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Purpose – A structured comparison, based on underlying social ecological constructs, provides the framework for this preliminary investigation of the commonalities and differences between three emerging approaches to health disparities: community-based participatory research (CBPR), community-focused health outreach (CFHO), and community health promotion programs (CHPP).

Methodology/approach – A conceptual review and preliminary analysis at the macrolevel of major community trends that focus on eliminating health disparity outcomes.

Findings – Each of the three community health approaches share similar purposes using community-focused collaborative efforts, but involve different change agents, levels of partnership, timeframes, social participation, and implementation methodologies.

Research limitations/implications – Additional in-depth literature reviews and meta-evaluations highlighting the contributions of each of the three approaches (CPBR, CFHO, and CHPP) are strongly recommended.

Practical implications – Interested community stakeholders can monitor results and impacts of each of the three approaches within their environments.

Originality/value of paper – Past reviews have concentrated on isolating individual contributing social causes of health disparities. This analysis introduces three emerging trends that currently function within community-based frameworks as potential mechanisms for helping the health disadvantaged.

This chapter examines how people weigh and discuss opportunities for collective action to improve community health. Drawing from research on civic and social movement engagement, it focuses specifically on how cultural logics of pragmatism, activism, and cynicism are invoked in such debates.

Qualitative data come from four focus group discussions of strategies for reducing tobacco use in Atlanta’s lesbian, gay, bisexual, and transgender (LGBT) communities. Participants included 36 self-identified community members.

Pragmatic logics were used most often in evaluating the tobacco control strategies, with activist logics second and cynicism a distant third. This echoes prior research, but our participants used these logics in unexpected ways: they combined pragmatism and activism, downplaying the former’s emphasis on individual self-interest and the latter’s emphasis on contentious confrontation. In addition, use of the logics varied by focus group and strategy, but not with individual speaker’s identities.

Though limited by a narrow demographic focus and small convenience sample, our study suggests that public support for community health initiatives will likely depend on how they are framed and on the interactional dynamics and shared identities of the groups they are presented to.

Logics of pragmatism, activism, and cynicism inform debate over community health initiatives, as with other forms of civic action. However, use of these logics is not uniform but varies with the groups and issues at hand. Our study participants’ mutual LGBT identification gave them a sense of shared community and a familiarity with the politicization of personal life that led them to combine pragmatist and activist logics in novel ways.

Improving access and the quality of health services requires community health initiatives. However, in order for such efforts to be successful, there has to be some agreement at the community level as to which community initiatives ought to be pursued. With diversity of population, health disparities, limited resources, and competing needs, agreement is unlikely; instead a negotiated consensus among key stakeholders (community advocates, agency leaders, service providers, and consumers) must be developed. A negotiated consensus takes into account differences and allows for some kind of resolution of these differences in order to achieve a given end. A negotiated consensus is necessary for the identification of common goals, prioritizing these goals, and either seeking funding or utilizing available funding for selected community initiatives. The chapter examines efforts by a regional health care system which fostered community initiatives in four diverse sites. We develop a framework which can guide other community initiatives in health care.

As a movement for alternative means of food production and consumption has grown, so, too, have civic efforts to make alternative food accessible to low-income persons (LIPs). This article examines the impact of alternative food institutions (AFIs) on low-income communities in the United States and Canada, focusing on research published since 2008.

Through a three-stage literature search, I created a database of 110 articles that make empirical or theoretical contributions to scholarly knowledge on the relationship of AFIs to low-income communities in North America. I used an in vivo coding scheme to categorize the impacts that AFIs have on LIPs and to identify predominant barriers to LIPs’ engagement with AFIs.

The impacts of AFIs span seven outcome categories: food consumption, food access and security, food skills, economic, other health, civic, and neighborhood. Economic, social and cultural barriers impede LIPs’ engagement with AFIs. AFIs can promote positive health outcomes for low-income persons when they meet criteria for affordability, convenience and inclusivity.

This review exposes productive avenues of dialogue between health scholars and medical sociology and geography/environmental sociology. Health scholarship offers empirical support for consumer-focused solutions. Conversely, by constructively critiquing the neoliberal underpinnings of AFIs’ discourse and structure, geographers and sociologists supply health scholars with a language that may enable more systemic interventions.

This article is the first to synthesize research on five categories of alternative food institutions (farmers’ markets, CSAs, community gardens, urban farms, and food cooperatives) across disciplinary boundaries.

This chapter explores the significance and implementation of family planning practices, emphasizing their vital role in enhancing reproductive health outcomes. This chapter conducts an in-depth examination of family planning practices within marginalized communities in Bangladesh, shedding light on the unique challenges and opportunities faced by these populations. By uncovering the nuances of family planning practices in marginalized contexts, this chapter underscores the need for tailored and culturally sensitive family planning programs. It advocates for program designs that facilitate the effective adoption of family planning practices among marginalized communities, ultimately promoting better reproductive health outcomes. Furthermore, this chapter highlights the importance of empowerment strategies in reaching and engaging marginalized communities. Through practice enhancement initiatives, it seeks to empower marginalized populations with the knowledge and resources necessary to make informed decisions about family planning, thereby contributing to improved reproductive health and overall well-being.

Population, community, and public health notions are addressed separately in the Patient Protection and Affordable Care Act (ACA), have different foci and stakeholders, build on different frameworks to achieve their aims, and apply different measures to determine the long-term impact of interventions. This paper attempts to clarify each concept and proposes a method of evaluating each of these sets of health-related activities based on the benefits that accrue to the respective stakeholders.

In addition to indicating how to affect change and improvements in health, the ecological model of health also provides insight into how the benefits from health-related activities may or may not flow back to the entities sponsoring health interventions. By clearly defining each of the concepts and examining the methods and metrics being used to select activities and measure benefits, a valuation model is developed that measures the financial impact on the targeted population as well as the sponsoring institution.

Defining, measuring, and evaluating are important to bring clarity to how individual organizations can contribute to the overall health of the population, as well as the limits of any single organization in doing so. Collective and upstream action will be required to improve the population’s health, but identifying and justifying the role of each participating organization is a challenge that still lacks an overarching vision that can be explained and measured to the satisfaction of all stakeholders.

Decision makers must justify how resources are committed in an era of scarcity and limited financial means. Moreover, methods must be in place to measure the impact of potential collaborations. The proposed valuation framework lays out the natural incentives, the responses to those incentives, and how to select initiatives that maximize value from the perspective of the various stakeholders.

The overall objective of this research was to elucidate the ecosystem of women’s health social enterprises (WHSEs) based in the United States. The Aim I was to conduct a secondary data analysis of a random national sample of non-profit WHSEs based in the United States regarding their characteristics and areas of intervention. Aim II was to conduct a qualitative assessment of a sample of WHSEs based in the United States regarding their perspectives on the ecosystem of WHSEs. Aim I utilized the GuideStar database and assessed enterprise size, geographic location, financial distress, health intervention area, and health activity category using descriptive statistics, statistical tests, and multivariable regression analysis via SPSS. Aim II utilized in-depth interviewing and grounded theory analysis via MAXQDA 2018 to identify novel themes and core categories while using an established framework for mapping social enterprise ecosystems as a scaffold.

Aim I findings suggest that WHSE activity is more predominant in the south region of the United States but not geographically concentrated around cities previously identified as social enterprise hubs. WHSEs take a comprehensive approach to women’s health, often simultaneously focusing on multiple areas of health interventions. Although most WHSEs demonstrate a risk for financial distress, very few exhibited severe risk. Risk for financial distress was not significantly associated with any of the measured enterprise characteristics. Aim II generated four core categories of findings that describe the ecosystem of WHSE: (1) comprehensive, community-based, and culturally adaptive care; (2) interdependent innovation in systems, finances, and communication; (3) interdisciplinary, cross-enterprise collaboration; and (4) women’s health as the foundation for family and population health. These findings are consistent with the three-failures theory for non-profit organizations, particularly that WHSEs address government failure by focusing on the unmet women’s health needs of the underserved populations (in contrast to the supply of services supported by the median voter) and address the market failure of over exclusion through strategies such as cross-subsidization and price discrimination. While WHSEs operate with levels of financial risk and are subject to the voluntary sector failure of philanthropic insufficiency, the data also show that they act to remediate other threats of voluntary failure.

Aim I findings highlight the importance of understanding financial performance of WHSEs. Also, lack of significant associations between our assessed enterprise characteristics and their financial risk suggests need for additional research to identify factors that influence financial performance of WHSE. Aim II findings show that WHSEs are currently engaged in complex care coordination and comprehensive biopsychosocial care for women and their families, suggesting that these enterprises may serve as a model for improving women’s health and health care. The community-oriented and interdisciplinary nature of WHSE as highlighted by our study may also serve as a unique approach for research and education purposes. Additional research on the ecosystem of WHSE is needed in order to better inform generalizability of our findings and to elucidate how WHSE interventions may be integrated into policies and practices to improve women’s health.

Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health information in order to improve patient outcomes and quality of life. A broader impact of health sciences librarianship is its advocacy for improvements in public health. In recent years, health science librarians have been actively involved in advocating for adequate, responsive, and culturally competent health care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Health sciences librarians have advocated for LGBTQ+ individuals through a variety of specialized outreach projects to address health disparities found in the LGBTQ+ community such as HIV/AIDS, women’s health, or substance abuse, have collaborated with public health agencies and community-based organizations to identify health disparities and needs, and have implemented outreach to address these needs.

This chapter maps the landscape of health sciences librarian outreach to LGBTQ+ people. The authors develop this theme through case studies of health science librarians providing health information to the LGBTQ+ community and healthcare professionals. Following an overview of advocacy for LGBTQ+ health by the US National Network of Libraries of Medicine and professional information organizations, they conclude the chapter by discussing the “pioneering” nature of these projects and the common threads uniting them, and by identifying the next steps for continued successful outreach through the development of an evidence base and tailoring of outreach and resources to address other demographic aspects of the members of the LGBTQ+ community.

While public libraries are well-established as a place to borrow books and use reference materials, they are less recognized for the services and programs they offer to their local communities. These programs and services often directly or indirectly impact the health of patrons and the larger community.

While some public libraries offer programs that address patron health in collaboration with other health professionals, such as those at local universities, public health departments, and other health-related organizations, these collaborations are often informal, offered for an indefinite period of time, and rely on finite funding. While public health professionals and organizations are often overlooked in public library collaborations, they are a natural fit for collaboration.

As public libraries serve the needs of vital and often vulnerable members of our communities, it is important to build sustainable community partnerships when offering programs and services that impact patron health. This will not only identify organizations committed to improving the health of these populations and those that provide reliable resources; it will also streamline information and provide consistent information to identify safe and reliable resources on social media, the internet, and in the community.

This chapter serves as a reflective narrative which explores how public libraries and community organizations can collaborate, identifies anticipated challenges, and describes considerations and strategies for addressing these challenges. The ultimate goal is to identify how libraries can expand the depth and breadth of both library services and public health organizations to sustainably improve the health of the local community.