I thought you may be interested in an Australian perspective. There are about 100 CHCs in Victoria , Australia , which are probably a different model in that they are largely state funded but provide a wide range of services and are a platform for lots of State and Federal initiatives. There is a current consultation in process to look at the future of these services particularly in response to the burgeoning demand on public hospitals. The following paper presents an interesting policy position which is very much based on social determinants of health philosophy. Community Health Services - Creating a Healthier Victoria: Public consultation draft Available at www.dhs.vic.gov.au/phkb Published by Primary and Community Health Branch Victorian Government Department of Human Services Melbourne Victoria January 2004 Contents are: * Executive summary iv * Introduction 1 * The vision and principles for Community Health Services 3 * Guiding vision 3 * Principles for planning, delivery and evaluation 3 * The benefits of strong community health services 5 * Improving health and diverting patients 5 * Tackling the causes of ill-health 7 * Enhancing the role of general practice 9 * Promoting mental health and wellbeing 11 * Enhancing planning to meet community needs 12 * Improving business systems, efficiency and productivity 13 * Strengths and weaknesses of Community Health Services 14 * Conclusion 14 * Strategic policy initiatives 15 * Appendix 1 - Shaping the role of Community Health Services 22 * Appendix 2 - Comparative analysis of Community * Health Services in Australia 28 * Appendix 3 - WHO principles for primary health care 31 * References 32 * Common terms and abbreviations 34 Kind regards Debra O'Connor Director of Allied Health and Health Promotion Dianella Community Health ph 03 8345 5450 mob 0417 690291 fax 8345 5831 -----Original Message----- From: AnnetteAPenney [mailto:[log in to unmask]] Sent: Thursday, 8 April 2004 7:42 To: [log in to unmask] Subject: Re: [SDOH] Primary Care Cooperatives I can respond to this topic very easily by simply stating the title of my upcoming thesis work. "Health Status and Outcomes for Patients of Community Health Centres: A Case for Inclusion of the Broader Social Determinants of Health in Addressing Health Issues. A Case Study of Lang's Farm Village Association." The answer to primary health care delivery woes is CHCs. This model of primary health care addresses all of the social determinants of health by providing access to services that address SDOH. The CHC is an empowerment model and allows for community members to contribute by volunteering their services in any of the many programs offerred if they want to. I will contribute more over the next year on this as my thesis develops. Thank you for allowing me to contribute to this listserv. Annette A. Penney, Masters Student Community Psychology Program Wilfrid Laurier University 75 University Avenue West Office N2068, Science Building Waterloo, ON N2L 3C5 Tel. 519-884-0710 ext.2955 DISCLAIMER: The information in this message is confidential and may be legally privileged. It is intended solely for the addressee. Access to this message by anyone else is unauthorised. If you are not the intended recipient, any disclosure, copying, or distribution of the message, or any action or omission taken by you in reliance on it, is prohibited and may be unlawful. Please immediately contact the sender if you have received this message in error. Thank you.