Belonging: The Missing Link to Good Health

Connected and caring communities keep people well. If you feel you belong to a community, and that community makes you feel valued and accepted, you're more likely to be healthy. In fact, research shows that not only do our connections to others and the strength of those relationships make us less likely to suffer from poor health, strong social networks encourage engagement to community and willingness to take action.


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That's why Community Health Centres across Ontario deliver medical services in combination with health promotion and community development programs designed to build vital communities where everyone feels they belong. The stories in this guide are a testament to this work. You'll read about what belonging is and why it matters to good health. You'll learn about initiatives and programs that cultivate relationships and community connections, for example: community gardens, programs, sports and cultural groups, advocacy committees to advance healthier public policy, and programs that enable community members to take on leadership roles. You'll hear about client experiences and how they shape decision making. And you can use these examples to inform and inspire the development of your own programming, help you reflect on your approaches and actively put belonging into practice.

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Building Community Vitality and Belonging is one of the core principles of the Model of Health and Wellbeing, which lays the foundation to our approach to keep people healthy and address their health and wellbeing needs. It speaks to one of the things that community health centres do best: provide a safe and caring place where everyone belongs, regardless of skin colour, age, sexual preference, income level or any myriad of attributes. No one is excluded.

We are also united by the belief that the people we serve are encouraged to participate in efforts not only to improve their health and wellbeing, but also that of the communities in which they live. We strongly believe that everyone we serve has precious gifts to offer which, if named and harnessed, are an integral part of the path to health and wellbeing benefitting both individuals and communities as a whole.

Association of Ontario Health Centres (AOHC) members prioritize cultivating relationships and work to create initiatives that lead to positive community connections. Research supports this rationale. "These kinds of programs enhance a sense of community belonging," says Philip Baiden from the University of Toronto and lead researcher on The Role of Sense of Community Belonging on Unmet Health Care Needs in Ontario which emphasized the need for more community initiatives like those delivered by Ontario's Community Health Centres. "Whereas these may appear to some people as less important, I would stress that all these priorities lead to social inclusion, safety, decreased stress, and increased sense of belonging."
 
These efforts are enabled by community governance. Because Community Health Centres are governed by community members, they are optimally equipped to identify the types of programs that will best enhance a strong sense of belonging in their community.
It is very crucial to involve local community members in the design of any health related programs and policies, states Baiden. These individuals are in a much better position to tell what is likely to work, the likely challenges and the setbacks that might arise. They also know how to best promote these programs to their community members so that they see themselves as a part of it.

What is Community Vitality and Belonging?


When viewed through the powerful lens of the Canadian Index of Wellbeing, Community Vitality is one of eight major domains that are essential for people to enjoy optimal health and wellbeing.

According to the Canadian Index of Wellbeing: "Vital communities are characterized by strong, active, and inclusive relationships between residents and private sector, public sector, and civil society organizations that work to foster individual and collective wellbeing. Vital communities are those that are able to cultivate and marshal these relationships in order to create, adapt and thrive in the changing world." (University of Waterloo)

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A sense of belonging is one of the building blocks of healthy, vital communities.

Set against the backdrop of community vitality, belonging can perhaps be best understood as something people experience when they feel accepted and valued for who they are, regardless of the norms by which our culture assigns worth, such as income level, educational attainment, ethnicity, and/or health status.

And who among us does not have this basic human need? To feel like they are a part of a group, family, or community? It is our connection and ties with others that not only provide us with our identity but also some semblance of meaning and purpose, while loneliness, social isolation and living alone can harm our health and even increase a person's risk of premature death.

 

Why is belonging important for health and wellbeing?


At the individual level, belonging leads to numerous positive health benefits, both physical and mental. Conversely, people with poor or insufficient relationships experience a number of negative effects on their long-term health and wellbeing when their sense of belonging is lower.

