Culture of Health Institute for Leadership Development Online Training Resource Guide

Building and Unleashing Community Power Course Description Communities experiencing the greatest health inequities are often less likely to exert their power to influence the institutions, decisions, and resource allocations that significantly impact health outcomes. Health equity approaches should consider power and community leadership, especially by those most affected by inequities, in the co-creation of conditions in which people can reach their full health potential. This training situates power in a health equity framework, describes authentic community engagement and community power building practices, and provides examples of how partnerships grounded in a health equity approach can advance policy and systems changes to promote health. Participants will also be introduced to community power mapping tools to help inform partnership development and strategies for building and shifting power. Learning Outcomes By the end of this module, participants will be able to:

• Define power and explain how power fits into a health equity framework; • Distinguish various approaches to community engagement, including asset-based and

community power building; • Identify the role of power building and partnerships with power building organizations

among strategies for advancing health equity; and • Interpret a power map and how it informs strategies to shift power and advance health

equity.

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Community Power Resource Guide

Module Outline Unit 1: Health Equity and Power

I. Defining health equity II. Connecting health equity, powerlessness, and power III. Applying the BARHII health equity framework IV. Shifting conditions of power

Reflection Questions: Think about a health or community issue you are working on or is important to you…

1. Does it focus on health behavior, access and quality of clinical care, social & economic factors or physical environment?

2. What aspects of institutional power, social inequities, and historical contexts do you think affect it most?

3. How do you think institutional power, social inequities, and historical contexts shape the ways the issue is commonly addressed?

4. Through what mechanisms and at what level do you want to impact the issue? [Insert Slide 20 (BARHII framework)] References and Suggested Readings

• Braveman, P. A., Kumanyika, S., Fielding, J., LaVeist, T., Borrell, L. N., Manderscheid, R., & Troutman, A. (2011). Health disparities and health equity: the issue is justice. American Journal of Public Health, 101(S1), S149-S155. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222512/

• Brennan Ramirez LK, Baker EA, Metzler M. (2008). Promoting Health Equity: A Resource to Help Communities Address Social Determinants of Health. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention.

• Iton, A., & Shrimali, B. P. (2016). Power, politics, and health: a new public health practice targeting the root causes of health equity. Maternal and child health journal, 20(8), 1753-1758.

• Solar O, I.A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice).

• Expanding the Boundaries: Health Equity and Public Health Practice, National Association of County &City Officials, May 2014

• Exploring the Roots of Health Inequity: Essays for Reflection, National Association of County &City Officials, May 2014

Unit 2: Community Engagement and Power

I. Community engagement frameworks II. Asset-based and deficit-based approaches to engagement III. Empowerment and community power IV. Community power building organizations V. Examples of Ex-Prisoners Organizing

Reflection Questions: Think about a health or community issue you are working on or is

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Community Power Resource Guide

important to you… 1. Who is the core constituency or constituencies? 2. How is this constituency currently defining or addressing the issue? 3. What power does this constituency have to impact this issue? 4. Are you familiar with any power building organizations or activities associated with this

constituency? [Insert Slide 39 (community power and spheres of influence)] References and Suggested Readings

• Adams, R. (2008). Empowerment, participation and social work. New York: Palgrave Macmillan; p.xvi.

• Center for Disease Control and Prevention (CDC). (2011). Principles of community engagement. Second Edition. https://www.atsdr.cdc.gov/communityengagement/pdf/PCE_Report_508_FINAL.pdf

• Christens, B.D. (2013). In search of powerful empowerment. Health Education Research, 28(3).

• Christens, B. D., & Speer, P. W. (2015). Community organizing: Practice, research, and policy implications. Social Issues and Policy Review, 9(1), 193-222.

• Healy, R. & Hinson, S. (2016). The Four Faces of Power. The Grassroots Policy Project. • Lukes, S. (1986). Power: A Radical View. NYU Press. • Kretzmann, John P and John L. McKnight. (1993). Building Communities from the Inside

Out: A Path Towards Finding and Mobilizing Community’s Assets. Chicago, ACTA Publishing. • Mondros, J. B., & Wilson, S. M. (1994). Organizing for power and empowerment. Columbia

University Press. Community Psychology; p. 43–63. • Zimmerman, M.A. (2000). Empowerment Theory: Psychological, Organizational and

Community Levels of Analysis. Handbook of Community Psychology; p. 43–63. • Wellstone. The Organizers Guide to the Galaxy: Strategic Planning.

Unit 3: Putting it Together: Partnerships that Shift Power

I. Public health and powerful partnerships II. Treatment alternatives to prison health impact assessment example III. Collaborative power mapping IV. Constituencies, allies, targets

Reflection Questions: Think about a health or community issue you are working on or is important to you…

1. Who can give you what you want? 2. Who are the targets? 3. Where do interests align and collide among players? 4. How will you shift power?

a. What would it take to move powerful players to the right and allies up? b. What would it take to neutralize the influence of opponents? c. How does your strategy move your core constituency up in a sustainable way

and intervene on broader decision-making processes?

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Community Power Resource Guide

[Insert Slide 61 (the power map grid)] References and Suggested Readings

• Human Impact Partners and WISDOM. November 2012. Healthier Lives, Stronger Families, Safer Communities: How Increasing Funding for Alternatives to Prison Will Save Lives and Money in Wisconsin.

• IOM. (2015). Chapter 4: The Role and Potential of Communities in Population Health Improvement. Organizing Around the Social Determinants of Health. https://www.nap.edu/read/18946/chapter/5.

• Christens, B. D., & Inzeo, P. T. (2015). Widening the view: situating collective impact among frameworks for community-led change. Community Development, 46(4), 420-435.

• Schrantz, D. M. (2012). Drawing on community organizing to advance public health in Minnesota and beyond. Health Affairs, 31(12), 2799-2800.

• Speer, P. W., Tesdahl, E. A., & Ayers, J. F. (2014). Community organizing practices in a globalizing era: Building power for health equity at the community level. Journal of health psychology, 19(1), 159-169.

• Tesfai, A. (2015). Does Organizing Have a Place in Public Health? http://www.humanimpact.org/from-the-hip-blog/does-organizing-have-a-place-in-public-health/

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