadian research landscape since the 2004 meeting and identify current challenges and opportunities facing Pillar 4 researchers; and
  • Develop concrete solutions and recommendations directed at research funders, academic institutions, and researchers to further strengthen Pillar 4 research in Canada.

Through small-group and plenary discussions, participants identified challenges, opportunities, and strengths related to Pillar 4 research as well as strategies for strengthening Pillar 4 research in Canada. A more detailed report of the discussion is available upon request.

Challenges and Opportunities in Pillar Four Research

Data Liberation and Infrastructure

Participants discussed the need for better access to existing population-based data sources within and across provinces/territories and sectors.

A Value Proposition for Primary Prevention: Alignment Around Outcomes

A clear articulation of the value proposition of prevention strategies needs to be made and linked to cost avoidance of healthcare services.

Interdisciplinary Activity

Pillar 4 research requires the application of a wide range of theoretical and methodological approaches to develop a deep and nuanced understanding of what gives rise to health and illness. Despite the challenges, bringing together scientists from a wide range of disciplines to address the complex biological, social, cultural and environmental interactions, as Pillar 4 research does, is critical to developing a deeper and richer understanding of how to make health improvements

Strengths in Pillar Four Research

Canada has demonstrated leadership and innovation and generates a significant research output in Pillar 4, “punching above its weight” in production.

  • Canada has a growing community of Schools of Public Health that may help in the formation and sustainability of Pillar 4 research networks.
  • Canadian researchers have demonstrated a capacity and willingness to work with international collaborators which facilitate opportunities for population linkages in global health research.
  • The inherent multi-disciplinarity, health outcome orientation, and the population level perspective that acknowledges complexity and systems approaches are integral to Pillar 4 research

Strategies for Strengthening Pillar Four Research (as identified by participants)

  1. Strengthen (public) health economics capacity in PPH research to be able to evolve current economics capacity and answer questions of relevance to decision-makers.
  2. Develop effective communication and marketing strategies for the population and public health agenda, which includes research.
  3. Enhance strategies for the appropriate peer review of Pillar 4 research at CIHR.
  4. Continue to build on Canada’s strengths in terms of leadership and innovation in areas of research (e.g. ongoing “basic science” (theory and methods development) in population and public health research).
  5. Align PHIR and cohort study initiatives, e.g. include a PHIR component to cohort studies; “life cohort” approach; cohort studies are a surveillance tool to capture natural experiments.
  6. Demonstrate value, importance, and impact of PHIR.
  7. Adapt to context while working towards the same outcome.
  8. Strengthen global health research partnerships and leadership and demonstrate impact.
  9. Develop metrics (cost benefit metrics; demonstration that Pillar 4 research responds to CIHR mandate).
  10. Develop a business/value proposition: make the case for the importance of Pillar 4 research.


The Forum provided an opportunity for a cross-organizational dialogue on strengthening Pillar 4 research in Canada. A number of Canada’s strengths in Pillar 4 research were acknowledged by the group and a keen interest in supporting these was expressed. A number of actions were identified as possible strategies for building on and underpinning Canada’s strengths. It was acknowledged that, although IPPH plays a central role in supporting Pillar 4 research, all participants – as well as others not present for the discussion – had roles to play.

  1. Adapted from a report prepared by Lillian Bayne, Lillian Bayne and Associates
  2. Glossary of Funding Related Terms – research (social, cultural, environmental and population health)
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