A sense of belonging creates:
  • Lower prevalence of mental health issues
  • Lower rates of unhealthy behaviours such as smoking, not exercising, not getting enough sleep and drinking too much alchol
  • Lower risk of cardiovascular disease mortality
  • Better health in general
  • Lower rates of unhealthy, and drinking too much alcohol






What's more, the benefits of belonging extend beyond the individual to the community's health and wellbeing. (Journal of Public Health)
  • People who belong are more likely to participate and become engaged in their community and have better health outcomes
  • People who feel a strong sense of belonging are more likely to donate their time and money to improving the community, and show caring for other people who live there

     
 
DID YOU KNOW?
Feeling like you belong matters. 
 
  • According to the Public Health Agency of Canada, people with adequate social relationships have a 50% lower risk of death than those with poor or insufficient relationships. As a risk factor for mortality, social isolation exceeds obesity and physical inactivity, and the positive effects of social connectedness on long-term health are equal to those of quitting smoking. (Public Health Agency of Canada)
  • An increased sense of community belonging is just as important as developing healthcare policies and programs that meet the needs of individuals states the Canadian Community Health Survey. (Journal of Public Health)
  • People who don't know their neighbours are more likely to face serious health issues. Lack of strong connections can also lead to mental health issues, addictions and even physical illnesses such as diabetes. (Brian Bethune, Macleans Magazine)
  • Seniors are especially vulnerable to isolation, and tend to feel its effects more keenly than others – yet 20% of Ontario seniors do not participate in frequent (i.e., weekly or monthly) social activities. (Institute of Marriage and Family Canada)
  • There are also emotional benefits. Even a person's awareness that they could receive assistance in times of need from their social network can lead to greater levels of wellbeing.
     


What can community health centres do to increase belonging?

 
The Missing Link: Belonging and Programs is a two-part video series that explores the links between belonging, program design and effectiveness. In the series, Gary Machan introduces the concept of sense of belonging and why it matters to good health and provides an overview of the typology of supports, i.e. concrete, educational, emotional, and social integration. Drawing on over twenty years of field experience as a community developer, he offers some key program design considerations required to have a positive impact on complex clients, especially those who are socially isolated.



  
Now that you have a better grasp of what belonging is as a subset of community vitality and some key program design considerations, the next obvious question is: what things can staff working for community health centres bring into their everyday work to help build higher levels of belonging?

To be successful, we should embrace a team approach in which everyone who is employed within a centre understands that they have a part to play in performing this work. In other words, adopt a mindset where EVERYONE IS A HEALTH PROMOTER.

1. Front Room/Reception
When it comes to ensuring that the people we serve feel valued and accepted, the way they are treated at this first point of contact is essential. And that first encounter for a client is the lobby and people staffing the front desk. Learn More

2. Clinical Services
It is essential that we make every effort to work with the people we serve in a way that makes them feel respected and accepted. Learn More

3. Ongoing Programs/Groups
One of the tell-tale indicators of a strong interdisciplinary team are the number of cross referrals; especially, between clinicians and health promoters.

4. Community Development
The very act of participating in community initiatives can often have a profound impact on increasing a person's sense of belonging in a community. Learn More

5. Policy/Systems Change
While many approaches can have a profound impact on increasing our client's sense of belonging, the reality is that there are many systemic barriers in our communities which can undermine the extent to which someone feels accepted and valued.
 

Connecting the dots


There is a real element of interconnection between each of the domains of the CIW. And by learning to see our work through the lens of the Index, we can better see what it is we do in a more holistic way.

Learn about the Wasaga Beach Community Garden through the lens of the CIW to see how to build the Index into the outcomes of your work.

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Helpful Resources


Download the companion materials for The Missing Link: Belonging and Programs video series: The Missing Link Resources.pdf

Read the Community Foundations of Canada's belonging reports including the 2015 national Vital Signs report Belonging: Exploring Connection to Community which looks back over the past 50 years at our sense of belonging and where we, as communities and a country, are headed