The times given in the conference program correspond to Japan Standard Time (JST).
Social Interventions, Advocacy and Community Empowerment: Embedding Action on Social Risks to Health in Primary Care
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Gary Bloch is a family physician with St. Michael’s Hospital and Inner City Health Associates in Toronto and an Associate Professor at the University of Toronto. His research, clinical, education, program development, and advocacy interests focus on the intersection between social risks to health and front line health care. He has developed internationally recognized clinical tools, clinical programs and educational curricula. He is Physician Lead, Equity and Social Interventions, for the St. Michael’s Hospital Academic Family Health Team, and has overseen the implementation of a multifaceted, culture-shifting incorporation of interventions and approaches to the social determinants of health and health equity.
Dr. Bloch is co-founder of Inner City Health Associates, a group of over 90 physicians working in homeless service settings across Toronto. He also co-founded the advocacy group Health Providers Against Poverty. He is a social policy expert, and served on a working group on income security reform for the Government of Ontario. Dr. Bloch’s work is recognized locally, nationally, and internationally, and he is frequently asked to speak in academic and non-academic settings, as well as to the medical and popular media.
Health providers, and especially primary care providers, are well positioned to act on social determinants of health and health inequities. Social interventions, however, are not traditionally seen as a core part of primary care practice, but the last few years have seen a dramatic increase in their development, evaluation and dissemination.
The St. Michael’s Hospital Academic Family Health Team (SMHAFHT), based in downtown Toronto, Canada, serves almost fifty thousand patients with an interdisciplinary team of over 300. Since its inception 50 years ago the SMHAFHT has explored ways to address the health needs of the most socially marginalized community members. Over the past 15 years it has placed an increasingly intense focus on directly understanding and addressing social needs and health inequities faced by its patients and its community.
The shape of social interventions in front line care has evolved, from offering simple clinical tools to be used in office interactions to embedding social care specialists in health teams, to a more concerted engagement and empowerment of communities in the design, delivery and evaluation of programs. Throughout, health providers have advocated for and helped to shape the social policies that will reduce inequities on a large scale.
This presentation offers a critical reflection on a large health team’s evolution towards building social interventions into its core structure and practice. The incorporation of social interventions is fraught with conceptual and practical challenges. A shift in health team culture has been attempted through supportive innovation, education, conversation, and the building of an infrastructure that enables providers to understand, address and continuously improve approaches to health inequities. The most recent interventions seek to deepen this transformation with an explicit focus on community engagement and community empowerment.
It is hoped this evidence- and experience-grounded story will offer participants an opportunity to reflect on the potential for health providers to reduce social pressures on individual and community health, while aware that these efforts may reinforce hierarchies of privilege and power they purport to challenge.
Good practice from Japan for improving health equity for patients
Fukuoka Iryo Dan - Chidoribashi General HospitalKyushu Institute for Social MedicineJapan HPH Network
Mitsuhiko Funakoshi serves as the Chairman of the Fukuoka Iryo Dan - Chidoribashi General Hospital and is the Director of the Kyushu Institute for Social Medicine. He specializes in occupational medicine and social medicine, and also practices clinical internal medicine. He has played a central role as the Coordinator of the Japan HPH Network, from its establishment in 2015, to the successful bid for hosting the current International HPH Conference.
His areas of interest include addressing health disparities and creating healthier work environments. Health disparities have also become a significant issue in Japan, with an increasing number of patients unable to continue necessary medical treatment due to economic hardship. Therefore, he is developing tools to assess patients' social determinants of health (SDH) in clinical settings and provide support utilizing social resources. He is also involved in promoting 'No Lifting' practices as part of back pain prevention for nurses and caregivers, and advocates for reducing working hours to prevent overwork-related deaths (Karoshi) in collaboration with labor unions.
Funakoshi, Mitsuhiko
The Japan HPH Network (J-HPH) was established in 2015 with the aim of improving health standards of all people in Japan and contributing to a fair society. In Japan, health disparities are widening and the isolation of the elderly in this super-aging society have become significant issues. Here, I introduce our experiences in addressing these challenges.
J-HPH developed an "Economic Support Tool（Poverty Intervention Tool)" to assist economically distressed patients. This tool includes simple questions to understand their economic situation and indicates the available social resources. An online version is utilized in patient support at medical sites and in the education of medical students. Moreover, J-HPH holds seminars twice a year to promote equitable medical and nursing care through the exchange of good practices from member institutions, as outlined below.
