While a citizen-centred approach to health is essential, many factors beyond an individual and his/her family impact health. Health is a community accomplishment. Structural and social community assets such as easily accessible recreation facilities, green spaces, employment opportunities, affordable housing, safe roads, faith-based and cultural organizations, and service clubs are examples that contribute to health outcomes.
Focusing at the community level helps change the story about what needs to be done and who needs to be involved to improve health outcomes. If the size of target population/community is chosen wisely, it also acknowledges that ‘one size does not fit all’ and supports communities coming together to address their own specific health issues. Albertans should be able to take collective pride in the health of all their fellow Albertans (regardless of ability, gender, race, geography etc.).
Albertans have much knowledge and ability to contribute to their own health. Citizens need reliable and tested ways in which to take part in their own health endeavours. This varies by individual. It may be as simple as measuring your own glucose level for diabetes or as complex as caring for an elderly partner who lives with dementia when your own health is frail and you have limited financial means. They need to have knowledge of their condition and what they can do, if they’re able, to be an effective partner with health and community providers.
Albertans also need agency over their community’s health. They need a purpose-driven mechanism to build community capacity based on their unique needs. This means they’ll need reliable timely information to assess their own citizens’ health and to assess progress.
We offered these recommendations to Alberta Health’s Modernizing Alberta’s Primary Health Care System (MAPS) initiative.
- Community Dashboards. A community-specific publicly-shared dashboard that provides timely and updated information about key indicators of importance to citizens (in addition to those of importance to providers) is required.
- Asset Based Approach. Communities should be supported to use an asset-based approach so that strengths of many stakeholders can be included. There should be health planning at a community level that is truly multi-sectoral and collaborative and involves leadership and governance by invested community members who are committed to a healthier community. This would require decision-making over public expenditures coupled with responsibility and accountability for community health outcomes.
- Commitment to Provincial Outcomes. In our digital era there needs to be mechanisms that connect people to resources outside their physical community. This should include pathways to reliable health information, specialist care/services, special interest networks, etc. Adopting a philosophy of community ownership and agency must acknowledge the interconnectedness of communities and the varying resources that are needed but not available in every community. One’s geographic location should not create barriers to access of needed support and services.
ICN believes that fundamental change to our collective approach to community-based health and wellness is essential and possible with commitment of key stakeholders. It COULD be different. It MUST be different.