Supporting health equity through community engagement - Minnesota Dept. of Health

Supporting health equity through community engagement

Genuine engagement with the community is one way to assure public health recognizes needed changes and takes appropriate action.

Engagement that advances equity
Communities co-creating their own healthy futures

 

Engagement that advances equity

A new focus for an established public health practice

Public health has emphasized engagement as a practice to advance population health. However, public health—like any profession—can unintentionally develop and sustain structural inequities. Genuine engagement with the community is one way to assure that the local health department recognizes needed changes and takes appropriate action.

When thinking about engagement that advances equity, think about these reflective questions:
What partners do you engage to advance public health?
Who influences decisions made about public health policies and practice?
Would populations experiencing health inequities describe your department as working with them to find solutions, or offering solutions to them?

To advance health equity, health departments must explicitly include and engage with those in poverty, communities of color, American Indians, immigrant communities, and others experiencing health inequities. Efforts to advance health equity will be more successful if they are designed with (not simply for) communities experiencing health disparities.

This engagement must be authentic; health departments must go beyond forming intermittent relationships for the purposes of gaining feedback, and instead seek to build and sustain lasting relationships. In these relationships, a health department must be willing to listen and allow the community to lead the work. We should not use engagement as a way to confirm or advance a pre-existing idea or agenda (source: Public Health Accreditation Board standards and measures version 1.5: Domain 4 [PDF]).

An asset-based approach

Taking an asset-based approach to health and well-being necessitates engaging communities experiencing health inequities. We cannot know the assets of a community without engaging those who are part of that community. Once identified, these strengths and assets will inform how we shape public health policies, practice, and decisions.

Again: Identifying existing strengths and assets is not a new public health practice. It is a component of a community health assessment, a core feature of adolescent health efforts, and a practice of successful coalition work. However, we can provide new focus to existing practice by thinking about what assets we consider and who identifies them.

 

Communities co-creating their own healthy futures

Triple Aim of Health Equity

The Minnesota Department of Health identified three critical practices to advance health equity (above):

  • Implement a health in all policies approach with health equity as the goal
  • Expand our understanding of what creates health
  • Strengthen the capacity of communities to create their own healthy future

The centerpiece of the Triple Aim of Health Equity is social inclusion. It begins by acknowledging the diversity within and across our society and working to include their wisdom and world views in our work. Community engagement can inspire innovation and create opportunities for individual and organizational growth. Public health agencies working to engage communities experiencing health inequities should challenge power imbalances and foster shared leadership.

Community engagement is more than an essential set of activities to get things done with and in communities. Engagement must go beyond physical attendance to include generating ideas, contributing to decision-making, reasonably distributing resources and labor, and having mutual accountability for outcomes. By doing so, community engagement can strengthen communities’ abilities to create the conditions for health and well-being.

Authentic community engagement should support partners’ capacity to act. Building capacity in communities experiencing health inequities to take targeted action in our communities and develop scalable solutions such as:

  • Reclaiming Indigenous language, food and traditions that promote physical and mental well-being and a culture of health
  • Voicing their stories and taking control of the narrative around issues and policies that impact them
  • Within ethnic communities, organizing professional, cross-sectoral partnerships that connect different social determinants of health for more comprehensive understanding of services, systems, and solutions
  • Leading groups that hold policymakers accountable for changes that impact access and opportunities
  • Identifying trends and disaggregating data that demonstrate the variety and nuance of experiences among marginalized groups