scholarly journals Power, control, communities and health inequalities I: theories, concepts and analytical frameworks

2020 ◽  
Author(s):  
Jennie Popay ◽  
Margaret Whitehead ◽  
Ruth Ponsford ◽  
Matt Egan ◽  
Rebecca Mead
Keyword(s):  
Health Equity ◽  
Social Transformation ◽  
Community Empowerment ◽  
Power Dynamics ◽  
Community Settings ◽  
Collective Control ◽  
Communities Of Place ◽  
Analytical Frameworks ◽  
Health Field ◽  
Original Concept

Summary This is Part I of a three-part series on community empowerment as a route to greater health equity. We argue that community ‘empowerment’ approaches in the health field are increasingly restricted to an inward gaze on community psycho-social capacities and proximal neighbourhood conditions, neglecting the outward gaze on political and social transformation for greater equity embedded in foundational statements on health promotion. We suggest there are three imperatives if these approaches are to contribute to increased equity. First, to understand pathways from empowerment to health equity and drivers of the depoliticisation of contemporary empowerment practices. Second, to return to the original concept of empowerment processes that support communities of place/interest to develop capabilities needed to exercise collective control over decisions and actions in the pursuit of social justice. Third, to understand, and engage with, power dynamics in community settings. Based on our longitudinal evaluation of a major English community empowerment initiative and research on neighbourhood resilience, we propose two complementary frameworks to support these shifts. The Emancipatory Power Framework presents collective control capabilities as forms of positive power. The Limiting Power Framework elaborates negative forms of power that restrict the development and exercise of a community’s capabilities for collective control. Parts II and III of this series present empirical findings on the operationalization of these frameworks. Part II focuses on qualitative markers of shifts in emancipatory power in BL communities and Part III explores how power dynamics unfolded in these neighbourhoods.

scholarly journals Power, control, communities and health inequalities III: participatory spaces—an English case

2020 ◽  
Author(s):  
Katie Powell ◽  
Amy Barnes ◽  
Rachel Anderson de Cuevas ◽  
Clare Bambra ◽  
Emma Halliday ◽  
...  
Keyword(s):  
Community Empowerment ◽  
Early Years ◽  
Sense Making ◽  
Power Dynamics ◽  
Theoretical Frameworks ◽  
Community Initiatives ◽  
Disadvantaged Communities ◽  
Institutional Power ◽  
Collective Control ◽  
Alliance Building

Summary This article—third in a series of three—uses theoretical frameworks described in Part 1, and empirical markers reported in Part 2, to present evidence on how power dynamics shifted during the early years of a major English community empowerment initiative. We demonstrate how the capabilities disadvantaged communities require to exercise collective control over decisions/actions impacting on their lives and health (conceptualized as emancipatory power) and the exercise of power over these communities (conceptualized as limiting power) were shaped by the characteristics of participatory spaces created by and/or associated with this initiative. Two main types of participatory spaces were identified: governance and sense-making. Though all forms of emancipatory power emerged in all spaces, some were more evident in particular spaces. In governance spaces, the development and enactment of ‘power to’ emerged as residents made formal decisions on action, allocated resources and managed accountability. Capabilities for alliance building—power with—were more likely to emerge in these spaces, as was residents’ resistance to the exercise of institutional power over them. In contrast, in sense-making spaces residents met informally and ‘made sense’ of local issues and their ability to influence these. These processes led to the development of power within capabilities and power to resist stigmatizing forms of productive power. The findings highlight the importance of designing community initiatives that: nurture diverse participatory spaces; attend to connectivity between spaces; and identify and act on existing power dynamics undermining capabilities for collective control in disadvantaged communities.

scholarly journals Power, control, communities and health inequalities. Part II: measuring shifts in power

2020 ◽  
Author(s):  
Ruth Ponsford ◽  
Michelle Collins ◽  
Matt Egan ◽  
Emma Halliday ◽  
Sue Lewis ◽  
...  
Keyword(s):  
Qualitative Data ◽  
Social Inequalities ◽  
Fundamental Problem ◽  
Analytical Framework ◽  
Power Dynamics ◽  
Community Members ◽  
Individual Level ◽  
Collective Control ◽  
Health Empowerment ◽  
Health Field

