How the Experts Think about Power and Belonging

Pritpal S Tamber

March 24, 2022

As I mentioned in my first post, we began our research into the link between community power and health by speaking with ten key informants (experts). What I’ve covered in these posts so far is what we found in the health literature but the key informants were more expansive. In this post, I want to pick out a few of the things they said that have stayed with me.

Throughout this work, there has been an assumption that community power matters because it can change the conditions in which people live, often through political processes. Mahasin Mujahid and Paul Speer worried that this was a middle-class view of the value of community power, and that it afforded little space to other, equally valid views. Communities can, in fact, use their power to turn inwards, away from political processes, perhaps because those processes are biased against them. They may even turn to crime, perhaps because legitimate forms of earning are not available to them. These expressions of power are logical and protective, but they can look ‘wrong’ if the only view that matters is a middle-class one.

Mujahid also worried that making community power the solution meant that disadvantaged communities had a greater burden than advantaged communities (who have, by definition, more power). In that way, it’s a John Henryism, the idea that people who have been discriminated against have to work harder to achieve the same results as others, which comes with significant physical and psychological cost. In that way, focusing on community power has the potential to increase inequity.

Speer also felt that it was not enough to just focus on building community power. It’s also important to examine how power creates change. His view is that it happens through organizations that mediate between people and policymakers. These organizations are (or know of) points of leverage. He felt uncomfortable about the growing belief that spontaneous uprisings are the only things that matter. Our focus on community power may, he worried, be adding to that belief.

On change, Speer felt we needed to be clear about the types of change possible, and which we advocate for. His view, and the view of john a powell, Margaret Whitehead and Shannon Sanchez-Youngman, was that what matters is structural change – where the distribution of resources in society changes. All too often the change achieved is symbolic (such as when a person of color is employed as a newsreader) or incremental (when change occurs but the gap between advantaged and disadvantaged communities remains the same).

Sticking with change, Sanchez-Youngman talked about what is possible is dependent upon dominant narratives. For instance, violence against women used to be considered normal. It was only when it was de-normalized that alternative roles for women became possible.

When I interviewed the key informants, we were thinking about belonging as well as power. powell believes that you can only belong to something if you are allowed to shape it. This contrasted with most of the other key informants who thought of belonging as a different word for inclusion. The problem with ‘inclusion’ is that it assumes that the thing you’re being included in is the right shape for everyone. Inevitably, as populations become more diverse, that won’t be true. Importantly, powell talked about how his notion of belonging can be measured both subjectively and objectively. Subjectively, you can ask people if they feel they belong to something. Objectively, you can assess whether the structure and processes of the thing encourage those included to shape it.

Returning to political processes (while acknowledging the middle-class prejudice inherent to focusing on them), Speer and Whitehead reflected on the general erosion in participation. Speer talked about how democratic societies need leadership, expertise, and participation, and that these things operate in tension with each other. His view is that the recent deference towards expertise has been at the expense of participation. Whitehead referenced the work of Peter Townsend who posited that participation requires resources, and so poverty was a way to inhibit participation.

As I said, these are just a few of the things that have stayed with me. The sharp ones amongst you will have noticed that I’ve only mentioned five of the ten key informants. The others were Michael Little, Michael Marmot, Rebeca Sandu, Richard Smith, and Nina Wallerstein (who was only available by email). You can read what I learnt from them in our report (pages 21 to 29), as well as more from the five mentioned above.

In my next post, I’ll propose a model based on the results of our research. It connects community engagement, health improvement, and the building of community power. And if you’d like to receive these posts by email, you can sign up here.

Until next time.

Pritpal S Tamber

Notes

  • Paul Speer’s example of incremental change is Sesame Street, the educational children’s television series. It was created to improve the school-readiness of children of low-income families but all children benefited so, although there was change, the gap between children remained the same.
  • john a powell prefers his name to be spelt all lower case
  • I appreciate that violence against women is still considered normal in some cultures. I wasn’t sure how to acknowledge that in the text so am doing it here.
  • My write-ups of the conversations with the key informants were based on my notes. I didn’t ask them to check and approve the notes so any inaccuracies in presenting their views are entirely mine.
  • The research being described in this season of posts was in partnership with the Insight Center for Community Economic Development, and I thank Brad Caftel of the Center for overseeing the administrative details involved.

The photo behind the title is by Photo by Douglas Lopez on Unsplash.

Pritpal S Tamber

I'm an independent writer, researcher and consultant focussing on community health and medical information. I'm a former physician, medical editor and medical publisher, and also the former Physician Editor of TEDMED. I began my career at The BMJ. For more information, see the About page.

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