As an example of member activities, I introduce Chidoribashi General Hospital. Located in a low-income area, this hospital protects patients' rights to receive medical care by reducing the financial burden through the Free and Low-Cost Medical Care Project. Among elderly people living alone who have interrupted regular visits, there are more than a few cases of solitary death or worsening chronic diseases. To prevent such cases, staff regularly conduct outreach activities by visiting patients' homes. Additionally, the hospital quantitatively monitors the implementation of equitable medical care. All inpatients are interviewed about their economic situation and whether they are isolated, and for necessary cases, social workers provide consultations and promote the use of social resources. The hospital measures the evaluation and support rates of patients' economic status and living status to clarify their attainment of equitable medical care.
Furthermore, efforts are being made to address health disparities among minorities such as foreign residents and LGBTQ individuals, as well as health damages caused by the climate crisis.
Natural disasters significantly impact the health of vulnerable people, making them an important issue from the perspective of health disparities. For example, since the 2024 Noto Peninsula Earthquake, Jouhoku Hospital in Kanazawa City has been continuing its earnest support for disaster victims.
Social Prescribing: A Strategy for Health Promoting Hospitals
SingHealth Community HospitalsDukeNUS Medical School
A/Prof Kheng Hock Lee is an opinion leader in the field of social prescribing in Singapore and the region. He practices as a family physician at the Singapore General hospital managing patients with complex health and social care needs.
As Deputy CEO (Education and Community Partnerships) at SingHealth Community Hospitals, he oversees clinician training and community partnerships in health and social care integration.
He teaches family medicine at DukeNUS Medical School and held leadership roles in many professional bodies including the President of the College of Family Physicians and Assistant Master of the Academy of Medicine Singapore. In recognition of his contributions to education and patient care, he had received multiple national and international awards.
LEE, Kheng Hock
The implementation of social prescribing in Singapore can serve as an exemplar of the principles of health promoting hospitals. The SingHealth Community Hospitals (SCH) in Singapore adhere to the health promotion ethos by focusing on empowering patients, supporting staff well-being, and engaging the broader community. SCH offers educational programs, comprehensive care, and community outreach to address social determinants of health. SCH is the first hospital in the world to implement a structured social prescribing into its model of care. In this social prescribing program, patients are screened for the social determinants of health to co-develop and initiate a social prescription to complement the medical prescription during the hospital stay. On discharge, patients are connected to community partners to continue the social prescribing plan to tackle issues like social isolation and lack of access to support services. This patient-centric approach empowers individuals to take an active role in their health and well-being. Crucially, the success of social prescribing hinges on strong partnerships between healthcare providers and community organizations, ensuring culturally appropriate resource referrals.
The implementation process itself mirrored the values of health promoting hospitals. The team prioritized understanding local needs, engaging diverse stakeholders, and committing to continuous program evaluation and improvement. This contextualized, collaborative, and iterative approach reflects the core principles of health promoting hospitals. Singapore's experience demonstrates how social prescribing can be a powerful tool for health promoting hospitals. By addressing social determinants, empowering patients, and fostering community partnerships, social prescribing embodies the ethos of this public health-oriented model of healthcare. As healthcare systems worldwide seek innovative ways to improve population health, Singapore's pioneering work offers valuable insights and inspiration.
Professor, Department of Medical Education, Juntendo University, Faculty of Medicine
Professor Takeda is a primary care physician by training. Her focus in teaching is health inequities and social disparities. She serves as a board member of the Japan Primary Care Association and chairs the SDH (Social Determinants of Health) Committee. She is also a board member of the Japan Society of Medical Education. She has been appointed Chief Editor of its journal, Medical Education (Japan), which enables her to promote teaching SDH. She participates in an outreach program for people in homelessness and collaborates with an NGO helping children whose parents are from overseas. She has been working to improve healthcare access for international residents by promoting “plain Japanese” among healthcare professionals. She is also eager to create a safer space for students and patients regardless of their sexual orientation and gender identity.
CEO of the International HPH Secretariat, OptiMedis AG, Hamburg, Germany
Professor Dr Oliver Groene is CEO of the International Network of Health Promoting Hospitals and Health Services and Vice Chairman of the Board at the population health management company OptiMedis AG, where the Network's secretariat is hosted.
He also holds the position of Professor at the Department of Management, Economics and Society at the University of Witten/Herdecke, Germany. Previously, he was Associate Professor in Health Services Research at the London School of Hygiene and Tropical Medicine and Manager of the "Quality of Health Systems Programme" at the World Health Organization.
He holds an MSc and PhD in Public Health and an MA in medical sociology and organizational sciences. Oliver Groene publishes widely on quality of care and health services research topics (H-index: 45).