Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE (Open Access)

Health promotion activities in Ontario Community Health Centres: a descriptive report

Sara Bhatti A * Jennifer Rayner A B C
+ Author Affiliations
- Author Affiliations

A Alliance for Healthier Communities, Toronto, ON, Canada.

B Centre for Studies in Family Medicine, University of Western, London, ON, Canada.

C Department of Research and Policy, Alliance for Healthier Communities, Toronto, ON M6A 3B6, Canada.

* Correspondence to: sara.bhatti@allianceon.org

Australian Journal of Primary Health 31, PY25009 https://doi.org/10.1071/PY25009
Submitted: 25 January 2025  Accepted: 3 March 2025  Published: 27 March 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

Community Health Centres (CHCs) in Ontario, Canada have been delivering health promotion programming as part of their model of comprehensive primary health care to communities for decades. The purpose of this paper is to describe how health promotion programming is delivered within the context of Ontario CHCs.

Methods

This report used both quantitative and qualitative methods. Electronic medical record data were used to describe the variety of health promotion programming offered, as well as target populations, funding sources, and evaluation. Six focus groups were conducted with 72 health promotion staff and managers across 42 CHCs between February and March of 2023 to provide greater context on how health promotion is delivered.

Results

In 2021–2022, 2452 programs were reported amongst 69 CHCs, with the top three priorities for programming being social support, food security and education, and physical activity. The most prevalent target populations reported were the general community (24%) and children and youth (15%). Focus group data revealed that priorities are identified through a variety of approaches to ensure programs are relevant, address the needs of their communities, and promote health equity. Programs provided by CHCs leverage community volunteers to support program development and delivery, reduce barriers to participating, and link participants to other programs and services offered by the CHC.

Conclusion

Health promotion as an upstream approach can relieve pressure on the healthcare system, reduce disease prevalence and health inequities all while being cost-effective. Greater investments in health promotion are needed if we want to support and sustain our healthcare systems.

Keywords: Community Health Centres, health promotion, healthcare systems, prevention, primary health care, social determinants of health and health equity, upstream.

References

Bailey S, West M (2020) Ethnic minority deaths and covid-19: what are we to do? The King’s Fund. Available at https://www.kingsfund.org.uk/insight-and-analysis/blogs/ethnic-minority-deaths-covid-19 [cited 1 June 2020]

Canadian Medical Association (2023) Health workforce report recommendations are sound, now is the time for decisive action. Canadian Medical Association. Available at https://www.cma.ca/about-us/what-we-do/press-room/health-workforce-report-recommendations-are-sound-now-time-decisive-action [cited 18 April 2024]

Canadian Public Health Association (2024) Strengthening public health systems in Canada. CPHA. Available at https://www.cpha.ca/strengthening-public-health-systems-canada [cited 19 April 2024]

Cancer Care Ontario (2024) Chronic disease prevention strategy 2020–2023. CCO. Available at https://www.ccohealth.ca/en/what-we-do/general-health/chronic-disease-prevention/strategy2020 [cited 19 April 2024]

Deaton BJ, Deaton BJ (2020) Food security and Canada’s agricultural system challenged by COVID-19. Canadian Journal of Agricultural Economics/Revue canadienne d’agroeconomie 68(2), 143-149.
| Crossref | Google Scholar |

Dorn Av, Cooney RE, Sabin ML (2020) COVID-19 exacerbating inequalities in the US. The Lancet 395(10232), 1243-1244.
| Crossref | Google Scholar |

Dubas-Jakóbczyk K, Kocot E, Kissimova-Skarbek K, Huter K, Rothgang H (2017) Economic evaluation of health promotion and primary prevention actions for older people – a systematic review. European Journal of Public Health 27(4), 670-679.
| Crossref | Google Scholar |

Haldane V, Chuah FLH, Srivastava A, Singh SR, Koh GCH, et al. (2019) Community participation in health services development, implementation, and evaluation: a systematic review of empowerment, health, community, and process outcomes. PLoS ONE 14(5), e0216112.
| Crossref | Google Scholar |