Abstract In the health field, there is great interest in the role empowerment might play in reducing social inequalities in health. Empowerment is understood here as the processes of developing capabilities that individuals and/or communities need to exercise control over decisions and actions impacting on their lives and health. There is a fundamental problem, however, in identifying and measuring capabilities for collective control that emerge at the level of the collective, with much of the existing literature focusing on individual measures even where community-level processes are concerned. Collective measures need to capture the dynamics of interactions within and between groups, not simply aggregate individual-level measures. This article, Part 2 in a three-part series, takes up the challenge of identifying qualitative markers of capabilities for collective control. We applied the emancipatory power framework (EPF) reported in Part 1 of the series, to qualitative data generated during a longitudinal evaluation of a major English area-based empowerment initiative, the Big Local (BL). We identified empirical ‘markers’ of shifts towards greater collective control pertaining to each of the ‘power’ dimensions in the EPF—‘power within’, ‘power with’ and ‘power to’—and markers of communities exercising ‘power over’ other institutions/community members. These markers can usefully be applied in the evaluation planning and evaluation of empowerment initiatives. Part 3 in the series uses these markers and a second analytical framework developed during our evaluation of BL to explore how power dynamics unfold in participatory spaces in BL neighbourhoods.

Community Empowerment and Health Equity

2021 ◽  
Author(s):  
Jennie Popay
Keyword(s):  
Public Health ◽  
Social Determinants Of Health ◽  
Health Equity ◽  
Social Determinants ◽  
Local Community ◽  
Population Level ◽  
Community Empowerment ◽  
Determinants Of Health ◽  
Policy And Practice ◽  
Collective Control

Empowerment features prominently in public health and health promotion policy and practice aimed at improving the social determinants of health that impact communities and groups that are experiencing disadvantage and discrimination. This raises two important questions. How should empowerment be understood from the perspective of health and health equity and how can public health practitioners support empowerment for greater health equity? Many contemporary definitions link empowerment to improvements in individual self-care and/or the adoption of “healthier” lifestyles. In contrast, from a health equity perspective community empowerment is understood as sociopolitical processes that engage with power dynamics and result in people bearing the brunt of social injustice exercising greater collective control over decisions and actions that impact their lives and health. There is growing evidence that increased collective control at the population level is associated with improved social determinants of health and population health outcomes. But alongside this, there is also evidence that many contemporary community interventions are not “empowering” for the people targeted and may actually be having negative impacts. To achieve more positive outcomes, existing frameworks need to be used to recenter power in the design, implementation, and evaluation of local community initiatives in the health field. In addition, health professionals and agencies must act to remove barriers to the empowerment of disadvantaged communities and groups. They can do this by taking experiential knowledge more seriously, by challenging processes that stigmatize disadvantaged groups, and by developing sustainable spaces for the authentic participation of lay communities of interest and place in decisions that have an impact on their lives.

scholarly journals The Rohingya Little Local: exploring innovative models of refugee engagement in Sydney, Australia

2020 ◽  
Vol 26 (5) ◽  
pp. 367
Author(s):  
Amy Bestman ◽  
Jane Lloyd ◽  
Barbara Hawkshaw ◽  
Jawat Kabir ◽  
Elizabeth Harris
Keyword(s):  
Community Empowerment ◽  
Health Priorities ◽  
Community Members ◽  
Funding Model ◽  
Collective Control ◽  
Ongoing Work ◽  
Field Notes ◽  
The City ◽  
Priority Population ◽  
Sydney Australia

The Rohingya community living in the City of Canterbury-Bankstown in Sydney have been identified as a priority population with complex health needs. As part of ongoing work, AU$10000 was provided to the community to address important, self-determined, health priorities through the Can Get Health in Canterbury program. Program staff worked with community members to support the planning and implementation of two community-led events: a soccer (football) tournament and a picnic day. This paper explores the potential for this funding model and the effect of the project on both the community and health services. Data were qualitatively analysed using a range of data sources within the project. These included, attendance sheets, meeting minutes, qualitative field notes, staff reflections and transcripts of focus group and individual discussions. This analysis identified that the project: (1) enabled community empowerment and collective control over funding decisions relating to their health; (2) supported social connection among the Australian Rohingya community; (3) built capacity in the community welfare organisation –Burmese Rohingya Community Australia; and (4) enabled reflective practice and learnings. This paper presents an innovative model for engaging with refugee communities. Although this project was a pilot in the Canterbury community, it provides knowledge and learnings on the engagement of refugee communities with the health system in Australia.

