Public Health Palliative Care

Engaging communities in palliative care

Related Evidence

A relatively new concept in palliative care is that of public health palliative care (also known as health promoting palliative care). This is based on the public health concept of a population approach linking to the World Health Promotion Guidelines ‘the Ottawa Charter’.

Stemming from this the goals of public health palliative care have been described as:

Building public policies that support dying, death, loss and grief
Creating supportive environments (in particular social supports)
Strengthening community action
Developing personal skills in these areas, and
Re-orientating the health system. [1]

World Health Organization: ‘The Ottawa Charter for Health Promotion’

The Ottawa Charter

The Ottawa Charter has provided a framework for many international efforts aimed at improving end-of-life care through greater community involvement. For example, the compassionate communities model has been used to describe engagement of communities in matters related to death and dying, such as death education in schools and engaging public policy. [2,3] Along with similar initiatives including, community engagement, compassionate cities, and public health approaches to palliative care these collectively represent ‘public health palliative care’. [4,5]

These initiatives are likely to impact both community-based social outcomes for the person who is dying as well as health services-related outcomes including hospital admissions and place of death. Evidence for the impact of public health palliative care is emerging and although it is currently limited and largely descriptive in nature it suggests improvements in health care service utilisation may be achieved. [4] Through partnerships and increased collaboration between communities and health services there is opportunity to strengthen the evidence through more robust study designs. [4,6]

About palliative care: Health promoting palliative care

Video from Palliative Care NSW

Kellehear A. Health promoting Palliative care. Melbourne. Oxford University Press; 1999 p20.
Kellehear A. Compassionate communities: end-of-life care as everyone’s responsibility. QJM. 2013 Dec;106(12):1071-5. Epub 2013 Sep 30.
McIlfatrick S, Noble H, McCorry NK, Roulston A, Hasson F, McLaughlin D, et al. Exploring public awareness and perceptions of palliative care: a qualitative study. Palliat Med. 2014 Mar;28(3):273-80. Epub 2013 Sep 11.
Collins A, Brown JEH, Mills J, Philip J. The impact of public health palliative care interventions on health system outcomes: A systematic review. Palliat Med. 2020 Dec 23:269216320981722. doi: 10.1177/0269216320981722. Epub ahead of print.
Sallnow L, Paul S. Understanding community engagement in end-of-life care: developing conceptual clarity. Crit Public Health. 2015;25(2):231-8.
Mills S, Mills J. Future directions for community engagement as a public health approach to palliative care in Australia. Prog Palliat Care. 2016;24(1):15-18. doi: 10.1179/1743291X15Y.0000000012