Our public health frameworks are failing us - here’s the one thing we’re missing

Our public health frameworks are failing us.

They're true. AND they're failing us.

Let me explain why.

I had the pleasure of giving a Lightning Talk at the National Network of Public Health Institutes Open Forum conference in Pittsburgh earlier this month (it was a balm to the soul to be in the company of fellow community-based public health practitioners!)

Here’s how and why our public health frameworks are failing us, the one thing we're missing, and what we need instead:

Now, let me break down each of these ways to begin treating building community power as a public health imperative.

Way #1: Cultivating community connection

• The status quo: What our former surgeon general Vivek Murthy calls a loneliness epidemic. We have an individualistic lens, an obsession with self-care and self-help.

• What we need instead: A sense of COMMUNITY. Ways to work, play and simply be together. Third spaces to hang out. Mutual aid. Land use planning that prioritizes connections. Group care and group help. What Priya Parker calls Group Life.

• An on the ground example (in Pittsburgh, where NNPHI's conference took place!) - Pittsburgh's wedding cookie table!

• A public health example - community coalitions of course!

• Ways to cultivate community connection in YOUR work: look for low-lift opportunities + think strategically about convening (What could you change if you teamed up with others that feels impossible alone? Bring folks together around a specific goal.)

Way #2: Strengthening the foundations for civic organizing

• The status quo: Our civic muscles have atrophied. Direct involvement in local politics, union membership, and civic activity beyond voting have all declined.

• What we need instead: Stronger foundations for civic organizing that can advance health-transforming policies. This requires: community connection as the foundation for effective organizing; strong local news to know what's happening and hold officials accountable; strong community organizing infrastructure

• An on the ground example: Pittsburgh's "Our Water" Campaign, led by Pittsburgh United.

• A public health example: The Public Health for Community Power Coalition (whose members include Health in Partnership (HIP), Public Health Institute, Prevention Institute, ChangeLab Solutions, Berkeley Media Studies Group, and others)

• Ways to strengthen the foundations for civic organizing through YOUR work: For organizing/advocacy groups - long-term, consistent organizing across topics is key. For those with limits on direct advocacy - there's still so much you can do! Convene people and make intros across your government and community partners, and build storytelling and other skills among community members that make effective organizing more likely.

Way #3: Fostering narrative change

• The status quo: Individualistic, "blame myself and shame on you" narratives about what shapes our health.

• What we need instead: a narrative recognizing what lies further upstream and the role of community power. We need a new narrative – that gets explicit about the political and corporate forces shaping the policies and systems that shape our health. And then, beyond better messaging, we need actual narrative infrastructure to construct and sustain narratives over time, through things like community partnerships, research, legal advocacy, and institutions of meaning-making like schools, mass media, and museums.

• An on the ground example: Healthy Start’s infant health equity coalition in Pittsburgh, who we here at PoP Health have been so grateful to work with over the years! They’ve crafted a community-driven narrative by funding local organizations to gather member stories, hosting town halls featuring community stories, and training community members as health advocates who speak to systemic issues.

• A public health example: My new project, GASLIT (Gaslit by Corporations / Ignited by Community). I launched GASLIT to explicitly name corporate power as a root cause of public health harms and center community power in the fight for our health, planet, and future. Please sign up for the GASLIT newsletter if you’re interested in receiving action steps you and your neighbors can take to ignite change, stories of communities reclaiming their power, and investigations into corporate gaslighting.

• The foundations for fostering narrative change in YOUR work: Think about the narrative itself: Revisit how you talk about root causes of health. Are you going upstream enough? And build narrative infrastructure: Build community members' skills to tell their stories, create spaces for them to speak directly to decisionmakers. Engage with institutions of meaning-making to shape narratives about health.

So, what's next?

Which of these ways fits in most directly with your work?

What steps are you hoping to take next?

Drop me a line and let me know.

And if I can help, whether that's through a keynote talk on community power as a public health imperative; training, tools, and coaching for your coalition, or simply answering a question via email, please reach out!

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