Building Community Power To Dismantle Policy-Based Structural Inequity In Population Health

Health Affairs 41, No. 12 (2022): 1763–1771. DOI: 10.1377/ hlthaff.2022.00540
Anthony Iton, Robert K Ross, Pritpal S Tamber
December 2022

Population health strategies tend to focus on individuals’ behaviors, genes, or health care access, yet it is well established that socioecological conditions are fundamental to health and strongly influenced by policy. In the US, health and other policies continue to be shaped by the country’s unique legacy of racial and economic segregation. Policy reform must be at the center of population health. This requires communities to have power. We present theoretical and empirical research linking community power and health, and we share an example of our work in which communities organized to hold policy makers accountable for advancing health equity in the distribution of parks. We call this a democratic approach to health improvement and discuss how population health, whether part of public health, philanthropy, or health care, needs to focus on community power and include funding for power- building organizations. We conclude that achieving health equity requires enhancing the quality of democracy.

This article was published in Health Affairs. It builds on my exploration of how community agency links to health in the bio-medical literature (the report of which is available here). The article has an appendix. PDFs of both the article and the appendix are available from the download button below.

The California Endowment has paid Health Affairs to make this article open access (CC BY-NC-ND 4.0). That means that you can distribute it freely without having to ask for permission. You cannot, however, use it commercially and if you modify it in any way, you cannot distribute the modified version. For more information, see the full details of the license here.

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Iton 2022, Building community power to dismantle policy-based structural inequity in population health - cover

Project this report was part of: Agency, Belonging and Health

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