Health Sciences

Palliative Care Unit

Compassionate Cities

Compassionate Cities is a health promotion initiative conceptualised and developed by Professor Allan Kellehear from La Trobe University’s Palliative Care Unit.

Compassionate Cities builds upon World Health Organisation’s (WHO) model of Healthy Cities in order to include compassion and all its implications. Compassion is both an attitude and an action and can be defined as sharing with another’s suffering. Compassionate Cities assert that quality of life is not merely the absence of problems. Therefore, the main aim of Compassionate Cities is to deepen the quality and the extent to which a community may look after its own members.

In Compassionate Cities, care for those who are dying or experiencing loss takes on a health promoting approach and involves the whole community. This is in contrast to approaches that define palliative care as clinical care at the end of life and focus solely on professional help. In Compassionate Cities, palliative care services can take a leadership role in initiating community action.

Designed as one way to implement the Ottawa Charter for Health Promotion and applicable to any urban city, Healthy Cities takes a global public health approach to the promotion of community-wide strategies for health. Its emphasis is the ongoing process of achieving better physical and social environments, thus improving the health and wellbeing of those dwelling in the city. Action strategies are designed to be applied across a diverse range of sectors: workplaces, recreational sites and events, schools and universities, nursing homes and hospitals, churches and temples, local government and voluntary organisations.

This intersectoral approach to public health draws heavily on the idea that personal health depends on strong and sustainable social foundations: partnerships, community involvement and supports, re-orientation of health services, and the development of personal skills for all citizens. The basic assumption of this public health approach is that health is not merely the absence of disease.

Additional informational about Healthy Cities can be found at www.who.dk/healthy-cities/.

Compassionate Cities builds upon this model in order to include compassion and all its implications. Compassion is both an attitude and an action and can be defined as sharing with another’s suffering. The opposite of compassion is apathy. Compassionate Cities assert that quality of life is not merely the absence of problems. Therefore, the main aim of Compassionate Cities is to deepen the quality and the extent to which a community may look after its own members.

Central concepts of Compassionate Cities are that compassion is an ethical imperative for health; health is a positive concept even in the presence of disease, disability or loss; compassion is a holistic/ecological idea; and that compassion implies a concern with the universality of loss. These central concepts have been translated into the Nine Defining Characteristics of Compassionate Cities. A Compassionate City:

1. Has local health policies that recognise compassion as an ethical imperative
2. Meets the special needs of it’s aged, those living with life threatening illness, and those living with loss
3. Has a strong commitment to social and cultural difference
4. Involves the grief and palliative care services in local government policy and planning
5. Offers its inhabitants access to a wide variety of supportive experiences, interactions, and communication
6. Promotes and celebrates reconciliation with indigenous peoples and the memory of other important community losses
7. Provides easy access to grief and palliative care services
8. Has a recognition and plan to accommodate those disadvantaged by the economy including rural and remote populations, indigenous people and the homeless
9. Preserves and promotes a community’s spiritual traditions and storytellers

- Kellehear, A. (in press). Compassionate Cities: Public Health and End-of-Life Care. Routledge: UK

Thus, in Compassionate Cities, care for those who are dying or experiencing loss takes on a health promoting approach and involves the whole community. This is in contrast to approaches that define palliative care as clinical care at the end of life and focus solely on professional help. In Compassionate Cities, palliative care services can take a leadership role in initiating community action.

For further information about the Compassionate Cities Project contact the Palliative Care Unit.