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Community engagement: A public health strategy to inform action on health inequities

Written ByDianne OickleDianne Oickle on January 26, 2020
Dianne Oickle

Dianne Oickle, MSc, BSc

Knowledge Translation Specialist

Dianne is a dietitian with over 15 years’ experience working in public health in Ontario focused on reproductive and child health in a mostly rural setting with many diverse clients. Part of her work involved development of practice guidelines for health professionals, train-the-trainer initiatives, public presentations, educational resource development, working with the media, community coalition and network support, writing for the public and professionals, and program planning, implementation, and evaluation. She has taught university nutrition courses, worked with the provincial network supporting and advocating for dietitians in public health practice, and precepted over 20 dietetics and other students. Dianne earned her BSc in Nutrition and Consumer Studies (now Human Nutrition) at St. Francis Xavier University, and her MSc in Nutrition from the University of Saskatchewan.

doickle@stfx.ca

In this blog post, Knowledge Translation Specialist Dianne Oickle identifies new and past NCCDH resources that address how to incorporate the lived experiences of equity-seeking populations into public health work.


 

The Tamarack Institute defines community engagement as a “process by which citizens are engaged to work and learn together on behalf of their communities.” They elaborate further, saying that community engagement “increases community cohesion and allows for the community to have ownership over the outcomes that will ultimately impact them.”

Community engagement is an inherent part of public health work — frontline practitioners have relationships with community members as part of the services they deliver and through the partnerships they establish. This intentional engagement makes it possible to identify and work with the community on the issues that are of importance to its members. This is how public health works.

Engaging with equity-seeking communities

It is important to remember, however, that engaging with a community broadly does not inherently include those who live with socioeconomic inequities. Sometimes referred to as living/lived experience, the concept of lived expertise positions community members who live with inequities as experts in what they need. Their lived experiences represent a valid and important source of evidence or expertise to inform public health practice and policy.

Engagement may happen directly with community members who live with inequities, but the mechanisms to connect the input or voice of citizens into public health decision-making and prioritization processes are not always present or straightforward. What is heard or witnessed in communities is not always easily brought to the attention of decision-makers. Public health practitioners play a key role to amplify the voice of community members who live with inequities, providing space for meaningful engagement to occur.   

Resources to support public health engagement with equity-seeking communities

How can public health shift from considering communities that live with inequities as a target for service delivery to being seen as a source of expertise essential to inform decisions about priorities, policies and programs?

To answer this question, the National Collaborating Centre for Determinants of Health (NCCDH) has recently worked with partners to:

  • describe strategies for public health to engage meaningfully with community members who live with social and structural determinants of health inequities;
  • highlight ways to support engagement of those with lived/living experience in public health program and policy development; and
  • compile and share practice-based learning and relevant resources for use in public health practice in Canada.

As a result, we produced and contributed to products to draw attention to community engagement as an important public health strategy to inform action on health inequities.

  • In July 2019, an online discussion was hosted within the NCCDH’s Health Equity Clicks: Community that asked the question “Can we check our privilege?” Building on the Pan-Canadian Health Promoter Competencies, this discussion explored power imbalances in community engagement activities and the concept of "Nothing about me without me."
  • In September 2019, we hosted a webinar titled Informing public health programs through engagement with communities that live with health inequities (recording here). Speakers explored mechanisms to develop and support relationship-building with communities whose members live with inequities. We also discussed strategies to increase community influence on public health priority-setting, as well as program and policy decision-making.
  • I participated in episode 4 of Tenfold, a 10-part podcast series exploring various aspects of public health engagement with communities that experience health inequities. In this podcast episode (notes here), we talked about the reciprocal and symbiotic relationship between community engagement with communities that live with inequities and knowledge translation (KT) concepts. We also looked at how KT influences (and is influenced by) community engagement strategies.

Additional resources on community engagement

The NCCDH Resource Library contains a number of resources related to community engagement.

For example, the community-engaged research project Towards healthy homes for all: What the RentSafe findings mean for public health in Canada draws attention to the importance of community members who live in low-income rental units as co-researchers. This work draws attention to both the roots of the inequities experienced as well as potential solutions.

On our website, you will find a number of other resources describing community engagement and public health practice broadly. For example, Vittoria Vecchiarelli, a public health inspector (PHI), wrote a blog post describing how low-income residents in social housing received training and co-delivered a program to improve indoor air quality in their building called Clean Air at Home.

A 2018 webinar titled Participatory practice and health promotion in Canada (recording here) profiled the work of the Downtown Eastside SRO (Single-Room Occupancy) Collaborative that mobilized SRO tenants to advocate for and inform housing policy in their communities.

Future projects

We are planning future projects for the coming year about engaging community members that live with social and structural inequities. We would love to hear from you with ideas about what we can explore this topic.

If you have thoughts on how to support public health to shift practice to engage more meaningfully with community members with lived/living expertise to inform decisions and priorities, let us know by contacting Dianne Oickle, knowledge translation specialist.

 

Photo credit: Omar Lopez

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