Article published in NACCHO Exchange, the quarterly publication by the National Association of County & City Health Officials, that describes frameworks to explore the concepts of power and community power building as well as ways that health departments can use these concepts as part of a strategy to advance health equity.
Overview
Local health departments (LHDs) around the country are making tremendous progress in explicitly committing to end structural racism as a strategy to achieve health equity. Many local and state governments are passing resolutions and training staff on equity, creating and implementing work plans, and shifting organizational policies, practices, and culture to advance equity. This suggests palpable energy and momentum to address the ongoing effects of this country’s founding sins of genocide and slavery.
Alongside this progress, LHDs are also growing more curious about the concept of power, especially in light of the strong and well-researched connection between greater levels of democracy and higher life expectancy, and living healthier, more productive lives. Building power at a small scale within historically marginalized communities has the potential to transform how decisions are made, by whom, for whom, and with whom—all of which lead to improved health equity outcomes. Community power building is not only a process to achieving health equity, but is an outcome in and of itself.
Some LHDs have begun to build and share power with communities—a core strategy to achieving health and racial equity goals. Indeed, social justice advocates have long understood that achieving racial equity is necessarily about building power in communities most harmed by inequities, and which have been most disenfranchised from centers of power.
This article describes frameworks to explore the concept of power and its dynamics, and community power building; how health departments’ explicit support for power building with grassroots community organizations is a strategy to achieve health equity; and relevant examples and resources for health departments.
