Abstract

Building community power in health equity partnerships: Applying the three faces of power framework

Olivia Little, PhD¹, Paula Tran, MPH¹ and Simone Alhagri, MPH²
(1)University of Wisconsin Population Health Institute, Madison, WI, (2)University of Wisconsin Population Health Institute, Hamtramck, MI

APHA 2023 Annual Meeting and Expo

The public health field is recognizing the role that power imbalances play in creating, perpetuating, and exacerbating health inequities. There are increasing calls for, and investments in, efforts to address power dynamics and build power among groups experiencing inequities. Yet there remains a gap between calls for action based in theory and implementation research on building community power in real-world public health settings. This study addresses that gap by examining how community partnerships build and shift power through the lens of the Three Faces of Power (Lukes, 2021). The Three Faces of Power is a pragmatic framework outlining how power influences decision making and how power can be shifted across three dimensions: (1) influencing public or formal decision-making processes through direct civic participation; (2) building long-term civic infrastructure to affect the conditions that precede decision making; and (3) lifting up information, beliefs, and worldviews about social issues by shaping public narratives. This presentation will share themes and examples from a study examining how successful community partnerships employed power-building approaches in their health equity work. Through three detailed case studies, including interview data from multiple coalition members, the presentation will highlight key strategies, lessons learned, and challenges faced by these partnerships. For example, the case studies demonstrate how partnerships deeply engaged residents most affected by inequities, built community awareness and organizational capacity to address power imbalances, and influenced decision making across the three faces of power. Strategies included: embedding resident engagement practices throughout coalition work; educating organizational partners and community members about social determinants of health and power imbalances as causes of health inequity; and reshaping decision making forums through use of popular education, youth empowerment and leadership, and community organizing partnerships. The case studies illustrate the spectrum of collaborative and power-based approaches in different community contexts and public health settings. The study findings differentiate between efforts that function within current systems of power and those that aim to shift power. This is important for helping practitioners, funders, policymakers, and others better understand and identify power-building approaches, to inform how they pursue, fund, and evaluate health equity work. The presentation will engage the audience in discussion about how the faces of power show up in their work and the different roles that public health professionals can play to support community power building.

Advocacy for health and health education Basic medical science applied in public health Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Systems thinking models (conceptual and theoretical models), applications related to public health