Letting Community Take the Wheel
In our previous blog post, The E Word, we explored ways to talk about barriers to health without relying on often misunderstood or politicized terms. But what do we do next, to actually start breaking down those barriers? It starts with community.
Public health thrives where community begins, meaning we must work together with the communities we serve in order to begin to turn shared challenges into collective solutions. Now, that is easier said than done and can be difficult due to mistrust, staff capacity, funding and not knowing where to begin. One might think it would be easier and faster to implement a public health program or conduct in assessment, such as the Community Health Assessment (CHA), on their own using existing information. However, as seen in the diagram below, the route you take with collective control leads to better community health.
As shown in the diagram, many communities face disproportionate disadvantages due to systematic barriers. Social protective factors--such as community empowerment--can lead to meaningful change and positive health outcomes. As a community member, collective control feels like having a voice in decisions that affect your life, like shaping local public health programs. It requires organizing, building shared understanding, and working in coalition with institutions and other communities to advance social change. When done well, collective control ensures that public health decisions are being made with the people closest to the problem as the co-leaders in defining the solutions.
Image: NACCHO Roots of Health Inequity 2024
To get to the collective control path, here are a few steps suggested by the Roots of Health Equity Training:
Attend community events and meetings as a participant to listen and learn about the community’s concerns, desires, and ideas; and to connect with community leaders, organizers, and residents.
Adopt community-led processes for internal decision-making, for example, participatory budgeting.
Meet one-on-one with community organizers and leaders in your community to get to know them, share interests in working and being in a relationship together.
Explicitly allocate time in staff work plans to support and facilitate community-led processes and community relationship building.
Establish steering committees, task forces, or other advisory boards that have decision-making power over processes, products, and/or resource.
Remember to build time into plans for involving community when possible. To also practice what you teach, look for internal ways to build community involvement. At the Carlton-Cook-Lake-St. Louis Community Health Board our staff, including myself, voluntarily participate in what we call Health Equity Squads. In our squads, we discuss emerging barriers to health, listen to stories from people with lived experiences, and reflect as a unit. Personally, this has held me accountable and expanded my knowledge on how to be a more inclusive and effective public health worker.
You may be surprised by the input and results you see from working together with community that you wouldn’t get through a quick Google search for data. To learn more, check out the Roots of Health Inequity site and explore their free trainings.