The Role and Potential of Communities in Population Health Improvement: Workshop Summary (2015)

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Introduction¹

There is a large and diverse body of practical work and research demonstrating that community engagement is a critical ingredient in efforts to improve the social determinants of health and the built environment, said David Kindig, professor emeritus and emeritus vice-chancellor for health sciences at the University of Wisconsin School of Medicine and Public Health and a co-chair of the Institute of Medicine (IOM) Roundtable on Population Health Improvement. Examples of such research include Griswold et al. (2013), Lundquist et al. (2012), Pastor et al. (2011), and Speer and Hughey (1995). But, Kindig continued, it is important to keep in mind that effective community engagement consists of more than simply surveying the community or holding a few focus groups. Community leadership, voice, and power are essential components of successful interventions. The role of the community in improving health has been discussed by a number of previous IOM committees (IOM, 2003, 2011, 2012).² Those reports describe a multisector system in which public health, health care, community-based organizations, busi-

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¹ This workshop was organized by an independent planning committee whose role was limited to identification of topics and speakers. This workshop summary was prepared by the rapporteurs as a factual summary of the presentations and discussion that took place at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the Institute of Medicine or the roundtable, and they should not be construed as reflecting any group consensus.

² For more information on what is meant by “community” in a health context, see MacQueen et al., 2001.

ness, and other stakeholders work together toward the goal of healthier people, said Mary Lou Goeke, the executive director of United Way of Santa Cruz County, California, and the chair of the workshop planning committee. The 2003 IOM report provided a framework for collaborative action that endorsed the notion of shared governance through which population health would be improved in partnership with community members. Across the country there are now many community groups and organizations involved in noteworthy and effective ways of improving livability, wellness, and health in their communities, Goeke said.

On April 10, 2014, the IOM Roundtable on Population Health Improvement held a public workshop at the California Community Foundation’s Joan Palevsky Center for the Future of Los Angeles that featured invited speakers from community groups that have taken steps to improve the health of their communities. For background, Kindig referred participants to two discussion papers released on the day of the workshop and available on the roundtable’s website—“Engaging the Public Through Communities of Solution and Collaborative Empowerment” (Etz, 2014) and “Safe Summer Parks Programs Reduce Violence and Improve Health in Los Angeles County” (Fischer and Teutsch, 2014)—and to the brief summary of a related roundtable workshop held in December 2013, Supporting a Movement for Health and Health Equity: Workshop in Brief (IOM, 2014).

WORKSHOP OBJECTIVES

The roundtable supports workshops for its members, stakeholders, and the public to discuss issues of importance for improving the nation’s health. An independent planning committee, chaired by Mary Lou Goeke and including George Flores, Kate Hess Pace, Melissa Simon, and Julie Willems Van Dijk, was charged with developing a workshop to explore the roles and potential of the community (e.g., resident groups, organizations, and diverse coalitions) as leaders, partners, and facilitators in transforming the social and environmental conditions that shape health and well-being at the local level (see Box 1-1). The workshop, titled The Role and Potential of Communities in Improving Population Health, was designed to facilitate discussion about important ingredients, effective strategies, and other lessons learned in three contexts:

• youth organizing,
• community organizing or other types of community participation, and
• partnerships between community and institutional actors (e.g., universities and academic researchers, public health agencies, and government officials).

ORGANIZATION OF THE WORKSHOP AND SUMMARY

The workshop consisted of a keynote presentation on the power of communities in improving health (Chapter 2), a report of a site visit conducted on the previous day by several IOM roundtable members to a local community-based organization, and three panels designed around the topics listed above, each offering examples of the challenges and successes of their community organizing efforts. The first panel and the report of the site visit focused on how young people are developing skills and contributing to the health and well-being of their own communities (Chapter 3), the second panel considered how community organizations are tackling the social determinants of health (Chapter 4), and the third panel discussed aspects of establishing partnerships between institutions and communities (Chapter 5). In the closing session, roundtable members and invited speakers were asked to offer their observations on the main themes that emerged from the workshop sessions and their perspectives on how to move forward (see Box 1-2). Members of the audience were also invited to reflect on the workshop themes and engage the panelists and roundtable members in dialogue (Chapter 6).