Community Power and Health Equity: Closing the Gap between Scholarship and Practice.

Abstract

The last few decades have seen an upsurge in research linking health outcomes to the “conditions in the environments in which people are born, live, learn, work, play, worship, and age,” commonly referred to as the social determinants of health (Cash-Gibson et al., 2018). These conditions include “economic stability, education, social and community context, health and health care, and neighborhood and built environment” (Offi ce of Disease Prevention and Health Promotion, 2014). More recently, many in the public health fi eld are recognizing the need to analyze (and transform) the structural determinants of health that are at the root of inequities (Baum et al., 2018). Such structures include government rules and regulations, institutional policies and priorities, cultural norms and values (for example, racism, sexism, xenophobia, homophobia, and ableism), and disparities in the power and infl uence of diff erent communities to change those structures. This consideration of “community power” has acquired special salience in the wake of the widespread and devastating impacts of the COVID-19 pandemic in 2020–2021. The pandemic brought to broad public attention what communities of color and low-income communities have long known: that underlying inequities by race, income, and geography put their communities at higher risk of contracting the virus and with lower levels of access to vaccines (Ollove and Vestal, 2020). Simultaneously, protests swept the nation and the world in response to the tragic deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery, continuing to highlight the role of deep-rooted racial diff erences in treatment by the police and other social institutions. Together, these crises have accelerated long-overdue conversations across the country about how racism is a public health issue (Vestal, 2020). This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative eff ort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fi elds of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.