Community Engagement in Lower Central Hamilton: Resident Health Needs and Key Considerations for the Delivery of Health and Social Services
About us
Carolyn, Morgan and Subiksha’s capstone project puts into practice their shared passion for community engagement, health equity, and improving access to healthcare. They are working in Lower Central Hamilton (LCH), a region in Hamilton, Ontario in which residents are disproportionately affected by the social determinants of health (SDH). This project aims to understand the health needs of LCH residents and key considerations that facilitate the context-appropriate and sustainable delivery of health services in this community. This research enhances ongoing initiatives aimed at improving the health and social outcomes of LCH residents through engagement at the neighborhood level.
Background
In 2010 the Hamilton Spectator published the Code Red Series, an investigative report aimed at uncovering and tracking disparities in health outcomes between all Hamilton neighbourhoods. This work revealed that LCH has some of the worst socioeconomic variables among all Hamilton neighbourhoods regarding income, high school dropout rates, and number of individuals using government financial aid. In addition, LCH had one of the lowest average lifespans, highest average hospital and urgent hospital admission rate per 1000 people, highest emergency room visit rate per 1000 people, and the highest percentage of unattached patients. A decade later, a follow-up Code Red report revealed that despite interim initiatives to improve health outcomes in LCH, almost all health-related outcomes either worsened or remained the same.
To address the health disparities within this neighborhood, the Hamilton Family Health Team (HFHT) has championed the launch of a new primary healthcare program at the Eva Rothwell Centre, called “Health Care at Eva Rothwell Centre”. The Eva Rothwell Centre is a community hub in LCH that offers a variety of community programs aimed at increasing the skills, knowledge, and connectedness of community members. As efforts to develop and launch this new primary health care clinic were underway by the HFHT and their partners, this capstone project was undertaken to engage with the LCH community and identify key considerations specific to the delivery of primary health care for LCH residents.
This work being done in LCH aligns with Ontario’s current focus on health equity; the province is working to create a connected health system through the development of Ontario Health Teams (OHTs) and Primary Care Networks (PCNs). These initiatives are striving to improve access to primary care, provide tailored care delivery, and promote community engagement, and thereby increasing health equity.
The capstone project’s objectives were to identify: 1) the health needs of LCH residents, 2) key considerations related to the delivery of health and social services in LCH and 3) barriers and insights related to community engagement in LCH. Data collection occurred through semi-structured interviews with 12 residents and 15 health and social service providers in LCH. Data analysis was conducted through qualitative thematic analysis using inductive coding.
Resulting themes were categorized into enablers of health, barriers to health, and participant-suggested actionable recommendations for optimal healthcare delivery. These themes substantiate the need to address residents’ SDH through providing patient-centered care, giving tailored support to newcomers, and developing community relationships. In addition, researchers shared their reflections on engaging with the LCH community in the form of actionable recommendations that other service providers or researchers could utilize throughout their own community engagement. This project situates existing research on the SDH within the LCH context and offers strategies for how service providers can optimize health care delivery to meet residents’ needs. This research enhances ongoing initiatives aimed at improving the health and social outcomes of LCH residents through engagement at the neighborhood level.
