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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Community Power in Population Health Improvement: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26306.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Anna Nicholson and Tamara Haag, Rapporteurs Board on Population Health and Public Health Practice Health and Medicine Division PREPUBLICATION COPY—Uncorrected Proofs

THE NATIONAL ACADEMIES PRESS   500 Fifth Street, NW   Washington, DC 20001 This activity was supported by contracts between the National Academy of Sci- ences and AAMC, Aetna Foundation, BlueCross BlueShield of North Carolina, Nemours, The Rippel Foundation, Robert Wood Johnson Foundation, The Univer- sity of Texas at Austin, and Wake Forest Baptist Health/Stakeholder Health. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project. International Standard Book Number-13: 978-0-309-XXXXX-X International Standard Book Number-10: 0-309-XXXXX-X Digital Object Identifier: https://doi.org/10.17226/26306 Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu. Copyright 2022 by the National Academy of Sciences. All rights reserved. Printed in the United States of America Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Community power in population health improvement: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26306. PREPUBLICATION COPY—Uncorrected Proofs

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Marcia McNutt is president. The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. John L. Anderson is president. The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Victor J. Dzau is president. The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. PREPUBLICATION COPY—Uncorrected Proofs

Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process, and it represents the position of the National Academies on the statement of task. Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies. For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo. PREPUBLICATION COPY—Uncorrected Proofs

PLANNING COMMITTEE ON COMMUNITY POWER IN POPULATION HEALTH IMPROVEMENT1 HANH CAO YU (Chair), Chief Learning Officer, The California Endowment, Oakland, CA GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University, Winston-Salem, NC LOURDES J. RODRÍGUEZ, Senior Program Officer, St. David’s Foundation, Austin, TX ARVIND SINGHAL, Professor of Communication and Director of the Social Justice Initiative, The University of Texas at El Paso, El Paso, TX ADITI VAIDYA, Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speak- ers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. v PREPUBLICATION COPY—Uncorrected Proofs

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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1 SANNE MAGNAN (Co-Chair through December 2020), Senior Fellow, HealthPartners Institute, Emerald Isle, NC JOSHUA M. SHARFSTEIN (Co-Chair through December 2020), Vice Dean for Public Health Practice and Community Engagement, Professor of the Practice, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD RAYMOND BAXTER (Co-Chair from January 2021), Trustee, Blue Shield of California Foundation, San Francisco, CA KIRSTEN BIBBINS-DOMINGO (Co-Chair from January 2021), Professor and Chair of the Department of Epidemiology and Biostatistics; Lee Goldman, MD, Endowed Professor of Medicine; Vice Dean for Population Health and Health Equity, University of California, San Francisco, School of Medicine; San Francisco, CA PHILIP M. ALBERTI, Senior Director, Health Equity Research and Policy, Association of American Medical Colleges, Washington, DC DAWN ALLEY, Chief Strategy Officer, Center for Medicare & Medicaid Innovation, Washington, DC JOHN AUERBACH, Executive Director, Trust for America’s Health, Washington, DC CATHY BAASE, Chair, Board of Directors, Michigan Health Improvement Alliance (MIHIA); Consultant for Health Strategy, The Dow Chemical Company, MIHIA, Saginaw, MI DEBBIE I. CHANG, President and Chief Executive Officer, Blue Shield of California Foundation, San Francisco, CA ALLISON GERTEL-ROSENBERG, Operational Vice President, National Policy and Practice Nemours, Washington, DC MARC N. GOUREVITCH, Professor and Chair, Department of Population Health, New York University Grossman School of Medicine, New York, NY MEG GUERIN-CALVERT, Senior Managing Director and President, Center for Healthcare, Economics and Policy, FTI Consulting, Washington, DC GARTH GRAHAM, President, Aetna Foundation, Hartford, CT 1 The National Academies of Sciences, Engineering, and Medicine’s forums and round- tables do not issue, review, or approve individual documents. The responsibility for the pub- lished Proceedings of a Workshop rests with the workshop rapporteurs and the institution. vii PREPUBLICATION COPY—Uncorrected Proofs

GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University, Winston-Salem, NC DORA HUGHES, Associate Research Professor of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC SHERI JOHNSON, Director, Population Health Institute; Acting Director, Robert Wood Johnson Foundation Culture of Health Prize; Associate Professor, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin– Madison, Madison, WI WAYNE JONAS, Executive Director, Integrative Health Programs, H&S Ventures, Samueli Foundation, Alexandria, VA ROBERT M. KAPLAN, Professor, Center for Advanced Study in the Behavioral Sciences, Stanford University, Stanford, CA MICHELLE LARKIN, Associate Vice President and Associate Chief of Staff, Robert Wood Johnson Foundation, Princeton, NJ MILTON LITTLE, President, United Way of Greater Atlanta, Atlanta, GA PHYLLIS D. MEADOWS, Senior Fellow, Health Program, The Kresge Foundation, Troy, MI BOBBY MILSTEIN, Director, ReThink Health, Morristown, NJ JOSÉ T. MONTERO, Director, Center for State, Tribal, Local and Territorial Support; Deputy Director, Centers for Disease Control and Prevention, Atlanta, GA VON NGUYEN, Senior Vice President and Chief Medical Officer, Blue Cross Blue Shield of North Carolina, Durham, NC WILLIE OGLESBY, Interim Dean, College of Population Health, Jefferson University, Philadelphia, PA JASON PURNELL, Vice President, Community Health Improvement, BJC HealthCare; Associate Professor, Brown School, Washington University in St. Louis, St. Louis, MO LOURDES J. RODRÍGUEZ, Senior Program Officer, St. David’s Foundation, Austin, TX PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation, Princeton, NJ KOSALI SIMON, Herman B. Wells Endowed Professor, Associate Vice Provost for Health Sciences, Paul H. O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN HANH CAO YU, Chief Learning Officer, The California Endowment, Oakland, CA viii PREPUBLICATION COPY—Uncorrected Proofs

Health and Medicine Division Staff ALINA BACIU, Roundtable Director CARLA ALVARADO, Program Officer (through January 2021) AYSHIA COLETRANE, Senior Program Assistant HARIKA DYER, Research Assistant ROSE M. MARTINEZ, Senior Director, Board on Population Health and Public Health Practice ix PREPUBLICATION COPY—Uncorrected Proofs

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Reviewers This Proceedings of a Workshop was reviewed in draft form by indi- viduals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineer- ing, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review com- ments and draft manuscript remain confidential to protect the integrity of the process. We thank the following individuals for their review of this proceedings: JASON PURNELL, BJC Healthcare; Washington University in St. Louis IRENE YEN, University of California, Merced Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by BRUCE N. CALONGE, The Colorado Trust. He was responsible for making certain that an indepen- dent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies. We also thank staff member ANA FERRERAS for reading and pro- viding helpful comments on this manuscript. xi PREPUBLICATION COPY—Uncorrected Proofs

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Contents ACRONYMS AND ABBREVIATIONS xvii 1 INTRODUCTION 1 Workshop Objectives, 2 Organization of the Proceedings, 3 2 DARING TO LEAD 7 National Domestic Workers Alliance, 8 Radical Reimagining, 13 Discussion, 16 3 COMMUNITY POWER IN THE CONTEXT OF POPULATION HEALTH 21 Shifting Definitions of Power, 22 Addressing Power Dynamics in Health, 23 Personal Experiences in Power Building, 23 Addressing Internalized Devaluation, 25 Community-Building Influences, 26 Institutionalizing Power Building, 27 Objectivity and Relational Work, 29 Equality Improvement Conditions, 30 Progress in Power Building, 31 The Effect of Narrative on the COVID-19 Pandemic, 32 Values of People and Money, 34 xiii PREPUBLICATION COPY—Uncorrected Proofs

