A community oriented approach to primary health care.

A broader perspective is needed in family medicine. The traditional nuclear family is in transition; extended, single parent, reconstituted and surrogate families and couples living together without marrying, are becoming more common. The community is therefore replacing the family as the functional unit of society, and has become a significant determinant of health. Also, there are still social and economic barriers to health care. Those of lower socioeconomic status have poorer health and use health services less frequently than the more affluent. Primary care, which is essentially office-based and family oriented, must be augmented by an approach that is based on the community's needs and oriented towards at risk populations. Ontario's community health centres take this approach to care.