Health Education as a Tool for Social Justice and Health Equity

2020 ◽  
pp. 58-80
Author(s):  
Sarah Benes
Keyword(s):  
Social Justice ◽  
Health Education ◽  
Health Equity ◽  
Health And Wellness ◽  
Community Settings ◽  
Power Structures ◽  
Practical Applications ◽  
Race And Class ◽  
School And Community ◽  
The Many

All youth deserve access to effective health education that provides them with the tools they need to maintain or improve their health and the health of others. Health education, in school and community settings, can be a tool for addressing social justice and health equity across race and class. Effective health education can increase awareness and understanding of the many factors, including social determinants of health and power structures, that impact health and wellness. More importantly, health education can affect change by empowering students to address not only their own health but the health of others, their communities, and beyond. This chapter reviews the current literature, focusing on practical applications for school and community settings, and presents strategies for implementing health education that supports health and wellness at interpersonal, intrapersonal, and community levels.

scholarly journals The photogeny of revolution

2021 ◽  
Vol 14 (2) ◽  
pp. 111-122
Author(s):  
Helen V. Petrovsky ◽  
Keyword(s):  
19Th Century ◽  
Social Life ◽  
Social Transformation ◽  
Entire Class ◽  
Explosive Power ◽  
Art Form ◽  
Transformative Action ◽  
The 19Th Century ◽  
Original Concept ◽  
Chemical Formulas

Drawing on the works of three authors, namely, Jean Epstein, Auguste Villiers de l’Isle-Adam and P.A. Kropotkin, the article attempts to lay the grounds for what might be called a semiotics of forces. Jean Epstein, a filmmaker and theorist of the new art form, is the au­thor of an original concept of photogénie where cinema is presented as an instru­ment re­vealing the transformations of matter itself. Erupting Etna stands for the trans­formations in question. Villiers de l’Isle-Adam is a symbolist writer, who also mentions Etna, associat­ing its explosive power with the chemical formulas of explosives. These formulas, inte­grated into his “least literary” novella, become special signs of social transformation: The writer, challenging the entire class of bourgeoisie that he deeply detests, makes use of the fear incited by the anarchists amongst it. Finally, P.A. Kropotkin, one of the leading theo­rists of anarchism but also an outstanding scientist and geographer, insists on the priority of transformative action over theory and every other speculation. In fact, he proposes his own version of the performative – of words changing the existing state of things – already at the end of the 19th century. In one way or another, all these writers are united by their understanding of the inherent connection between natural and social disasters (Kropotkin’s position is explicit). Described by Epstein and only once mentioned by Villiers de l’Isle-Adam, Etna becomes an element of a correlation, i.e., of a connection that is unapparent and necessary at the same time. What is implied is the relation between volcano and cin­ema as well as that between volcano and explosives. In both cases this relation becomes the designation of matter itself or, to be more exact, of matter in a state of flux and trans­formation. But this is also true of transformative action in the proper sense of the word (re­sulting in revolution, according to Kropotkin), whose verbal expressions always carry within themselves the energy of multidirectional forces. Etna is not merely a volcano and not just an element of a correlation; from the perspective of physics, it is synonymous with heat (scorching lava), which stands for changes in the properties of a substance, i.e., its transformation in purely physical terms. It is clear that transformation in cinema, literature as well as in social life cannot be represented directly; it is revealed only through a set of relations, namely, a semiotics of forces.

scholarly journals Evaluation on Community Empowerment Policy after Conflict Resolution (A Study of Sub District Development Program in Poso District)

2020 ◽  
Vol 7 (8) ◽  
pp. 16
Author(s):  
Moh Irfan Mufti ◽  
Intam Kurnia ◽  
Irwan Karim ◽  
Muhammad Ahsan Samad
Keyword(s):  
Program Implementation ◽  
Social Transformation ◽  
Development Program ◽  
Community Empowerment ◽  
Target Groups ◽  
Evaluation Approach ◽  
Post Conflict ◽  
The Social ◽  
Context Data ◽  
Local Awareness

The research aims to investigate the collective mobilization mechanism for the adoption of the Sub District Development Program. This style of analysis is contextual in concise terms of case studies. The technique of data collection consists of extensive interviews, observations, and documentation. The evaluation approach using the CIPP model (context, data, procedure, and product) and the Seven E definition (intend, inform, remove, communicate, enthuse, equip, and evaluate). The findings revealed that: (1) Implementing PPK on the context, data, method and product aspects of the program, implementing PPK on the technological aspects of its fiscal, and uncharged empowerment; (2) certainty of program form was not adequate and the software system is still operating ineffectively; (3) Implementation of Sub District Development Program in context Besides, the Sub District Development Program implementation in Poso had programs for reconciliation and post-conflict peacebuilding sponsored by the "Sintuwu Moroso" community, but not yet wholly added to the social capital and local awareness. The variable that inhibits PPK is the variable in deepening public trust and low assistance for target groups in local bureaucrats; 4) The application of the Seven-E empowerment concept has not been effective, institutionally it is necessary to apply the Seven-E empowerment concept to KDP, so that social transformation will take place mainly through education, mentoring and evaluation

scholarly journals Global Health Equity and Advocacy: The roles of international Non-Governmental Organizations

