While the fundamental social determinants of health will only be fully addressed with major shifts in government policy and action, there are many innovative and effective ways in which their impact on health disparities can be tackled more immediately in front-line service delivery. One direction is where regional health authorities, community health centres and social service providers are delivering more coordinated community-based primary care, other health care, health promotion, public health and social services, often out of single locations.
An interesting example is underway in Winnipeg. The Winnipeg Regional Health Authority and Manitoba Family Services and Housing have been partnering on a new model to integrate health and social service delivery called the Winnipeg Integrated Services Initiative:
The vision of integrated community-based and social services is to provide efficient, effective and holistic services which are person or family focussed and recognize the principles of population health and primary health care.
Part of the integration of services is the creation of access models. Three of these models have already been announced. One in each of the River East, Transcona and Inkster areas.
An Access model is a provincially funded site that will provide community-based, integrated health and social services. Each model will offer a broad range of services that reflect the needs of the communities they serve. Where services are not available within Access, the public will be referred to related community resources. Access will provide a one-stop source of information to the community and will support community activity and development.
The WRHA, Manitoba Family Services and Housing and Manitoba Health are committed to working with communities to ensure that citizens are involved in decisions that affect their lives. In each community, there will be opportunities for citizens to express their opinions about Access as it is developed in their area. Watch for information about public consultation in your community.
They had earlier developed a comprehensive conceptual framework for how integrated health and social services and the community access model could work.
Appendices set out how this framework is solidly grounded in a determinants of health analysis, in the Alma-Alta declaration on primary care and in a wider commitment to primary care reform within the province.