Towards sustainable primary healthcare in Hong Kong: Applying social ecological model with ESG and SDG insights

As Hong Kong implements its Primary Healthcare Blueprint and district health centre (DHC) model, community engagement and empowerment remain critical yet underdeveloped components in achieving sustainable health outcomes. This study applies the Social Ecological Model (SEM) as a framework to examine the multilayered factors influencing community engagement and empowerment within Hong Kong’s primary healthcare environment. SEM enables a comprehensive analysis of how individual behaviours, interpersonal relationships, community structures, organisational practices, and policy environments interact to shape healthcare participation. This study extends previous work on health-social care integration by exploring how social dimensions of Environmental, Social, and Governance (ESG) frameworks, along with selected United Nations Sustainable Development Goals (SDGs), specifically SDG 3 (Good health and well-being), SDG 10 (Reduced inequalities), SDG 11 (Sustainable cities and communities), and SDG 17 (Partnerships for the goals) in the community-based primary healthcare strategies. Based on recent policy development and global health models as a foundation, the paper explores how the “social” part of ESG can connect with local community health systems. It emphasises the importance of including every relevant stakeholders in health planning, designing services with community input, and making sure that outreach efforts are fair, especially for older adults and underserved groups. The SEM framework facilitates a structured examination of both barriers and motivators of community participation, and highlights the opportunities for connecting local actions with global sustainability agendas. By rethinking how communities are involved, and linking these efforts to ESG and SDG goals, the study suggests ways to make healthcare systems stronger and more effective. It finally provides practical recommendations for using ESG-based measures and SDG targets to improve primary healthcare services in Hong Kong. To conclude, this work encourages a shift in healthcare systems from just focusing on medical services to creating inclusive, community-focused, and accountable care models.