Mount Carmel Clinic, located in the Point Douglas community in Winnipeg’s North End, stands as a leading example of an effective interprofessional healthcare delivery model that serves a diverse, multicultural population which, due to socioeconomic circumstances, typically experiences barriers to care. Originally established in 1926 to treat Eastern European and Jewish immigrants settling in Point Douglas, Mount Carmel Clinic aims to improve determinants of health and outcomes by providing holistic and integrative health services, including chiropractic, to meet the specific health needs of its community members. This model provides an extraordinary approach to healthcare that offers broad services to address issues that affect the health of the whole community.
With a history of community-centred and innovative programming, Mount Carmel continues to respond to the changing needs of the population it serves. When the clinic was established, like other North American cities during that era, the area had experienced increased joblessness and working poor, inadequate housing, drug abuse, growing crime and violence, and transient street youth.
“We know that 50 per cent of patient’s health outcomes are determined by their socio-economic factors, versus only 25 per cent by the actual health care system itself. The other 25 per cent of your health outcomes are determined by biological, genetic and environmental factors.”
— Dr. Anna Reid, president of the Canadian Medical Association (CMA), “Wealth equals health”, by Ken MacQueen, Maclean’s, January 31, 2013
Mount Carmel Clinic: We meet you where you’re at. No judgment here.
Recent demographic trends show that Point Douglas’ population is remarkably young, and comprised of mostly single-mother families, visible minorities, and low income households, but the area also includes a large group of elderly people who live alone. These factors can create significant barriers to accessing healthcare.
“We are all very aware of the community we treat,” said Mount Carmel Clinic’s Manager of Primary Health, Mackenzie Kein, RN, BSN. “We let the client lead and everyone is onboard with providing holistic healthcare to our clients.”
Health & Wellness Programs for Indigenous Peoples
A significant portion (29%) of the neighbourhood’s population includes Indigenous peoples. Statistically, this group has poorer health and worse outcomes than non-First Nations Canadians: “Poverty, social exclusion and discrimination are common barriers to accessing healthcare experienced by First Nations people residing in urban areas, and it is increasingly acknowledged that mainstream models of healthcare do not overcome these barriers.”1
“It is mandatory for every new hire to go to Aboriginal Cultural Awareness training,” said Kein. “We are very conscious of providing care where our community members come in and feel comfortable.”
A large part of that awareness, according to Kein, is a comprehension and sensitivity to the residual damage to Indigenous culture and psyche by the residential school system. Seven in 10 First Nations people in Winnipeg say they attended or a family member attended a residential school.2
By integrating traditional healing (previously under the guidance of an Aboriginal Advisory Committee, and now through consultation with Indigenous Wellness Specialist, Kimberly Morriseau), the Clinic’s Aboriginal Health and Wellness Program helps advance access to appropriate healthcare for the Aboriginal community in Point Douglas. The program offers traditional teachings, ceremonies and medicine, which, according to the 2010 Urban Aboriginal Peoples Study (UAPS), “is as, if not more, important than access to mainstream healthcare for the majorities of urban Aboriginal peoples.”
“Statistics Canada has reported that growing up in poverty is associated with increased rates of death and illness including diabetes, mental illness, stroke, cardiovascular disease, gastrointestinal disease, central nervous system disease and injuries.”
Chiropractic & Community-Centred Healthcare
Mount Carmel Clinic’s Chiropractic Program treats patients with a variety of musculoskeletal (MSK) conditions, including some conditions that present disproportionately in First Nations communities. For example, because this group has a higher rate of diabetes, chiropractors often treat the secondary MSK symptoms related to diabetic neuropathy or amputation.
In the case of accidental injury and motor vehicle accidents, First Nations Manitobans are almost four times more likely to suffer severe physical injury requiring hospitalization, but are less likely to receive follow-up care or rehabilitation due to a lack of access to healthcare specialists, as well as a lack of transportation to receive that specialty care. Unresolved injury often leads to chronicity and disability.
The team at Mount Carmel Clinic understand this and have adapted according to the needs of its clients. “We understand our community resources very well,” said Kein. “We will arrange handi-transit and pay cab fare for specialist appointments.”
Mount Carmel Clinic’s chiropractors continue to respond to community members’ needs, working to ensure treatment continues to be client-led, holistic and responsive to the Point Douglas community.
Next week – Using Data to Understand Patient Needs: How Mount Carmel Clinic’s chiropractors ensure they understand patient healthcare needs
1. McDonald, H. (2007).The organization and utilization of arthritis health services for First Nations people living in the Southern Mainland of British Columbia. Vancouver, BC: University of British Columbia, unpublished doctoral research proposal 2. The Urban Aboriginal Peoples Study: Winnipeg Report, Evironics Institute, 2011.