Building Community Power to Achieve Health and Racial Equity: Principles to Guide Transformative Partnerships with Local Communities.

Abstract

Leaders and practitioners across industries—including public health, health care, and clinical settings; local, state, and federal government agencies; and academic institutions—are asking hard questions about what it will take to achieve health equity. The COVID-19 pandemic, the 2020 uprisings for Black liberation, the January 6 insurrection, and increasing state and local restrictions on voting illuminate how high the stakes are for Black, Indigenous, and other People of Color (BIPOC). Previously quiet conversations about “advancing health equity” and “moving upstream” are evolving into more public debates about the need to center racial equity in institutional efforts to achieve health equity. As of October 2021, the American Public Health Association tracked more than 220 jurisdictions that had named racism a public health crisis, and organizations across various sectors are making visible commitments to transform their practices, programs, and policies to achieve racial equity (American Public Health Association, n.d.). What should go hand-in-hand with efforts to achieve racial and health equity are efforts to share and shift power with communities affected by health and structural inequities. For example, more health institutions and funders, such as the Robert Wood Johnson Foundation, National Association for County and City Health Officials, and The California Endowment, are making this commitment—looking for opportunities to help build community power, as an outcome in and of itself, in their sphere of influence. In this commentary, the authors discuss why this emerging emphasis on building community power is essential to achieving health and racial equity and highlight a set of values and principles to guide practitioners, researchers, and leaders in transforming how they work with communities to build their power. This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative effort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fields of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.