In the past 40 years community participation models have risen notably in several key policy domains -- health, environmental regulation, economic development, consumer protection, and education. This study develops a framework for analyzing civic participation across policy domains, and further considers whether health policy is exceptional. Based on a comparative case study of eight federal policies and programs from 1964-1998, including Community Health Centers, the Ryan White CARE Act, and Healthy Start, three analytic rationales for community participation policies emerged: normative, instrumental, and political. Policies based upon a normative rationale assume an intrinsic value in participation, which enriches the individual or community or that otherwise appeals to a fundamental need for self-governance. Community participation models based on an instrumental rationale assume that civic engagement is essential to achieving population-level outcomes or implementation of community-based initiatives. This rationale further assumes that government and institutions are fundamentally limited in their ability to adequately assess and "treat" communities because they lack sufficient cultural capacity or social networks to reach and influence community residents. The third model considered is the political rationale. Policies based upon this rationale may use community participation as a means of redistributing power from entrenched structural and political interests to otherwise disenfranchised populations, deflecting pressure groups when no viable policy alternative exists, or mobilizing support for national policies and reforms to be implemented at a local level. This analysis concludes that community participation in health policy is more likely to rest upon an instrumental rationale than do policies in other domains.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Describe a selected history of community participation models in US federal policy from 1964-present; 2. List three analytical rationales for community participation models; 3. Articulate whether health policy is considered exceptional according to these analytic rationales
Keywords: Politics, Policy/Policy Development
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.