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OBJECTIVES

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Objectives

  • Describe how health professionals may promote health equity through community engagement.

  • Discuss the importance of partnering with the community.

  • Outline how a health professional can engage with a community, including the Community-Oriented Primary Care (COPC) model.

  • Discuss how to define a target community.

  • Describe techniques of healthy community assessment.

  • Explain how health professionals can promote community empowerment.

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Health depends, in large part, on the social context within which a person lives. Community, a concept derived from the Latin word communitas, meaning common or shared,1 will be defined in this chapter as a group of people with a shared identity. The community or communities with which an individual identifies define their social context and are potent determinants of health (see Chapter 1).

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Engaging with communities to address the broader social and environmental conditions that undermine health is an important role for health professionals. The Centers for Disease Control (CDC) (http://www.cdc.gov/phppo/pce/) defines community engagement as “the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the well-being of those people.”2 Community engagement is a powerful tool for the promotion of health and health equity.

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By partnering with a community, learning about its needs and resources, and assisting a community with community-based health interventions, health professionals have the potential to improve the well-being of many more people than they care for individually in clinical settings. For example, health professionals ­participating in addressing issues like eliminating “food deserts” in low-­income communities, or contributing to community-based efforts to prevent violence, can contribute greatly to these endeavors. Ultimately, these efforts improve the health of their patients. One approach is through advocacy work, publicizing and campaigning for policy and political changes to reduce inequities (see Chapter 8). Another approach is to directly engage with members of underserved communities and community-based organizations and partner with them to implement programs at the local level.

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This chapter discusses concepts and strategies for health professionals seeking to engage with communities at home and abroad, focusing particularly on community partnership and community assessment. Woven through this chapter is the story of the establishment of the San Diego, California–based Environmental Health Coalition (www.environmentalhealth.org) and its community health worker (or promotora) program.

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PARTNERING WITH COMMUNITIES

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The Environmental Health Coalition (EHC), a grassroots community organization, was founded in San Diego in 1980. It initially worked with union members concerned about occupational health and safety issues and community members concerned about cancer and other environmental illnesses. Founders included industrial workers, environmentalists, health and human service providers, and university professors. Their mission statement includes: “We believe that justice is accomplished by empowered communities acting together to make social change.”3 Health professionals from several southern California universities, including the University of California, San Diego (UCSD), ...

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