xiv CONTENTS 4 COMMUNITY POWER: APPROACHES AND MODELS 37 The Measure Care Model, 38 Healthy Richmond Collective-Building Policy Initiative, 41 The Positive Deviance Approach, 46 Discussion, 49 5 FROM VISION TO ACTION: EFFECTIVE WAYS TO SUPPORT GRASSROOTS COMMUNITY POWER BUILDING 53 Community Power-Building Ecosystem, 54 Partnerships Between Researchers and Community Groups, 56 Current Power-Building Strategies and Approaches, 60 Discussion, 68 6 COMMUNITY-LED TRANSFORMATIONAL NARRATIVES 73 Agency and Community Power, 74 The Power in Honoring Culture, 75 Go Austin/Vamos Austin Community Initiatives, 76 Church-Based Community Services, 77 Policy Advocacy for Health Equity, 78 Discussion, 80 7 AMPLIFYING THE EMPIRICAL BASE LINKING COMMUNITY POWER AND HEALTH EQUITY 93 Personal Drive for Power Building, 94 Challenges and Tensions in the Exercise of Community Power: Practice Implications for Research, 95 The California Endowment: Building Healthy Communities, 99 Building Evidence for Power and Health: The BHC Initiative as a Learning Engine, 104 Community Power and Health Equity: The Memphis Model’s Cardiac Disparity Case Study, 109 Community Empowerment and Health Equity: Practicing Community-Based Participatory Research in the Time of COVID-19, 113 Discussion, 116 APPENDIXES A References 123 B Biosketches of Speakers, Moderators, and Planning Committee Members 127 C Workshop Agenda 145 D Readings and Resources 149 PREPUBLICATION COPY—Uncorrected Proofs

Boxes, Figures, and Table BOXES 1-1 Statement of Task, 3 1-2 Workshop Highlights, 4 1-3 Definitions of Power Provided by Speakers, 5 2-1 Recognizing Oppression Within Oneself, 17 4-1 Healthy Richmond’s Vision, Purpose, and Horizon Statements, 42 5-1 Robert Wood Johnson Foundation’s Definition of Community Power, 55 FIGURES 2-1 The theory of power used by NDWA, 10 4-1 The MEASURE CARE model, 39 5-1 Domains of power in health, equity, and justice, 66 5-2 Approaches to cultural, political, economic, and transformative power building, 67 xv PREPUBLICATION COPY—Uncorrected Proofs

xvi BOXES, FIGURES, AND TABLE 7-1 Power-building ecosystem, 102 7-2 Example of comparative interrupted time series design, 106 TABLE 7-1 Diverse Practices for Developing Community Power, 98 PREPUBLICATION COPY—Uncorrected Proofs

Acronyms and Abbreviations AMI acute myocardial infarction BHC Building Healthy Communities BHCLB Building Healthy Communities Long Beach BVM Black Voters Matter CARE community, advocacy, resilience, and evidence CAUSE Central Coast Alliance United for a Sustainable Economy CBPR community-based participatory research CHN Congregational Health Network COVID-19 coronavirus disease 2019 GAVA Go Austin/Vamos Austin HIP Human Impact Partners ICSF Iglesia Cristiana Sin Fronteras JHU Johns Hopkins University LBF Long Beach Forward LGBTQ lesbian, gay, bisexual, transexual, queer xvii PREPUBLICATION COPY—Uncorrected Proofs

xviii ACRONYMS AND ABBREVIATIONS MLBH Methodist Le Bonheur Healthcare MSC Movement Strategy Center NDWA National Domestic Workers Alliance P3 possible, powerful, and probable PICO People Improving Communities through Organizing RFF Rockefeller Family Fund RWJF Robert Wood Johnson Foundation SNF Stavros Niarchos Foundation TCE The California Endowment USC University of Southern California USC PERE University of Southern California Program for Environmental and Regional Equity UTEP The University of Texas at El Paso WFBH Wake Forest Baptist Health PREPUBLICATION COPY—Uncorrected Proofs

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To explore issues related to community-driven power-building efforts to improve population health, the Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine hosted a virtual public workshop, "Community Power in Population Health Improvement", on January 28 and 29, 2021. Participants discussed the different components and dimensions of community-led action around different population health improvement topics such as education, transportation, environmental health, healthy eating, and active living, among others. This Proceedings of a Workshop summarizes the presentations and discussion of the workshop.

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