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Theory in Action: Public Health and Community Power Building for Health Equity.

“Power imbalances manifest as social injustices across multiple determinants of health, including housing, education, employment, and criminal justice, and thereby impact health and equity outcomes.”

While prominent public health bodies and publications have called for redistributing power, public health has little guidance on how to develop strategies and actions that do so in order to advance structural change and promote health and racial equity. This article begins to fill this gap and provides some key action areas for public health.

Power Framework

After defining power and community power, the authors summarize a pragmatic framework for conceptualizing power, called “The Three Faces of Power.” They describe each face, what work public health is already doing that relates to it, and additional actions public health can take to intentionally shift power. For each face, they also provide examples of novel interventions that governmental, non-profit, and academic public health institutions in the United States have made.

Examples of public health action

This article describes a program that intentionally builds partnerships between local health departments and community organizing groups, through which the health department supports a campaign related to a determinant of health led by the organizing group. These partnerships have influenced local decision making and the built infrastructure to change what is on the political agenda, two of the faces of power.

Three initiatives are described that focused on shaping worldviews by changing public narratives, the third face of power. These initiatives take participants through a facilitated process “to identify shared values and beliefs, understand narrative power, unmask current dominant narratives, and identify transformative narrative themes.” These new narratives have been applied across many determinants of health - income, paid family leave, debt, transportation, incarceration, and housing, for example.

Finally, the paper calls on public health to continue developing these types of innovative interventions, to evaluate them, and to provide resources to efforts to shift power.

This paper provides public health with an introduction to power as a key driver of health inequities and names concrete ways public health practitioners and decision makers to shift power and build community power in their work. It is an important contribution for those looking for practical guidance on how to advance health and racial equity.

Use this resource to:

  • Build understanding of power as a root cause of health and racial inequities
  • Develop public health strategies grounded in redistributing power, to make structural change to address health and racial inequities
  • Guide action on redistributing power to advance health and racial equity


Related Resources:

From risk to resilience: An equity approach to COVID-19 (2020)

Just societies: Health equity and dignified lives (2018)

Closing the gap in a generation (2008)


See other resources on power and health equity.


Heller, JC., Little OM, Faust V, Tran P, Givens ML, Ayers J, and Farhang L. (2023) Theory in Action: Public Health and Community Power Building for Health Equity. Journal of Public Health Management and Practice, 29(1), 33-38.

Tags: Power, Academic Institution, Public Health Organization, Journal Article