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Power, control, communities and health inequalities I: Theories, concepts and analytical frameworks

The article by Popay and colleagues (2021) is a starting point for public health practitioners, professionals, and decision-makers, or anyone who wishes to take an anti-oppressive approach to community empowerment initiatives. It is a critical resource for those who are working in community development, outreach, or service delivery.

Authors suggest that the COVID-19 pandemic has renewed public health’s interest in the community’s role in promoting and protecting population health. However, to meaningfully engage with community, there must be special care taken to identify the role of power, sociopolitical contexts, and other structural-level factors. Popay and colleagues (2021) have developed this resource to help public health do the important work of community empowerment. This resource is the first in a three-part series aimed at shifting community empowerment approaches in public health to address structural drivers of health inequities.

To construct their analysis, Popay and colleagues (2021) draw upon a longitudinal evaluation of a prominent British community empowerment initiative called Big Local. They also integrate literature on neighborhood resilience. 

Within the article, Popay and colleagues (2021) explore the historical context of community empowerment initiatives in public health. A key value of this resource is its critical analysis of the consequences of neoliberalism, which have led to:

  • an under-emphasis of social and political transformation for health justice (in other words a de-politicization of public health practice)
  • an over-emphasis on communities’ psycho-social capacities, lifestyle changes and proximal neighbourhood conditions

To take an equity-driven approach in the context of community empowerment, authors call upon public health practitioners to implement a three-pronged initiative which clarifies key concepts such as collective control and provides two theoretical frameworks to guide action. Importantly, authors offer a variety of conceptualizations of power that can guide health equity and social justice public health approaches. 

Use this resource to:

  • Build awareness of historical roots of public health community empowerment approaches.
  • Develop community empowerment project plans rooted in dynamic understanding of power and structural drivers of health inequities.
  • Use the theoretical frameworks to guide equity-driven action with communities.


Related Resources:

COVID-19 Conversation Series Part 3: Recognizing Power


See other resources related to power, health, and equity.


Popay, J., Whitehead, M., Ponsford, R., Egan, M., & Mead, R. (2021). Power, control, communities and health inequalities I: Theories, concepts and analytical frameworks. Health Promotion International, 36(5), 1253–1263.

Tags: Power, Journal Article