Today, every area of healthcare has a public health agenda. That is, every area of healthcare except palliative care! Palliative care would benefit from a public health approach by developing a wider community context in which palliative care services can make their contributions. A public health approach takes the responsibility of palliative care from a few highly trained specialists to a community that considers it “everybody’s business.”

Public Health Palliative Care is also known as Health Promoting Palliative Care (HPPC) and was developed as a social movement. The underlying philosophy behind HPPC is the international charter for public health, known as the Ottawa Charter for Health Promotion. It was established in 1986, and is based on 5 core principles:

  • Building public policies that support health
  • Creating supportive environments
  • Strengthening community action
  • Developing personal skills
  • Reorienting health services

HPPC places emphasis on community development and partnerships across all sectors to empower communities, instead of emphasizing the responsibilities of health services as the primary advocate or deliverer of care for death, dying, loss and bereavement. A fundamental goal of a HPPC approach is to build community capacity such that access to “palliative care’ is enhanced across Canada.

Compassionate Communities (CC) – the HPPC theory of Practice

The Compassionate Cities/Communities model is a theory of practice for HPPC. In many jurisdictions around the world where HPPC has been embraced, the Compassionate Cities/Communities model as developed and published by Dr. Alan Kellehear and colleagues is the actual model being used. Based heavily on the success of the WHO Healthy Cities model, CCs treat palliative and end-of-life care as a community responsibility and creates partnerships between the community and services. The goal is to bridge gaps in the community, especially those involving social care. These gaps include inadequate and inequitable access to care, inadequate support for caregivers, lack of clear accountability for this care across systems of care, and lack of real integration of care.

Compassionate Communities Projects in Action

Where around the world are examples of successful CC project and initiatives? What steps did they take to take this concept through to application? Illuminating and learning about existing international CC projects is a great way to start to make CC projects a reality for Canada. Here are a sample with links to learn more: