There’s No Silver Bullet to Community Engagement—But Centering Equity Is the Start

December 21, 2022

Through the Community Voices for Health (CVH) initiative, we at Public Agenda, a research-to-action nonprofit organization, and our partner Altarum, a nonprofit that helps federal and state health agencies and foundations improve health equity and outcomes through better systems of care, are working closely with community-based organizations in four states to build infrastructure for better community engagement in health. Our goal is to amplify community voice in health policy by building on existing assets, strengthening pathways for ongoing communication, using data to inform engagement, and creating partnerships for sustainability, cohesion, and consistent community deliberation in health policy. 

Since 2021, we’ve worked with organizations in Colorado, Georgia, Indiana, New Mexico, Nevada, and Pennsylvania to explore place-based approaches to community engagement in healthcare and share learning among a diverse group of partners. Public Agenda and Altarum have offered workshops, peer-to-peer learning opportunities, and customized technical assistance and resources for state-based efforts. In the summer of 2023, we will share what we’ve learned through the stories, resources, and strategies gleaned from each state in a “toolkit” for use by organizations seeking to expand community voice in health policy.  

What we won’t be able to share is a quick fix for engaging the public. Collectively, we’ve learned through this effort that there is no “silver bullet” for addressing challenges in community engagement. Transformative public engagement is complex. Mistakes are a given—and are necessary for learning, building trust, and creating lasting spaces of inclusion. 

Meaningful engagement requires deep introspection and humility, as well as the willingness to be uncomfortable. At the heart of meaningful public engagement is relationship building between people and the institutions that serve them—not only governmental structures, but also hospitals and schools. Critically, engagement is also about the relationships between and among people.

We enter this work with the beliefs that all people have equal worth and dignity, and that everyone benefits when we all are heard and when we all participate fully in shaping our own health policy. These commitments imply an approach that puts equity at the center of a substantive analysis of power in communities, expressed in clear language that is accessible to all.

Centering equity in the practice of expanding public engagement also requires us to examine the power dynamics within our own organizations, our structures, policies, and practices.  Expanding opportunity for voice is a gradual process, and it can happen only when we are comfortable with failing and learning. 

An example from the Community Voices for Health project comes from the New Mexico Alliance of Health Councils (NMAHC). NMAHC prioritized racial equity in their engagement efforts—beginning with their own organization. They established an internal racial equity design group to focus on the integration of racial and health equity elements in all facets of the organization, including the services they provide to the community. This work will have ripple effects, from the health councils in New Mexico, through fundamental changes to NMAHC’s internal language, processes, and accountability, which then informs their work with partners like the Department of Health and communities across the state. 

Over the coming months, we will continue to share stories and learning from the Community Voices for Health initiative through presentations, blogs, and in our toolkit. There will be a wealth of good resources–but no silver bullets here.