Health Promotion Ontario (2023) White paper on the value of local health promotion in Ontario. HPO. Available at https://cdn.ymaws.com/www.alphaweb.org/resource/collection/822EC60D-0D03-413E-B590-AFE1AA8620A9/HPO-Value-of-Local-Health-Promotion-White-Paper.pdf [cited 18 April 2024]

Holman HR (2020) The relation of the chronic disease epidemic to the health care crisis. ACR Open Rheumatology 2(3), 167-173.
| Crossref | Google Scholar |

Jackson SF, Perkins F, Khandor E, Cordwell L, Hamann S, Buasai S (2006) Integrated health promotion strategies: a contribution to tackling current and future health challenges. Health Promotion International 21(suppl_1), 75-83.
| Crossref | Google Scholar |

Jones CH, Dolsten M (2024) Healthcare on the brink: navigating the challenges of an aging society in the United States. npj Aging 10(1), 22.
| Crossref | Google Scholar | PubMed |

Lin SL (2023) The “loneliness epidemic”, intersecting risk factors and relations to mental health help-seeking: a population-based study during COVID-19 lockdown in Canada. Journal of Affective Disorders 320, 7-17.
| Crossref | Google Scholar |

Masters R, Anwar E, Collins B, Cookson R, Capewell S (2017) Return on investment of public health interventions: a systematic review. Journal of Epidemiology and Community Health 71(8), 827-834.
| Crossref | Google Scholar |

McManus A (2013) Health promotion innovation in primary health care. Australasian Medical Journal 6(1), 15-18.
| Crossref | Google Scholar |

Mental Health Commission of Canada (2013) Making the case for investing in mental health in Canada. Mental Health Commission, London (ON). Available at https://mentalhealthcommission.ca/resource/making-the-case-for-investing-in-mental-health-in-canada/ [cited 1 June 2020]

Moore K (2022) Being ready: ensuring public health preparedness for infectious outbreaks and pandemics. Government of Ontario. Available at https://files.ontario.ca/moh-cmoh-annual-report-2022-en-2023-03-15.pdf

National Centre for Immunization and Respiratory Diseases (U.S), Division of Viral Diseases (2020) Health equity considerations and racial and ethnic minority groups. CDC. Available at https://stacks.cdc.gov/view/cdc/103876 [cited 5 August 2020]

Nurse J, Dorey S, Yao L, Sigfrid L, Yfantopolous P, et al. (2014) The case for investing in public health: a public health summary report for EPHO 8. WHO Regional Office for Europe. Available at https://iris.who.int/bitstream/handle/10665/170471/Case-Investing-Public-Health.pdf [cited 1 June 2020]

Rayner J, Muldoon L, Bayoumi I, McMurchy D, Mulligan K, Tharao W (2018) Delivering primary health care as envisioned: a model of health and well-being guiding community-governed primary care organizations. Journal of Integrated Care 26(3), 231-241.
| Crossref | Google Scholar |

The Lancet Healthy Longevity (2021) Care for ageing populations globally. The Lancet Healthy Longevity 2(4), e180.
| Crossref | Google Scholar |

Toronto Public Health (2020) COVID-19 and the social determinants of health: what do we know? Toronto Public Health, Toronto. Available at https://www.toronto.ca/wp-content/uploads/2020/05/96e0-SDOHandCOVID19_Summary_2020May14.pdf [cited 1 June 2020]

World Health Organization (1986) The Ottawa charter for health promotion. WHO Geneva Available at https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference [cited 5 June 2020].
| Google Scholar |

Zanganeh M, Adab P, Li B, Frew E (2019) A systematic review of methods, study quality, and results of economic evaluation for childhood and adolescent obesity intervention. International Journal of Environmental Research and Public Health 16(3), 485.
| Crossref | Google Scholar |