The History of Community Health Centers in Canada (Essay Sample)

The History of Community Health Centers in Canada
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Introduction
Community Health Centers (CHCs) are known to be a distinctive primary care delivery models that are governed by community boards. They deliver programs and services within a certain population health framework and have extensive community involvement, including volunteerism. The Community Health Centre concept represents an important next step in the development of the Canadian health system. CHCs shift focus from individuals seeking medical attention when sick to preventative care and keeping Canadians healthy, ultimately removing other barriers to good health (Shah, 2010).
Community Health Centers provide primary care services and health promotion programs with an emphasis on priority populations which require improved access to care and/or have a higher disease burden requiring additional resources. Problems of access may be the result of socioeconomic status, geographic isolation, cultural or language barriers. Illness burden may be related to age, socio-economic status, or environment factors. Community health centers have the following qualities in Canada; use a population needs-based and determinants of health approach to plan, develop and provide primary health care services, including treatment and health promotion, Encourage individuals, families and communities within a specific population, defined by either geographic boundaries or communities of affiliation to take greater responsibility for their health and wellbeing (Moloughney, 2010).
Apart from those qualities they also create inter-disciplinary teams of salaried staff, who provide coordinated services 24 hours a day and Maximize the outcome of services provided by involving clients and community in resource allocation decisions through Integrating culturally appropriate services (e.g. provide native healing and medicines in centers with an Aboriginal focus or settlement services for immigrant communities (Douglas, 2012). In Canada Community health centers are not-for-profit corporations but are governed by volunteer community based boards of directors that encourage healthy community by working in partnerships with organizations in other sectors, such as justice, education, recreation and economic development.
Health centers in Canada begun early in Ontario. Community Health Centers date back to the early 1960s and 1970s. Generally they began as the result of community activism to improve access to health care. The Sault St. Marie and District Group Health Association was the first health to open as a group practice due to the mobilization of mine workers in the area. Although its model is based on a different funding formula, it has been a source of inspiration to the further development of clinical health centers in the country (Angus & Pran, 2012).
History and Development of Community Health Centers
Public participation or consumer sponsorship of health facilities and services has a long and rich history internationally, across Canada and in Nova Scotia itself. They have included voluntary health agencies and charities, mental health programs, well-women clinics, women’s centers, hospital foundations and auxiliaries, and of course, community health centers to name a few. According to the Canadian Association of Community Health Centre Associations, there are at least 250 community health centers (CHCs) across Canada including the CSLCs in Quebec and Aboriginal Health Access Centers (Yalnizyan, 2011).
Community health centers in Canada have generally been organized in response to a crisis or to meet a recognized need. Important precedents have included co-operative group practice clinics and neighborhood health centers, labor-sponsored programs, aboriginal and immigrant services and the co-operative movement in Canada.
Community Health Centers across Canada
Community clinics were organized in Saskatchewan during the Medicare crisis of 1962. After a bitterly fought provincial election in 1960, the Saskatchewan Medical Care Insurance Act was passed by the provincial Legislature in November 1961. By January 1962, the established medical profession began to show its resistance to this legislation. Groups of citizens began to meet in various locations to consider what should be done in view of the opposition from the medical profession. The idea of health facilities operated jointly by citizens and health providers began to be discussed. The plan took effect on July 1 and most doctors in Saskatchewan withdrew their normal services until their strike was settled with the Saskatoon Agreement on July 23. While only a few community clinics opened during the strike, a total of thirty-six (36) associations joined a provincial association of community clinics by March 1963. Today, only five (5) of these clinics are still functioning (Association of Ontario Health Centers, 2013).
In other provinces, provincial government support and leadership has been important in fostering the growth of community health centers. Quebec’s Castonguay-Nepveu reports 1969-71 initiated broad legislative and administrative reform of health and social services including the establishment of 160 neighborhood CSLCs. After issuing a white paper on health policy, the Manitoba government passed legislation in the early 1970’s providing a legal mechanism for 6 CHCs to open in both urban and rural areas. About the same time, the B.C. government set up a CHC development group and funded five centers as pilot projects, one urban and four rural. Even with a change in government and a rigorous evaluation, four of the centers have continued to operate (Association of Ontario Health Centers, 2013).
In Ontario, community health centers date back to the early 1970s. After extensive public pressure and extensive reviews such as the 1982 Task Force to Review Primary Health Care, there were until last year sixty-eight (68) community health centers represented by the Association of Ontario Health Centers: fifty-six (56) CHCs, ten (10) Aboriginal Health Access Centers (AHAC) and two (2) Community-Governed Primary Health Services (CHSO), all of which are funded through the Ministry of Health and Long-Term Care. Co-operative health centers have been set up in several provinces. In November 2005, the Ontario Government announced it was committed to 22 new CHCs and 17 satellites. In July 2006, the Government announced the sponsoring organizations for 4 new Community Health Centers and 8 new satellite clinics.
In Ontario there are seventy four community Health centers. These Community Health Centers, together with satellite locations, provide programs and services for people who have difficulty accessing the full range of appropriate primary health care services. CHCs serve a variety of priority populations that experience barriers to health services such as; members of linguistic or cultural groups, individuals who live in remote underserviced communities, individuals with lowincomes, individuals who are homeless, isolated seniors, individuals with mental health and addiction issues, and the sexual/gender diverse (Macdonald, 2011).
In Ontario, Community Health Centers and Family Health Teams are the chief inter professional primary health care models. Together they now account for 21 percent of family physicians practicing in the province. The number of family physicians working in inter professional teams increased from 176 in 2002 to more than 2,500 in early 2011.
The first Community Health Centers were established in 1979. In 2004/2005, the provincial government announced its intention to create twenty-one new Community Health Centers and twenty-eight satellite clinics. Forty-eight new centers and satellites are now in operation, bringing the number of Community Health Centers (not including satellites) to seventy-three. Community Health Centers employ more than 300 physicians; 290 nurse practitioners; more than 1,700 other clinical, health promotion, and community development professionals; and more than 800 administrative and management personnel.
In a multifaceted study of four organizational/physician payment models in Ontario in 2005/2006, Community Health Centers performed better than fee-for-service practices and two capitation-based models in chronic disease management, health promotion, and community orientation (Hogg et al. 2009; Muldoon et al. 2010; Russell et al. 2009) but were the least efficient model (Milliken et al. 2011).
Established in 2005, Family Health Teams are the provincial government's flagship initiative in primary health care renewal and are the first explicitly inter professional primary health care model introduced to Ontario in three decades. Currently, 170 teams are operational, and 30 are under development. They include more than 2,100 family physicians and approximately 1,400 other primary health care professionals, most commonly nurses, nurse practitioners, dietitians, mental health workers, social workers, pharmacists, and health educators.
Nurse Practitioner–Led Clinics are similar in concept to Family Health Teams except that the ratio of family physicians to nurse practitioners is much lower and physicians function mainly as consultants. Four Nurse Practitioner–Led Clinics have been established, and twenty-two are in various stages of development. No studies of Family Health Teams' performance have been published to date, but a multiyear evaluation of the Family Health Team initiative, commissioned by the Ontario Ministry of Health and Long-Term Care, is in its third year. (Shah, 2010).
The approach to community health encompasses broad factors that determine health such as education, employment, income, social support, environment and housing. Health centers provide accessible primary health care services in northern and rural communities and in communitie...