Improving Access to Primary Healthcare in Alberta: A Socio-Ecological Approach

Access to primary healthcare is a fundamental pillar of a well-functioning health system, yet many Albertans face significant barriers in obtaining timely and equitable care. Whether due to geographic isolation, physician shortages, or systemic inequities, these barriers create ripple effects that impact overall health outcomes. To address this issue effectively, we must consider healthcare access through a multilevel model of health, recognizing the complex interplay between individual, interpersonal, community, institutional, and policy-level factors.

The Individual Level: Personal Barriers to Healthcare

At the core of healthcare access are individual factors—a person’s knowledge of healthcare services, their health literacy, socioeconomic status, and physical ability to seek care. Many rural Albertans, for example, may delay seeking medical attention due to long travel distances or financial concerns, while individuals with lower health literacy may struggle to navigate the system.

Imagine Citizens (2023) highlights the need for increased public awareness and education to empower individuals in making informed healthcare decisions.

The Interpersonal Level: The Role of Family and Support Networks

Family members and social networks often play a crucial role in guiding individuals through the healthcare system, particularly for children, the elderly, and individuals with disabilities. However, when caregivers lack adequate support or knowledge, this can become a barrier rather than a facilitator of access.

Cumming School of Medicine (n.d.) discusses initiatives aimed at strengthening community-based healthcare support, particularly in underserved populations.

The Community Level: Geographic and Infrastructure Challenges

Access to healthcare is heavily influenced by a person’s location. In Alberta, rural and Indigenous communities face significant disparities due to the shortage of primary care providers and limited healthcare facilities. Indigenous populations, in particular, experience higher rates of chronic illness and reduced access to culturally appropriate healthcare services. Addressing these challenges requires a collaborative approach that includes Indigenous perspectives and community-driven solutions.

Government of Alberta (2023) explores how the province is working to address these challenges through strategies such as expanding telehealth services and investing in mobile healthcare units.

One initiative that has demonstrated success in supporting Indigenous healthcare access is Dr. Mendez’s Virtual Health Hub in Saskatchewan (Virtual Health Hub, n.d.). This model leverages virtual care to connect Indigenous patients with primary and specialist care in a culturally safe manner. Expanding similar programs in Alberta could significantly improve access and trust within Indigenous communities.

The Institutional Level: Systemic Barriers within Healthcare Facilities

Even when healthcare facilities exist, issues such as long wait times, provider shortages, and overburdened emergency rooms can prevent people from receiving timely care. Alberta’s healthcare system faces physician burnout, inadequate integration of nurse practitioners/physician assistants, and outdated infrastructure that limits efficiency.

Ladd, B (2015) highlights how these institutional barriers contribute to healthcare inequities, and how modernizing healthcare delivery models can help alleviate some of these pressures.

Alethea Medical’s eConsult platform has emerged as a solution to these systemic issues. Currently the most widely used eConsult service in Alberta, Alethea enables primary care providers (PCPs) to consult specialists asynchronously, reducing unnecessary referrals and improving efficiency. In Indigenous and remote communities, Alethea has proven especially impactful, with providers in Siksika Nation, Tsuu T’ina Nation, and the Alberta Indigenous Virtual Care Clinic using the platform to facilitate culturally safe, trauma-informed care (Alethea Medical, 2024). In 2024, they facilitated a total of 21,841 eConsults, enhancing timely access to specialist care and reducing unnecessary referrals.

The Policy Level: Government Interventions and Public Health Strategies

At the highest level, government policies play a crucial role in shaping healthcare accessibility. Funding, legislation, and strategic planning determine whether primary healthcare is adequately staffed, resourced, and available to all communities.

Public Health Agency of Canada (2023) examines how policies addressing social determinants of health impact healthcare accessibility and equity.

Clarifying the Multilevel Model vs. Socio-Ecological Model

It’s important to note that while the multilevel model of health and the socio-ecological model share similarities, they have distinct focuses. The socio-ecological model emphasizes social and environmental determinants of health, while the multilevel model is often used to analyze healthcare system structures and delivery. Both frameworks are valuable in discussions of healthcare access and equity, and in practice, they are sometimes used interchangeably.

Moving Toward Solutions: What Can Be Done?

By applying this multilevel model of health, we can identify concrete actions to improve access to primary healthcare in Alberta:

✅ Expand telehealth services to rural and underserved regions.

✅ Develop culturally sensitive healthcare programs for Indigenous and immigrant communities.

✅ Increase funding for team-based care models, integrating nurse practitioners, physician assistants and other healthcare professionals to relieve pressure on physicians.

✅ Invest in community health initiatives that support caregivers and patient education.

✅ Advocate for policy changes that prioritize healthcare access in provincial planning.

Final Thoughts: A Call to Action

Improving access to primary healthcare in Alberta requires a comprehensive, multilevel approach that addresses individual, community, and systemic factors. However, meaningful change requires action beyond just identifying these barriers. Policymakers, healthcare professionals, and community leaders must work together to implement innovative solutions that address healthcare disparities.

What can you do? Advocate for increased healthcare funding, support community health initiatives, and encourage awareness around healthcare accessibility issues. If you are a healthcare professional or policymaker, consider how systemic changes can be made to create a more equitable and effective healthcare system.

The challenge is significant, but with coordinated efforts across communities, healthcare institutions, and government policy, Alberta can take meaningful strides toward ensuring that every resident has access to the care they need, when they need it most.

References

Alethea Medical. (2024). Improving access to care through eConsult. Retrieved from https://aletheamedical.com

Alberta Health Services. (n.d.). Social determinants of health. Retrieved from https://www.albertahealthservices.ca/Blogs/PFH/Posting300.aspx

Cumming School of Medicine. (n.d.). Local community health. Retrieved from https://cumming.ucalgary.ca/community/areas-focus/local-communities

Government of Alberta. (2023). Modernizing Alberta’s primary health care system (MAPS). Retrieved from https://www.alberta.ca/modernizing-albertas-primary-health-care-system-maps

Imagine Citizens. (n.d.). Addressing the social determinants of health: Modernizing primary health and care. Retrieved from https://imaginecitizens.ca/

Primary Care Alberta. (2025). Family with primary care provider [Photograph]. Retrieved from https://primarycarealberta.ca/

Public Health Agency of Canada. (2023). Associations between social determinants and healthcare access. Retrieved from https://www.canada.ca/content

Virtual Health Hub. (n.d.). About us. Retrieved from https://virtualhealthhub.ca/about-us/