Nova Scotia health departments and authorities recognize social determinants of health as modifiable factors to help improve the health of Nova Scotians. Changing the primary care delivery model will help improve population health. By using an upstream approach from a population perspective, the province is empowering the population to make changes to improve their well-being. The Nova Scotia Health Authority (NSHA) and the Nova Scotia Department of Health Promotion and Protection presented two documents I reviewed.
NSHA is proposing a move to deliver care through “health homes” and collaborative team based primary care.
“Primary health care is an approach to health that acknowledges the determinants of health and the importance of healthy individuals and communities. It focuses on factors such as where people live, the state of the environment, education and income levels, genetics, and relationships with friends and family. It also includes the continuum of care from pre - conception to end - of - life care, emphasizing health promotion, disease and injury prevention, health maintenance, and supporting patients and families in being partners in their health journey. With patients and families being core partners on the team, primary health care professionals include family doctors, family practice nurses, nurse practitioners, pharmacists, social workers, dietitians, physiotherapists, behaviourists, psychologists and many others, who all work collaboratively to improve the health and well - being of their patients and clients. Primary health care is the foundation of the health system, where the majority of people experience most of their health care, in the community, and is the ongoing point of contact a person has with the overall health system.” (NSHA, 2017, p3).
The Department of Health Promotion and Protection recognizes it is not good enough to just focus on one or two determinants of health to improve the health of a population. Focusing on an upstream approach, there are initiatives in place to help improve population health. For example, a low cost transportation service that relies on volunteers to take people to visit loved ones, go to work or school, etc. A program such as this affects many determinants of health: fostering healthy relationships, increasing self-esteem, increasing income, supporting education and many more. The key elements of program are: focusing on populations (youth, elderly, different cultures, etc), looking at the interaction of determinants, using evidence based strategies, investing in upstream initiatives, using multiple strategies across different sectors (economic, education, social services) and giving the population opportunity to be involved in the development of initiatives.
References
Primary Health Care, NSHA (2017). Strengthening the Primary Health Care System in Nova Scotia. Evidence synthesis and guiding document for primary care delivery: Collaborative family practice teams and health homes. Nova Scotia: Primary Health Care, Nova Scotia Health Authority http://www.nshealth.ca/sites/nshealth.ca/files/phc_evidence_synthesis_april_2017_final_updated.pdf
Nova Scotia Department of Health Promotion and Protection- “Healthy People, Healthy Communities: Using the Population Health Approach in Nova Scotia” https://novascotia.ca/dhw/publications/Public-Health-Education/Healthy-People-Healthy-Communities-Population-Health-Approach.pdf