About
This initiative focuses on generating evidence to reshape how health systems recognize, measure, and respond to inequities by valuing the people, contributions, and lived experiences that sustain care. It advances a justice-informed approach to health economics and health systems research, centring the realities of communities most marginalized by financial, gendered, and structural barriers. There are three foci in this iniative:
First, we advance methods to quantify the economic burden of illness, measure financial risk protection, and explore the costs of inaction on issues such as cancer and gender-based violence. By integrating community perspectives and intersectional analysis, this work exposes how financial barriers and system blind spots deepen inequities for groups such as Indigenous communities, racialized women, immigrants, and people affected by complex conditions. The research generates actionable evidence that informs priority setting, supports investment planning, and strengthens pathways to Universal Health Coverage.
Second, we examine how equity and efficiency goals can be jointly advanced through modern health economics tools. This includes extending approaches such as extended cost-effectiveness analysis to evaluate how health policies distribute benefits, financial protection, and development gains across diverse populations. These methods are developed in global partnerships to support reforms in areas such as financing, taxation, and service delivery.
Third, we interrogate how gendered labour, caregiving, and leadership shape health system performance. By valuing unpaid and under-valued health work, examining capability constraints, and generating evidence on gender representation in leadership, this research highlights the systemic conditions that perpetuate inequality, and the opportunities to redesign institutions for fairness and impact.
Together, these strands form a cohesive program that advances equity-focused evidence, strengthens decision-making in health and social systems, and supports more inclusive, people-centred policy transformation.
Illustrative Publications
- Yap ML, Bhoo-Pathy N, Essue BM, Naghsh-Nejad M, Batumalai V, Chukwu OA, Dowe K, Moodley J, Spence D, Stanaway FF. Invisible Populations: The Need for Race and Ethnicity Data in Cancer Control. JCO Glob Oncol. 2025 Apr;11:e2500049. doi: 10.1200/GO-25-00049. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 40239141/ - Ritter J, Allen S, Cohen PD, Fajardo AF, Marx K, Loggetto P, Auste C, Lewis H, de Sá Rodrigues KE, Hussain S, Omotola A, Bolous NS, Thirumurthy H, Essue BM, Steliarova-Foucher E, Huang IC, Bhakta N. Financial hardship in families of children or adolescents with cancer: a systematic literature review. Lancet Oncol. 2023. 24:e364-e375. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 37657477/ - Essue BM, Oliveira Cd, Bushnik T, Fung S, Hwee J, Sun Z, Navas EG, Yong JHE, Garner R. The Burden of Health-Related Out-of-Pocket Cancer Costs in Canada: A Case-Control Study Using Linked Data. Current Oncology 2022; 29:4541-4557. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 35877219/ - Iragorri N, de Oliveira C, Fitzgerald N, Essue B. The Out-of-Pocket Cost Burden of Cancer Care-A Systematic Literature Review. Curr. Oncol. 2021; 28: 1216-1248. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 33368032/ - Essue BM, Iragorri N, Fitzgerald N, de Oliveira C. The psychosocial cost burden of cancer: A systematic literature review. Psychooncology. 2020; 29: 1746-1760. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 32783287/ - Essue BM, Laba M, Knaul F, Chu A, Minh HV, Nguyen TKP, Jan S. Chapter 6 Economic burden of chronic ill health and injuries for households in low and middle-income countries. In: Jamison DT, Gelband H, Horton S, et al, eds. Disease Control Priorities: Improving Health and Reducing Poverty, 3rd ed. Washington, DC: The International Bank for Reconstruction and Development/The World Bank, 2017. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 30212160/ - Metheny N, Dusing GJ, Essue BM, O’Campo P. Non-Physical Intimate Partner Violence and Long-Term Public Healthcare Costs in a Representative Sample of Canadian Women. Violence Against Women. 2025 Aug 3:10778012251362231. doi: 10.1177/10778012251362231. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 40754773/ - Saenz-de-Miera B, Wu DC, Essue BM, Maldonado N, Jha P, Reynales-Shigematsu LM. The distributional effects of tobacco tax increases across regions in Mexico: an extended cost-effectiveness analysis. Int. J. Equity Health. 2022; 21: 8. Available from: https://
pubmed.ncbi.nlm.nih.gov/ /35057813 - Essue BM, Jan S, Phuc HT, Dodson S, Armstrong K, Laba TL. Who benefits most from extending financial protection for cataract surgery in Vietnam? An extended cost-effectiveness analysis of small incision surgery. Health Policy Plan. 2020; 35: 399-407. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 32031615/ - Essue BM, Kapiriri L, Mohamud H, Veléz MC, Kiwanuka S. Planning with a gender lens: A gender analysis of pandemic preparedness plans from eight countries in Africa. Health Policy Open. 2023 Dec 12;6:100113. doi: 10.1016/j.hpopen.2023.100113. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 38274670/ - Knaul FM, Essue BM, Arreola-Ornelas H, Watkins D, Langer A. Universal health coverage must become a best buy for women. Lancet. 2021; 398: 2215-2217. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 34895475/ - Knaul FM, Arreola-Ornelas H, Essue BM, Nargund RS, García P, Gómez USA, Dhatt R, Calderón-Villarreal A, Yerramilli P, Langer A. The feminization of medicine in Latin America: ‘More-the-merrier’ will not beget gender equity or strengthen health systems. Lancet Reg. Health – Am. 2021; 8: 100201. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 36778730/ - Kelly A, Pirrie L, Toccalino D, Bhuiya AB, Lee W, McMahon M, Essue B. “The Space Is as Much Yours as It Is Mine”: Insights From Health System Leaders About Inclusive Leadership. Healthc Q. 2024. 27(1):34-41. Longwoods. Available from: https://
pubmed.ncbi.nlm.nih.gov/ 38881483/
