Health Equity Tip: Establish Community Engagement Guidelines that Advance Power Sharing

Image of person’s hands cutting a slice of strawberry pie. The slice is labelled “community power-building” and the pie itself is labelled “health equity.”
Community power-building is a big slice of the pie when it comes to health equity work / Image by Raina Wellman

Community engagement to advance power-building with those most impacted by health inequities can result in:

  • Changes in existing power dynamics with and within the health department
  • Better understanding of the barriers and challenges facing the communities
  • Creative solutions and opportunities to address the inequities
  • Increased clarity on why and how to address the determinants of health inequities
  • Greater buy-in and support for health department actions to move more upstream/address root causes
  • Deeper and more trusting relationships
  • Increased capacity to advance “inside-outside” strategies that leverage health departments’ power and build community power

Where to start:

Ask your colleagues who work most often with communities impacted by inequities:

  • How they engage community members, whether the department has any existing community engagement guidelines, and if/how the guidelines are used

Review existing practices or documentation, with an attention towards:

  • Where do the department’s practices and internal guidance on community engagement fall on the spectrum of community engagement to ownership? Consider how teams across the department may be engaging in different ways
  • To what extent does the department have relationships with community power building organizations (CPBOs)? (Learn about CPBOs in our report, Building Power to Advance Health Equity for the Robert Wood Johnson Foundation’s Lead Local project)

Share your findings with your leadership and propose that the health department:

  • Identifies opportunities to try something new in a current project or process (e.g. delegates power or defers to community driven decision-making) and practices being adaptive
  • Establishes an equity-driven process to develop clear guidance on why and how to engage community members impacted by inequities
  • Contract a community organizer to train department staff on community power building and how to use the approach in community engagement work

Keep the following considerations at the front of your mind in your process:

  • How can these department efforts facilitate building deep and trusting relationships with community power-building organizations led by directly impacted people, so that there are more consistent feedback loops to advance community health?
  • How can community power-building organizations use their power to advocate for stronger public health policies and practice in partnership with health departments?

Looking for inspiration?

Here are just a few of the health departments investing in power building to improve the conditions of people’s lives

  • Santa Barbara County Addresses Latinx and Indigena Farmworker Health
    The Santa Barbara County Public Health Department partnered with community organizers CAUSE and MICOP to protect farmworker health and safety during COVID-19 by establishing the Latinx and Indigenous Migrant COVID-19 Task Force, documenting community conditions impacting COVID-19 risk, issuing a Health Order on H2A housing, and increasing attention to Indigenous workers’ COVID-19 risks and language needs. For more details, see the case study on page 28 of this HIP report.
  • San Mateo County Builds Youth Engagement
    The San Mateo, California, Youth Commission was created to facilitate youth leadership and capacity building and to inform policy. As the Youth Commission funder, San Mateo County Health System leveraged their contracting process to explicitly include equity metrics and requirements in the youth facilitator contract.
  • Health Improvement Partnership (HIP)-Cuyahoga, Ohio
    The Cuyahoga County Board of Health, Ohio, worked with a multi-sectoral consortium to develop an equity-focused Community Health Improvement Plan (CHIP). Their CHIP identifies health equity as a guiding principle and tackling structural racism as 1 of 4 strategic priorities.
  • Cook County Collaborative for Health Equity, Illinois
    The Cook County Department of Public Health, Illinois, partnered with community organizers on worker and immigrant rights campaigns through its participation in the Collaborative for Health Equity. The Collaborative makes addressing structural racism and building community power an explicit element of its mission, with community organizers sitting on the Steering Committee and guiding Health Department work.

Other resources

  • When working and collaborating with community members “it pays to ask people about what they want. It also pays to pay those people to tell you.” We recommend reading this article, “Cities Are Looking to Get Better Community Engagement By Paying for It” to learn more about compensating community members for their time.
  • Our “Power-building Partnerships for Health” project seeks to cultivate collaboration between local health departments and community power-building organizations to advance health equity. Our project page includes lessons from past participants and read articles about how community power-building helps to catalyze, create, and sustain healthy community conditions.
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