2012 ◽  
Vol 2 (1) ◽  
pp. 103-114 ◽  
Author(s):  
S G Lurie
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health Equity ◽  
Social Systems ◽  
The United States ◽  
Fund Raising ◽  
Community Empowerment ◽  
Civil Society Organizations ◽  
Governmental Organizations ◽  
Non Governmental Organizations

International health equity and community empowerment are promoted through local and global collaborations with non-governmental organizations (NGO’s). Civil society organizations and inter-agency partnerships assume central roles in addressing global health inequity, within the context of national health and social systems, local realities and priorities. Community health promotion through public-private collaboration by NGO’s on health needs assessments and fund-raising is designed to increase support for local programs in the United States. This paper compares health promotion and advocacy roles of an international non-governmental organization in global and local arenas, based on community case studies by the author in rural Hungary and North Texas from 2009 to 2011, using ethnographic and qualitative research methods. Findings confirm the need for systematic evaluation of the effects of complex socioeconomic, political and multi-ethnic contexts, and the impacts of prevention programs and healthcare on health equity.

The Power of Place and the Place of Power

2018 ◽  
Author(s):  
John Gaventa
Keyword(s):  
United Kingdom ◽  
Early Development ◽  
Social Transformation ◽  
Three Dimensions ◽  
The Political ◽  
Power Dynamics ◽  
Political Scientist ◽  
Appalachian Studies ◽  
The United Kingdom ◽  
Power And Powerlessness

The political scientist John Gaventa’s prizewinning analysis of power and powerlessness was a foundational study in the early development of Appalachian studies. In this chapter he outlines a new, multidimensional conception of power (the “power cube”) to understand the “power of place” and the “place of power.” He suggests that effective efforts at place-based social transformation must operate on three dimensions that challenge the forms, spaces, and levels of power. He also describes how the places in which he has worked and lived, including African nations, Appalachia, Canada, and the United Kingdom, have influenced his thinking about power dynamics.

scholarly journals ‘Back to better’: amplifying health equity, and determinants of health perspectives during the COVID-19 pandemic

2021 ◽  
pp. 175797592110009
Author(s):  
Sume Ndumbe-Eyoh ◽  
Pemma Muzumdar ◽  
Claire Betker ◽  
Diane Oickle
Keyword(s):  
Health Promotion ◽  
Social Justice ◽  
Health Equity ◽  
Emergency Preparedness ◽  
Social Transformation ◽  
Indigenous Health ◽  
Social Systems ◽  
Policy Research ◽  
Determinants Of Health ◽  
Structural Determinants

Introduction: Equity and social justice have long been key tenets of health promotion practice, policy and research. Health promotion foregrounds the pertinence of social, economic, cultural, political and spiritual life in creating and maintaining health. This necessitates a critical structural determinants of health perspective that actively engages with the experiences of health and wellbeing among diverse peoples. The inequitable impacts of pandemics are well documented, as are calls for improved pandemic responses. Yet, current pandemic and emergency preparedness plans do not adequately account for the social and structural determinants of health and health equity. Methods: Through five one-hour online conversations held in April 2020, we engaged 13 practice, policy, research and community leaders on the intersections of COVID-19 and gender, racism, homelessness, Indigenous health and knowledge, household food insecurity, disability, ethics and equitable futures post-COVID-19. We conducted a thematic analysis of speaker and participant contributions to investigate the impacts and influence of COVID-19 related to the structural and social determinants of health. We analyzed which policies, practices and responses amplified or undermined equity and social justice and identified opportunities for improved action. Findings: Analysis of the COVID-19 pandemic revealed four broad themes: • oppressive, unjust systems and existing health and social inequities; • health and social systems under duress and non-responsive to equity; • disproportionate impacts of COVID-19 driven by underlying structural and socioeconomic inequity; and • enhanced momentum for collective mobilization, policy innovations and social transformation. Discussion: There was a strong desire for a more just and equitable society in a post-COVID-19 world, going ‘back to better’ rather than ‘back to normal.’ Our analysis demonstrates that equity has not been well integrated into pandemic planning and responses. Social movement and systems theories provide insight on ways to build on existing community mobilization and policy openings for sustained social transformation.

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