CHB Health Planning
About Health Planning
Community Health Boards (CHBs) strive to advocate, engage communities, educate and be a leader for collaborative actions to accomplish needed change. A key CHB activity is health planning.
Health planning enables participation by community members and provides the public a voice to identify what is needed to improve the health of our communities. The community must be a key player in the health planning process. As part of health planning, the CHBs engage with the public and listen to what they feel is important to their health. The results of that consultation and engagement feeds into the creation of a three-year community health plan.
Foundations of Health Planning
A collaborative approach to health planning provides opportunities for integrating different perspectives, pooling resources, and engaging in creative problem-solving. Some CHBs may develop plans in collaboration with other CHBs, based on boundaries that make sense, to maximize opportunities.
Education and training are necessary to conduct health planning. CHB members are not required to have specific skills but rather to represent their communities. However, health planning does require particular skills in research and analysis. Since not all members may possess these skills, education is required to help volunteers gain the necessary basic skills for research and data analysis. While members may not be required to engage in in-depth research, they will be required to help analyze information for setting priorities and creating recommendations. The frequency, design, and themes of education sessions may vary depending on the situation, but some form of education is necessary, and it is valued by the volunteers as it enables them to become more effective in health planning.
Community input and participation
Community participation and input are very important to health planning. They ensure local ownership of the plan, help interpret the factual information gathered, provide mechanisms to incorporate local values, attitudes, and meaning into the plan, help generate broad community support and volunteer commitment, and encourage coordination between local health services and health-related agencies (N.S. Dept. of Health, 1997).
Population Health Approach
CHBs adhere to the philosophy that health is more than just the absence of disease, and have therefore adopted a population health approach in their mandate. This approach aims to improve the health of the population by reducing health inequities among groups (Public Health Agency of Canada, 2002), drawing attention to the variety of factors that are known to have an impact on individual and community health. These social determinants of health (Health Canada, 2004), as adopted by Canada and many other nations, are:
Employment and Working Conditions – People who are employed are healthier, and working conditions are known to have an impact on health.
Gender – Some conditions and diseases are linked to gender.
Healthy Child Development – Prenatal and early childhood experiences affect health, well-being, and competence.
Income and Social Status – The greater the gap between the richest and poorest classes, the greater the disparities in health across the population.
Social Support Networks and Social Environments – Support from family, friends, and communities is linked to better health.
Education – The more education one has, the more likely one is to be healthy.
Health Services and Social Services – A person’s health benefits from access to services that prevent disease and maintain and promote health.
Physical Environments – Clean air and water, healthy workplaces, safe and affordable housing, and safe communities and roads are known to improve one’s health.
Biology and Genetics – Some physical characteristics that a person inherits play a role in how long s/he lives, how healthy s/he will be, and how much at risk he/she is for certain illnesses.
Personal Health Practices and Coping Skills – Diet, levels of physical activity, habits such as smoking, drinking, and gambling, and the way one responds to other people, stresses, and challenges all affect an individual’s health.
Culture – Customs, race, traditions, and beliefs of families, communities, and individuals all affect health.
(Source: Health Canada, 2004)
A population health approach also includes a series of principles that will aid in improving the health of the population. These include basing decisions on evidence, investing upstream, applying multiple strategies, collaborating across sectors, increasing community involvement, and increasing accountability (Public Health Agency of Canada, 2002). CHBs should use a population health approach with an equity lens throughout the entire planning process.
Evidence-based decision making
Community health planning is based on two essential sources of information:
Data & Evidence – This includes research articles, systematic reviews, reports, and other information published either in print or through the Internet, including statistical and demographic data that describes local communities and/or target groups. There are great resources on the National Collaborating Centre for Methods and Tools website (www.nccmt.ca/resources/multimedia-eng.html).
Community and Participant Input – This is the result of consultation and is necessary to assess both the level of need and the level of support for health in a community (Pennock, Catano, & Ross, 2000).
This information is used to help provide evidence as a foundation for the creation of the health plan, including the setting of priorities, the development of recommendations, and implementation. Good planning is a function of balancing the evidence, data, and community input. All are essential, and it is important to base decisions and priorities not on feelings or conversations but rather on evidence from the community.
Health equity refers to the fair distribution of the resources needed for health, fair access for opportunities to be healthy (i.e. access to the social determinants of health), and fairness in the supports and services provided to people when they are ill or injured (WHO, 2008). It is important to consider equity in health planning because not everyone has the resources they need to be healthy, and some groups experience unfair treatment in health systems. Using an equity lens can help identify priority populations who face barriers or require additional supports to access the conditions needed for health, and the services and supports needed to address health concerns.
Alignment with relevant strategies
Provincial population health strategies are implemented to take action on issues of public health concern. These are evidence-informed, based on the best available research and the prevalence/incidence of a health-related concern. Consideration should be given to how the strategies align with other relevant strategies and how health planning is aligned with the intent (e.g., THRIVE, Tobacco Control strategy, Public Health protocols).
As directed by the Health Authorities Act, CHBs will be actively involved in the identification and implementation of health promotion initiatives that will serve to improve the health of the community. According to the World Health Organization’s (WHO) Ottawa Charter for Health Promotion, “Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.”
The Ottawa Charter for Health Promotion
The Ottawa Charter builds on personal and community strengths for the improvement of health.
Collaborative Community Health Planning Examples
Colchester & East Hants Health Plan Launch
The Community Health Boards in Colchester and East Hants were proud to launch their new three year community health plan. They have identified 4 priority areas of focus including:
Enhance and Promote Mental Wellness,
Healthy Active Living, Affordable Thriving Communities,
Build Relationships and
Foster Inclusive Communities.
The areas of focus were decided based on data collected from community surveys and community conversations within the Colchester / East Hants Area
Health Promotion Workshop
This spring Western Zone was excited to host a Health Promotion Workshop for CHB members all across the Western Zone.
The session was originally developed together with NSHA Public Health. The workshop was designed to be interactive and to strengthen CHB knowledge around health promotion. Everyone present had an opportunity to work in depth with the Health Impact Pyramid, practiced applying the principles of health promotion to their work, and learned about current tools, resources and best practices. Participants from Yarmouth to Wolfville and Shelburne to Lunenburg gathered in Digby for this great day of networking and learning together.
All resources developed for the day are available and we encourage their use by all CHBs .