Given the COVID-19 pandemic’s disproportionate effects on people of color and increased attention to racial justice in the US, initiatives to increase health equity are sprouting up across the country (Ndugga, Artiga, and Pham 2021).These efforts range from addressing immediate health and social needs among communities most affected by the pandemic’s impacts to broader and longer-range policy changes designed to eliminate systemic barriers to good health. This brief examines the role of community engagement in informing and advancing efforts to eradicate health inequities. Here, we define “community engagement” as collaborating and sharing power with communities to identify concerns and develop and implement solutions.
This brief draws on interviews with representatives from national organizations, health equity experts, and stakeholders in four states, including representatives from state agencies, community-based organizations (CBOs), consumer advocacy groups, and foundations. Through these interviews, we investigated ways community engagement is being used to advance health equity and factors that promote or hinder community engagement. Many study participants expressed that community members are experts in their lives and communities who need resources and support to facilitate equitable community health and well-being. Though community engagement can take many forms, authentic and meaningful engagement in which community members are not just present but actively take part in decision making requires extensive relationship and trust building that involves a significant investment of time and resources. However, interviewees acknowledged that a lack of institutional commitment, limited funding, and bureaucratic barriers impede efforts to effectively engage communities.
Our study participants shared numerous strategies to support effectively, authentically, and meaningfully engaging community members in health equity work, organized around four guiding principles:
- Community engagement relies on establishing trust.
- Be humble, listen, and act on feedback.
- Be transparent.
- Partner with trusted community leaders and CBOs.
- Community engagement requires sufficient and flexible funding and cross-sector support.
- Secure flexible and sustainable financial resources.
- Adequately compensate staff and community members.
- Collaborate across public health, health care, and social service sectors.
- Community engagement should be continuous and sustained.
- Allocate considerable time and patience.
- Provide infrastructure, technical assistance, and support.
- Follow through and “close the loop.”
- Community engagement should pay explicit attention to eliminating structural racism.
- Hire from the community.
- Address participation barriers.
- Address racism inside and outside governments and organizations. (abbreviated author introduction)
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