Public Health and Community Organizing as Agents for Change in Health and Risk Messaging

Abstract

Agents of change serve as catalysts for stimulating social change, particularly at community and societal levels of analysis. We often think about the characteristics of individuals who act as change agents, such as their capacity to motivate others or their training skills. However, organizations and disciplinary fields can also serve as agents of change. There is an emerging awareness in the fields of public health and community organizing as to how these respective fields can collaborate to leverage their collective insights and skills to become effective agents of change for community health outcomes. Importantly, while public health is concerned with the social determinants that shape health inequities in all communities, community organizing is focused on community issues that residents confront as constraints or problems in their daily lives. There is an inchoate understanding within the fields of public health and community organizing that the social determinants addressed in public health are often the same issues identified and addressed by community organizing groups. Both disciplines work as agents of change through their traditional efforts; however, there is promise in the evolving collaborations between these two fields. Recognition that both fields are addressing the same community phenomena is an important step, but whether collaborations and shared practices become distributed and institutionalized is an open question. Public health possesses research and analytic sophistication capable of identifying different social determinants and the pathways through which such determinants contribute to poor community health outcomes. In contrast, community organizing supplies an understanding of social change that requires the exercise of power through the participation and active engagement by those most directly affected by local issues or social determinants. One tension in this emergent collaborative practice stems from the fact that, at times, these different disciplinary skill sets are at odds. Whereas public health has a deep value of data analysis and expertise, community organizing prioritizes the participation and self-determination of those impacted by community problems. Fundamentally, the tension here is between the value placed on expertise versus the value placed on public participation. Neither value is inherently superior to the other; understanding how these two values can complement one another to address social determinants that shape community health outcomes is critical for realizing the promise of these organizational agents of change.

“Now, I am Empowered. Now, I am a Woman With Spirit”: Evaluating CARE’s Public Health Work Through a Community-Organizing Framework in Sri Lanka and Bangladesh

“…41,42 Our findings confirm existing literature showing that these public health approaches can be augmented by using community organizing to develop local engagement and participation. 14 This combination of a data driven public health approach with community-based participatory efforts is a potent effector of change.…”

“…While community organizing is concerned with the participation and self-determination of those community members impacted by health problems, public health tends to be more focused on using data analysis and the evidence base to identify and address social determinants of health. 14 As a result, a fundamental tension exists between the emphasis placed on expertise versus that given to public participation. Neither emphasis is inherently better; yet, understanding how these two fields can leverage their collective insights and skills to address social determinants that impact community health is essential for realizing the promise of these approaches to change.…”

“…Neither emphasis is inherently better; yet, understanding how these two fields can leverage their collective insights and skills to address social determinants that impact community health is essential for realizing the promise of these approaches to change. 14 In this article, we also take the view that community organizing and public health are complementary, and we explore how the two effectively combine to improve community health in a unique case study of three sites.…”