Everyone’s business? Public health palliative care translates the big picture into concrete action

A blog post written by Dr John Rosenberg, President, Public Health Palliative Care International

Dying is everyone’s business, right? It’s the catch cry for many of palliative care campaigns, and quite rightly, too.

But what does this really mean when it comes to meeting the palliative and end-of-life care needs of whole communities, even whole countries? If dying is everyone’s business in Australia, then who is ‘everyone’?

In health care, we have specialist palliative care services whose untiring work towards improving quality of care has an invaluable role. Of course, people die in other places, such as non-specialist palliative care health services in hospitals, primary care settings, aged care and the wider community. In palliative care parlance, families and carers are part of the ‘business’ of dying too.

A public health palliative care approach holds that ‘everyone’ includes individual citizens, their social networks, as well as organisations, corporations and governments. Friends and neighbours, places of work, places of worship, schools, recreational groups, businesses – these are part of the ‘everyone’.  So too the media (in all its forms), and all levels of government.

Why take this public health approach? Isn’t it really a matter of funding more specialist palliative care services, improving the skills of the wider healthcare workforce, or providing improved support to carers? Well these are important goals and form part of the response to ever-growing demand for palliative and end-of-life care. A public health approach addresses the social, psychological and spiritual morbidities and mortalities associated with dying, caregiving, death, and grief; it utilises health promotion, community capacity-building and community development strategies in order to equip communities and countries, their citizens and organisations, with the knowledge and skills to navigate end of life in ways that appropriately support dying people and those who matter to them.

‘Everyone’ is a lot of people. It’s essential to acknowledge and embrace the different roles each player can have towards achieving the same goals. Working in partnership – particularly between healthcare services and communities – is fundamental to success. What can that look like in concrete ways?

At the recent 6th Public Health Palliative Care International Conference, over 300 delegates from all over the world gathered to showcase their efforts in this approach. We heard about small, local community development projects to increase death literacy; utilising the creative arts to engage the wider public; programs in schools to mobilise families; compassionate communities in universities; innovative partnerships between aged and palliative care services; local government programs for support of bereaved people; and policy development at national and international levels – and much more. In 2020, a Special Issue of Progress in Palliative Care will publish the plenary papers in full and the abstracts of other presentations from this conference, and you can get more details about the concrete work of researchers, practitioners, governments and creatives in this approach.

You can find out more about Public Health Palliative Care International at www.phpci.info

Dr John Rosenberg, President, Public Health Palliative Care International