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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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Page xiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
×
PageR13
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Civic Engagement and Civic Infrastructure to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26590.
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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.

Alina Baciu and Alexandra Andrada, Rapporteurs Roundtable on Population Health Improvement Board on Population Health and Public Health Practice Health and Medicine Division PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 1 15/06/2022 1:12 PM

THE NATIONAL ACADEMIES PRESS   500 Fifth Street, NW   Washington, DC 20001 This activity was supported by contracts between the National Academy of Sciences and Kresge Foundation, New York Health Foundation, Robert Wood Johnson Foundation, and The California Endowment, and with additional sup- port from Association of American Medical Colleges, Blue Cross Blue Shield of North Carolina, Fannie Rippel Foundation, Nemours, Samueli Foundation, and Wake Forest Baptist Medical Center. Any opinions, findings, conclusions, or rec- ommendations 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/10.17226/26590 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. Civic engagement and civic infrastructure to advance health equity: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26590. PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 2 15/06/2022 1:12 PM

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 con- tributions 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 NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 3 15/06/2022 1:12 PM

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 typi- cally include findings, conclusions, and recommendations based on information gathered by the committee and on 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 opin- ions 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 NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 4 15/06/2022 1:12 PM

PLANNING COMMITTEE ON CIVIC ENGAGEMENT AND CIVIC INFRASTRUCTURE TO ADVANCE HEALTH EQUITY1 SHERI JOHNSON (Chair), Director, Population Health Institute; Associate Professor, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin– Madison, Madison, WI ERIKA BLACKSHER, John B. Francis Chair in Bioethics, Center for Practical Bioethics; Research Professor, University of Kansas Medical Center, Kansas City, MO DANIEL DAWES, Executive Director, Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, GA BRUCE LINK, Distinguished Professor of Sociology and Public Policy, University of California, Riverside, Riverside, CA PHYLLIS MEADOWS, Senior Fellow, The Kresge Foundation, Troy, MI KARTHICK RAMAKRISHNAN, Professor of Public Policy and Political Science, University of California, Riverside, Riverside, CA ITZHAK YANOVITZKY, Professor of Communication; Chair of the SC&I Health and Wellness Faculty Cluster, Rutgers University School of Communication and Information, New Brunswick, NJ 1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution. v PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 5 15/06/2022 1:12 PM

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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT2 RAYMOND BAXTER (Co-chair), Trustee, Blue Shield of California Foundation, San Francisco, CA KIRSTEN BIBBINS-DOMINGO (Co-chair), Professor and Chair of the Department of Epidemiology and Biostatistics; Lee Goldman, M.D., 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 and Medicaid Innovation, Washington, DC JOHN AUERBACH, Executive Director, Trust for America’s Health, Washington, DC DEBBIE I. CHANG, President and Chief Executive Officer, Blue Shield of California Foundation, San Francisco, CA MARC N. GOUREVITCH, Professor and Chair, Department of Population Health, New York University School of Medicine, New York, NY MEG GUERIN-CALVERT, Senior Managing Director and President, Center for Healthcare, Economics and Policy, FTI Consulting, Washington, DC GARY R. GUNDERSON, Vice President, Faith Health, School of Divinity, Wake Forest University, Winston-Salem, NC HILARY HEISHMAN, Senior Program Officer, The Robert Wood Johnson Foundation, Princeton, NJ 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; 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 2 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. vii PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 7 15/06/2022 1:12 PM

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 KARA ODOM WALKER, Executive Vice President and Chief Population Health Officer, Nemours Children’s Health System, Washington, DC 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 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 OKTAWIA WÓJCIK, Senior Program Officer, The Robert Wood Johnson Foundation, Princeton, NJ HANH CAO YU, Chief Learning Officer, The California Endowment, Oakland, CA Health and Medicine Division Staff ALINA BACIU, Roundtable Director ALLIE ANDRADA, Program Officer AYSHIA COLETRANE, Senior Program Assistant HARIKA DYER (through July 2021), Research Assistant MAGGIE ANDERSON (from September 2021), Research Assistant ROSE M. MARTINEZ, Senior Board Director viii PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 8 15/06/2022 1:12 PM

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 individual for her review of this proceedings: Dawn A. Morales, National Institutes of Health Although the reviewer listed above provided many constructive com- ments and suggestions, she was not asked to endorse the content of the proceedings nor did she see the final draft before its release. The review of this proceedings was overseen by Marthe R. Gold, City University of New York School of Medicine. She was responsible for making certain that an independent 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 Emily Twigg for reading and providing helpful comments on this manuscript. ix PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 9 15/06/2022 1:12 PM

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Contents 1 INTRODUCTION 1 Organization of the Workshop and this Proceedings, 4 2 KEY CONCEPTS AND MEASURES 5 On the Political Determinants of Health, 5 On the Intersection of Civic Engagement and Health, 7 Discussion, 9 Quantitative and Qualitative Approaches for Measurement, 10 Discussion, 14 3 CIVIC INFRASTRUCTURE 21 Youth Panel, 21 Civic Infrastructure Panel, 25 Civic Infrastructure Discussion, 31 4 MEDIA AND NARRATIVE 37 Media and Narrative: Discussion, 37 5 DEMOCRATIC DELIBERATION AND CLOSING REFLECTIONS 45 Democratic Deliberation Exercise, 45 Closing Reflections, 49 xi PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 11 15/06/2022 1:12 PM

xii CONTENTS APPENDIXES A References 51 B Biographical Sketches of Speakers, Moderators, and 53 Planning Committee Members C Workshop Agenda 67 D Prioritizing Civic Infrastructure Investments to 71 Advance Health Equity: A Mini-Deliberation E Readings and Resources 77 PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 12 15/06/2022 1:12 PM

Box, Tables, and Figures BOX 1-1 Statement of Task 2 TABLES 2-1 Linking “Cost of Voting” and Health Data 11 5-1 Notetaking Sheet, Completed by Participants in a Shared Google Doc 47 FIGURES 2-1 A depiction of civic infrastructure 8 5-1 Deliberative exercise handout 46 xiii PREPUBLICATION COPY—Uncorrected Proofs NAS-A00974-Civic_Engagement_and_Civic_Infrastructure.indd 13 15/06/2022 1:12 PM

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There is increasing evidence that civic participation - from voting to volunteering - is a social driver of health. To explore how civic engagement and civic infrastructure can contribute to public health, the National Academies of Sciences, Engineering, and Medicine's roundtable on Population Health Improvement convened a workshop to explore the link between measures of civic engagement and quantitative and qualitative measures of health equity and the roles that civic infrastructure, narrative, and media play in shaping civic engagement. The workshops found that voting is only one important dimension of civic engagement; others include the ability to set agendas, shape how policies are implemented, communicate information, model civic behavior, and support the involvement and inclusion of other individuals and groups. Attendees also explored whether civic engagement itself improves health equity, or if it simply allows communities to enact policies that reverse entrenched racist and exploitative structures that in turn further health equity, or both.

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