Geographical Proximity and Community Health Centres: A Sustainable Solution for Denmark

Abstract

Highlights: Public health relevance—How does this work relate to a public health issue? Geographical proximity, encompassing both physical distance and relational access, influences patient well-being and health equity, particularly in rural and island contexts. Everyday geographies and small-scale mobility patterns are crucial in determining whether residents can effectively access and utilise healthcare services. Public health significance—Why is this work of significance to public health? The findings show that integrating sectors such as health services, urban planning, and social policy is crucial to closing accessibility gaps in sparsely populated areas. Additionally, social and cultural sustainability plays a vital role in effective healthcare, emphasising the significance of local social networks, cultural traditions, and community cohesion. Public health implications—What are the key implications or messages for practitioners, policymakers and/or researchers in public health? Rural and island healthcare systems require patient-focused planning that accounts for transport challenges, local practices, and organisational barriers, even when services are available. Island municipalities offer lessons in proximity-based, multifunctional service models that can inform equitable health planning in settings beyond rural areas. The Danish healthcare system has transitioned from a decentralised municipal hospital model to a centralised structure dominated by large, specialised hospitals. While this shift has improved efficiency and healthcare quality in some respects, it has also created challenges in terms of accessibility, patient mobility, and sustainability. Community health centres represent a strategic response to these issues by decentralising essential healthcare services and reintroducing geographical proximity as a core principle of healthcare. In this article, we propose drawing on the 15-min city concept to discuss how accessibility and spatial equity should be integrated into the planning of community health centres as platforms for active living and strong communities. We argue that proximity and accessibility in healthcare can benefit from a broader view of mobility and a focus on developing active, independent mobility systems. Data from semi-structured interviews with patients and professionals at 11 community health centres and three regions empirically demonstrate this. The 15-min city concept can lead to a reduction in travel time and improve accessibility and proximity for older adults.