As an undergraduate, I was always interested in doing work related to health disparities and increasing health equity. After completing my Bachelor’s degree, I decided to take a few years off before going to graduate school. During this time, I took a position with a social service organization, and that work cemented my interest in public health.
While there, I worked across a range of community programs dedicated to issues like maternal and child health, youth violence prevention, and employment in low-income communities. Through this work, I began to understand how social factors impact health beyond what happens in the clinical setting. Young people lacking effective conflict resolution skills would eventually land in the emergency department with gunshot wounds. Without decent employment, community members would be more susceptible to chronic disease, as they wouldn’t be able to afford healthy food. I came to realize that we had to think about health more broadly and improve the conditions that people live in, in order to ultimately improve the health of the public. I knew then that I wanted to be involved with work that addressed the social determinants of health.
Since that time, I have been involved in projects related to health equity in participatory research, with a focus on community engagement—both as a researcher and an instructor.
What Is Community Engagement?
For me, community engagement is about developing trusted and long-lasting partnerships with community agencies and individuals. In these partnerships, all have a voice in how public health projects are planned, implemented, and evaluated. Community engagement is a science. Some people may not traditionally think of it in those terms, but we use methods that have been tried and tested, and we learn from the challenges and the successes of people who have done similar work before. There are theories and frameworks in place for how to think about the ways to engage with community members. It’s really important to use these resources when planning community-engaged work. The work to be done is not easy—but it’s certainly rewarding.
Don’t Be a “Helicopter Researcher”
Partnerships are crucial for public health professionals interested in impacting community health. As public health professionals, we are often not members of the communities where we work. This means that we may not understand the history of the community, the public health issues that exist, the approaches that have already been tried, and past successes or failures. We need people on the ground who can give us insight into these areas. Further, communities don’t trust people that they don’t know. Underserved communities typically have a long history of being exploited by those with self-serving interests, so they are rightfully suspicious of new faces and organizations. To earn trust, you need partnerships with community agencies and individuals who are recognized as those who care about the community. This helps to ensure that outsiders do not exploit the community for their own purposes.
Researchers interested in community-based work must be careful not to become “helicopter researchers.” That’s what we call researchers who swoop in, collect the data they need to advance their projects, and then swoop out without making a real investment in the community. Community members have seen plenty of it, and they don’t like it. They don’t want to participate in research if it offers no real community benefit.
How to Develop Partnerships
In the Community Engagement in Public Health Practice course that I teach, we discuss how to develop partnerships with community members. What are the challenges? How do we make sure that community members and public health professionals have voices in how projects are planned, implemented, and evaluated?
Those interested in community-engaged work must learn where power is held in a particular community—and that’s not necessarily with the elected officials. I teach my students that they must learn to identify the trusted, often unofficial, leaders, in the community. Who has a voice in the community? Who does the community respect and listen to?
At the end of the semester, students in my course are asked to develop their own community-engaged project focused on a community and public health topic of their choice. The students learn how to engage with people who know that community, live in the community, and have a vested interest in that community. This increases the students’ knowledge about how the community works, and what the community needs. Students also learn how to train community members to be directly involved in the public health work as well, such that community programming activities can be sustained over time.
Successful Community Partnerships in Flint
In my courses, I use examples from some of my own research.
In one project—the “Church Challenge”—our research team partnered with a local faith partner to develop a multilevel intervention that included a 16-week physical activity and nutrition program within Flint’s African American faith community. With training, the church members collected data, served as fitness instructors for the project, and assisted with nutrition education. We all worked together to troubleshoot problems, talking through issues, and determining what next steps made sense. It was truly a partnered initiative.
For several years, we also partnered with the City of Flint and Genesee Health System (the local public mental health provider) to conduct a community survey that evaluated mental health outcomes in Flint in the aftermath of the Flint Water Crisis. We trained community members to go door-to-door, within their own neighborhoods, to collect data on mental health and water-related needs over time. We then presented this data back to the community and to local, state, and federal officials in order to advocate for resources for Flint residents. This work led to increased federal funding for behavioral health initiatives in Flint that still exist today. This is a clear example of how community members and public health professionals can work together to promote community health.
Training the Next Generation
Many of our partners in community-engaged work are older adults who are retired professionals or social workers. Their knowledge and experience must get passed down to the next generation in order for successful activities to be sustained. That’s why it’s important to get young people involved now; we need to reach across generations where public health is concerned. Young people have a lot of passion and they know what their own needs are. A 65-year-old may not have a clear sense of adolescents’ knowledge and attitudes about community health issues. Public health work must be passed on to younger generations to ensure that the work continues to be responsive to the needs of all ages.
Trusted People in Trusted Places
Over the years, we have developed successful partnerships with numerous organizations: the Valley Area Agency on Aging; the Community Outreach for Family and Youth (COFY) Center; the City of Flint; Genesee Health Plan (GHP); the MADE Institute, which offers programs and resources for individuals who were previously incarcerated; and the Genesee Health System, among others.
The work we do in community engagement is really innovative. Community members have a heart for their communities, and that’s contagious. Their passion and creativity continuously inspire me. Every day, I am able to apply the skills I have gained as a traditional researcher in new and interesting ways.
So, if you’ve read up to this point, you may still be asking yourself: “What truly makes community engagement successful?” I asked this question of a colleague not too long ago, and she gave me an answer that I will always carry with me: “For community engagement to work, you must have trusted people, in trusted places, delivering trusted content.”
Rodlescia Sneed, PhD, MPH, is an assistant professor in the Division of Public Health in MSU’s College of Human Medicine. She is a social and health psychologist interested in how older adults age successfully in economically vulnerable communities.
Interested in taking Dr. Sneed’s course? Check out HM 828: Community Engagement in Public Health Practice.
September 13, 2021