Building Compassionate Communities to Improve Public Health

Julian Abel, MD has been a consultant in palliative care since 2001, as well as the Vice President of Public Health Palliative Care International, and the Director of Compassionate Communities UK. Since 2016 Julian has been collaborating with Frome Medical Practice in the UK to roll out their innovative model of building social connection within the community to improve health outcomes and quality of life. The initial results have been remarkable, with dramatic decreases in local emergency admissions compared to surrounding areas.

On this podcast with Tommy Wood, MD, PhD, Julian describes the compassionate community model of care, including the financial and social benefits that come with weaving social support into an existing health care system. He explains how creating stronger connections within the community is a public health imperative and a socially conscious alternative to rising health care costs. He’s also developed a replicable system for bringing the concept to other communities and businesses.

Here’s the outline of this interview with Julian Abel:

[00:02:19] Compassionate communities: Things that matter most to people who are dying and the supportive networks that surround them.

[00:03:08] Palliative care.

[00:05:18] The impact of kindness and compassion on how we function.

[00:06:01] Death: how best to help people with terminal illness.

[00:08:40] Frome Medical Practice in Somerset; Health Connections Mendip.

[00:10:47] Impact of social connection: 14% reduction in emergency admissions in Frome, compared to 28.5% increase in admissions within Somerset; Study: Abel, Julian, et al. "Reducing emergency hospital admissions: a population health complex intervention of an enhanced model of primary care and compassionate communities." Br J Gen Pract 68.676 (2018): e803-e810.

[00:11:53] Social relationships and mortality; Study: Holt-Lunstad, Julianne, Timothy B. Smith, and J. Bradley Layton. "Social relationships and mortality risk: a meta-analytic review." PLoS medicine 7.7 (2010): e1000316.

[00:12:37] Bringing compassionate communities into health services.

[00:14:35] Benefits to health, medicine, and society.

[00:16:23] Compassionate Communities UK.

[00:18:32] Key functions of the model.

[00:23:16] Reciprocity and altruism.

[00:24:31] Systematic program implementation: How to bring these practices to new communities.

[00:26:16] Public Health Palliative Care International; Compassionate City Charter.

[00:29:00] Implementation within companies for staff retention and recruitment, employee morale, productivity.

[00:30:25] Physicians: Emotional distance vs. compassion.

[00:33:49] Placebo effect and therapeutic relationship.

[00:37:14] Fitting the model into even very brief medical consultations.

[00:37:31] Health Connections Mendip service directory.

[00:38:48] A “malnourishment of compassion”, across all age groups.

[00:41:34] Resurgence & Ecologist Magazine article: Compassion is the best medicine, by Julian Abel and Lindsay Clarke.

[00:41:37] Guardian article: The town that’s found a potent cure for illness – community, by George Monbiot.

[00:42:13] Highlights email discussing compassionate communities paper and intervention.