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Introduction¹

The idea of holding a workshop to explore civic engagement and civic infrastructure emerged from conversations among members of the Roundtable on Population Health Improvement concerning the recognition of civic participation as a social driver of health and the bi-directional relationship between voting and health (NASEM, 2020a). The charge to the planning committee that organized the workshop, which is provided in Box 1-1, outlines several aspects of the topic that the workshop was designed to discuss. The virtual workshop took place on June 16–17, 2021, and was webcast live. Video and other materials related to the workshop have been archived on the event page.²

Kirsten Bibbins-Domingo of the University of California, San Francisco, welcomed viewers of the workshop and began her remarks with an acknowledgment of the Nacotchtank and Piscataway elders and people who lived in the areas around the home of the National Academies of Sciences, Engineering, and Medicine and their descendants who live in the region. Further acknowledging “all of the ancestors who have struggled for justice,”

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.

²https://www.nationalacademies.org/event/06-14-2021/civic-engagement-and-civic-infrastructure-to-advance-health-equity-a-workshop (accessed January 18, 2022).

she continued, “In their memory, we seek to help build a just future by centering health equity as the prerequisite to improving population health.”

As is customary for the roundtable’s public events, Bibbins-Domingo described its vision and mission. The roundtable, she said, recognizes that health and quality of life for all are shaped by interdependent historical and contemporary social, political, economic, environmental, genetic, behavioral, and health care factors. Therefore, the roundtable seeks to provoke and catalyze urgently needed multi-sector community-engaged collaborative action. One way that the roundtable attempts to do this is by hosting several public workshops each year that bring together different perspectives, disciplines, and sectors to explore and share what works to improve the conditions for equitable health and well-being in U.S. communities.

In outlining the rationale for the workshop, Bibbins-Domingo said that the topic of civic engagement is not new either for the roundtable or for the National Academies. Committees of the institution have examined civic engagement and social cohesion, advised the nation on matters related to the U.S. Census and securing the vote, and recommended including voter participation among the Leading Health Indicators in Healthy People 2030 (NASEM, 2018a, 2020a,b; NRC, 2014). The roundtable³ itself has showcased practical examples of civic engagement in community settings around the United States, including

• faith-based efforts such as the community organizing work of ISAIAH in the Twin Cities (see IOM, 2014) or the Medicaid expansion campaign led by Greater Cleveland Congregations (see NASEM, 2021b);

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³www.nas.edu/pophealthrt (accessed December 14, 2021).

• community organizations that partner with others to target living conditions that hamper and harm health around the country, from Beyond Housing in Missouri to the Tenderloin Health Improvement Project in San Francisco (see NASEM, 2018b); and
• community-driven efforts to co-create and steward inclusive healthy places in partnership with public and private sector partners, from Detroit’s Fitzgerald Revitalization Project to Omaha’s Highlander Village (see NASEM, 2021a).

Bibbins-Domingo then introduced the chair of the workshop planning committee, Sheri Johnson of the University of Wisconsin–Madison, who stated that the Roundtable’s exploration of civic engagement and related topics began with Supporting a Movement for Health and Health Equity: Lessons from Social Movements (a 2013 event and 2014 publication). More recently it included the event Community-Led Initiatives to Improve Population Health, which featured the scholarship and practice of recognizing and building the power of community members as well as nurturing leadership and capacity.

Johnson provided definitions of civic engagement and civic health. According to the National Conference on Citizenship (NCoC), she said, civic health reflects the degree to which citizens participate in their communities, from local and state governance to interactions with friends or family. Civic health also relates to the overall well-being of neighborhoods, communities, states, and the nation. NCoC describes civic engagement as the act of working with local institutions and fellow residents to promote meaningful actions, movements, and relationships within a community or population. Most definitions describe a broad range of structures, practices and activities that characterize how people, as individuals and groups, are involved in imagining what they want, identifying problems to solve and joining together to implement solutions. Familiar constructs such as voting and attending public meetings are included. Johnson remarked that membership in groups that emerged in the context of systematic exclusion, such as Black Greek Lettered Organizations and the National Council of Negro Women, also represents powerful forms of civic engagement.

Research indicates, Johnson added, that health and civic engagement (from voting to participation in civic organizations) have a bidirectional relationship. Civic engagement, like affordable housing, a living wage, and a good education, is a social driver of health status, affecting the health of both engaged individuals and society. “In other words,” she said, “the health of members of a democratic society and the health of the democracy are intertwined.”

ORGANIZATION OF THE WORKSHOP AND THIS PROCEEDINGS

This workshop proceedings summarizes the event’s five sessions, which progressed from a context-setting conversation and an exploration of the qualitative and quantitative measures of health and measures of civic engagement and the links between them (Chapter 2) to presentations and discussion about civic infrastructure (Chapter 3) and the role of narrative and media in shaping civic engagement (Chapter 4). Each chapter provides a highlights box at the beginning. The proceedings concludes with an overview of the mini deliberative exercise that gave attendees who had pre-registered for the workshop an opportunity to interact and put into practice some of what they learned, followed by brief closing reflections (Chapter 5). Appendixes provide a list of references, speaker biographical sketches, the workshop agenda, a summary and discussion of the practical exercise (a mini public deliberation) authored by Erika Blacksher, and the workshop readings and resources that were provided as part of the meeting materials and made available on the web page.