Switching Gears—Looking at "Health Care" 

The last few posts on this site were focused on how community members can work to improve their health, safety and wellbeing by initiating projects, starting causes, measuring health statistics, and collaborating with partners—be they for-profits, non-profits or public administrators—in raising the standard of health in their communities. But we haven't yet talked about how communities are supported by a health care system that provides the kind of direct care that’s needed when one isn’t feeling physically or emotionally well. These services compliment those of the community—an example to help illustrate:  

The Royal Alexandra Hospital in Edmonton, Alberta is often considered an “inner-city” hospital, frequented by those who are homeless or who suffer from chronic poverty. Persons who find themselves in this social group may also suffer from psychological trauma experienced in their early years through violence, physical and/or sexual abuse, and may dull these traumatic experiences through the abuse of substances like alcohol and illegal or prescription drugs. Since the inner-city provides economic and social opportunities for these persons, they tend to congregate there. The inner-city may also provide the kind of community support services that they frequently access, like a shelter or food kitchen, which is another reason why they stay “near”. And when these persons suffer the kind of indignities that are often experienced when homeless and impoverished, this leads them to access a hospital, usually the first place of contact with a medical professional, if not brought there first by ambulance, to be treated.   

Now, without the support of the hospital, they will surely perish on the streets with time. Access to a hospital provides a point of physical and emotional care that is not available on the street. Alone, however, the hospital’s mandate of treating patients who are subsequently discharged may lead to a revolving door of admissions as the underlying condition of these persons’ chronic poverty remains unaddressed. Hospitals, then, compliment community health supporting services, like a shelter, food kitchen, affordable housing program or other initiative supporting vulnerable persons, by being available when these persons find themselves in dire physical or emotional straits. Together, they work to raise the standard of health in the community—The Royal Alexandra Hospital takes pride in working with community partners to link those who need community-led health supporting services (in addition to offering treatment programs that they operate themselves.)  

A critical point to note is that this hospital exists for everyone, regardless of social or economic background, and provides care whenever and to whoever needs it. While a more privileged member of the community may not ever access a shelter or food kitchen, they would certainly access that same hospital. This hospital, then, plays a more significant role in the community in also offering an opportunity to be empathetic to those around us, and especially when we find ourselves sitting next to each other in the same care unit.   

A hospital is not the only health care facility that serves the community; it’s only one of few health care facilities that operate as part of a wider health care system. The next few posts will introduce you to how a health care system “works” and the various roles played within it. I intend to focus on the relationships a community has with and between them, as opposed to the mechanics of how they work.   

The way we relate to health care systems differ between countries, and I’ll try my best to focus on common tracts. Finally, I should say that I write this as someone who has both experienced and worked in the Canadian health care system, and I’ll eventually offer some thoughts on how well it’s been working. Know that health care is a “human construction”, and the way that it works does not have to be “set in stone.” By studying it, as with other human endeavors, we can make changes to make it better, more efficient, and easier to access.   

And, as always, please let me know your thoughts—it not only helps me offer more complete writings, but also supports those who happen to access this page and who can appreciate a perspective other than mine.   


A link that may be interesting for you: Homeless Patients Get Novel Treatment From Chicago Hospitals: Housing   

A Health Care System – The "Basics"

Attending the 2017 Washington State Public Health Association Conference